How to Open a DPC Practice from Telemedicine to Brick and Mortar
- Maryal Concepcion
- Sep 13, 2020
- 17 min read
Updated: 2 days ago
How Dr. Kapur discovered Direct Primary Care
From a clinic closing to a new path in DPC
Quick answer: Dr. Neeti Kapur opened her DPC practice in Fayetteville, NC by starting with low-cost telemedicine visits while she searched for clinic space, then transitioned to a full membership model once she found an affordable, close-to-home location after a five-month search. She integrates homeopathy with Western medicine and runs her practice using the Atlas MD EHR.
If you are a physician thinking about leaving insurance-driven medicine, the hardest part is often the start. How do you open without a clinic? How do you find space you can afford? How do you keep your family life intact while building a business from scratch?
Dr. Neeti Kapur answered all of those questions when she joined Dr. Maryal Concepcion on episode 2 of My DPC Story. As the only DPC doctor in Fayetteville, NC, Dr. Kapur built her practice, Devoted Family Practice, step by step: telemedicine first, then a brick and mortar clinic she renovated to feel like a second home.
In this post, you will learn how she discovered DPC, how she found a low-overhead location, how she balanced two young kids with opening a clinic, and how she blends homeopathy with conventional family medicine. You will also find the tools and resources she leaned on, plus the full episode transcript and show notes.
How Dr. Kapur discovered DPC
Dr. Kapur cannot pinpoint the exact moment she first heard the term DPC. It came into focus when the clinic she worked at in Fayetteville closed down and she started thinking about her next move.
She began watching old recordings of the Nuts and Bolts conference. Something about the content and the energy in those talks shifted something in her. The more she learned about the model, the more she wanted to learn. Eventually she stopped studying and jumped in.
Her path to medicine was a long one. Dr. Kapur graduated with High Distinction from the University of Toronto, conducted research on atherosclerosis at SUNY Buffalo, and earned her MS and MD from Chicago Medical School at Rosalind Franklin University. She completed her residency at St. Joseph's Hospital in Chicago, where she served as Chief Executive Resident and received the Roger Nosal Leadership Award. She moved to Fayetteville, NC in 2013.
Starting with telemedicine before opening a clinic
Dr. Kapur opened with telemedicine about two months before the episode was recorded. The goal was simple: get the ball rolling and introduce DPC to her community.
She started virtual because she did not yet have a brick and mortar clinic. The space she planned to lease needed an aesthetic renovation to make it her own. While that work happened, she offered one-time telemedicine visits at very low rates. This helped people who could not afford, could not get into, or did not want to visit a regular doctor during the COVID pandemic.
About four weeks before the interview, she opened her clinic doors and shifted to a pure membership model. She still uses telemedicine, but now as part of an ongoing relationship with members rather than one-off visits.
If you are doing telemedicine first while you search for space, you are following the same path Dr. Kapur walked.
How to find a DPC clinic location with low overhead
Finding the right space took Dr. Kapur more than five months. She had a clear checklist:
Close to home. She wanted a short drive. The clinic she found is just a few minutes from her house.
A safe, suitable area with other medical practices nearby.
Low overhead. Affordable rent was non-negotiable so she would not lose sleep over a fixed cost before her membership base grew.
Room to grow. She did not want a space she would outgrow in a year. She wanted one that would expand with her.
A warm, welcoming feel. She did an aesthetic renovation on the older space so it would not feel like a clinic. She wanted it to feel like a second home for her patients and for herself.
Patience paid off. She found a location that checked every box, with rent low enough that she could put the savings into making the space her own.
Keeping the rent low is the single biggest piece of advice she has for DPC physicians on the hunt. Rent is a fixed cost. Keep it manageable so you can sleep at night before the memberships roll in.
Balancing DPC ownership with family life
One of Dr. Kapur's biggest worries was time. In a fee-for-service world, she assumed running her own clinic would pull her away from her two kids, her daughter who was 10 and her son who was 8 at the time of the episode.
The reality turned out to be the opposite. In a two-physician household, with her husband working in a subspecialty, she knew she wanted to remain the primary caregiver. DPC gave her a flexible schedule so she could be present when her kids needed her. She even chose a clinic where her children could come during the uncertainty of COVID school closures.
At a Nuts and Bolts conference, Dr. Kapur sat in on an all-female panel where physicians described running their DPC practices from home, working part time, and structuring their days around their children. That, she says, is the beauty of the model. Whether you are a parent or not, DPC promotes balance and reminds physicians that they need to care for themselves in order to care for their patients. In a fee-for-service system where burnout is rampant, that balance is rare and valuable.
Integrating homeopathy and Western medicine in a DPC practice
Dr. Kapur was introduced to homeopathy by her grandfather, who lived with her family and was a homeopath. Her parents practiced Western medicine, her father a family physician and her mother an anesthesiologist. As a young person, she dismissed homeopathy as hocus pocus and pursued conventional medicine.
That changed within her first year of practice. She found she could control patients' symptoms with medication but could not heal them the way she had hoped. In family medicine, she explains, we see things that make life miserable but do not kill you, and Western medicine sometimes falls short of true healing in those moments.
She found a course in Chicago through the CDH, the Center for Education and Development of Homeopathy, taught by physicians for physicians. The training was scientific and grounded in pharmacology, built on thorough history-taking and physical exams.
At first she felt torn between her two kinds of training. Over time she realized they are synergistic. They work on different levels, cover each other's weaknesses, and can be prescribed together. She often gives patients both at once, letting them start with one and add the other as needed. This blended, whole-person approach now defines the care she offers at Devoted Family Practice.
Marketing DPC in your community: radio, small businesses, and residents
As the only DPC doctor in her town, Dr. Kapur knew she had to educate people about a model most had never heard of. She took several routes:
Radio. Her first opportunity was a radio spot for a local church group.
Small businesses. She spoke with employers who signed up their employees, some of whom had not had regular medical care in decades. Affordable DPC filled a real need.
Residents. She spoke with family medicine residents at the local hospital. Many already knew DPC existed, far more than she did at the same stage of her own career.
The nearest DPC to her is in Apex, about an hour away, with a few more in Raleigh about an hour and a half north. Those doctors supported her with answers while she set up and continue to do so. The willingness of the DPC community to open their hearts and clinics to a stranger, she says, is what fuels the whole movement.
Tools and resources Dr. Kapur recommends
Dr. Kapur shared the specific tools and resources that carried her through her launch:
Atlas MD EHR. Her favorite tool by far. She calls it a one-stop shop. From her phone or computer she can book appointments, write notes, manage inventory, receive faxes, send emails, run telemedicine calls, and send prescriptions. For a physician worried about juggling multiple programs, it was a lifesaver.
Douglas Farrago's book on direct primary care. FIND IT ON AMAZON HERE.
The first few paragraphs convinced her there was another path. His guide, The Official Guide to Starting Your Own Direct Primary Care Practice, is a staple for new DPC physicians.
The Nuts and Bolts conference. The online recordings lit a fire in her that she could not put out.
The DPC Docs Facebook group. Even reading the questions and answers as a quiet bystander gave her a wealth of information.
The CDH for her homeopathy training.
The Butterfly IQ ultrasound. The device that first connected her with Dr. Concepcion at Nuts and Bolts in 2019.
Most of these resources are free, she points out, and all of them are invaluable.
What to do when you feel scared to make the leap
Dr. Kapur's message to physicians standing on the edge is direct: it is not as scary as you think.
She grew up in Canada, where billing was straightforward, and assumed the complexity of the US insurance system put private practice out of reach. She believed the overhead and the administrative tangle would be beyond her. DPC proved her wrong. The model strips medicine back to the doctor-patient relationship, and everything else becomes simpler and secondary.
You do not need a large clinic. Every DPC practice is unique. Some run out of a home, a basement, a single room, or the bottom floor of a building. As the doctors say, you really just need you, the patient, and your stethoscope. That, she says, is exactly true.
Where to start your own DPC journey
Dr. Kapur's story shows that the leap into DPC does not require a perfect clinic or a flawless plan. It requires a clear checklist, patience, a supportive community, and the willingness to start small. Begin with telemedicine if you must. Search for the right space until you find it. Lean on the books, conferences, and groups that came before you.
If you are exploring DPC and want more stories like this one, subscribe to the My DPC Story newsletter for new episodes, tools, and guidance delivered straight to your inbox.
You can reach Dr. Kapur and learn more about Devoted Family Practice at devotedcaremd.com, located at 4140 Ferncreek Dr. Suite 501, Fayetteville, NC 28314, or by calling or texting (910) 302-6529.
Full episode transcript
Dr. Maryal Concepcion 0:05Direct primary care is an innovative alternative path to insurance driven health care. Typically, patients pay their doctor a low monthly membership and in return, build a lasting relationship with their doctor and have their doctor available at their fingertips.
Dr. Neeti Kapur 0:26Direct primary care is the freedom to do the medicine I envisioned. Medicine that is simple, thorough, holistic and personal. I am Dr. Neeti Kapur of Devoted Family Practice, and this is My DPC Story.
Dr. Maryal Concepcion 0:51I met Dr. Kapur at the last Nuts and Bolts conference in November of 2019, before all of this pandemic business. She was walking around the different vendor tables, and I somehow got to chatting with her about the Butterfly IQ ultrasound. For those who might know me, it's easy to see how I could look like I'm a vendor for the device because I love using it so much, and I tend to get very excited when someone I meet is unfamiliar with the Butterfly. So a little bit about Dr. Kapur. She's a graduate of the University of Toronto, then went on to do research at SUNY in Buffalo, and then received her doctorate from Chicago Medical School, Rosalind Franklin University. She went on to train in residency at St. Joseph's Hospital in Chicago. She moved to Fayetteville in 2013 and opened up her DPC doors within the last few months. So welcome, Dr. Kapur, thank you so much for taking another leap today as the very first interview for the podcast.
Dr. Neeti Kapur 1:55It's my absolute pleasure to be here.
Dr. Maryal Concepcion 1:58So I wanted to get started with the key to pretty much everyone's story. How did you come to learn about DPC?
Dr. Neeti Kapur 2:08So the interesting thing about that is that if I try and pinpoint a time where I can say this is where I heard about DPC, I can't do that, because somehow it came into the picture when the clinic I was at in Fayetteville closed down. And I really started to think about my next move. I don't remember exactly how I heard about DPC, but at one point I did start watching old conferences, the Nuts and Bolts old recordings. And there was something about the content and the energy in those conferences that just got me so excited. The energy in me changed, and I started looking to find out more about this model. And the more I learned, the more I wanted to learn. After a point, I just jumped in, and it's been a great journey.
Dr. Maryal Concepcion 3:25That's fantastic and very inspiring, especially to those folks who are considering jumping into DPC. I want to ask you, when did you open exactly, and how has it been going ever since you opened your DPC doors?
Dr. Neeti Kapur 3:44So I opened about two months ago with telemedicine. The idea was just to get the ball rolling, to get the idea of DPC and a new paradigm in medicine out into the community. The reason I started with telemedicine is because I didn't have a brick and mortar clinic to actually move into. The place that I decided to lease needed a bit of an aesthetic gut, which is what I wanted to do to make it my own comfortable space. While that was happening, I wanted to do one-time telemedicine visits to help out a lot of the folks who couldn't afford, or couldn't get into, or didn't want to go to a regular doctor for whatever reason because of the COVID pandemic. So my rates were very low. It was just to give a community service while I set up my DPC. About four weeks ago, I actually opened my clinic doors, and although I'm still doing a lot of telemedicine, it's now a pure membership model. The telemedicine one that I was doing was kind of one-time visits, but now I have a membership base that's being built up, and people coming into the clinic, as well as people taking advantage of telemedicine when and if we need to do that as well.
Dr. Maryal Concepcion 5:18That's wonderful. For those listeners who are also, because of COVID or other reasons, doing telemedicine primarily but who are looking for a location, can you tell us a little bit about your experience in looking for and finding a location?
Dr. Neeti Kapur 5:39So when looking for a location, I had a few things on my checklist. I didn't want to be too far. I wanted it to be in a safe, suitable area, maybe where there were some other medical practices around. I knew I needed to have a low overhead. All those things were on my checklist. It was a journey, definitely, because I'd been looking for the past five months. I was frustrated at times, thinking I wouldn't find the place that was best for me. But with patience and persistence, I found something that is just a few minutes drive from my home. The rent is extremely affordable, so I don't have to lose sleep over paying the rent even if I don't have a lot of memberships at the time. And I was able to make the clinic my own with the money I saved in a higher rent. So in that sense, this clinic is exactly what I wanted, for a lot of different reasons. But it did take me a while to find what I was looking for.
Dr. Maryal Concepcion 7:07Me too. When you were making the transition from having a telemedicine exclusive membership to also incorporating a brick and mortar, can you tell us a little bit about your experience in looking for and finding a location?
Dr. Neeti Kapur 7:28Sure. It was a process. It took about five plus months. The reason is because I didn't want to rush into a location that I would grow out of quickly. I know some DPC physicians will start at a smaller place that they can lease and then hope to grow. But I wanted something that would grow with me in the next few years and give me the flexibility of having more space. Two, I wanted something that was close to my house. This clinic in my mind is going to be like my second home. It's a place that I knew I was going to make into a warm, welcoming space that wouldn't feel like a clinic for my patients. And I had the same feeling for myself. If it was going to be somewhere I'm spending time at, I really wanted to make it comfortable. For that, the vicinity was important. I also wanted a space that, believe it or not, my kids could also come to. With this COVID pandemic, I didn't know if they were going to go back to school, or what the school year was going to look like. Because I don't have full time help with them at home, having a space for them at my clinic was important to me. So after a five month search and going through a lot of frustrated moments where I doubted I was going to find the right place, I did find a place that fit me perfect. The other thing that should be on every DPC doc's checklist is keeping the overhead low. The rent, as you know, is a fixed cost that really needs to be kept low so that you don't lose sleep if you don't have members initially. For me, that was super important. So I was fortunate to get all those things that I wanted, and I did a little aesthetic gut on the clinic because it was an older space, but it had the rooms that I wanted, and I could make it into a space that was my own, clean and warm and welcoming to patients.
Dr. Maryal Concepcion 10:18Absolutely. I'm a huge believer in things happening for a reason. It sounds like you paid the price, you waited the five months, but in return you got something that ticks off all of your boxes. So I'm really happy for you. I love that your space is individualized, especially to the fact that you have two kids. Can you share with us, how old are your kids, and in terms of balancing being a mom and opening up your DPC, how is that working out for you?
Dr. Neeti Kapur 10:54That's a great question, and that was one of my concerns. When I was contemplating the idea of DPC, I really thought that if I had my own clinic, I wouldn't be able to spend as much time at home, and I'd be very preoccupied with trying to run my own clinic and my own business. But it can be the exact opposite. My children are eight and 10. My daughter is 10, my son is eight. I had my daughter about a year out of residency, and when my son was born two years after that, I took off a few years to raise my kids. When I was contemplating DPC, being in a two-physician household, and my husband is in a subspecialty, I knew that I would still want to be the primary caregiver for my kids. Although running a clinic is going to be a priority, having a family is just as important, and being able to have time for them, see them, and have a flexible schedule so I can be available when I need to be for them, that I knew was going to be on the forefront for me. When I went to the Nuts and Bolts conference, there was one talk that was an all-female panel. They talked about this exact thing, running their DPC practices out of their house, doing it part time, and arranging it so they could still be there to care for their children. That, I think, is just the beauty of the model. Whether you're a parent or not, whether you're female or not, the DPC model allows you and promotes having balance in your life, and having the physician understand that they need to look after themselves so they can look after their patients. In a fee for service model where burnout is so common, and we're hearing about it more and more, we need to realize that the doctors also need time and balance so they can continue to do what they do.
Dr. Maryal Concepcion 13:35Definitely. I think that's a huge pull for people who, especially in these pandemic times, are being treated as they never thought a physician could be treated by corporations. In that sense, you're taking a stand for your own health and your family's health, and being able to be there for your kids as they grow up, which happens way too quickly. As a mom myself, I know that is painfully true sometimes. I think that's wonderful that you've been able to incorporate your family into your DPC plans.
Dr. Neeti Kapur 14:14Thank you.
Dr. Maryal Concepcion 14:18I want to shift to your actual practice, specifically that you have a special interest in complete patient wellness and homeopathy. I want to hear a little bit more about where this interest stemmed from, and where you were able to get training for this, so if other people are interested they can have a resource to refer to.
Dr. Neeti Kapur 15:34Yes, absolutely. So I was introduced to homeopathy actually at home by my grandfather, who lived with us when we were growing up. He was a homeopath, and my parents were regular Western medicine docs. My father was a family practitioner, and my mother an anesthesiologist. I never really looked at homeopathy as a very legitimate form of medicine. I used to think my grandfather was just trying to keep himself busy, practicing what I thought was a hocus pocus medicine. The legitimate medicine for me was Western medicine, so that's what I pursued. I never really learned anything more about homeopathy. I did my medical training and my residency. However, once I started practicing, within the first year I quickly realized I couldn't get patients healthy like I envisioned I would be able to. I would put them on a medication, and although I'd be able to control their symptoms, if they were on this medication for a long period of time, I knew it wouldn't cure them in the way I thought I could cure them. It was that sort of dissatisfaction, I think, that made me search for something more. In family practice we see things that make life miserable, but they don't really kill you. Sometimes I feel that Western medicine in those instances falls short of true healing. I found out there was a course in Chicago, which is where I was, offered through the CDH, the Center for Education and Development of Homeopathy. It's a course taught by physicians, for physicians. I took this course, and it was everything I didn't know about homeopathy. It's scientific, it's based on pharmacology, you take a very thorough history and do a physical, and you're able to come up with alternatives to areas that we sometimes lack in Western medicine when it comes to treatment. After I started integrating homeopathy, I came to a point where I questioned what I was going to do, because I felt torn between my Western medicine training and homeopathy. I felt at times that I would need to pick and choose which medication to give. I went through a phase of hardship trying to figure this out. Slowly I realized they actually are very synergistic. They work well together, and they make up for areas where the other one is lacking. They also work on two different levels, which means I often prescribe them both at the same time. I tell patients, you can start with this and add this, or you can start with the other and add this if needed. It's been amazing with the healing and the amount of options it gives my patients when Western medicine lacks in certain areas. Of course, there are areas homeopathy lacks as well. The art of the practice comes in when you can use both, use their strengths, and understand their weaknesses when you're prescribing.
Dr. Maryal Concepcion 20:01That is wonderful that you're able to find a place where you use both types of medicine, Western as well as homeopathic, together for your patients. Not only is your clinic personalized to what you need it to be, but also your practice is individualized. Have you been able to get out into your community since you've opened your doors, or even your telemedicine doors, to speak about DPC, and how has that been perceived?
Dr. Neeti Kapur 20:35It's been great. I've gotten a few opportunities. The first opportunity I had was with a radio station, for a local church group, and I got to speak with the pastor. I've also spoken to a number of small businesses who have signed up their employees, and some of those employees have not had regular medical care in decades. I think it's very supportive of the employers to want to look after their employees in that way and realize that this is a need that can be filled in a very affordable way through DPC. I've recently also spoken to the family medicine residents at the hospital in our town. A lot of them are aware that DPC exists. The word is spreading, the interest is growing, and they are much more informed than I ever was at that phase in my career about the other practice options and models that exist in primary care. So I've gotten some opportunities, and I'm looking to get more and continue to educate people, because I'm the only practicing DPC in my town. Making people understand that there's a different paradigm in medic
Photos of Devoted Family Practice in Fayetteville, NC.
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*Transcribed by AI so there may be discrepancies.
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