DPC Week One

It's been seven months since I started seriously planning this, and one week since I actually became a Direct Primary Care doctor.

The massive to-do list didn't evaporate when I left corporate medicine — it just changed shape. But now it hits different: every task on it moves me closer to an authentic version of how I want to practice medicine. I get to prioritize my patients in a way that simply wasn't possible when I was juggling 2,500 of them alongside the administrative weight of fee-for-service care.

Here's a couple of things that stood out in week one.

A Crash Course in a New Tech Stack

At my last job I was a certified Epic builder — meaning I had advanced training in the EMR that connected our entire health system. I also used Abridge for AI-assisted documentation, Outlook and Teams for communication, Pacific Interpreters for live video translation, and mModal for dictation. I knew that system inside and out.

None of it transferred. Epic is too expensive and too bloated for a small startup. Live interpreters run $2-5 per minute — fine when you're doing 7-minute visits, not fine when you're doing 50-minute ones. I needed to start over.

Enter Hint, Guava Health, Dosespot, Spruce, Fullscript, and Care to Translate.

Day one was genuinely chaotic — jumping between windows, losing things I needed, misunderstanding how to order labs I used to pull up with a single click. But five days in, I'm finding my footing. The new system integrates wearable data from Apple Watches, Fitbits, and Oura rings. Patients can tag medications, meals, and symptoms. The HIPAA-compliant translator worked flawlessly for all seven patients I used it with this week. Patient communication through Spruce is fast and direct — no call center relay, no hours-long delays.

There's still plenty to learn. But the pieces I need are all there — and in some ways I already prefer this setup to what I left behind.

A House Call

On day five I locked the clinic doors, packed a denim backpack with diagnostic equipment, and drove out to a frontier business to meet my first employer group — two local business owners and seven Spanish-speaking migrant workers.

I set up my laptop on a table, opened my translator app, and spent about four hours seeing the whole group. Most had no immediate concerns. I went over paperwork, talked about how to reach me when they need something, discussed sunscreen and electrolytes, listened to hearts, and checked vital signs. They talked about work, about their homes, about what it's like being in Colorado.

The translated transition from one worker to the next still makes me smile: “Si eso es todo lo que necesitas, te agradeceria que fueras a buscarme mi proxima victima.” "If that's all you need, I'd appreciate if you'd go find me my next victim."

Interpreter visits can slow things down — language barriers are real, and nuance gets lost. But without a packed schedule and a waiting room full of people, the pace didn't matter. As late morning turned into early afternoon, I realized it had been a long time since I'd had that much fun talking to a group of strangers.

Since none of them drive, I'll probably head back out there soon.

Time for My Own Family

One of the biggest reasons I made this shift was exhaustion. Nine years of corporate medicine had worn me down in ways I had not expected.

This week I saw my family more than I have during any work week of my adult life:)

My wife and I decided to set aside Wednesday mornings for hikes and other daytime dates in this new chapter — and this week we did a moderate five-mile loop up to Button Rock Dam. The clinic is a seven-minute walk from our house, so I had lunch at home every single day. Sometimes it was even fresh and made on the spot — which is a revelation after nine years of nuking last night's leftovers with 15 minutes left in a corporate lunch break before the afternoon rush hit.

I drove teenagers to buses in the middle of the workday. I watered plants and dogs. I emptied the dishwasher. I watched funny videos shoulder to shoulder instead of firing off a quick text between patients when I had 30 seconds to breathe.

There's better work-life balance in Direct Primary Care. And I genuinely cannot believe it took me this long to give it a try.

For any employer looking to provide meaningful, high-touch primary care for their employees — Direct Primary Care is worth a conversation. Founding spots are still open at Metronome Family Medicine.

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