This episode explains that pediatricians can start a Direct Primary Care (DPC) practice even while carrying substantial student loans, as long as they plan carefully and intentionally. Phil and Marina share personal examples of launching DPC with 1500–2000 dollar monthly loan payments and original balances around 250,000 dollars to show it is possible but requires realism about cash flow. They describe strategies like keeping a part‑time employed position, timing departure around potential loan‑forgiveness milestones, and building savings and cutting expenses before opening. A major theme is not allowing fear or uncertainty about federal loan programs and politics to be the primary reason for staying in a burnout‑inducing job. They encourage combining detailed financial planning with an internal sense that “this is the right time,” emphasizing that student loans are usually a challenge to plan around, not an automatic deal breaker for DPC.

In this episode, Phil and Marina discuss how Direct Primary Care (DPC) physicians can still experience burnout, though from different causes than in traditional fee‑for‑service systems. Instead of systemic pressures, burnout in DPC often stems from overcommitment, poor boundaries, and underpricing. They emphasize the need for clear expectations with patients, realistic pricing, and structured time management to sustain balance and prevent exhaustion. Ultimately, they encourage DPC doctors to take ownership of practice design so that their systems truly support well‑being and longevity in medicine.

Summary: This podcast episode features a conversation between DPC pediatrician Dr. Marina and entrepreneur/coach Sarah from Soul Seat Academy, focused on how physicians and small business owners can effectively hire, lead, and, when necessary, fire team members in a way that centers culture and humanity over rigid metrics. The discussion emphasizes hiring for cultural alignment and a “servant’s heart” first, then training for skills using clear job descriptions, fun and specific role titles, and detailed standard operating procedures so employees feel safe, supported, and empowered in their roles. They highlight the importance of regular check‑in meetings that normalize two-way feedback, encourage employees to propose solutions, and actively address “workplace trauma detox” from past toxic environments so trust can grow over time. Finally, Sarah shares her structured “come to deity” conversation framework for handling serious performance issues, outlining clear paths of resolution, resignation, or termination while still treating people with dignity and viewing mistakes as “tuition” for learning rather than automatic grounds for dismissal.