If you feel like you spend more time checking boxes than caring for the human in front of you, this conversation will hit home.In this episode, I sit down with Dr. Marissa Fusella, a family medicine physician in Latham, New York, who’s in the early days of launching her Direct Primary Care practice, Fusella Family Medicine. After eight years in employed medicine, she felt the growing tension between loving her patients and feeling trapped in a system that doesn’t.

We talk candidly about what it’s like to leave a “stable” job, start a DPC with just one enrolled patient, and keep going when growth is slower than the Instagram highlight reels. Marissa shares how community, courage, and lots of imperfect action are shaping her path back to patient-centered care.

Who This Is For

• Physicians buried in paperwork who want to practice real, relational medicine again

• DPC‑curious doctors who want the unfiltered version of what the early months look like

• New DPC owners who need reassurance that slow, steady growth is normal

  
  

In This Episode, You’ll Learn:

• Why you should start before you feel fully ready

• How “done is better than perfect” looks in a real DPC launch

• Why community may be the most important growth strategy you have

• How simple meet‑and‑greets can educate a community and attract the right patients

• Why building slowly does not mean you’re building wrong

  
  

If this episode encourages you, share it with a physician who might be quietly questioning their current path. It might be the permission they need to take their next step.

Channel Resources

🌐 Website: https://fusellafamilymedicine.com

📘 Facebook: Fusella Family Medicine

📸 Instagram: Fusella Family Medicine

And if you're exploring your own DPC launch, don’t forget to check out the Breakeven Calculator for New DPC Practices to help you gain clarity and confidence around your numbers before you leap.

Breakeven Calculator for New DPC Practices: https://harmonyopshealth.com/launch

In this episode, I share the 10 fears I hear over and over from physicians who are thinking about Direct Primary Care but feel unsure about leaving employed medicine. We talk about realistic patient follow‑through, contracts, finances, timing, and how to know if you’re actually ready to move.

You’ll see that you’re not alone, you’re not the only one thinking about this, and there is a clear path forward.

In this episode, you’ll learn:

• What usually happens when you leave an employed practice (and what % of patients typically follow)

• How to explain a monthly membership fee to insured patients without feeling salesy

• When to start telling patients and colleagues you’re leaving, and how non‑compete / non‑solicit clauses affect that

• How to think about runway, side gigs, and the financial risk of leaving too early vs too late

• Simple ways to start talking about DPC so meet‑and‑greets feel less awkward

• How to build interest and a waitlist before you open, instead of launching to an empty panel

• The mindset and family / financial questions to ask when deciding if you’re ready to leave employed medicine

• Why you’re absolutely not the only one considering DPC, and how many practices are already thriving

• The Practice Momentum Flywheel: reach → resonate → respond → retain, and how that builds your practice over time

  
  

About the Independent Practice Path

Many physicians don’t need more information about DPC. They need a clear path and a small group to walk it with them.

The Independent Practice Path is an 8‑week small‑cohort program for physicians who want to move from “thinking about it” to actively preparing to open an independent direct care practice.

Over eight weeks, you will:

• Clarify your practice model so you know exactly what you’re building

• Practice how to talk about DPC and your membership in a way that feels natural

• Begin building interest and a waitlist before you open

• Put the basic systems in place that support your future practice

  
  

How to take the next step

1. Start the Readiness Reflection. Complete the short Readiness Reflection on the Independent Practice Path website to see where you are in the process and what your next step should be.

   Link: https://ipp.harmonyopshealth.com/

2. Join the next cohort. The next Independent Practice Path cohort starts on March 24. Enrollment closes once we begin, so if you want to be part of this round, complete the Readiness Reflection and register as soon as you’re ready.

3. Ask your questions. If you’re unsure if this is a fit, complete the Readiness Reflection and then email me using the address listed on that page.

   
   

Your future patients need you practicing medicine the way you imagined when you wrote your personal statement. If you’ve been thinking about DPC for a long time, this is your invitation to start taking concrete steps toward your own independent practice.
Email me at ⁠anne@crescendooperations.com⁠ and let’s figure out if IPP is the right fit for you.

What if growth didn’t have to cost you your emotional bandwidth?

In this episode of the DPC Life Podcast, I’m joined by Dr. Noemi Adame, a pediatric Direct Primary Care physician in rural Indiana who has deliberately built systems to protect her time, energy, and longevity.

After years in employed and academic medicine, she chose DPC for more autonomy, but then realized that “freedom” without systems still felt overwhelming.

We get into gender bias, invisible labor, pricing discomfort, and how automation became the unexpected tool that transformed her practice.

What You’ll Learn

• Why female physicians often carry more invisible labor and how that accelerates burnout

• How automation can act as a boundary, not a barrier

• The specific systems that cut inquiries by 80% while increasing enrollment

• How to use pre-education marketing to filter and qualify leads

• Why self-scheduling slashes back-and-forth messaging and mental load

  
  

Key Moments

• The data showing female physicians receive 25% more portal messages

• The realization that the problem wasn’t time, it was emotional bandwidth

• The shift from answering every call manually to automated meet-and-greet funnels

• Panel growth up 20% while message volume stayed flat

• 80% fewer inquiries but 30% higher enrollment

• An honest conversation about pricing discomfort and guilt

  
  

About the Guest

Dr. Noemi Adame is a pediatric Direct Primary Care physician in rural Indiana. She founded her DPC practice after years in academic and employed medicine to create a more sustainable, relationship-centered way to care for families.

She is also the founder of DPC Women’s Café and host of an annual DPC Women’s Retreat, where she focuses on physician wellbeing, autonomy, and burnout-proofing practices through intentional systems and community.

Resources & Links

• DPC Women’s Café – Weekly virtual gathering for female DPC physicians (hosted by Dr. Noemi Adame)

• DPC Women’s Retreat – Culver, Indiana | October 15–18 | CME included. Physician wellbeing and burnout-proofing.

• SigmaMD – EMR platform mentioned in this episode: https://www.sigmamd.com

• Harmony Ops – CRM platform referenced: hhttps://24-7-bot.harmonyopsfordpc.com/dpc

Ready to See How DPC Really Stacks Up for Your Patients?

I created a DPC Patient Savings Calculator that lets patients compare what they might spend on DPC + a health share versus traditional insurance, using their own numbers.

When you click the link in the show notes, you’ll get:

1. Calculator options for PhysiciansYou’ll see a free, generic calculator you can share with patients right away.

2. You’ll also see how to:

3. • Get a branded version of the calculator for your own practice

   • Have it hosted for you with lead capture built in

   • Plug it into my DPC‑specific CRM and nurture sequence, so every calculation becomes a tracked lead

     
     

The calculator is one of the tools inside my Independent Practice Path + CRM system, built so you can open or grow your practice with patients already lined up, not just hoping inquiries trickle in.

Click here: https://dpcsavings.com/calculator-physicians

Curious about the Independent Practice Path? Email me at anne@crescendooperations.com and let’s figure out if IPP is the right fit for you.

Start with the free generic version. The rest of the system is waiting quietly inside.

This episode of the DPC Life Podcast is streaming now on Spotify and all major platforms. Let’s build practices that protect us, not consume us.