Dr. Brian Ostick is an ER medical director who spent three years as his wife's unpaid chief marketing officer and, in his words, chief furniture officer. He now sees patients one day a week at Health and Healing Direct Primary Care with a panel capped near 50, mostly the dads of families already enrolled. He and Dr. Aimee Ostick paid off $550,000 in student debt in six years before opening.

In his first week at Fischer Clinic, a new patient told Dr. Brewer Eberly, I am looking forward to dying with you. A third generation family physician who nearly left medicine in his third year of medical school, Eberly got to Raleigh through years of friendship rather than a job board, and started with 170 patients another physician had onboarded for him.

Dr. Kyle Adams formed his LLC on his cell phone between urgent care patients, then opened Auburn Direct Primary Care with about ten people preenrolled and one patient at 9am on day one. He had already cleared $360,000 in student loans. He grew past 300 patients on a Facebook budget that never topped $200 a month, and he goes home at five.