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If you own a direct primary care or concierge practice, you may be the physician, the front desk, the marketer, the bookkeeper, and the person who orders supplies, and maybe you're still picking up shifts elsewhere while the practice grows. In this episode of The Profit Loop, Alisa Conner starts with a question she asks almost every practice she works with, which is what you're actually building, and a one-sentence exercise that turns it into a 90-day goal. She walks through what doing everything really costs you beyond money, from burnout and lost time with family to team members who leave and members who notice you're running on empty. You'll also hear a physician's story about dreading snow days, and Alisa's own frustrating experience waiting on a follow-up from her eye doctor. You'll learn: The 2 phases of growth most DPC and concierge practices move through The one-sentence exercise for setting your practice's next 90-day goal 3 signs you've become the bottleneck: decisions, relationships, and processes that all run through you Why hiring without defined roles, automating before you have a process, working harder, and capping your panel tend to backfire A 3-step plan: a 2-week role and time audit, handing off your first role before you're full, and deciding now how you'll grow at capacity The goal isn't to build a practice that doesn't need you. The goal is to build a practice that doesn't need you for everything. Book a Growth Review Call here. Read the blog post here. Catch last week's conversation with Dr. Brian Juan, "From Burnout To Building His Own Practice"

What does it really take to leave employed medicine and build your own practice? Dr. Brian Juan, MD, FAAFP, knows firsthand. A former touring musician who started medical school after his dueling piano gig was replaced by a mechanical bull, he spent 9 years in corporate medicine before opening Metronome Family Medicine, a direct primary care practice in Longmont, Colorado, on June 1, 2026. In this episode of The Profit Loop, Alisa Conner talks with Dr. Juan about the burnout that pushed him to make the leap, the pro forma (and the spouse) he had to convince first, and the break-even math behind his goal of 200 to 250 members. He explains how he chose his ideal patient, midlife adults and especially women navigating perimenopause and menopause, and how that choice shaped everything from his equipment to his content. You'll hear how he found his first members without soliciting his old panel, why only about 2% of his former patients followed him, and how 2 videos and a blog every week put him in the top local search results and even in ChatGPT answers. Dr. Juan also shares why he doesn't offer 24-hour access, the Wednesday morning hike that was part of the deal, the systems he's still building so nothing slips through the cracks, and why he's already planning for a second physician less than 5 months after opening. He closes with advice every physician considering DPC or concierge medicine should hear: you finally have permission to fail. Connect with Dr. Juan: Website Instagram Facebook LinkedIn YouTube Physicians curious about DPC can call or text the practice at (720) 856-4058 Stream his music on Spotify and Apple Music Book a Growth Review Call Here Read the blog post

You left traditional medicine and opened your concierge or direct primary care practice, and now patients aren't joining as fast as you hoped. If you're lowering your price, adding perks, working longer hours, or asking everyone you know for referrals, you're not alone, and you may be rebuilding the very life you tried to escape. In this episode of The Profit Loop, Alisa Conner brings back the idea that started this show in 2017, "Feed You, Feed Your Business." She explains the Walmart-or-Nordstrom choice every practice makes when it discounts, what patients really mean when they say "it's too expensive," and why more features can overwhelm people instead of convincing them. You'll hear her personal stories about a pelvic floor specialist who never revisited the timeline, the endocrinologist her family left and then rejoined, and her mom waiting for the next gym promotion. She also walks through the math on how a $50 discount on 100 members costs $60,000 a year and requires about 34 new members to replace. Alisa closes with a 3-step plan: design your business around the life you want, set a price you'll stick with, and tie that price to what it means for your patients. Book a Growth Review Call here. Read the blog post here.

You did the hard part. You opened your direct primary care or concierge practice, bought the equipment, launched the website, and maybe did some marketing. A few friends and former coworkers joined, and then it got quiet. In this episode of The Profit Loop, Alisa Conner explains why opening the practice isn't the real work, filling it is. She covers the questions patients ask themselves before paying outside their insurance, why "we need more leads" usually misses the mark, and 5 reasons your marketing hasn't worked yet: unanswered foundational questions, messaging that's about you instead of them, trying to be everywhere, no follow-up system, and trying to be everything to everyone. You'll also hear what growing practices do differently, including a pelvic floor specialist whose business name makes referrals almost effortless, and what panic decisions like lowering your price are really costing you. Alisa closes with a 3-step plan for your next 100 members: define your best members in 1 sentence, rewrite your offer from the patient's point of view, and choose 2 acquisition channels to focus on for 30 days. Book a Growth Review Call Here. Read the blog post here.

If you run a concierge or direct primary care practice, you've probably thought a lot about what to charge and what to include. What you may not have asked is what your patients are actually paying extra for. In this episode of The Profit Loop, Alisa Conner shares conversations with an endocrinologist who moved to a subscription model 3 years ago and a direct primary care owner who has run one for 10 years. Both had just added a PA, and neither could fill their schedule because both believed patients only pay to see the physician. One was about to discount his membership for patients who saw the PA. You'll learn: Why the belief that patients only pay for the doctor stalls growth and keeps physicians overloaded What patients actually value in a membership, from access and continuity to care under one roof The 3 most common reasons a PA's schedule stays empty How this belief can make a practice harder to sell when it's time to retire A 3-step action plan to test your assumptions, learn what your members value, and transfer trust to the rest of your care team Book a Growth Review Call Here. Read the blog post here. Watch on YouTube here.

What happens when demand isn't the problem anymore? At a recent medical conference, Alisa Conner met practice after practice with more patients than they could handle: physicians who can't take vacations, teams staying late, authorizations piling up, and a practice running 4 EHR systems that don't talk to each other. In this episode, Alisa explains why the usual fixes, like hiring, adding a PA, extending hours, or buying new software, only work for a little while, and why the real issue is usually processes that live in someone's head or no longer fit the size of the practice. She walks through what happens when a process built for 2 physicians has to carry 14, what it's really costing physicians and their teams beyond dollars, and how independent practices can build their own playbook without giving up their autonomy. You'll leave with a 3-step action plan. Not sure where to start? Book your Growth Review Call here.

If your calendar isn't full, the instinct is always to spend more on marketing. This week, Alisa Conner makes the case that the real problem for most independent ophthalmology practices isn't a shortage of leads, it's a patient journey full of unmanaged handoffs. She walks through where referrals fall apart, what most practices try that quietly fails, what larger competitors do differently, and the practice math on what referral leakage is really costing you per surgeon, per year. Then she closes with a 3-step action plan you can start today. Book a free Growth Review call here. Read the blog post here.

According to a March 2026 Veradigm survey, 3 out of 4 independent practice owners can't point to exactly where their revenue is leaking. In this episode, Alisa Conner explains why that's not a data problem; it's a visibility problem, walks through a real scheduling example most practices never catch, and lays out the 3-step plan to build the kind of dashboard visibility that private equity groups already have. This week we dive into: The 24% visibility statistic and what it means for your practice Why separate department reports never add up to one picture The referral, billing, and marketing examples of where visibility breaks down A personal customer-experience story on where even big organizations still have gaps Practice math: the cost of a scheduling gap you're not currently tracking 3-step action plan: pick 5 metrics, assign an owner, review monthly Grab the free Referral Loss Worksheet and book a 20-minute Practice Triage Call using the links below. Practice Triage Call Referral Loss Worksheet

Most independent practices treat referral partnerships as relationships to maintain rather than processes to build. That gap is exactly what private equity organizations exploit. In this episode, Alisa Conner breaks down what keeps referred patients from becoming scheduled patients, runs the practice math across 3 specialties, and lays out a 3-step plan to start recovering that revenue without spending another dollar on marketing. Book your Practice Triage Call: https://docs.alisaconner.com/widget/bookings/medical-triage-call Grab the free Referral Loss Worksheet: https://alisaconner.com/worksheet/

A 15-year patient, one warm referral away from leaving. Not because she was unhappy, but because her dentist retired and nobody worked to keep the relationship warm through the transition. In this episode, Alisa breaks down what happens to patients when a physician leaves the practice, the two communication mistakes almost every practice makes during a transition, and the practice math across four specialties: orthopedics, ophthalmology, dental, and functional medicine, showing exactly what's financially at stake. She closes with a three-step plan to protect your patient panel before, during, and after any physician transition. In this episode: Why patient loyalty is rarely just about the physician alone The two communication mistakes that quietly push patients to competitors The full practice math across four specialties, both annual and lifetime value A three-step action plan you can start building this week Resources: Book your 20-minute Triage Call Watch the YouTube Video Read the blog

Nearly every practice Alisa talks to already suspects their technology doesn't talk to itself; they just assumed another subscription would fix it. In this episode, Alisa Conner breaks down why the technology leak is almost never a software problem, using a real example of a referral getting lost between two systems, the math behind why that gap can run over $1.1 million per physician, a 2024 physician time-use study, and a look at where online scheduling quietly loses the most patients. She closes with the three-step audit you can run on your own practice this week, no new software required. Book your 20-minute Practice Triage Call here.

If your longest-tenured front desk person, billing specialist, or medical assistant gave notice tomorrow, what would that do to your practice? In this episode, I break down what I call the knowledge gap, one of the most expensive and least-discussed leaks in specialty practices. It's not a hiring problem. It's what happens when the knowledge that runs your practice lives in one person's head rather than in a documented system. In this episode, I break down: Why replacing an employee costs 50-200% of their salary, not just their paycheck (Gallup) The revenue that leaks out the door with them: missed calls, uncollected copays, claim denials, rising no-shows Why the medical assistant role is the hardest in your practice to fill and keep, and what your competitors have already figured out The full practice math: what replacing two medical assistants costs a six-physician practice The 3-step action plan to protect your institutional knowledge before it walks Book Your 20-Minute Triage Call Here

She loved her surgeon. She loved her results. She almost never came back anyway. In this episode, I tell the true story of a patient who nearly left a practice she loved, not because of anything the doctor did, but because nobody called her back to schedule her second procedure, she couldn't book online, and her medication refills required her husband to physically drive to the office every single time. Nothing about her care was ever in question. The gap was process, and it's one of the most common (and most fixable) reasons practices lose their most loyal patients. In this episode, I break down: Why "they like the doctor" isn't a retention strategy, and why Gen X may be the last generation with real brand loyalty The real cost of losing existing patients to follow-up and access friction (conservatively $1.2M/year, per physician) Why private equity-backed practices can out-market you but can't out-experience you The 3-step audit to find and close this leak in your own practice Resources: Free Triage Call: https://links.alisaconner.com/widget/bookings/medical-triage-call Referral Loss Worksheet: https://alisaconner.com/worksheet

There's a number most practices have never pulled a report on: how many people started the journey to become a patient and never finished it. In this episode, Alisa Conner walks through why an ad-first growth strategy keeps failing specialty practices, the seven transition points where patients actually disappear between referral and repeat visit, and the practice math behind what an unoptimized patient journey costs a physician every month. You'll learn the exact questions to ask about your referral process, the friction points most practices miss in scheduling, and why the entire patient experience, not just the clinical part, determines whether a patient stays or leaves. Free resource: calculate your own numbers with the Referral Loss Worksheet here Book a free 20-minute Triage Call here, and we'll identify the three places your practice is leaking the most revenue.

If you called your own practice right now, pretending to be a new patient, would you get a busy signal? Sit on hold? Have to fill out ten fields online before landing on a real appointment time? In this episode, Alisa Conner walks through why an overwhelmed front desk is a process problem, not a staffing problem, and what that friction is actually costing specialty practices. She runs the math on an orthopedic surgeon losing $1.17 million a year to referral non-conversion at a conservative 20 percent rate, and a functional medicine practice losing $600,000 a year in self-referred leads who never make the schedule. She also breaks down why roughly 60 percent of patients hang up after 90 seconds on hold, and lays out the 3-step plan to redefine the front desk role in the next 30 days. If you want the real number behind your practice's referral loss, grab the free worksheet here. Or, if you're not sure where to start, book your free 20-minute Triage Call here.