Podcast Summary:

In this episode of DPC Pediatricians, Dr. Phil Boucher and Dr. Marina Capella address a common concern among physicians considering or practicing Direct Primary Care (DPC): how to handle weekend availability without compromising personal time or patient care.

Key Highlights:

* Weekend Worries Are Common but Manageable

Many physicians worry about being on-call 24/7 in a solo practice, especially on weekends. Both hosts affirm this concern is valid but emphasize that the reality is often far less stressful than expected.

* Setting Weekend Office Hours

Phil's practice offers limited Saturday morning hours (8–10 AM), split among providers. Over three recent weekends, only one Saturday visit occurred, showing that weekend demand is often minimal.

* Patient Communication is Key

Patients are trained to reach out early on Saturdays if needed. An automatic message sets expectations about office availability and response times for non-urgent vs. urgent concerns.

* Texting on Weekends

Physicians typically monitor texts on weekends, especially for simple questions. If urgent care is needed, patients are directed to trusted facilities. Newborns or serious cases are referred to the ER with proper guidance and notification.

* Delegating and Covering Time Off

When out of town, Marina communicates transparently with patients and uses a covering pediatrician when needed. Most issues can still be handled via text.

* Clear Expectations Prevent Burnout

Setting and enforcing boundaries during onboarding helps patients understand when and how their pediatrician is available. Respect for the physician’s humanity and life outside the clinic fosters mutual trust.

* Flexible and Dynamic Scheduling

Marina structures her schedule around personal priorities, like spending summers at a mountain cabin or working only specific days. Patients are understanding when expectations are communicated.

* Adult vs. Pediatric DPC

Pediatric DPC tends to involve more weekend support than adult DPC, due to the nature of children's needs and parental anxiety. However, this support can still be well-structured and limited.

* Practice What Works for You

The beauty of DPC is the autonomy to design a schedule that supports both your personal and professional life. Experimenting with availability and structure is encouraged and often leads to improved satisfaction.

* Patient Retention Supports Boundaries

Neither host has experienced patients leaving their practice due to limited weekend availability. In rare cases where expectations aren’t aligned, a respectful referral to another provider is appropriate.

Takeaway Message:

DPC allows pediatricians to set boundaries, build sustainable schedules, and still provide excellent care. Clear communication, mutual respect, and smart planning make it possible to enjoy both a fulfilling practice and personal life.

Key Highlights:

In DPC pediatric practices, text messaging and selective telehealth use foster meaningful, efficient, and family-centered care. By embracing modern communication styles and setting clear boundaries, DPC physicians are redefining how pediatric care is delivered—with less stress, more connection, and greater flexibility for both families and providers.​

1. Text Messaging for DPC Practices

* Texting is a great feature DPC clients love to use.

* It aligns with modern parents’ communication preferences—especially millennials who dislike phone calls.

* Texting creates a faster, more convenient, and less stressful experience for families.

2. Transitioning from Fee-for-Service Mindset

* Initial hesitation around texting (e.g., fear of being overwhelmed) disappears once providers experience the manageable volume of communication in DPC.

* The shift from a panel of thousands of patients to smaller, intentional patient panels reduces burnout and increases connection through text.

3. Efficient Care Without Office Visits

* Many issues can be resolved via text or photos—e.g., diaper rash, pink eye, or a bug bite—saving families time and unnecessary visits.

* Examples include avoiding full office visits for simple questions like constipation or bug bites.

4. Personalized, Ongoing Care

* Unlike large healthcare systems, DPC physicians build personal relationships with patients and families, leading to more thoughtful, individualized care.

* Patients often prefer asynchronous communication with someone they know and trust over impersonal telehealth with unfamiliar providers.

5. Managing Message Volume and Expectations

* Physicians set boundaries around response time (typically same day, not instant).

* Automated replies help set after-hours expectations and offer booking options or advice for urgent needs.

* Teams often triage messages first thing in the morning and during downtime.

6. Recognizing Urgency Without Overreacting

* Physicians discuss the psychology of interpreting urgency and how most parents are seeking reassurance—not demanding immediate appointments.

* They encourage trusting relationships where patients feel heard without needing instant access 24/7.

7. Minimal Use of Video Visits

* Contrary to initial expectations, video visits are rare.

* Asynchronous methods (texts, pictures, short videos) often work better than live video, which can be awkward or unnecessary.

* Video visits are occasionally used for behavioral health consults or special cases.

8. Texting Builds Trust & Peace of Mind

* Knowing they can easily reach their physician brings parents peace of mind.

* The model promotes trust and reduces unnecessary stress or reliance on unverified online sources.

In this candid and inspiring episode, Phil and Marina explore the theme of failure—how it's an inevitable part of the human and entrepreneurial experience, and more importantly, how to learn and grow from it. They share personal stories of setbacks, including missteps in business ventures, early academic struggles, and social media flops, underscoring that failure is not the end but a stepping stone to success. The episode encourages fellow pediatricians, especially those in or considering irect primary care, to frame failure as a growth opportunity rather than a stopping point.

Key Highlights

* Reframing Failure: The hosts emphasize that failure is a natural and necessary part of learning—just like in child development, where kids must fall before they walk.

* Cultural Challenges in Medicine:

* Medicine often penalizes failure harshly, especially during training, which leads to a deep-rooted fear among physicians.

* In entrepreneurship, however, failure is less risky and often essential for learning.

* Phil’s Experiences:

* Launched a virtual membership inspired by Blueberry Pediatrics that didn’t gain traction but led to a new patient retention strategy.

* Attempted to start a clinic-based pharmacy, which failed due to regulatory and logistical issues—highlighting the importance of focusing on what patients truly need.

* Uses social media prolifically and embraces that many posts will flop. He views each post as an experiment and doesn’t dwell on metrics.

* Marina’s Vulnerability:

* Shared her experience of failing foundational biology courses at Stanford and how she overcame academic setbacks to eventually succeed in medicine.

* Spoke candidly about taking an extra year in medical school due to depression and how she found her stride during clinical rotations.

* Takeaway Mindset:

* Progress is not linear. The journey includes setbacks, and resilience is built by continuing through them.

* Physicians have the training and adaptability to recover from business failures.

* Having community and mentorship makes the process of learning from failure more manageable and less isolating.

* Call to Action:

* For pediatricians in or considering DPC, the takeaway is: don’t let fear of failure stop you. Try, pivot, and adapt.

* Phil and Marina also offer one-on-one consulting through their site, dpcpediatrician.com, to support others on this path.