Opening Eve

My path to leaving corporate medicine and opening a Direct Primary Care practice had its roots in residency. I'd heard about the DPC model mostly from physicians I met at annual summits hosted by the Colorado Academy of Family Physicians. They all seemed so happy — and so convinced that carving your own path in private practice, free of the burden of satisfying insurance payers, meant leaving red tape behind and refocusing on the most important part of being a doctor: taking care of patients.

Easy enough to understand in theory. It would take years to really feel it.

I finished residency and stepped into the wild as an attending physician in 2017. Coming from the 80-hour weeks of graduate medical education, the requirements of corporate medicine felt like a breeze. I couldn't understand the complaints from older physicians — "it used to be easier when we saw 14 patients a day, now it's 16" seemed almost laughable when we'd been running 25-30 patients a day in residency, quietly hoping a handful would no-show so we could finish on time. "The Electronic Medical Record is impossible" was another one I didn't get — I loved it. I organized my charts meticulously, never entered a new encounter until the previous note was done.

But nine years later, I'd joined the ranks of the grippers.

Making sure diagnosis codes align correctly does take time away from talking to patients. It does make you late room to room. Seeing 20 patients a day is harder than 16 — especially when 2,500 patients are emailing, calling, and requesting refills, and the number of people you're actually interacting with daily is closer to 50. Somehow I still managed to talk to some patients longer than 5-7 minutes — but doing so meant running 45 minutes behind, cramming lunch into a phone call, and staying late to empty my inbox.

I was exhausted. And being me, my first instinct was to blame the music — that if I could just find more time to write and play, everything would balance out.

Then I realized something. Every 10-minute patient encounter was already a performance. An improvised one, with structure, tension, and resolution. Always evolving, always unique. The creativity I thought I was missing from music was fully alive in the room with my patients — it was everything around those encounters that was draining me.

Corporate medicine is full of decisions made for the organization that don't always align with how individual physicians want to deliver care. More and more time going into administrative tasks. Less and less going into the actual conversation.

That's not to say that opening a private practice means leaving administrative burden behind — I've been a business owner before. The music business, granted, but it's not so different. Your baby demands your time.

The difference is that this is my baby.

Metronome Family Medicine is built around the way I like to practice medicine, with the people I like to practice it for at the center of every decision I've made building it.

And oh my god — we open tomorrow.

I can't wait to get to work for all of you. You know who you are. I'll see you soon.

And if you haven't signed up yet — you still can. Book a free 10-minute call here.