Marina & Phil's practice updates

Should I Increase My Prices?

In this podcast episode, Phil and Marina discuss one of the most uncomfortable but important topics in Direct Primary Care: raising membership prices. They challenge the common advice that physicians should avoid price increases and simply see more patients, arguing that this mindset undermines the core DPC goal of providing high-quality, relationship-based care. Phil and Marina explain that rising costs—including staffing, rent, supplies, and inflation—make periodic price adjustments necessary for maintaining a sustainable practice. They also address the emotional barriers physicians face, including fears of losing patients, disappointing families, or appearing profit-driven, while sharing examples of practices that successfully increased prices with little to no patient attrition. The conversation focuses on practical strategies for implementing price increases, including annual inflation-based adjustments, larger corrections when fees no longer reflect the value provided, changes to enrollment fees or family maximums, and passing through credit card processing fees. Phil and Marina emphasize that physicians should regularly evaluate whether their pricing supports long-term sustainability rather than simply covering short-term expenses. They also encourage practices to communicate the full scope of services they provide—including specialized evaluations, integrative medicine offerings, and other value-added services—when discussing fee changes. Their central message is that a financially healthy practice benefits both physicians and patients, and that raising prices should be viewed as a normal and necessary part of responsible DPC practice management. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com [https://dpcpediatricians.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Dealing with Entitled Patients

In this episode Phil and Marina discuss the challenge of dealing with entitled or difficult patients in a Direct Primary Care pediatric practice. Using recent real-world examples, they explore how unrealistic expectations, manipulative behavior, and misunderstandings can create emotional and operational strain for physicians. The conversation emphasizes the importance of maintaining clear communication, setting firm boundaries, trusting your instincts when interactions feel problematic, and recognizing that not every patient is the right fit for your practice. They also highlight the value of using difficult encounters as opportunities to refine processes and messaging while protecting both physician well-being and the culture of the practice. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com [https://dpcpediatricians.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

How to Plan for Summertime Growth

In this episode of DPC Pediatricians, Phil and Marina discuss how DPC practices can use the slower summer season as an opportunity for growth and innovation. Phil shares his idea for an ADHD “tune-up” program focused on improving sleep, nutrition, exercise, routines, and school readiness before the academic year begins. They explain how DPC physicians have the flexibility to create specialized programs and provide more personalized care than traditional practices. The episode also focuses on physician sustainability and creativity within the DPC model. Marina describes a potential summer mental health program for parents and children centered on emotional wellness and family involvement. Throughout the conversation, Phil and Marina encourage physicians to use slower seasons to recharge, explore new interests, strengthen patient relationships, and build a more sustainable and fulfilling practice. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com [https://dpcpediatricians.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Marina & Phil's practice updates

Episode Summary: This episode provides a detailed update from Phil and Marina as they reflect on the current state of their direct primary care pediatric practices. They walk through what it looks like to approach and reach patient capacity, and the operational and emotional shifts that come with that milestone. They share practical insights into how growth impacts day-to-day workflows, patient access, and key decision-making. A significant portion of the conversation focuses on hiring—one of the most complex aspects of scaling a DPC practice. They discuss considerations around bringing on additional physicians or team members, structuring compensation in a sustainable way, and ensuring alignment with the DPC model. The discussion highlights the importance of maintaining a strong cultural and philosophical fit as practices expand. They also explore the financial and operational implications of growth, including balancing increasing patient demand with preserving the personalized, relationship-based care that defines DPC. The episode offers a candid look at the tradeoffs involved in scaling, along with practical insights for navigating this next phase of practice development. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com [https://dpcpediatricians.substack.com?utm_medium=podcast&utm_campaign=CTA_1]

Our favorite AI scribes and how to use them

In this episode, Phil and Marina explore how AI scribes are transforming everyday pediatric practice. What once required hiring and managing a human scribe can now be handled by tools that integrate directly into the clinical workflow. They share their experiences with different platforms and emphasize that there’s no one-size-fits-all solution—getting the most out of these tools requires some customization and experimentation. A key benefit is the ability to shift attention back to patients, with less time spent on the computer and more meaningful interaction during visits. They also discuss the importance of reviewing AI-generated notes for accuracy, along with the relatively low cost and accessibility compared to traditional scribes—especially for DPC and independent practices. Overall, AI scribes are quickly becoming a practical, patient-centered tool for improving efficiency while maintaining high-quality care. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com [https://dpcpediatricians.substack.com?utm_medium=podcast&utm_campaign=CTA_1]