Play On: Finding Balance in Direct Primary Care

The frenetic pace of corporate medicine was real. A panel of 2,500 patients. Fifty messages a day on top of 15-20 appointments. Labs to interpret in whatever cracks were left. It was an overwhelming amount of work, and I kept pace the way my colleagues still do — because the amount of work one person can do in a day is finite, even when the demands are infinite. Eventually you simply have to stop and go home.

And when I got home, I was wrecked. Some days too tired to do anything but sit in a warm bath and stare at my phone. What frustrated me most was the music that wasn't getting made. I wasn't writing songs. I wasn't recording. The energy those things require was nowhere to be found, and I resented that it had gone missing.

That frustration turned out to be the stimulus that sent me looking for a better way.

What Music Taught Me About Autonomy

In Direct Primary Care, I came back to something I learned long ago in the music business: I value autonomy above all else in my work.

I was never as satisfied in music as when I was in my own band. Real partnership — making decisions with bandmates about what we'd play and where, writing our own songs, giving each other room to bring unique talents into the spotlight as equitably as we could manage.

At other points in my life, I played covers for a living. Especially dueling pianos, where the entire all-request show is built around one directive: keep the room engaged and get them singing along. In that world, a ballad could be a slow death — killing the room's momentum, bringing the energy down, cutting off the flow of tips and requests to the stage.

Financial need moved me from original music to cover shows. And financial need, years later, drove my initial pursuit of corporate medicine.

The Hand That Feeds You

Steady paychecks aren't without cost. In corporate medicine and in cover bands alike, the hand that feeds you belongs to a large machine — and that machine doesn't run without income.

So the rule that you never let the room stop dancing is the same rule that says a doctor must see 20 patients and answer 50 emails a day. Both are driven by the same fear: that if the dancing stops — or if each physician serves fewer than 2,500 patients — the money that keeps the business running will evaporate.

Innovation is hard to come by in either world. Cover shows follow rules handed down from iteration to iteration. The dueling piano playbook I worked from was created by a small group of innovators in a tiny Austin club two decades before I ever sat down at the bench. Corporate medicine is no different — any change has to crawl through committee after committee, over weeks and months and years, before it can reach a patient.

DPC Feels Like Being in My Own Band Again

If I want to try something, I just try it. If a rule isn't working, I'm the one who gets to change it — to adapt my practice to my life and to my patients' needs.

There's truth in the idea that work never disappears; it just changes form. I'm no longer grinding at an impossible task, but I do have a to-do list that feels endless: the things it takes to get a business humming, to collaborate well with my patients, to meet my financial goals and my family's needs. The work is just as hard as anything I've done.

But somehow I'm no longer exhausted every day. I come home with energy to spare — and I get to pour it into my family, my songwriting, and my life.

What One Week Now Looks Like

This week, I gathered paperwork and hired help to apply for an interstate medical license. I fleshed out my business financials based on the first month of operation. I signed up new members and saw many existing ones. I solidified my lab ordering, interpretation, and release workflow in my new EMR. I joined the Longmont Chamber of Commerce to keep rooting myself in the community.

I also hiked 10 miles round trip to Ouzel Lake in Rocky Mountain National Park. I celebrated my stepson's 16th birthday with dim sum and Disclosure Day. I performed with Colorado Rock and Roll Hall of Famer Otis Taylor and the newest iteration of his band at a party in Cherry Creek — I've been playing with Otis since he was about my age, and he turned 78 this month. I took visiting family to dinner and finally saw the Denver Museum of Nature and Science for the first time. I stood at Red Rocks and marveled at the premiere of Andrea Gibson's concert film, Love Letter from the Afterlife.

Direct Primary Care has brought me back to the kind of work-life balance I always valued but never quite reached in corporate medicine. It's made more room for music and family, and it's made me better resourced to help my patients find their own pathways to authentic health.

Play on:)

Still accepting new patients in Longmont, CO.

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