Finding Purpose and Flexibility: Dr. Lisa Tritto’s Journey in Pediatric Obesity Direct Primary Care
- Maryal Concepcion
- Oct 12
- 7 min read
DPC Doctor
How Pivoting to a DPC Model Reinvigorated a Specialist’s Impact, Schedule, and Joy in Medicine
For physicians who have embarked on or are considering the Direct Primary Care (DPC) pathway, the ever-present question is—“How can I truly transform my work, my relationship with patients, and my sense of purpose?” The story of Dr. Lisa Tritto, featured on My DPC Story Podcast, offers powerful insights for anyone seeking to reflect on or refine their own DPC trajectory. Dr. Tritto, a pediatrician specializing in childhood and adolescent weight and wellness, shares a journey marked by reinvigoration, intentional practice design, and the rewards of working more deeply, not just more widely, with patients.
If you’re ready to rethink your own DPC approach, especially if you have or are considering a clinical niche, Dr. Tritto’s experience provides a map for sustainable, meaningful, and patient-centered care.
From Generalist to Specialist: Answering the Call for Deeper Impact
Dr. Lisa Tritto’s medical career began in general pediatrics, spanning practices in rural, suburban, and urban settings—each with its unique patient populations and system demands. While she found satisfaction in group practice ownership and some autonomy, the shift into academic environments revealed a stark misalignment with her values.
“The layers of bureaucracy and lack of control over my schedule just kind of did it for me. They would want your schedule to be full, full, full… and then you couldn’t see a kid with an ear infection,” Dr. Tritto recalled. The frustration was not just about administrative constraints—it was about the inability to address the full reality of her patients’ needs, particularly for those struggling with obesity and related health consequences.
That frustration seeded a bold pivot: seeking out a highly specialized fellowship in Pediatric Obesity Medicine at the University of Minnesota. “I really felt like I wanted that level of education…that hands-on experience with people doing it every day. I probably could have pieced it together on my own, but the fellowship was a chance to be intensive.”
Reflection Point:Many DPC clinicians launch their practices with a broad generalist approach, but Dr. Tritto’s story underscores how following your clinical passions—even into a niche—can address unmet community needs and prevent physician burnout.
The Power (and Necessity) of Time: Addressing Complex Pediatric Needs
Obesity medicine in children is a nuanced, time-consuming, and deeply interpersonal field—one not easily shoehorned into hurried visits. In standard pediatrics, Dr. Tritto faced the impossible: “Time was always a factor. This is a topic that takes a lot of time. In the space and time I had, I could not allow the amount of time needed to do a deep dive…I couldn’t carve out time specifically for dealing with weight.”
DPC completely reimagined her model of care:
Initial Consults: 90 minutes, encompassing medical records, life story, social dynamics, bullying, and more.
Follow-ups: 45 minutes, with flexible options for telehealth. Key for families balancing school activities, mental health, and chronic conditions.
Contact & Accessibility: Direct communication via email, facilitating quicker, more holistic care, especially for medication management and urgent issues.
By choosing DPC, Dr. Tritto could provide the continuity, psychological safety, and practical support her patients needed. Time wasn’t just a luxury—it was the backbone of effective specialty care.
Reflection Point:Regardless of your specialty focus, DPC’s greatest asset may be the gift of time. How might your own patient care, satisfaction, and outcomes change if you could structure visits for deep exploration and real follow-up?
Building a Specialty DPC: Origin Story of Evora for Kids
When Dr. Tritto relocated back to St. Louis after her fellowship, the path to launching a specialty DPC was not guaranteed. Lacking existing connections in the city, and unsure how quickly a cash-pay model would catch on, she networked intentionally. A chance meeting with Dr. Becky Lynn, founder of Evora, at an obesity medicine society meeting altered her course.
Evora’s practice began as a women’s health and menopause DPC. Instead of resisting expansion, Dr. Lynn grew her offerings in response to patient demand—weight management, dietary counseling, therapy, internal medicine, psychiatry, chiropractic care, and eventually pediatrics with Dr. Tritto’s arrival.
“She already knew how to market, make a webpage…completely foreign to me. I was very fortunate to come into a system that was already in place,” Dr. Tritto shared. This partnership not only mitigated the startup learning curve but showed the power of collaborative, inter-disciplinary DPCs.
Evora for Kids was essentially built around Dr. Tritto’s skillset, serving families directly but also attracting patients through internal word-of-mouth from parents already in the practice.
Reflection Point:Are you considering starting a DPC from scratch or joining/partnering with an existing group? Dr. Tritto’s experience highlights how aligned collaboration can speed progress, broaden services, and bolster your practice’s resilience.
Community, Connection, and Growth: Lessons from Starting Over
Relocating and starting a practice anew, Dr. Tritto faced the challenge many DPC clinicians know well: How to get those first patients and nurture steady growth?
Her strategies included:
Personal Outreach: Walking into pediatric practices, leaving materials, and introducing herself.
Institutional Networking: Attending grand rounds at local hospitals, joining committees, and leveraging professional societies.
Community Anchoring: Tapping into mental health, eating disorder, and pediatric networks; being active on social media and maintaining a content-rich website; speaking at local events.
Flexible Pay Models: Dedicating one day a month to see any patient, regardless of ability to pay—ensuring continued service to underserved populations.
Despite the learning curve and slower-than-ideal growth in a new city, Dr. Tritto remained steadfast. She supplemented her income with telehealth and other medical side gigs as the patient panel grew—a realistic picture for anyone starting a niche DPC outside their established network.
Reflection Point:Direct, grassroots community effort lays the foundation for any DPC, but especially for specialty practices. How can you expand your own network—both inside and outside the healthcare ecosystem—so that referrals and growth are organic and sustained?
Multistate Practice and Patient-Centered Flexibility
Dr. Tritto’s licensure extends to Missouri, Illinois, Minnesota, Indiana, and Ohio—allowing her to serve patients both in-person and through telehealth. While most patients are local, this multistate model offers options for families with busy schedules, those at a distance, or for follow-ups that don’t necessitate a physical visit.
Clinic schedule design is equally patient- and physician-friendly:
“9-to-5-ish”: Mondays start late, Fridays end early, supporting personal travel and work-life balance.
Evening/After school: Adjusting for families and teens’ extracurriculars (such as after-volleyball appointments).
Preparedness: Ensuring forms and questionnaires are completed before visits so face-to-face time focuses on connection and problem-solving.
Dr. Tritto’s practice reflects a key DPC principle: the schedule should serve both patient needs and the physician’s desired lifestyle.
Reflection Point:What does your ideal clinical week look like? Are you building in flexibility, or unconsciously recreating the constraints of fee-for-service? Where could you embrace “ish” instead of rigidity, enhancing satisfaction for everyone involved?
Holistic, Nonjudgmental Pediatric Weight Management
A major misconception about obesity medicine—especially for children and adolescents—is that care is prescriptive, weight-focused, and potentially stigmatizing. Dr. Tritto upends this stereotype, embracing an intuitive eating and health-at-every-size philosophy.
“We don’t expect everybody to get into the ‘normal’ BMI range. We just need to get them out of health consequences and feeling better. Not everybody can or should make it to that in a healthful way,” she explained.
Her clinical approach addresses:
Comorbidities: ADHD, neurodiversity, anxiety, depression, and more are commonly addressed in tandem with weight issues. Sometimes, this means treating conditions that have never been diagnosed before.
Family-Centered Care: Deep dives into bullying, family dynamics, and life stories to uncover root causes, not just symptoms.
Medication Management: Seamless follow-up for novel therapies like GLP-1 agonists, including swift navigation with pharmacy benefit managers (PBMs) and state-specific Medicaid policies.
Collaboration: Rapid, direct communication among the multidisciplinary Evora team—dietitians, therapists, primary care, psychiatry—without bureaucratic barriers or EHR hurdles.
Reflection Point:Is your practice—generalist or specialist—creating a safe, stigma-free, and truly holistic medical home for patients? How can you reexamine both your philosophy and your systems to support deeper, more respectful healing?
Boundaries, Balance, and Evolving Care
Dr. Tritto notes that as a still-growing practice, she’s been able to grant patients more flexibility—helping with travel medicine visits or form completion, even when outside the original scope. She recognizes that as panels grow and demand increases, clearer boundaries may be necessary.
DPC physicians often walk the line between accessibility and overextension, especially with “high utilizers.” Dr. Tritto’s story illustrates the importance of evolving boundaries, informed by current capacity and the ultimate goal of maintaining a sustainable, joyful practice.
Resources and Continuing Education: Staying Ahead
To stay at the forefront of her field (and to support her patients and peers), Dr. Tritto recommends:
Clinician Resources: Annual CME conferences at the University of Minnesota, American Academy of Pediatrics’ Institute for Healthy Childhood Weight, and online content for both medical professionals and families.
Her Own Content: Website blogs, YouTube videos, and community talks to bridge knowledge gaps.
Empathy-Driven Education: Emphasizing the disease nature and biochemistry of obesity cultivates empathy, deconstructs internal bias, and supports nonjudgmental care.
Final Thought: The DPC Payoff in Medicine and Life
When asked how DPC changed her daily life, Dr. Tritto beams: “Just the ability to schedule a doctor’s appointment or actually have lunch with a friend where I can just block off some time and not have to do that six or eight weeks in advance…that kind of flexibility in my schedule is really great.” In a profession too often marked by fatigue and frustration, DPC brought Dr. Tritto renewed satisfaction—and, crucially, the sense that her care finally matches her purpose.
What would she say to pediatricians considering DPC, or those contemplating a niche practice? “You won’t regret it. It might take a minute to get up to where you need to be, but you can still be making an impact—maybe even more effective—when seeing fewer patients.”
For DPC physicians and aspiring DPC founders, Dr. Lisa Tritto’s story is a testament to reimagining career satisfaction, pursuing deep expertise, and building the practice you want—however unique, however specialized. Let her journey inspire you to be bold, patient, and steadfast as you carve out your own path to purposeful, flexible, and transformative direct care.
Connect with Dr. Tritto: WEBSITE
Check out her educational resources, connect for referrals, or get inspired by her collaborative and compassionate model at Evora for Kids.
Further Exploration:
Listen to her full episode on My DPC Story Podcast
Reflect: Which aspects of Dr. Tritto’s journey resonate most for you? How could you integrate her strategies into your own DPC practice—or the one you hope to build?
The path is yours. Step forward boldly.
