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.
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