Why is the direct primary care (DPC) model gaining so much popularity? And what does it actually take to scale a direct primary care practice - from a single clinic to an 11-location organization with nearly 30 providers?
Dr. Kyle Rickner, co-founder and chairman of Primary Health Partners, joins Jakub Grajcar to share the full story. From the decision to leave the fee-for-service world, to the very real operational challenges of multi-site growth, to what it takes to build a practice genuinely centered on patients instead of billing codes.
We talk about:
๐ Dr. Rickner's #1 tip for growing a sustainable practice - on the importance of planning
๐ฅ The three core tenets of direct primary care
๐ฅ "Moral injury" vs. burnout - why the volume-based model doesn't just exhaust physicians, it puts them in conflict with their own oath
๐ค How Primary Health Partners went from two doctors to 11 locations - and the business partners who made it possible
๐ The EOS visionary/integrator dynamic for founders
โ ๏ธ Why the third location is always the hardest - and the stacking complexity that breaks practices trying to grow
๐งโ๐ผ What to look for in a great operator - and why doctors neglect to ask for this kind of help
๐ค Guest: Kyle Rickner, MD
LinkedIn:
https://www.linkedin.com/in/kyle-rickner-md-353986111/Organization - Primary Health Partners:
https://primary-healthpartners.com/๐ Books mentioned:
Who Not How - Dan Sullivan
Traction (EOS) - Gino Wickman
๐ฅ See how Talkie.ai works - AI medical receptionist demo:
https://www.youtube.com/watch?v=oOiJ3ITTrLY&list=PLLjcCBHYN2KoBqm-Dx-8lIwWLuU-CHXSgTimestamps:
0:00 Teaser: how fee-for-service medicine causes moral injury โ and why no DPC doctor ever wants to go back
2:24 Scaling Practice Management intro & meet Dr. Kyle Rickner, Co-Founder and Chairman at Primary Health Partners
3:11 Icebreaker: Dr. Rickner's favorite destination and a Cabo ATV-and-whale-watching adventure
7:12 #1 tip for growing a practice: plan ahead, mitigate risk, and reduce dependence on third-party payers
10:19 The story of a practice that insurance companies literally forced to shut down
12:26 What is direct primary care โ and what are its three defining tenets?
14:53 24/7 physician availability in DPC: how it actually works without burning out the doctor
16:58 What physicians love about DPC: escaping the volume treadmill and reclaiming time with patients
20:04 The honest conversation about transitioning to DPC โ sacrifice, risk, and the promise of fulfillment
22:33 Moral injury in medicine: how fee-for-service quietly harms both physicians and patients
27:36 How Primary Health Partners grew to 11 locations โ and why they're a unicorn in the DPC world
30:04 "Who, not how": bringing in business expertise and funding growth through clinical research revenue
33:06 The EOS framework โ visionary vs. integrator โ and how it shaped their founding partnership
37:16 Recruiting physicians into DPC and the multi-site operational complexity that kicks in at location #3
40:17 Why they intentionally paused expansion to close operational gaps before the next growth phase
43:40 Why doctors are often the worst at asking for help โ and what the ideal ops person looks like
45:59 Where to follow Dr. Rickner and Primary Health Partners