From burnout to building his own practice
Dr. Brian Juan joined Alisa Conner on The Profit Loop to talk about leaving nine years of employed medicine, planning the numbers before he resigned, and building boundaries into Metronome Family Medicine from day one.
What it really takes to leave employed medicine
Dr. Juan's path into medicine began with a mechanical bull: the dueling piano gig that paid his bills as a touring musician was replaced by one, and he decided to go to medical school. Nine years of corporate medicine later, with weekends spent answering an overflowing inbox and his creative side fading, he opened Metronome Family Medicine, a direct primary care practice in Longmont, Colorado, on June 1, 2026.
In episode 33 of The Profit Loop, host Alisa Conner walks through the leap with him in practical detail: the pro forma he had to build (and the spouse he had to convince) before resigning, the break-even math behind a goal of 200 to 250 members, and how he decided exactly who he wanted to serve, midlife adults, and especially women navigating perimenopause and menopause. That one decision shaped everything from the equipment in the office to the content he publishes.
He also gets specific about the parts most physicians worry about: finding his first members without soliciting his old panel, why only about 2% of his former patients followed him, and how two videos and a blog every week put the practice in top local search results and even in AI chatbot answers. The conversation closes on boundaries, no 24-hour access, a Wednesday morning hike that was part of the deal, and the systems still being built, along with advice for any physician weighing DPC or concierge medicine: you finally have permission to fail.
What Dr. Juan and Alisa dig into
The Burnout That Forced the Question
Weekend inboxes, a quieter creative life, and the realization that employed medicine no longer felt fulfilling.
Numbers Before Resigning
Building the pro forma, winning over his wife, and the break-even math for a 200–250 member practice.
Choosing the Ideal Patient
Why he focused on midlife adults, especially women in perimenopause and menopause, and how that shaped the whole practice.
Finding Members the Right Way
Building a panel without soliciting his old patients, and the weekly videos and blogs that put Metronome on the local map.
Boundaries as Business Plan
No 24-hour access, a protected Wednesday morning hike, and why he built limits in from day one.
Permission to Fail
Systems still in progress, planning for a second physician, and advice for anyone considering DPC or concierge care.
Moments worth finding
Timestamps if you want to skip straight to a topic.
- 1:02The mechanical bull, and the decision to go back to school
- 5:11Values: why building a practice feels like making an album
- 8:46His wife's perimenopause question, and choosing his ideal patient
- 15:25Only about 2% of his old panel followed, and what filled the practice instead
- 19:30No 24-hour access, and the Wednesday morning hike
- 21:17“The easiest decision in the world” on boundaries
- 35:41Permission to fail
Alisa Conner
Alisa Conner is a Performance & Growth Strategist who helps independently owned and physician-owned practices, especially concierge, direct primary care, and membership-model practices, find the one thing holding back their growth. Her Boulder, Colorado consulting firm focuses on where patients quietly slip away between first interest and a scheduled visit, so owners can fix the real breakdowns instead of guessing at them.
Her background includes enterprise operations work with GE and Canon, StoryBrand certification, and more than 50 revenue diagnostics across specialty practices. She is the voice behind The Profit Loop, a weekly podcast for practice owners who want to grow without burning out.
About the show: each week, Alisa breaks down the acquisition, retention, and referral strategies that work for specialty medical practices and professional-services firms, built around what she calls Purposeful Hospitality: the idea that the experience you design for patients and clients is your most profitable differentiator. Physician owners, practice administrators, and managing partners will all find a practical playbook.
Thinking about opening your own practice?
Dr. Juan's offer from the episode stands: if you're a physician quietly wondering whether you could do this too, call or text the practice at (720) 856-4058 and talk it through.