Your DPC Practice is Filled. Hooray! But is that all there is?

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“The lies I told myself were ‘Once we win a Super Bowl, I’ll be happy’,” McVay said. “My identity was so tied up into winning or losing games, and that’s where I felt my self-worth lay.”

Los Angeles Rams head coach Sean McVay

Starting a Direct Primary Care Practice is simple but not easy. It’s a struggle with a lot of suffering. That’s both a good and a bad thing. Bad because you have to grind, and it is emotionally taxing. Good because suffering is part of life and is what makes success so sweet.

The risk is that your self-worth gets caught up in this. Getting to the top of the mountain is awesome, but it is not all that you are, and it can be a trap.

Why?

Let’s say you finally get there. Your practice is humming. You have been filled for a while. And you start to lose that drive. You get complacent or even a little depressed. And you feel alone.

It happened to me. I got a little bored. Don’t get me wrong, I loved the freedom and agency in my career. I loved working with my medical assistant and my wife, who worked as my practice manager. And I loved my patients. But I started to think, “Is this all there is?

I started to want more. I was on the hedonic treadmill. Do I add more patients? Do I expand by creating more clinics?

It was unsettling.

I don’t think I am alone in this. I bet there are many of you who struggle after succeeding in this DPC journey. Just know that you are not alone.

What helped me was finding new ways to get better at medicine. That’s how I started. I wanted to be great at my craft. I started to dig deep and read more about certain medical topics. The free time between patients became rabbit-holing down about Lyme disease, peptides, hormones, etc.

I also started to really try to help other DPC docs. I wrote three books on the subject and pushed to create the DPC Alliance.

And I was there for my family at home, even though I was an older doc and my kids were grown. I wish I could’ve been there more when I was in the system, but it didn’t allow for that.

Life slowly got better. It wasn’t perfect, but it definitely helped with the “success” letdown.

You may feel the same weird letdown after filling your DPC practice. It’s normal. I recently listened to a podcast with Arthur C. Brooks about happiness. At one point, he talked about how what you do in your leisure time predicts how happy you will be. The three things were:

  1. Fostering deep relationships with others.
  2. Learning something regularly that you don’t HAVE to.
  3. Exploring your relationship with the metaphysical or spiritual world.

I can say that I did a lot of these things and still do. One issue that DPC docs have is being alone without peers to hang out with. I do think that is a MAJOR problem. What helped me was getting together with the same group of DPC docs for ten years. We are active on Slack, and we always hang out together at conferences. We have even vacationed together.

So, here is my question: are you having a slight letdown after finding success in your DPC Practice?

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About Douglas Farrago, MD

Dr. Farrago is a retired family physician based in Forest, Virginia. Since 2021, he has run DPCnews.com, a leading resource for the Direct Primary Care (DPC) movement. He is the author of three best-selling books on Direct Primary Care: The Official Guide to Starting Your Own Direct Primary Care Practice The Direct Primary Care Doctor’s Daily Motivational Journal Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) In 2016, Dr. Farrago conceived the idea for the Direct Primary Care Alliance and co-founded the organization alongside other pioneering DPC physicians. He is widely recognized as a leading expert in the DPC model and frequently lectures to medical students, residents, and practicing physicians on how to successfully start and run their own DPC practices. Dr. Farrago sold his Direct Primary Care practice in October 2020.