My DPC Story

Maryal Concepcion, MD
  • 5.0 (114)
  • Medicine
  • Updated Weekly

As the Direct Primary Care and Direct Care models grow, many physicians are providing care to patients in different ways. This podcast is to introduce you to some of those folks and to hear their stories. Go ahead, get a little inspired. Heck, jump in and join the movement! Visit us online at mydpcstory.com and JOIN our PATREON where you can find our EXCLUSIVE PODCAST FEED of extended interview content including updates on former guests!

  1. 2d ago

    Growing a Rural DPC Practice in Year 8: How Dr. Klaucke Built Patient Trust, Avoided Burnout, and Scaled Team-Driven Care

    Dr. Jillian Klaucke, MD, FAWM. Board-certified family physician at Sandpoint Premier Direct Primary Care, Idaho. Wilderness medicine fellow. Eight years into Direct Primary Care, Dr. Klaucke shares what actually works running a rural family medicine practice without insurance. Her practice runs on three pillars: teamwork, accountability, and patient safety. Teamwork means working with patients as partners. When imaging is needed, someone follows up to confirm it happened. Accountability means closing every loop: a weekend text gets a Monday check-in call. A referral goes out? Her staff confirms scheduling. Care management is where rural DPC shines, loaning crutches, sourcing equipment for Medicaid patients, walking alongside people through the whole process. This work can't be billed to insurance. It's exactly why patients choose DPC. After eight years, Dr. Klaucke has real data on after-hours access. She gets three to four calls or texts per weekend. Most are appropriate and time-sensitive. Patients don't abuse the privilege because they trust her. The relationship is the whole point. Managing a practice while seeing a full panel requires strategy. She leans on her office manager, partners with reliable vendors, and divides big tasks with her partner. The risk isn't systems on autopilot—it's neglecting to monitor them. She checks in regularly on vendor performance and catches cost creep before it happens. Many patients come to DPC after healthcare trauma. Dismissal. Delays. Lost in the system. Dr. Klaucke rebuilds trust by listening and keeping patients from slipping through cracks. This emotional healing matters as much as the medicine. Trust changes how you practice: instead of firefighting, you do prevention. Cardio IQ testing. Risk stratification. Lifestyle conversations. You have time to help people see grandkids born, kids graduate. Residents and early-career physicians ask Dr. Klaucke about DPC. She advises doctors in other states considering it. She tells them the truth: you need time in the trenches first, seeing volume and learning triage. Then DPC makes sense. In DPC, you collaborate with colleagues, check rashes together, call about differential diagnoses. Once you see that, you can't unsee how dysfunctional big systems are. Dr. Klaucke's grandfather pioneered rural medical education in the 1960s-70s. She wonders what he'd think of her now, practicing the kind of medicine he believed in, through a model that protects it from the insurance system. She thinks he'd be proud. And he'd probably be right about what matters: teamwork, accountability, showing up for patients. This is what Direct Primary Care looks like when given time to grow. Resources: Sandpoint Premier DPC: sandpointdpc.com | (208) 263-3091 | My DPC Story: mydpcstory.com Leave a 5-star review on Apple Podcasts. Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare. Get the DPC Pricing Calculator sponsored by Goodman CPA HERE Support the show GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE POD My DPC Story VOICEMAIL! DPC SWAG! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

  2. Sep 6

    From GameStop to DPC Owner: Dr. Sarai Ambert-Pompey on Telehealth, EHR Vetting & Trust-Based Care

    Dr. Sarai Ambert-Pompey opened Libélula Primary Care in Boise, Idaho. "Libélula" is Spanish for dragonfly, chosen for transformation. One year in, she joins Dr. Maryal Concepcion to talk about what changed when she left the VA for Direct Primary Care. Her path is unconventional: CompUSA and GameStop, Sony PlayStation reviewer training, oncology research at OHSU, then internal medicine residency in Boise. At the VA she joined a Primary Care Center of Excellence and helped launch the Boise Clinical Resource Hub, delivering clinic-to-clinic telehealth to rural sites across the Northwest, then trained physicians in telemedicine through the Ada County Medical Society during the pandemic. In this episode: Why time is the intervention - patients arrive never having been told their A1C goal, their blood pressure goal, or what their medications are for. Longer visits keep high ER utilizers out of the ER. Culturally responsive care in Idaho - Boise is predominantly white, but farming communities and employers like Micron bring diversity the traditional system was never built to serve. Healthcare trauma can take several visits to overcome before a patient consents to a blood draw. Telehealth done right - her top three: screen whether the visit is appropriate, build an emergency protocol and know your state's consent law, and actually perform a physical exam on video. Most clinicians skip that last one. How to vet an EHR - test customer service response time first, ask about interoperability, run a full patient walkthrough instead of the salesperson's highlight reel, get pricing broken out line by line, ask how an AI scribe stores data, and watch for 12-month contracts. Community as marketing - she launched a Walk with a Doc chapter before the clinic opened. Chamber involvement, immigration medical exams, and one paid social promo that returned its investment in a week. Leaving the system - 15 pounds lost, sleep restored, weekends back. "I tell anyone who will listen: I wish I had done it earlier." Mentioned: IN -PERSON DPC SUMMIT COMING IN OCT 2026! Illinois DPC Summit, first week of October, open to out-of-state physicians - register at caradirectcare.com/summit · Walk with a Doc · Latino Conservation Week · Idaho Hispanic Chamber of Commerce Free DPC startup checklist, the Physician Owner's Planner, and the DPC Toolkit Magazine: mydpcstory.com  Leave a voice message for the show: mydpcstory.com/contact  Follow @mydpcstory · Leave a 5-star review on Apple Podcasts Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare. Get the DPC Pricing Calculator sponsored by Goodman CPA HERE Get your copy of the Physician Owner's Planner today at mydpcstory.com/library Support the show GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE POD My DPC Story VOICEMAIL! DPC SWAG! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

  3. Aug 30

    How to Choose an EHR for Your DPC: What I Learned Switching After Almost 5 Years

    One month shy of five years. That is how long Big Trees MD ran on the electronic health record it opened with, and this month, that ended. Not because Dr. Maryal Concepcion went looking for something shinier, but because the terms under which her patients' data lived changed, and she could not accept them. In this solo episode, Dr. Concepcion documents the switch in real time from her rural Direct Primary Care practice in Arnold, California, which she owns with her husband, Dr. Jeremiah Fillo, and runs with a fully virtual team. No vendor names, on purpose. The names change. The framework does not. Built from The Toolkit's Battle of the EHRs issue, where over 200 DPC EHR users shared what they use and why, this episode walks through how to choose an electronic health record that grows with your practice instead of boxing you in: Why an EHR is the memory of your practice, and why the DPC version of this decision is nothing like the fee-for-service versionThe 10 categories to score every EHR on, from membership billing and charting speed to support quality and scalabilityThe 5 questions to ask before you switch, starting with "what problem am I really trying to solve?"How to run a demo on your terms: build a fake patient, count clicks out loud, ask about migration before features, and ask the question nobody asks, which is "how do I leave you?"Why you should research who owns the EHR company, especially as private equity and venture capital creep into Direct Primary CareRunning the real math: subscription, add-ons, switching costs, and exit costs over a three year horizon, plus what an hour of your life is actually worthThe hidden costs no spreadsheet captures: patient trust, the emotional weight of change, and the 90 day post-switch reality checkThings have changed since the Summer 2025 issue published, and the second Battle of the EHRs opens for voting in Q1. The only way to vote is through the My DPC Story newsletter, so sign up at mydpcstory.com. FREE from The Toolkit at mydpcstory.com: How to Interview Electronic Health Records comparison worksheetPatient handout on choosing healthcare vs. health insurance (perfect for open enrollment season)The Lean Startup Business PlanThe First Year RoadmapEvery issue of The Toolkit, including the new Battle of the Support StackFollow the full switch in real time: demos, migration answers, the four-bucket spreadsheet, and the second guesses, all inside the My DPC Story Patreon community.  Leave a voice message with your question, challenge, or win at mydpcstory.com/contact and you might hear it on a future episode. If this episode helped you, a five star review on Apple Podcasts helps other physicians find these stories when they need them most. Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare. Get the DPC Pricing Calculator sponsored by Goodman CPA HERE Support the show GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE POD My DPC Story VOICEMAIL! DPC SWAG! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

    How to Choose an EHR for Your DPC: What I Learned Switching After Almost 5 Years

  4. Aug 23

    How to Start a State DPC Alliance: Direct Primary Care in New York with Dr. Laura Petrescu

    When Dr. Laura Petrescu opened Athena Direct Primary Care & Lifestyle Medicine, she was the only Direct Primary Care physician in the Rochester, NY metropolitan area. Health system leadership thought she was out of her mind. Colleagues told her nobody would pay a membership on top of insurance. The advice everywhere was the same: New York is too restrictive, and DPC will not work here. Today there are seven or eight DPC practices in the Rochester area, and Dr. Petrescu has founded the New York State Direct Care Physicians Alliance with board members from Buffalo, Syracuse, Hudson Valley, and New York City. In this episode of My DPC Story, she and Dr. Maryal Concepcion get specific about the mechanics most physicians never hear. In this episode: Why she filed as a 501(c)(6) business league instead of a 501(c)(3), and why the charitable designation would have blocked advocacy entirelyWhat the state and IRS filings actually cost, and where the paperwork gets returnedHow reading her contract first led to her health system releasing her from a 10-mile non-compete radiusHow to build a board representing rural, metropolitan, and downstate practicesWhy eight busy physician owners vote on motions by email instead of scheduling Zoom callsWhat New York's lab restrictions mean in practice, and why they are the alliance's top legislative priorityHow California organized, from monthly meetings that fizzled to a state summit with 80 physiciansAbout the guest: Dr. Laura Petrescu is triple board certified in internal medicine, lifestyle medicine, and menopause medicine, with 25 years in practice. Originally trained as a surgeon in Romania, she is founding president of the New York State Direct Care Physicians Alliance. Links: New York State Direct Care Physicians Alliance: nysdirectcare.com  California DPC: calidpc.com  Legal question for My DPC Story State by State with Dr. Phil Eskew? Leave a voicemail at mydpcstory.com/contact  Organizing in your state? Leave a voicemail there too so we can highlight your group  Free startup checklist, The Physician Owner's Planner, The Toolkit Magazine, and every episode: mydpcstory.com  Follow @mydpcstory Upcoming: Illinois DPC Summit, October 2 to 3, NIU Naperville. California DPC Summit, June 2027, registration open. caradirectcare.com/summit Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare. Get the DPC Pricing Calculator sponsored by Goodman CPA HERE Get your copy of the Physician Owner's Planner today at mydpcstory.com/library Support the show GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE POD My DPC Story VOICEMAIL! DPC SWAG! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

  5. Aug 16

    DPC and HSAs: The $150 Rule and How to Opt Out of Medicare | Dr. Phil Eskew

    Direct Primary Care no longer disqualifies patients from HSA eligibility. As of January 1, 2026, DPC membership fees are a qualified HSA expense at or below $150 per month for one person and $300 for a family. Above $150 you are not in violation. You are in the same gray zone DPC lived in for a decade, and the tax position belongs to the patient and their accountant, not to you. Dr. Phil Eskew (DO, JD, MBA) of DPC Frontier joins Dr. Maryal Concepcion to break down what changed and what it means for your practice, then walks through the Medicare opt-out calendar most physicians discover too late. KEY NUMBERS AND DATES $150/month per person, $300 family. Effective January 1, 2026. Opt-outs take effect only on January 1, April 1, July 1, October 1. Affidavit must be filed at least 30 days before the effective date. File by roughly December 1, 2026 to be opted out January 1, 2027. 90-day reversal window, but you must refund every membership dollar collected. QUESTIONS ANSWERED Can patients use an HSA to pay for direct primary care? Yes, as of January 2026. Both old IRS objections were fixed: whether the fee is a medical expense, and whether membership disqualifies HSA contributions. Should I put "HSA eligible" on my website? No. Write "We accept HSA cards." Promising eligibility in your marketing or agreement takes on a tax position on your patient's behalf. How do I get under $150 without losing revenue? Enrollment fees are not compensation for care. Blood draws, injections, EKGs, and dispensed medications can price separately. What does the rule exclude? Prescription drugs other than vaccines, and lab services not typically done in an ambulatory primary care setting. If I opt out, can I still order labs and referrals? Yes. Opting out is not disenrollment. You stay credentialed and Medicare pays for labs, imaging, referrals, DME, and prescriptions you order. Where can I still work while opted out? VA, Indian Health Service, corrections, and hospice administrative work. Precepting usually requires participation. TRICARE requires Medicare participation. Medicaid uses ORP/OPR status, prohibited in Kentucky and Colorado. Does opt-out apply to Medicare Advantage? Yes. Opt-out applies to all Medicare programs nationwide. You cannot opt out selectively. MENTIONED DPC Frontier · McCarran-Ferguson Act (1945) · ACA primary care carve-out · bronze and catastrophic plans as HSA-compatible · capacity vs. competency · durable power of attorney · prior authorization escalation strategy HAVE A QUESTION? WE ANSWER THEM ON AIR. Leave a voicemail at mydpcstory.com/contact with your name, state, and question. NEXT EPISODE: ILLINOIS, timed to the Illinois DPC Summit, October 2 and 3, NIU Naperville. Subscribe to the My DPC Story newsletter at mydpcstory.com to know when it drops. Educational only. Not legal or tax advice. Dr. Eskew is not your attorney. Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare. Get the DPC Pricing Calculator sponsored by Goodman CPA HERE Get your copy of the Physician Owner's Planner today at mydpcstory.com/library Support the show GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE POD My DPC Story VOICEMAIL! DPC SWAG! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

  6. Aug 9

    How to Grow DPC With Employers Without Losing Autonomy | Dr. Kyle Rickner, Primary Health Partners

    Dr. Kyle Rickner heard about Direct Primary Care in a side room at the AAFP National Conference in October 2014 and committed to it 50 minutes later. Today Primary Health Partners cares for employee lives in 30 states, and it started with a patient named Jason who owned a 22 person company and handed Dr. Rickner a check covering every employee for a full year, six weeks after opening. In this episode, Dr. Rickner talks with Dr. Maryal Concepcion about what it takes to build a DPC practice that serves employers without giving up autonomy. He opened with 198 members on day one after a 15 month runway, a $1,000 equipment haul from a shuttered nursing program, and a lot of honest conversations with patients he wanted to bring with him. He also gets direct about the mistakes he sees. Enrollment is not engagement. A 375 employee contract can gut a 600 patient panel overnight if that company sells or closes. And overpromising to an employer poisons the well for the next DPC doctor who walks through that door. What you will hear: Why commitment and enthusiasm persuade patients faster than any marketing budgetThe three pillars Primary Health Partners built on before opening the doorsHow to identify a good employer partner, and when to say noUtilization differences between retail members and employee members, and why adoption rates range from 10% to 92%How he built a 28 doctor affiliate network in three weeks using DPC MapperWhat he thinks about private equity and venture capital money entering DPC, and the two non-negotiables that protect your practiceWhy passive customer acquisition channels may be how DPC reaches the next tens of thousands of patientsLessons on autonomy from practicing inside the Army health systemFind resources and your next step at mydpcstory.com, including the free startup checklist and the Physician Owner's Planner built for the business side of practice ownership. Leave a voice message at mydpcstory.com/contact and your question could be featured on a future episode. Follow My DPC Story on socials @mydpcstory. Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare. Get the DPC Pricing Calculator sponsored by Goodman CPA HERE Get your copy of the Physician Owner's Planner today at mydpcstory.com/library Support the show GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE POD My DPC Story VOICEMAIL! DPC SWAG! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

  7. Aug 2

    130 Patients in 6 Weeks: Dr. Nyasha Spears on Her Non-Compete Appeal and Opening Amity Creek Direct Primary Care in Duluth, MN

    Two months after opening Amity Creek Primary Care in Duluth, Minnesota, Dr. Nyasha Spears returns to My DPC Story with the real numbers, the real costs, and the parts of a Direct Primary Care startup nobody puts on a slide. She and her DPC partner Dr. Kristin Lusian hit 130 patients six weeks in, with no advertising beyond a website and word of mouth. As of June they are covering overhead, rent, and debt payback, though they are not paying themselves yet. Meanwhile the non-compete case that made the opening possible is still moving. Her former employer appealed the temporary injunction and filed a motion to stay, so Dr. Spears is funding an appellate defense while building a brand new practice from scratch. In this episode: What a non-compete fight really costs, and what physicians considering the legal path should prepare for financially and emotionallyWhy keeping membership prices low was a boundary decision, not only a pricing decisionHow she handles patients wanting care her practice does not offer, and when "no" beats "yes, with limits"The justice and equity case for DPC, and why she is focused on patients who fall through the safety nets rather than on replacing Medicare and MedicaidBoring wins worth celebrating: custom patient ringtones so calls stop landing in personal voicemail, decoding hospital lab orders with CPT and ICD codes, and 12 successful blood draws in five weeksTwo-physician cross coverage, planning the first vacation, and the schedule she rebuilt once her husband started working three days awayKeeping skills sharp with journal club, procedures, and actually reading againWhy she says the more DPC the better, even in her own cityMaryal also shares how Big Trees MD partnered with Calaveras County Health so uninsured patients get same-day help, including one patient who went from panicking about medication access to picking up a prescription within eight hours. If you are weighing a non-compete, pricing your memberships, or wondering whether patients will actually come, this conversation is the honest version. Resources mentioned: Amity Creek Primary Care: amitycreekclinic.com Advocacy with the DPC Coalition: dpcare.org Big Trees MD: bigtreesmd.com Find your starting point at mydpcstory.com, from the free startup checklist to the Physician Owner's Planner built for the business side of your practice. Leave Maryal a voice message at mydpcstory.com/contact. Your question or win could be featured on a future episode. Follow @mydpcstory and please leave a five star review on Apple Podcasts so more physicians find these stories. Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare. Get the DPC Pricing Calculator sponsored by Goodman CPA HERE Get your copy of the Physician Owner's Planner today at mydpcstory.com/library Support the show GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE POD My DPC Story VOICEMAIL! DPC SWAG! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

  8. Jul 26

    Live from DPC Summit New Orleans: Boundaries, Employers, and Succession Planning in Direct Primary Care | Dr. Angela Andrews & Dr. Nicholas Jones

    Recorded LIVE on the floor at the AAFP Co-sponsored DPC Summit in New Orleans, Dr. Angela Andrews of Direct Primary Care of West Michigan and Dr. Nicholas Jones of Clear Health Direct Primary Care in Eugene, Oregon sit down with Dr. Maryal Concepcion for an honest roundtable on what changes between year one and year three of direct primary care practice ownership. Both opened in November 2023. Both came to New Orleans with a list. What they say out loud is what most physicians only think: the workflows you built on day one and never revisited, the boundaries you are usually the first to cross, and the succession question this movement has not solved yet. IN THIS EPISODE Physician owned regional DPC networks, and using them for call coverage, internal locums, and physician funded startup loans instead of banks Why you do not need a nonprofit to do nonprofit work Revisiting the workflows you built when you were solo, and what to automate, eliminate, or document Employers as the next phase of DPC growth, and the arrival of employed DPC positions Boundaries, moral injury, and why the physician is usually the first one to violate the boundary How to handle one star reviews and trolls without losing your weekend Succession planning, and what happens to patients when a DPC physician gets sick or closes Oregon's corporate practice of medicine law, the non compete ban, and what advocacy looks like when you own your practice Getting onto your state chapter committees, and why DPC needs representation at AAFP and state academies Spouses, kids, and the family roles that quietly keep practices running Choosing an EHR you will not have to leave in three years MENTIONED IN THIS EPISODE Dr. Emily Holt, Dr. Esther Khatibi, Dr. Julie Gunther, Dr. Timothy Blain, Dr. Phil Eskew, Dr. Jill Scherer, Dr. Clodagh Ryan, Dr. Neil Douglas, Dr. Hailey Miller, Dr. Amy Tressan, and Shaunna Sanders RESOURCES The Toolkit Magazine, including this year's Battle of the Support Stack and last year's Battle of the EHRs: toolkit.mydpcstory.com The Physician Owner's Planner Limited First Edition Bundle: mydpcstory.com/shop PHYSICIAN OWNER'S PLANNER BUNDLE Fifteen available. Each one includes the printed Physician Owner's Planner in a binder, the digital bundle with our Medicare and Medicare Advantage Open Enrollment Guide, the yellow "Insurance is not healthcare" T-shirt, and a personal website review from Dr. Maryal Concepcion and Nathalia Hyland, head of marketing and strategy at My DPC Story. Limited shirt sizes remain. mydpcstory.com/shop Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare. Get the DPC Pricing Calculator sponsored by Goodman CPA HERE Get your copy of the Physician Owner's Planner today at mydpcstory.com/library Support the show GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD Become A My DPC Story PATREON MEMBER! SPONSOR THE POD My DPC Story VOICEMAIL! DPC SWAG! FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube

    Live from DPC Summit New Orleans: Boundaries, Employers, and Succession Planning in Direct Primary Care | Dr. Angela Andrews & Dr. Nicholas Jones
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About

As the Direct Primary Care and Direct Care models grow, many physicians are providing care to patients in different ways. This podcast is to introduce you to some of those folks and to hear their stories. Go ahead, get a little inspired. Heck, jump in and join the movement! Visit us online at mydpcstory.com and JOIN our PATREON where you can find our EXCLUSIVE PODCAST FEED of extended interview content including updates on former guests!

Information

  • Creator
    Maryal Concepcion, MD
  • Years Active
    2020 - 2026
  • Episodes
    339
  • Rating
    Clean
  • Copyright
    © 2026 My DPC Story
  • Show Website
    My DPC Story

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