The Lonely Side of DPC: Finding Your Focus Five

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Entrepreneurship can be lonely. Being a physician can be lonely, too. In direct primary care, we sometimes get the double whammy.

We talk with patients all day, support our staff, and make complex decisions. But being around people doesn’t necessarily mean we feel connected. When you own the practice, you carry concerns that nobody sees and drains your ability to connect outside of work.

I appreciate the freedom DPC gives us. Still, running a practice can take over your attention. There’s always another patient message, expense, or problem to solve. Somewhere in there, we forget our own advice. As I often tell patients, take care of yourself so you can take care of others.

Sometimes I need that reminder myself.

Something I share with patients and remind myself on the daily is The Focus Five: Family, Finances, Fitness, Food, and Friends. I use it to bring attention back to parts of life that are easy to neglect when a problem occupies too much space in our heads. Setting a small goal in each area gives us something to work toward outside the office.  I particularly use check boxes on a sheet of paper and mark each one by the end of the day.  Simple, effective, and somehow just makes me feel better overall.   

Here’s what that might look like for a DPC physician:

  1. Family. Make a point of reaching out to someone. It could be a sibling, a cousin, or a distant relative you haven’t spoken with in years. A quick “Hello, I was thinking about you” is enough to start. Call on the drive home or put a family dinner on the calendar. You don’t need to wait for a holiday.
  2. Finances. We spend plenty of time thinking about money as practice owners, but how much time do we spend learning about it? Attend an investing seminar, meet with a financial planner, or have lunch with another DPC owner and compare notes. Set a goal to understand something you’ve been putting off.
  3. Fitness. Join a pickleball club, kickball team, or adult soccer league. Take a regular class at the gym and get to know the people there. Leave yourself time to enjoy the amenities, too, whether that’s a sauna or a cold plunge that suits you. Sign up for a 3K, 5K, or half marathon, or set a realistic fitness goal with a date attached. Having somewhere to show up (and people who expect to see you) can give the week a little more structure.
  4. Food. Plan a few healthy meals, do some meal prep, and bring an extra portion to share at the office. Schedule lunch with a colleague or dinner with another local physician. We all have to eat. It’s an easy opportunity to sit down with someone and have a conversation beyond the usual office questions.
  5. Friends. Bring your old and new friends together. Host a barbecue, organize a monthly dinner, or send an actual invitation to that group chat that keeps saying, “We should get together.” Celebrate small wins. One of my friends hosts “Celebrate Life” dinner parties, and they’re always fun. I like that idea: being together is reason enough to celebrate.

This is part of what I call the Focus Shift Protocol: pause, notice when you’re going around in circles with a problem, and choose one small action you can take.

I’ve noticed that one connection often leads to another. You meet someone, get invited somewhere, make another plan and so on and so forth.  It always seems to compound. Over time, the week can start to feel a little less lonely.

At the end of the day, I ask myself: Did I check the boxes in all five today?

I want my practice to do well. I also want people to call, things to look forward to, and a life I enjoy when I leave the office. I suspect a lot of us in DPC want the same.

Give it a try, hope this helps, and share if it does…

About Joseph Rotella, MD, DC

Joseph Rotella, MD, DC, is a board-certified family physician practicing in Scottsdale, Arizona. He opened an independent insurance-based medical practice in 2008, eventually growing it into a five-provider practice serving more than 25,000 patients. After experiencing the mounting administrative barriers of traditional healthcare firsthand, he transitioned his practice to Direct Primary Care in 2021. Dr. Rotella writes about DPC, physician independence, patient education, and practical ways to build a more personal and accessible healthcare system. He is also the founder of PENCIL Health™, an evidence-based patient education platform built around clear written care plans, and the author of The Illusion of Care: Why Patients Leave the Doctor’s Office Confused and the Clinical Operating System That Fixes It.