Finding Her Lionheart: Dr. Maria Rutmann’s DPC Pediatric Practice in Rural Maine
- Maryal Concepcion
- 46 minutes ago
- 6 min read
DPC Doctor
Reflecting on courage, creativity, and community while building your direct primary care practice.
Direct Primary Care (DPC) promises a model of medicine rooted in autonomy, relationship, and local impact. For many physicians transitioning from fee-for-service to DPC, the journey is as much about personal rediscovery as professional redirection. In a recent episode of the MY DPC Story Podcast, Dr. Maria Rutmann, pediatrician and founder of Lionheart Direct Primary Care in Maine, shares her compelling story of finding strength, building community, and designing care centered on joy, trust, and patient empowerment.
Her journey is unique, marked by her move from Venezuela to Miami, and then to the rural expanse of Northern Maine. But her strategies and reflections offer universal lessons for any DPC doctor—whether just starting out, reconsidering their approach, or seeking a new wellspring of courage in their career.
In this blog post, we’ll walk through core themes from Dr. Rutmann’s story, bringing forward strategies, mindset shifts, and practical advice for forging your own DPC path.
1. The Power of Internal Fortitude and Purpose
“I would encourage everybody to just really hone in on their internal fortitude…dig deep into their sense of purpose.”— Dr. Maria Rutmann
Many physicians arrive at DPC crossroads exhausted—by bureaucracy, by endless charting, by feeling responsible for outcomes yet powerless to enact meaningful change. Dr. Maria Rutmann encourages doctors not only to recognize this burnout but to seek out the “roar within.” She reframes the DPC transition as a calling to recommit to one’s professional purpose, reminding listeners that making it through medical training is proof of resilience.
Reflection Questions:
Where is your internal “roar” being stifled by current practice structures?
How did your sense of purpose shift when you first learned about DPC?
What sacrifices are you willing (or unwilling) to make to practice medicine on your own terms?
For those at a crossroads, Dr. Rutmann’s story suggests it is possible—and indeed necessary—to trust in your capability, recall your motivations for medicine, and let them guide bold decisions.
2. Building Community Connection: Rural Medicine as Richer Medicine
“There’s just a sense of, ‘we have each other’s backs’…I think we get to practice richer medicine in rural settings.”— Dr. Maria Rutmann
The leap from a bustling city (Miami) to “the county”—the vast, rural region of Northern Maine—is, for Dr. Maria Rutmann, both a challenge and blessing. She describes how deep relationships with patients (often neighbors, classmates, or local store staff), demand a higher level of dedication and responsibility.
Her experience highlights that rural medicine isn’t simply “harder” due to fewer resources and long referral drives. It’s “richer” because physicians become local fixtures, community problem-solvers, and trusted guides across generations of families.
Strategies for Connection:
Integrate local customs, language, and personalities into your practice.
Consider physical clinic design choices that foster inclusion, ease, and delight (see her iconic “clinic doors” for children).
Use every patient interaction as an opportunity to build trust—knowing your reputational “ripple effect” is magnified in smaller communities.
Whether rural, suburban, or urban, DPC doctors can reflect: In what ways is your clinic fostering connection, and how could you deepen those bonds further?
3. Navigating Systemic Change: Autonomy versus Moral Injury
“As physicians, we have all the responsibility and none of the autonomy. You can’t practice that way.”— Dr. Maria Rutmann
When her fee-for-service hospital group merged with a larger system, Dr. Maria Rutmann and colleagues fought to preserve autonomy. Instead, they faced shorter appointments, loss of scribes, more administrative burdens, and diminishing ability to “fit people in” or spend meaningful time with families—a cascade she likens to “the boiling frog” parable.
Moral injury grows not simply from long hours, but from a mismatch between the care physicians wish to give and what the system will allow. Dr. Rutmann’s transition (catalyzed by exhaustion, depression, and loss of joy at home with her young children) was driven by the recognition that her well-being and patient care quality could not be sustained under the old model.
Reflection Questions:
Where do policies, workflows, or cultural expectations in your current practice erode autonomy?
How does that impact patient care, and your own physical/mental health?
What would reclaiming “micro-autonomy” look like, even before a full transition to DPC?
4. Practical Steps: The Mechanics of Creating a Personalized DPC Clinic
“I poured my heart and soul into it…I wanted a space that conveyed a sense of peace.”— Dr. Maria Rutmann
Dr. Rutmann’s approach is systematic yet deeply personal. Her build-out involved:
Choosing a name (“Lionheart”) rich in symbolism—representing courage, community, faith, and her connection to patients and childhood stories.
Physical design: Solid maple doors with child-size entryways for joy and independence; child-height sinks in bathrooms; a soothing color palette (with special meaning—“Venezuelan Sea” teal).
Early investments in diagnostic tools (vision screeners, audiometry) that genuinely elevate preventative care—possible only outside traditional reimbursement constraints.
Thoughtful branding: Even before doors opened, thick business cards and an active website/social profiles made the clinic “real” both to herself and her future members.
She highlights the healing nature of reclaiming physician autonomy: “We deserve to have a
business card, a website, social media handles…it’s healing for our souls.”
Strategies for Your Clinic:
Let personal passions (design, colors, symbols) be reflected in your physical and digital spaces.
Don’t wait for the “perfect” moment—build your brand early, and let intention drive each choice.
Invest in the right equipment, especially those tools that grant independence and deeper service to members.
Treat each touchpoint—doors, waiting room, even the way you greet—as a chance to communicate your values.
5. Marketing and Community Engagement: Growth Beyond the Pediatric Niche
As a pediatrician in an underserved area, Dr. Rutmann saw an opportunity—but also recognized that DPC “might not be for everyone.” She articulates a flexible, needs-driven approach to marketing and outreach:
Identify each family’s motivation (convenience, cost savings, trust in the provider).
Center conversations not on a sales pitch, but authentic inquiry: “What are your biggest frustrations with healthcare access?”
Use both routine care and “unique services” (in-home visits, medical ear piercing, fourth trimester care, in-body scan) as doorways to demonstrate DPC’s value.
Remain open to unexpected opportunities—like becoming team physician for a junior hockey team, a partnership that deepened her impact, expanded her skillset, and built community trust.
She emphasizes that growth—whether hiring a new provider or launching new services—needs to be authentic and responsive to community needs. In her own words: “I would like to bring in an adult provider…The access to care in the adult world is, it’s really heartbreaking up here.”
Action Points:
Personalize outreach—never “one size fits all.”
Highlight the tangible value of DPC membership (“all visits included, no matter how many”).
Allow community needs (not simply business goals) to shape service expansion.
Consider local partnerships (sports teams, schools, local businesses) to extend your brand and deepen local roots.
6. Patient Experience and Clinic Culture: Making Healthcare a Joyful, Healing Space
“A sense of joy is just sprinkled all throughout the space, and I absolutely love it.”— Dr. Maria Rutmann
Perhaps the most powerful lesson from Dr. Rutmann’s journey is the intentional cultivation of joy, comfort, and empowerment in her clinic culture.
For children: Entry doors sized for kids spark delight; child-height facilities foster independence; calming colors reduce overstimulation.
For families: Every visit is personalized, every interaction driven by trust and shared history.
For the community: The open, welcoming design and local collaborations (face painting at opening, custom cookies from local bakeries) reinforce her practice’s connectedness.
Patient experience is not just about avoiding negative outcomes—it’s about proactively creating an environment where patients (and their families) feel safe, valued, and even joyful about seeking care.
Reflection Questions:
What elements of your clinic’s environment or workflow inspire joy or calm?
How do you honor both independence and partnership with your patients?
In what ways can design and experience shift healthcare visits from fearful, transactional moments to positive, community-affirming events?
7. Lessons, Mindset Shifts, and Encouragement for Your DPC Journey
“You can do this…find that roar within you.”— Dr. Maria Rutmann
Dr. Rutmann’s reflections come full circle: DPC offers time to listen, to practice “richer medicine,” to innovate, and to reclaim the autonomy so often eroded by systems. Her message is especially poignant for physicians who feel flattened or lost:
Healing is possible on the other side of burnout.
Autonomy, creativity, and community are not luxuries—they are prerequisites for the best medicine.
Your unique story, talents, and context should inform every choice—from name, to branding, to partnerships and workflow.
If you are planning your DPC transition, growing an existing practice, or simply considering new approaches, take time to reflect on Dr. Maria Rutmann’s lionhearted path. Search for your own “roar”—the source of courage and creativity that drove you into medicine in the first place.
Your Story, Your Roar, Your DPC Legacy
Dr. Rutmann’s story is a testament to what’s possible when physicians reclaim their power to practice medicine on their own terms. Through faith, intentional design, and unyielding commitment to her community, she created a space where families thrive, children are empowered, and the physician herself is healed.
What seeds of joy, courage, and transformation are waiting to be planted in your DPC journey? What legacy will you build within your own community, through your unique strengths and passions?
Listen carefully to your own lionheart—the world, and your future patients, need to hear it roar.
Want more insights from pioneering DPC doctors? Subscribe to MY DPC Story Podcast and connect with doctors blazing new trails, just like Dr. Maria Rutmann at Lionheart DPC.
Comments