New Year’s Resolutions for the DPC Physician
Another January. Another chance to pretend we’ll become entirely different people just because the calendar flipped.
Most resolutions are dead by February. We all know this. And yet here we are, ready to commit to gym memberships we’ll abandon and diets we’ll cheat on by Martin Luther King Day.
But maybe—just maybe—there are a few resolutions worth keeping for those of us in Direct Primary Care, or for those still peering over the fence wondering if the grass really is greener.
Fair warning: this list might sting a little.
Good.
Get Out of the Echo Chamber
Social media DPC groups can feel like support groups. Everyone agrees. Everyone validates. Everyone tells you how brave and brilliant you are for choosing this path.
It’s also a fantastic way to stop growing.
This year, seek out voices that challenge you. Read the critics. Engage with the skeptics. Talk to the physician who thinks DPC is elitist nonsense, or the health policy wonk who questions whether it can scale. You don’t have to agree with them. But if you can’t articulate why you disagree—with nuance and without getting defensive—you might be operating on faith rather than evidence.
Echo chambers feel warm. Growth feels uncomfortable. Choose discomfort once in a while.
Talk to Someone You Instinctively Disagree With
Related, but different. This one’s personal.
Find a colleague whose approach makes you bristle. The doc who charges twice what you do. The one who charges half. The physician who still takes insurance and thinks you’re naive. The hospital administrator who sees you as a threat.
And while you’re at it, grab coffee with someone whose politics make you twitch. The conservative who thinks you’re a bleeding heart. The socialist who thinks you’re a capitalist pig. The libertarian. The progressive. Whoever sits on the opposite end of your particular spectrum.
Here’s a secret: they might actually have a good idea. Not about everything. But about something. And you’ll never find out if you only talk to people who already agree with you.
Buy them coffee. Ask questions. Listen more than you talk.
You’ll either sharpen your own thinking or discover you were wrong about something. Both are wins.
Say “No” More Often
If you’re already in DPC, you probably left fee-for-service because you were drowning. Congratulations—you built a life raft. Now stop trying to cram 40 people onto it.
Say no to the patient who wants concierge-level access at budget prices without respecting boundaries. Say no to the “quick question” that’s really a 30-minute diagnostic puzzle. Say no to the committee, the board seat, the speaking gig that flatters your ego but drains your tank.
Your practice exists to serve your patients well. You can’t do that if you’ve run yourself dry serving everyone else’s requests.
For those still in traditional practice and considering DPC: this is the skill to develop now. The inability to say no is what buried you in the first place. DPC doesn’t fix that automatically. It just gives you permission to practice it.
Stop Performing Wellness
You don’t need a meditation app, a gratitude journal, and a morning routine optimized by some productivity guru. You need margin. You need a life.
Margin in your schedule. Margin in your patient panel. Margin in your day.
If your DPC practice has you just as burned out as your old job—different stress, same exhaustion—something’s broken. Either your panel’s too big, your boundaries are too porous, or you’ve rebuilt the hamster wheel with a nicer cage.
Audit honestly. Adjust accordingly. And stop posting about self-care while you’re running yourself into the ground.
Live in the moment once in a while. Have a donut. Let loose. The optimized morning routine can wait.
Remember Why You Did This
Somewhere beneath the business plans and membership agreements and EHR clicks, there’s a reason you chose medicine. And if you chose DPC, there’s a reason for that too.
Was it the relationships? The autonomy? The chance to practice medicine without asking permission from an insurance company?
Write it down. Stick it somewhere you’ll see it when February gets hard and some patient’s credit card declines and you’re wondering if this whole thing was a terrible mistake.
It wasn’t. But you’ll need reminding.
For Those Still on the Fence
If you’ve spent another year researching, reading, attending conferences, joining Facebook groups, and “preparing”—I’m going to be blunt: get your shit together and make a decision.
You will never feel ready. The timing will never be perfect. Your spouse will never be fully on board. Your financial cushion will never feel thick enough. At some point, preparation becomes procrastination in a responsible-looking mask. And procrastination becomes a slow surrender to a career that’s grinding you into dust.
As the classic rock band Trooper put it: if you don’t like what you got, why don’t you change it? If your world is all screwed up, rearrange it. (Image above is from the video)
Nobody’s going to help you. You’ve just got to stand up alone. Dig in your heels and see how it feels to raise a little hell of your own.
Set a deadline. Not a vague someday. An actual date on an actual calendar. Tell someone who’ll hold you to it.
Then either jump or admit this isn’t your path and stop tormenting yourself. Both are valid choices. Perpetual fence-sitting is not. It’s just slow-motion misery with extra steps.
Fish or cut bait. Your future self—and your patients—deserve someone fully committed to wherever they are.
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Happy New Year. May your resolutions outlast January, your boundaries stay intact, and your patients keep reminding you why this work matters.
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