My DPC Story: The Journey of Dr. Josh Chow and Ohana Medical

Mar 29

7 min read

Updated: 6 days ago

There is a version of Direct Primary Care (DPC) that many physicians dream about when they first hear about this model. A small, physician-owned practice. A doctor who knows your name, answers your texts, and has time to sit with you. A space where the philosophy is to take care of the physicians and providers so they can take care of the patients.

Dr. Josh Chow, DO, found that version of DPC. He worked inside it for five and a half years. And then, one day, it was sold.

The Job That Changed Everything

When Dr. Chow finished his family medicine residency at Sky Ridge in Colorado, he knew one thing for certain: he did not want to practice inside the traditional insurance fee-for-service hamster wheel. He learned about Direct Primary Care at a conference hosted by the Colorado Foothills Society of Medicine in the fall of 2017, during his second year of residency. From that moment, there was no going back.

He joined a DPC practice and stayed for five and a half years. The early years were good. Great, even. The philosophy of the practice matched his own. The relationships with patients were real. The work felt sustainable.

And then the owner decided to sell.

Once corporate ownership entered the picture, things changed quickly. The practice he had poured himself into became something he no longer recognized. The values that had drawn him there in the first place were gone.

Dr. Chow knew he could not stay. What he did not know yet was what came next.

The Hard Months in Between

Being laid off is disorienting, no matter how expected it might be. Even when you can see it coming, there is still a version of grief that comes with losing the patients you love, the colleagues you trust, and the daily work that gave your week its shape.

Dr. Chow had a three-month severance. He and his wife, Katherine, had savings. They were not big spenders and had been building a financial cushion for exactly this kind of uncertainty.

They spent those first months searching. Looking for another DPC position. Looking for somewhere he could practice the way he wanted. But they found nothing. No openings. No positions that fit.

That was the moment the decision got made for them. If the right DPC practice did not exist, they were going to build it.

What It Actually Costs to Open a Practice

Here is where I want to slow down because this part of the story does not always get told honestly.

Opening a DPC practice is not free. It is not cheap. And when you are a physician who just lost a salary, the financial reality of startup costs can feel paralyzing.

For Dr. Chow and Katherine, the path forward came from a combination of sources. A supportive family offered an interest-free loan. Their emergency fund helped. They also received guidance from a fee-for-service physician in their building who had opened his own private practice and could provide realistic numbers to plan toward.

That number was just over $100,000. And they hit it—pretty close, as Katherine put it.

That budget covered a move-in-ready space on the first floor of a medical professional building in the exact corridor of Centennial that Dr. Chow had envisioned. It covered an autoclave, surgical equipment, liquid nitrogen, an EKG, spirometry, an in-house pharmacy stocked with nearly 100 unique generic medications, and a Rubicon MD subscription for specialist eConsult support. It covered the things that were non-negotiable to him as a physician trained in surgery who came to family medicine specifically to offer more than a referral slip.

None of it was bought new if it did not have to be. His aunt, a psychiatrist who retired in 2025, donated office equipment. He shopped for used medical devices. He cross-referenced every medication in his pharmacy against GoodRx and SingleCare to ensure his patients were actually saving money, not just paying a different version of the same price somewhere else. This is what intentional practice ownership looks like. It is not glamorous. It is measured and careful, built on a genuine commitment to not wasting what you have.

The Rat Race, by Another Name

At one point in our conversation, Dr. Chow described the fee-for-service model in a way that I think every physician reading this will immediately recognize.

"You have to pay more to see more. And you gotta see more so that you can pay more."

It is a treadmill that only speeds up. More patients to fund more staff to handle more patients. The practice does not grow so much as it expands its own hunger.

DPC, he said, feels different. Even when the office is closed. Even when he is out sick or on vacation. Even when life happens and the clinic doors do not open for a week.

The membership dues hold the practice up. The stability is built into the model itself. That is not a small thing for a physician who is also a parent of three elementary-school-aged kids, a moonlighting hospitalist, a cello player at Tuesday and Thursday school orchestra, and one half of a two-entrepreneur household.

Two Entrepreneurs, One Ohana

Katherine Chow is not a physician. She is a former elementary school teacher, a concrete planter maker, and a newly published author whose book launched just weeks before this recording. She is also, by her own account, the reason Ohana Medical exists and keeps running.

She was the one who said surgery was not the right path for their family, redirecting her husband toward family medicine. She was the one who was in the room through medical school, residency, and every employed position after. And when it came time to open their own practice, she was the one who showed up every day to build it alongside him.

Their financial life reflects the same intentionality as their practice. One shared account. No surprises on either side. A dry-erase master calendar in the hallway of their home tracks everything from health fairs to book launches to a 40-mile midnight ski race in Crested Butte. A rotation among their three kids for who gets to sleep on Dad's side of the bed when he is moonlighting overnight.

They talk about money during school hours and save the harder financial conversations for after the kids are in bed. They use sticky notes. They use physical calendars. They are figuring out bookkeeping and tax strategy in real time, the way most small business owners do, by living through the first year and learning what they should have been tracking all along.

Dr. Chow contributes to Roth IRAs, has front-loaded 529s for each of his three kids, and has never once left employer match money on the table, even on a resident salary. He opted out of Medicare. He moonlights by choice, in part because the 1099 income helps offset the startup losses from Ohana's first two months—a tax strategy that was not accidental.

These are not the financial habits of someone who stumbled into stability. They are the habits of someone who has been building quietly and carefully for a long time.

Why Ohana Medical?

The name comes from Lilo and Stitch, a charity bike ride, and a family that has always treated the people around them like they belong.

Ohana means family. And family means nobody gets left behind or forgotten.

When the practice they built got sold to a corporation that did not share those values, Dr. Chow and Katherine did not try to fit into the new version of it. They took the name, the philosophy, and the patients who found their way to them on their own, and they built something new.

Ohana Medical opened in October 2025. It is still growing. It has not yet broken even. And Dr. Chow says he has never been happier in the work.

That is the thing about building your own practice. You do not get it perfect on the first day. But it is yours. And that changes everything.

Dr. Josh Chow, DO, is a board-certified family physician, and he and his wife, Katherine Chow, are co-founders of *Ohana Medical in Centennial, Colorado. Listen to his full episode on My DPC Story to hear the complete conversation about startup costs, insurance brokers, in-house pharmacy strategy, tax planning, employer groups, and what life looks like when two entrepreneurs build a practice and a family at the same time

Find Katherine's book Silly Shrimphony HERE/Katherine-Chow/Bitty-Bao-Cantonese-+-English-Series/9781958833766).

Katherine's Kindred Root Collection of Cement Planters HERE.

WATCH EPISODE HERE:

https://youtu.be/cDaBToNwLQs

LISTEN TO EPISODE HERE:

Frequently Asked Questions

How much does it cost to open a Direct Primary Care practice?

Opening a Direct Primary Care practice cost Dr. Josh Chow just over $100,000, a figure he confirmed with a fee-for-service physician in his building who had already opened a private practice. That budget covered a move-in-ready office space, an autoclave, surgical equipment, liquid nitrogen, an EKG, spirometry equipment, and an in-house pharmacy stocked with nearly 100 generic medications.

What happens when a DPC practice gets sold to a corporation?

When Dr. Josh Chow's Direct Primary Care practice was sold to a corporation, the values and philosophy that had drawn him there disappeared almost immediately, and he knew he could not stay. He was laid off with a three-month severance and spent months searching for another DPC position before deciding to open his own practice instead.

How did Dr. Josh Chow afford to open his own practice without a salary?

Dr. Josh Chow and his wife Katherine funded Ohana Medical using an interest-free loan from family, their emergency fund, and by buying used equipment instead of new, including office equipment donated by his aunt, a retired psychiatrist. He also moonlights as a hospitalist, in part because the 1099 income helps offset the startup losses from the practice's first two months.

Why did Dr. Josh Chow open an in-house pharmacy?

Dr. Josh Chow opened an in-house pharmacy at Ohana Medical because he trained in surgery before choosing family medicine specifically to offer more than a referral slip. He cross-referenced every medication against GoodRx and SingleCare to make sure patients were actually saving money rather than paying a different version of the same price somewhere else.

Why is Ohana Medical called Ohana Medical?

Ohana Medical is named after the idea that family means nobody gets left behind or forgotten, a philosophy Dr. Josh Chow and his wife Katherine wanted to carry into their new practice after their previous one was sold to a corporation. Ohana Medical opened in October 2025 in Centennial, Colorado.