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Most people start a direct primary care practice because they want better medicine and more time with patients, but the part that quietly decides whether the clinic survives is the financial foundation. I sit down with Dan Luna, a bookkeeper who works inside the DPC world, to talk through the unglamorous basics that keep a membership-based clinic alive: planning for the income gap, building a simple cash-flow buffer, and understanding what your fixed costs really are when you finally open the doors.

We also zoom out to the business setup decisions that confuse almost every first-time owner. Dan explains how to think about an LLC versus an S-Corp election, why liability and tax treatment drive the choice, and when it’s smart to bring in a CPA so your accounting system is built correctly from day one. Then we get tactical about bookkeeping, what it is and what it isn’t, and the real-world signal that it’s time to stop doing it yourself. His “queen bee” analogy is a reset for overwhelmed clinic owners: your highest-value job is caring for patients and growing a sustainable panel, not reconciling transactions at night.

Finally, we talk tools and pricing. QuickBooks is still everywhere, but AI accounting software is changing the landscape, and the right support matters more than the logo on your ledger. We also tackle the fear behind undercharging in direct primary care, how pricing connects to burnout, and why charging enough to fund support and systems is part of delivering great care. Subscribe for the next part of the series, share this with a DPC owner who needs a financial reset, and leave a review with your biggest question about pricing or startup cash flow.

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We just watched a room full of nurse practitioners and physician assistants realize they don’t have to practice medicine the way they’ve been told and that shift is the heart of what we’re talking about today. Coming off our second annual DPC Launchpad conference, we’re processing what we learned, what surprised us, and what we think is changing inside the direct primary care movement for advanced practice providers.

We break down the real-world wins and limitations of hosting a DPC conference on a cruise ship, then get into the most useful “steal this” ideas we’re bringing back to our own membership-based primary care clinics. That includes simple visibility changes like posting a menu of services, a memorable clinical tool that lit up the room (the sphenocath for migraines), and the operational relief that can come from delegating smarter, like hiring a virtual assistant for marketing and organization.

We also talk about why the content matured this year: bringing in experts who live in the business trenches, not just clinicians. Website design, bookkeeping, malpractice and business insurance, AI, and marketing show up as make-or-break skills for DPC sustainability. Then we look ahead to Austin, Texas and what we want to build next: hands-on skills workshops, cybersecurity, tax strategy, retirement planning, exit planning, HR and hiring, plus a bigger push into B2B direct primary care for employers.

If you’re curious about starting a direct primary care practice, already running one, or trying to grow beyond word-of-mouth, you’ll leave with concrete next steps and a clearer picture of what “better” can look like. Subscribe, share this with a colleague, and leave a review, then tell us what topic you want us to tackle next.

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Monica McKittrick returns to the podcast with a wealth of insights from her remarkable transformation from hands-on nurse practitioner to CEO of a thriving Direct Primary Care practice with seven providers across three locations. Her journey offers a roadmap for anyone considering the entrepreneurial path in healthcare.

When Monica transitioned away from patient care, she worried her 350 patients might leave. Remarkably, she lost only two. This testament to relationship-building reveals how thoughtful transitions can maintain patient trust while allowing provider growth. Now enjoying true freedom—including a recent two-and-a-half week vacation where "no one cared" she was gone—Monica demonstrates that building a self-sufficient practice is achievable but requires intentional systems and leadership.

The challenges of marketing DPC practices cannot be overstated. As Monica explains, "Nurse practitioners are not natural marketers" and the unique nature of healthcare means patients need to both know you exist AND need your services at precisely the right moment. Her experiences expanding to multiple locations reveal critical insights about community integration, geographic challenges, and why having a marketing strategy is essential. The realization that "success to me is not 10 clinics" but rather freedom to enjoy life while making an impact led Monica to create resources for other providers.

Her upcoming book "DPC: Dream Job or Total Disaster" (available August 4th) offers a crucial roadmap for determining whether DPC ownership aligns with your personality and goals. Rather than a technical how-to guide, it helps providers make the fundamental decision about whether to pursue DPC at all. Coupled with her "DPC Launch Kit" course, these resources reflect Monica's mission to help the right providers succeed in this model, ultimately expanding access to patient-centered care.

Connect with Monica at the DPC Launchpad conference in February and explore her resources at DPCformula.com to discover if direct primary care entrepreneurship is your calling or a path better left unexplored.

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