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Transforming a medical practice from a startup to a thriving, scalable business requires far more than clinical excellence. In this revealing conversation with physician assistant Brian Fretwell, we uncover the missing piece that prevents many direct primary care practices from reaching their full potential: a comprehensive operating system.
Brian shares the journey that led him to create the DPC Momentum Model after hitting his own plateau and experiencing burnout despite escaping the traditional fee-for-service system. His framework addresses the fundamental mindset shift required to evolve from provider to CEO—moving from compliance to leadership, perfectionism to progress, and from delivering care to building systems that deliver care.
At the heart of Brian's model is the Clarity Compass, a powerful tool that serves as your strategic foundation and decision-making filter. This document connects your purpose, values, and vision to concrete 90-day milestones that drive consistent execution. We explore how the momentum framework creates focus through impact metrics, mission alignment meetings, and an opportunity board that transforms problems into growth catalysts.
Perhaps most fascinating is Brian's perspective on scaling with additional providers. Rather than the typical "just do what I do" approach that creates bottlenecks, his model establishes clear guardrails based on core values while allowing flexibility for individual strengths. The result? A culture that naturally attracts aligned team members and patients while building internal leadership pathways.
For those feeling overwhelmed or plateaued in their DPC journey, Brian offers surprisingly simple yet profound advice: invest in yourself through daily reading and thinking time, then leverage your existing network by simply asking for what you want. With his guidance, you can transform your practice from surviving to truly thriving.
Ready to stop flying blind and build a practice with true momentum? Listen now and discover how to create the clarity, accountability, and financial sustainability your DPC deserves.

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