Five Years In: Lessons, Growth, and Real Talk from the My DPC Story Podcast Reunion
- Maryal Concepcion
- Sep 14
- 6 min read
Celebrating Practice Milestones, Community Impact, and the Changing Face of Direct Primary Care
For doctors blazing the DPC trail, reflection isn’t just an exercise—it’s an essential survival tactic. With every year in practice, new wrinkles (and wins) emerge. In the latest reunion episode of the My DPC Story Podcast, Dr. Maryal Concepcion hosts a roundtable with fellow DPC pioneers—Dr. Christina Mutch, Dr. Jake Mutch, Dr. Lauren Hughes, and Dr. Deepti Moncur—all marking their fifth (!) anniversaries in solo, partnership, and pediatric practices. More than a celebration, their conversation is a highly practical window into how DPC clinicians adapt, scale, and stay true to their values when stasis is never an option.
Here’s a deep-dive into their strategies, lessons learned, and advice—ideal for anyone already in DPC or on the edge of making the leap.
Building the Team: Growth Isn’t About Losing the “Small Batch” Feel
Expanding the Ranks Thoughtfully
The myth: Growing your DPC means sacrificing intimacy, personalization, and autonomy. The reality—at least at Defiant DPC and Bloom Pediatrics—is far more hopeful.
Drs. Christina and Jake Mutch at Defiant detailed their approach to scaling: adding more clinicians and engaging wellness professionals (like a nutritionist/wellness guide), while continually refining hiring protocols. Their evolving framework for onboarding new staff draws from the lessons of previous hires, making future growth less daunting. Notably, this also opens up space for collaboration with and mentorship of other physicians exploring DPC—turning the practice into an incubator, not just a clinic.
Dr. Hughes, leading Bloom Pediatrics, took a different path—she heads into year five with a third physician but still no formal staff. Even with practice growth, she values streamlining and the agility that comes with lean operations. Her social media presence bridges clinical work with direct patient and public education, expanding her impact without more in-clinic complexity.
Maintaining High-Touch, Individual Care Amid Expansion
How do larger teams or broader outreach not dilute the DPC magic? The cohort was adamant: scaling needn’t mean sacrificing the “small batch” ethos.
“We are curating, hand-picking specialists for people, not just sending to whoever is next in the system,” said Dr. Mutch. The focus is on intentionality: matching patient needs (and personalities!) with the right consultants, customizing prevention initiatives, and building community outside the traditional four walls of medicine—whether via “Doc Talks,” “Walk with the Doc,” or group fitness partnerships. The signal is clear: size doesn’t dictate culture; leadership and clarity of mission do.
Redefining Community: From Walks, Sweats, and Town Halls to Social Media Influence
Grassroots, Local, and Out-of-the-Box
Connection is currency in DPC. Dr. Christina Mutch spotlighted how Defiant DPC’s “Sweat with a Doc” and “Walk with the Doc” series anchor their practice in real-world community building—dismantling medical intimidation by literally meeting people where they are, from yoga studios to fitness bars to tai chi workshops. These aren’t marketing stunts; they’re strategic avenues for participatory prevention and trust-building.
“There’s just so much misinformation and resource overload. We take it back to grassroots and being available in the community,” she explained. These interactions—even with non-patients—seed visibility and confidence that ripple outward.
Education at Scale—One Reel at a Time
Meanwhile, Dr. Hughes leverages social channels for mass myth-busting and health advocacy, reaching not just her own ZIP code but followers as far as the UK. By demystifying issues like vaccine safety or transparent pricing (“Guess how much an x-ray is? $30!”), she models DPC values—access, honesty, empowerment—for a generation hungry for alternatives to the status quo.
“Just me yelling at my phone is making a positive impact across the world,” Hughes said. The lesson? Don’t overlook the power of digital word-of-mouth to expand your community, wherever you’re rooted.
The Power of Personalized Networks: Collaborative Care Outside the System
Building a Rolodex—Not a Referral List
The physicians emphasized the unique power of DPC models to curate cross-disciplinary collaborations tailored to each patient, not just inboxing generic specialist referrals out of expediency. Dr. Mundkur illustrates this in her “rare disease detective” role—pursuing challenging diagnoses with the time and intellectual oxygen DPC provides, then forging direct links with genetics and mitochondrial experts.
Results can be profound: “The usual timeline for diagnosis [of mitochondrial disease] takes about ten years,” Mundkur shared. “It’s crazy you’ve come to us in two and a half.” The direct channeling of cases (even involving sending edible arrangements to thank specialists!) creates bidirectional collegiality and problem-solving that the insurance treadmill can never supply.
Leveraging Modern Tools for Efficiency
Alongside these old-school connections, the panel celebrated the rise of AI-driven efficiencies. Open Evidence, they said, has transformed everything from real-time, evidence-backed patient education to compiling complex medical timelines in seconds for specialist consults. Though AI scribes still need better DPC adaptation (“AI scribes get lost in the weeds—we talk too much!”), the direction is promising.
Bottom line: Tech that supports dignity, personalization, and time savings (for both patients and clinicians) is embraced. Efficiencies are then plowed back into relationship-based care.
Standing for Science in the Era of Misinformation
Taking (and Communicating) a Stand
With an ongoing deluge of vaccine hesitancy, public health confusion, and a politicized landscape, the doctors described their transparent, proactive stances as essential—not risky.
When a measles outbreak loomed, Defiant DPC launched a handout-and-algorithm campaign, held titers clinics, and communicated directly about risks and solutions. Dr. Hughes described her own annual vaccine clinics and constant myth-correction as evidence that DPCs can indeed fill gaps left by besieged public agencies.
The key lesson: increasingly, patients and families want a physician who “takes a stand.” Early in her career, Dr. Hughes admitted to equivocating for the sake of appearing balanced; over time, she and the others embrace candor and clear boundaries—both for their own sanity and the safety of their patient communities.
Patient Partnership in Navigating Systemic Gaps
Especially as public programs face cuts and coverage gaps widen, DPCs become lifelines. Dr. Hughes helps families navigate insurance transitions, provides political advocacy, and addresses both present needs (“order equipment now while you have Medicaid”) and longer-term system reform. Such work, they admit, can be exhausting and frustrating—especially as insurers employ growing AI armies for denials, and affordable medications face global supply threats.
Yet, armed with real relationships, these doctors feel empowered to guide patients through practicalities—such as explaining the realities of insurance refusals, or arming patients to advocate for their own interests. Where possible, they direct colleagues to resources like the DPC directory and patient-facing maps to help patients and DPC-practicing peers find each other faster.
Reflecting on Burnout, Balance, and the Future: Advice for the New(er) DPC Doctor
Sustainable Growth Means Honoring Limits (and Joy)
Despite practice diversity (from tech-forward pediatric panel to small-town generalist), all the doctors echoed a commitment to keeping practices at a manageable size—intentionally rejecting “growth for growth’s sake.” The goal: never lose the joy or human element to the tide of administration.
The freedom to spend more time with patients, participate in family life (“I’m at the Halloween parade with my kids and that’s OK”), and pursue intellectual curiosity were cited not as ‘nice to haves,’ but as core survival strategies for lasting DPC careers.
Mentorship, Transparency, and Giving Back
The group is seeing the next wave of DPC prospectives—med students, residents, even premeds—reaching out more than ever out of disillusionment with conventional primary care. Their advice? Speak clearly about finances, emotional risks, and the reality that DPC isn’t an “easy” alternative—but an authentic one.
Dr. Hughes, now faculty, introduces students to DPC with a focus on boundaries, anti-burnout tactics, and patient-centered medicine. Dr. Mutch described the satisfaction of “getting people out” of broken insurance-driven jobs and into the DPC fold, whether as associates or new startups.
Resilience in the Face of Structural Headwinds
Finally, the panel doesn’t sugarcoat ongoing hurdles: intensifying insurance denials, AI-run prior authorization nightmares, and social media-induced misinformation. Yet through strategic tech adoption, robust peer-to-peer support, and an unwavering commitment to evidence-based medicine (and their patients), they believe DPC is poised not just to survive, but to lead by example.
Takeaways: Reflect, Adapt, and Never Lose Sight of “Why”
At the end of five years, these DPC clinicians offer a roadmap defined by practical tools, cultural humility, and an ability to flex as the world changes around them. Whether leveraging AI for time savings, hosting community fitness events, or just having the guts to say “no” to bad-faith insurance actors, their success comes down to intentionality—on behalf of their patients, their profession, and themselves.
For DPC doctors or those on the journey, their stories challenge us to:
Re-examine workflows and hiring in light of core values, not trends.
Build both high-tech and high-touch connections that reinforce trust, not bureaucracy.
Take a visible, evidence-based stand for public health—even when it’s hard.
Practice radical transparency (with patients and prospective colleagues) about what’s possible, what isn’t, and why you’re in DPC in the first place.
Celebrate incremental progress and the “small batch” moments that make the journey worth it.
Here’s to many more years, and to the thousands of microdecisions that make direct primary care not just an alternative—but an inspiration.
Stay tuned for future episodes, check out resources like the DPC Directory and CaringDirectly.com, and keep learning from voices—old and new—on the My DPC Story Podcast.
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