My DPC Origin Story - Part 1
I am a family physician preparing to launch a Direct Primary Care (DPC) practice in Longmont, Colorado. This blog is a personal account of that process — the transition out of corporate medicine, the relationships with patients, and what it means to build a more connected kind of primary care.
I am less than two months out from opening a private practice. I will be a Direct Primary Care doctor and a practice founder. This feels like rarified air - a quick google search tells me there are 2000-3000 active DPC practices in the USA, and 20,000 doctors out of nearly half a million primary care physicians in the country who are doing what I hope to be doing.
I have, at various points in my life, described myself as a writer. I was an English major and an avid reader, and I kept a journal almost daily in high school, college, and beyond. I’ve written essays and poetry and most of all, songs. I obsess over words and cadence, over rhyme and rhythm.
It has been enormously difficult to find time to write about what I am doing. Most nights I can barely find time to update the journal on my iPhone with a note of gratitude for an accomplishment or two:
1/11/26 - told my friends from residency, sketched a logo concept, spoke to a DPC doc in CO springs about her practice
1/12/26 - met another DPC doc after hearing him talk about a business pro forma in a podcast. And my lawyer. Got money out of savings to start a business bank account.
1/13/26 Started DPC bootcamp, a group class with other docs starting up practices put on by my electronic medical record company. Built that pro forma in a manic 3 hour google meets call with a super knowledgable doctor being very generous with his time and expertise.
1/15/26 spoke with another DPC doc in Fort Collins about his practice.
1/31/26 Gave notice that I was quitting my job. Submitted application for SBA 7a small business loan. Rebuilt my music studio, which had been disassembled for a plumbing catastrophe on new years’ day.
I am still working full time for almost 7 more weeks as a family doc and breaking the news about the new practice to my current patients; several are coming with me as founding members. These are people I have cared for since residency graduation and the start of my career in family medicine. Some have called me their PCP for nearly nine years.
Leaving Corporate Medicine
In these final days of my time with my corporate employer I am more resistant than ever to the notion that each visit should only last 20 minutes. The thing I have always enjoyed the most about doctoring is the opportunity for connection - conversations not limited to a single complaint, but permitted to organically move from talk about family, movies, vacations, meals, tattoos, music, star wars, cars, workplaces, and crazy notions about health that may have been shot down by some doctor hither or thither.
Talking to people in this way puts me behind on appointments and cuts into lunchtime, has me staying late, scrambling to finish my charting even with the assistance of ambient listening and an AI Scribe - and it’s worth it, especially if this will be the last time I speak to some of my patients, or if it gives me a chance to have a meaningful spark or a-ha moment in the course of participating in their care. It is. however, feeling unsustainable at the current volume - I can’t spent 45 minutes with every 20 minute visit because time does not work that way, and in DPC I am looking forward to hour long intakes and leisurely physicals, to enjoying these connections without inconveniencing the patient waiting in the next room.
Building a Direct Primary Care Practice
In the new practice, every call and text will all hit my personal phone. The emails will hit my personal inbox. I will invite all communication bypass anything resembling a call center or a virtual assistant or a nurse (at least at first, while I am setting up and scaling up). I will voluntarily relax the boundaries between my personal and professional lives to become a textable direct care doctor. Not a fancy concierge medicine $10 grand a year membership spa doc, but a phone-call-away family-style family doc for the people. Sounds hard, right? I think it will be hard, but I also think it’s going to be fun.
I have enormous gratitude for the people that have signed up so far, for the supplies I procured from a now-retired family doctor that are sitting in my basement and garage, for the efforts of my broker who is probably being paid peanuts for the amazing deal I am hopefully about to sign on my new location which is a 5 minute walk from my house. For the process and the purpose. For the chance to leave fee-for-service medicine and take control of my career by helping others cut out the insurance middleman and take control of their health. For the opportunity to explore midlife care as I bounce into midlife (truth be told, I’ve been here a while). And the ability to write about it, which I am about to do more often:)
Brian Juan
Tues 7 April 2026 on the shattered remains of my lunch break @ work with my soon-to-be former employer, Longmont CO
