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Being the first direct primary care clinic in your city sounds exciting until you realize you also have to teach your entire community what DPC is and why a monthly membership can beat insurance-based primary care. We sit down with Stephanie Miles, nurse practitioner and owner of Smith’s Primary Care and Wellness in Winston-Salem, North Carolina, to share what it really took to grow a thriving cash-based practice with a clear patient cap and a plan to scale.

Stephanie walks us through her story from nine years in a Level 1 trauma ER to becoming an adult primary care NP who wanted continuity, outcomes, and relationships. We talk about why she launched an IV hydration business first, how that experience prepared her for practice ownership, and what changed when she discovered direct primary care while researching a traditional clinic model. If you’re searching “how to start a DPC practice” or “direct primary care for nurse practitioners,” you’ll hear practical, specific decisions you can copy.

We also dig into the day-to-day mechanics that make membership medicine work: how she set pricing, what she includes for members, when she charges small supply fees for procedures, and why she offers a one-time visit option for non-members. Stephanie shares what’s actually driving growth (hint: word of mouth and Google), what marketing spend didn’t pay off, and how she keeps operations simple with an all-in-one EMR like Atlas MD. On the business side, we cover collaborating physician agreements, lowering overhead through smart real estate moves, hiring her first medical assistant, and the tough contractor lesson that taught her to keep personal and business separate.

If you found this helpful, subscribe, share it with a clinician who’s considering direct primary care, and leave a review so more people can find the show. What’s the biggest barrier between you and opening your own clinic?

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Your logo is not what makes patients trust you. What they trust is the position you hold in their mind, and whether the real-life experience backs it up. We talk through how to choose a clear positioning statement for a direct primary care clinic, how a name can instantly signal belonging, and why “brand assets” matter less than the feeling patients get when they interact with you.

From there, we get practical about digital presence and local SEO. We cover how to set up a Google Business Profile, why you should never let a staff member own key accounts under their personal email, and how consistent naming conventions across your website, directories, and social media can improve discoverability. If you want patients to find your DPC clinic, the boring details matter, and we spell out which ones to lock down first.

We also dig into operations: designing a clinic space that reflects DPC values, choosing an EHR based on strategy (not hype), and building a clean tech stack that reduces manual work. Then we move into payroll, staffing, and the money side that too many clinicians avoid, including break-even math, runway, reliable bookkeeping, and why looking at your bank balance is not a financial plan. Finally, we explore patient acquisition strategies that actually work, employer groups, onboarding tone, and how Claude AI can help you create a 90-day marketing plan, draft SOPs, and research competitors fast.

Before you go, Dan shares a free resource: the DPC Pre-Launch Playbook will be available as a straight download on the dpcbookkeeper.com resources page. If this helps you, subscribe, share it with a DPC owner friend, and leave a review so more clinics can find it.

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Most people start a direct primary care practice because they want better medicine and more time with patients, but the part that quietly decides whether the clinic survives is the financial foundation. I sit down with Dan Luna, a bookkeeper who works inside the DPC world, to talk through the unglamorous basics that keep a membership-based clinic alive: planning for the income gap, building a simple cash-flow buffer, and understanding what your fixed costs really are when you finally open the doors.

We also zoom out to the business setup decisions that confuse almost every first-time owner. Dan explains how to think about an LLC versus an S-Corp election, why liability and tax treatment drive the choice, and when it’s smart to bring in a CPA so your accounting system is built correctly from day one. Then we get tactical about bookkeeping, what it is and what it isn’t, and the real-world signal that it’s time to stop doing it yourself. His “queen bee” analogy is a reset for overwhelmed clinic owners: your highest-value job is caring for patients and growing a sustainable panel, not reconciling transactions at night.

Finally, we talk tools and pricing. QuickBooks is still everywhere, but AI accounting software is changing the landscape, and the right support matters more than the logo on your ledger. We also tackle the fear behind undercharging in direct primary care, how pricing connects to burnout, and why charging enough to fund support and systems is part of delivering great care. Subscribe for the next part of the series, share this with a DPC owner who needs a financial reset, and leave a review with your biggest question about pricing or startup cash flow.

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If you have questions, comments or want to be part of our community, follow us on Facebook at The DPC NP!