Rediscovering Medicine, Community, and Joy: Dr. Jason Hoke’s Journey to Flourishing in Direct Primary Care

Maryal Concepcion
Jun 15
7 min read

Updated: Jun 21

How One Physician’s Leap of Faith Brought New Life to Himself, His Family, and a Small College Town

Dr. Jason Hoke in front of his clinic — Dr. Jason Hoke

Burnout and disillusionment have sadly become all too common in modern medicine, especially among primary care physicians. Many of us enter the field with wide-eyed ideals of patient-centered care, deep community roots, and the ability to make a difference. Too often, however, the realities of insurance-driven medicine—bureaucracy, restricted relationships, and relentless pressure to see more patients for less compensation—sap the enthusiasm and very purpose that brought us to medicine in the first place.

For those considering Direct Primary Care (DPC) as a way back to joyful, purposeful practice, the story of Dr. Jason Hoke of Oxford, Ohio offers inspiration, practical lessons, and compelling reassurance that there is indeed a better way. In a recent episode of the My DPC Story podcast, Dr. Hoke shares his remarkable journey: from launching and then losing faith in traditional private practice, to the brink of leaving medicine, through a leap into the unknown that ultimately reinvigorated his calling, family, and community.

Here are a summary of his insights—reflecting on pivotal moments, strategic decisions, community responses, and office operations—to serve as both a mirror and a guide for DPC-curious physicians ready to build their own sustainable version of the practice they dreamed of in medical school.

Leaving Network Medicine: Identifying the Real Problem

Dr. Hoke’s career began in 2001 in Oxford, Ohio, right after residency. Together with two partners, he started an independent, insurance-billing practice that quickly flourished, expanding to four offices with 11 providers in a small college town. But as Medicare and insurance reimbursements stagnated and administrative burdens multiplied, financial stress and frustration mounted.

Hoping to alleviate some of these headaches, Dr. Hoke’s group joined a local health network, imagining freedom from insurance squabbles and a return to practicing medicine. Instead, new frustrations replaced the old ones. Meetings shifted from patient care and disease management to endless discussions of billing, coding, and charting—not the medicine he dreamed of. Worse, the work’s emotional toll became evident. Physicians—some barely two years out of training—were burning out and considering leaving medicine altogether.

Despite efforts to advocate for a new reimbursement model more favorable to primary care, Dr. Hoke was met with resistance at every turn. “I was just banging my head against a brick wall that was not going to relent,” he recalls.

Reflective Questions for DPC Physicians:

Are you experiencing burnout or apathy?
Do discussions in your current setting center patients, or paperwork?
Have you tried advocating for change, only to find the system immovable?

The Spark: Discovering Direct Primary Care

For physicians at a crossroads, inspiration sometimes arrives as a lifeline. For Dr. Hoke, the discovery of DPC came while searching for CME conferences. He stumbled upon the DPC Summit and, after attending in 2017, knew instantly that he’d found something transformational: “This is what medicine is supposed to be.”

Hearing pioneers like Dr. Julie Gunther speak with joy and enthusiasm reignited his own sense of purpose. Still, major life questions loomed—he was in mid-career, with six children, college and retirement to plan for, and the relative stability of network-employed practice.

A year later, fortified with more knowledge and inspiration at his second DPC Summit, Dr. Hoke encountered a moment of serendipity. A tea bottle at lunch bore the quote: “To dare is to lose one’s footing momentarily. Not to dare is to lose oneself.” In that moment, clarity and resolve crystallized: “I am losing myself in this medicine practice...It’s time to stop talking about it, and actually take that step forward.”

Reflective Questions:

What fears have you identified about leaving your current practice?
What or who might supply you with the clarity or encouragement to make a change?
What small signals or “signs” have you received on your journey so far?

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Making the Leap: Sacrifice, Strategy, and Resilience

The leap to DPC was not undertaken impulsively. Dr. Hoke and his family engaged in intentional, practical preparation. Known affectionately as the “beans and rice talk,” they sat down as a family and committed to significant short-term sacrifices—cutting spending, eating simply, and saving up a financial cushion.

Dr. Hoke’s transition planning included giving appropriate notice to his network employer (ensured by negotiating a key “private practice exception” into his contract early on). He and his team organized three well-attended community events explaining DPC—a move that would lead to an impressive 200 patients signing up before doors even opened in January 2019.

Key Takeaways for Transitioning Physicians:

Family Support: Be transparent with loved ones; their buy-in is critical.
Contract Review: If you’re employed, ensure you have a pathway back to private practice.
Community Education: Host events that demystify DPC and showcase its value.

Early Growth: Community Connection and Word of Mouth

Oxford, Ohio—a rural college town of 16–18,000—proved fertile ground for patient-centered primary care. Dr. Hoke’s practice drew from a wide demographic, from college students and professors to farmers and small-business owners.

Longtime patients, who had followed Dr. Hoke through various practice iterations, were eager for the renewed access and relationship-driven care that DPC promised. Many commented on his restored energy and the return of “the old Dr. Hoke.” Early community talks drew rapt attention, with audience members marveling that such personal care was possible outside the big systems.

Word of mouth spread rapidly. Within ten months, Dr. Hoke’s panel hit capacity at around 700 patients—a testament to both pent-up demand for better access and the strength of existing patient-physician relationships.

Implementation Strategies:

Leverage Relationships: Patients value continuity; don’t underestimate their loyalty.
Offer Personal Touches: Promise (and deliver) direct communication channels—phone, text, portal—just like a bigger system, but with personal connection.
Cap Your Panel: To preserve quality, set a patient cap and honor it.

Find marketers, lawyers, tech partners and more wherever you are in your DPC journey!

Building the Right Team: Recruitment, Delegation, and Community Roots

As the numbers grew, so did the demands on office operations—prompting strategic, mission-centered hiring. Dr. Hoke began with just one well-organized, trusted assistant. Serendipitously, a pre-med student from Miami University reached out, offering support at the front desk in exchange for DPC experience. This student (destined to return as a fourth-year rotation) contributed technological savvy and further strengthened the educational and community ties of the practice.

Anticipating further growth and patient need, Dr. Hoke recruited Julie, a former nurse who’d gone on to become a nurse practitioner. Their decades-long professional trust and shared values—plus the practical bonus of shared office hours and side-by-side desks—meant seamless office communication and “two providers for the price of one” from the patient’s perspective.

Practical Tips:

Lean Operations: Start small and add staff incrementally; cross-train for flexibility.
Mission Alignment: Hire those who share your values and who know their strengths and limits.
Mentorship & Pipeline: Engage local students to inspire the next generation of primary care.

Operations: Tech, Transparency, and the Simplicity Advantage

Dr. Hoke attributes much of his office’s smooth scaling to upfront investments in the right tech stack. His practice uses a comprehensive EMR that integrates patient records, billing, scheduling, and in-house dispensing—all facilitated by a single support line. This “one court of accountability” approach avoids tech headaches and siloed vendor support.

Efficiency is furthered by online patient registration and a secure patient portal for confidential messaging. The practice offers discounted labs and a small on-site pharmacy with common medications, amplifying value for the monthly membership fee and further simplifying patient care.

Dr. Hoke’s office philosophy—“medicine simplified”—is more than a slogan. It’s a daily operational goal: patients reach humans who know them, receive coordinated care, and see processes streamlined so that care remains front and center.

Key Questions:

Is your tech stack adding complexity, or subtracting it?
How can value-added services (labs, medications) enhance your pitch and practical offerings?
Are administrative processes transparent and reproducible as you grow?

The Impact: Patient Stories and Professional Renewal

The greatest rewards, Dr. Hoke affirms, are found in the daily relationships and outcomes made possible by DPC. Restored to the ability to “just take care of patients,” he describes how patient responses transformed from skepticism (“This is a fad. When you come back, I’ll rejoin you...”) to admiration and deep appreciation (“This is the best thing that could ever have happened to Dr. Hoke and to me as a patient”).

DPC enabled nimble, hands-on pandemic response—personal outreach, same-day patient newsletters, outdoor visits, use of new treatments, and zero COVID deaths among his 700 patients. Stories abound of running stitches after hours, meeting patients at home or in parking lots, and even involving his children in simple procedures. This flexibility and commitment were unimaginable within network-owned or fee-for-service practice.

And the ripple effect extends to family. Once resolved never to pursue medicine after watching their father burn out, Dr. Hoke’s children are now excitedly planning their own careers in healthcare—eager to work alongside him and continue a tradition not just of medicine, but of community stewardship.

Facing the Hard Parts: Realities and Relentlessness

While DPC is joyful, Dr. Hoke is candid about its work. Physicians in these practices wear many hats: doctor, manager, bookkeeper, marketer. “It is work,” he admits. But even his busiest day is more manageable, more meaningful, and more ethically sound than anything he knew in network medicine.

Challenges remain: fighting insurance denials for necessary imaging or medications, chasing down specialist notes outside the “epically big” hospital EMR, and keeping up with patient communication. Yet these are challenges he prefers, for they are in service of his patients—not impersonal metrics and bureaucracy.

Words for the Physician on the Brink

To the mid-career or burned-out physician, Dr. Hoke offers pragmatic reassurance: “Any physician that’s been in practice for 10 years has got enough of a loyal patient following to make this transition successfully, because patients know good medicine when they see it...When you take a stand and say I’m not going to continue to play in this false sense of reality [of network medicine], and they see that you’re willing to take a stand for what’s best for their patients, they will follow you.”

Dare, Prepare, and Flourish

Dr. Hoke’s journey to DPC is a story of risk and resilience, but also one of preparation, relationships, and deep rewards. For those considering a similar leap—or those needing to recalibrate their own DPC journey—his experience is both a practical playbook and an emotional touchstone.

To dare is to lose one’s footing momentarily. Not to dare is to lose oneself.

Let Dr. Hoke’s story be your invitation: to rediscover the medicine you once loved, the community you once imagined, and the life—both professional and personal—that you still deserve.

For more inspiring stories and practical pearls, subscribe to the My DPC Story podcast and join the conversation at mydpcstory.com.