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Consulting is paused while I get the MSO off the ground — back to it in a month or two.I'm Brad. I own a multi-million dollar private primary care practice and I help physicians start and scale their own. Subscribe if you want the business side of medicine nobody taught you in residency.Nothing here is medical, legal, financial, or tax advice. I'm a physician and a business owner, not your advisor. Every practice and every state is different — talk to your own counsel and CPA before making decisions.--------------A physician who's also my patient no-call-no-showed six times, showed up late to the appointment they finally kept, spent the visit venting about portal messages and work-life balance — and then told me that when they refer friends to me and I'm full, those friends should just go somewhere else. Not to my clinic. Somewhere else.None of that makes them a bad person or a bad doctor. They were in patient mode, which is exactly where they should have been. But as a business owner, that visit was one long message about what's broken in how I built this thing.That's hero syndrome. Key man risk. Star syndrome. Whatever you want to call it — when the patients only want you, you've built a bottleneck and called it a brand.In this one I break down the two paths you can pick at the start, why I picked the harder one, the worst possible middle ground to get stuck in (concierge-level care on fee-for-service pay), and why my practice is adding cash-pay and premium services in 2027.Chapters00:00 Hero syndrome, key man risk, star syndrome00:50 The physician-patient who inspired this01:16 Six same-day cancellations and professional courtesy02:30 "If they can't see you, go somewhere else"03:12 Two wolves: the two paths you get to choose04:29 Path two — boundaries from day one05:01 The tablet analogy: why changing the rules makes people furious05:20 You are the brand, and it doesn't scale06:17 The worst place to be: concierge care, fee-for-service pay06:43 Training patients and selling your PA07:30 Is a DPC / concierge hybrid the future?09:24 Listening to what patients are actually asking for11:03 She went online for HRT. I could have written it.11:29 The $10,000 check on my exam table12:04 The Disney fast pass model12:17 Don't get caught in the middle (sub-$100/month DPC)13:38 The fork in the road: charge the premium or set the boundary14:37 Listen to what your market is telling you15:35 Where I'm at with the MSO and CINMy website 🖥️: https://www.investingdoc.comMy podcast Spotify Link🎧: https://open.spotify.com/show/3JxluO7mJOSE312G1Ul9dgApple Podcast Link 🎧: https://podcasts.apple.com/us/podcast/investingdoc/id1790276462My Instagram: https://www.instagram.com/investingdoc/My Twitter: https://x.com/InvestingDocMy Facebook Group: https://www.facebook.com/groups/investingdocReddit Group: https://www.reddit.com/r/PrivatePracticeDocs/Want to consult with me for your practice: Book here. https://investingdoc.com/consulting