Most physicians dream of independence but dread the isolation and heavy lift of running a solo practice. What if there were a way to share infrastructure, lighten the load, and still maintain your autonomy?

In this episode, Dr. Disha Spath sits down with special interviewer Dr. Dan Sooriabalan and guest Dr. Natalie Gentile to explore how managed services organizations (MSOs) can strengthen direct primary care practices. From sharing cross-coverage to negotiating employer contracts, she shares how she and her partner built a collaborative model that supports physicians while keeping patient care personal.

This conversation is packed with lessons on leadership, partnership, and building something bigger than yourself!

Key Topics Covered:

1. The Hidden Price of 401K

• Breaking down what a managed services organization is and why it matters for direct primary care.

2. From Vaccine Clinics to Direct Primary Care Collaboration

• How grassroots community efforts during the pandemic sparked the creation of Pittsburgh's first DPC-focused MSO.

3. Shared Pain Points, Shared Solutions

• Cross-coverage, marketing, vaccine acquisition, mentorship—how an MSO makes solo practice less lonely.

4. The Business Side of Medicine

• Legal guardrails, employer contracts, and the financial realities of keeping physician ownership at the center.

5. Scaling Without Selling Out

• Why Natalie and her co-founder built their MSO without private equity—and how they're keeping it mission-driven.

6. Not a One-Size-Fits All

• Why MSOs aren't one-size-fits-all and what to consider before starting one in your own region.

Listener Takeaways:

• MSOs (Managed Services Organizations) give DPC doctors shared infrastructure—like marketing, cross-coverage, and legal support—without sacrificing independence.
• Collaboration often starts with small, local initiatives (like community vaccine clinics) before scaling into sustainable models.
• Legal and financial guardrails are essential to keep physicians—not private equity—at the center of ownership.
• Quarterly case reviews, mentorship, and camaraderie help prevent isolation and burnout in solo practice.

Resources Mentioned:

• Gentile Family DPC
• Maintenance Phase Podcast
• Atlas.md
• Direct Care Physicians of Pittsburgh
• Rebel Wellness

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Host: Dr. Disha Spath, The Frugal Physician
Guest: Dr. Natalie Gentile, Gentile Family DPC

This episode is brought to you by:

Earned Wealth: Earned's unique Doctor Wealth Playbook includes tax planning, investing, insurance, career advisory, and more. It's a holistic approach from advisors who get the financial pressures of your profession. And for a limited time, Frugal Physician listeners can visit Earned.com/Frugal for exclusive access to this comprehensive planning at a discounted rate.

Most of us assume our 401k plans are free because we never see a bill. But hidden fees—record keeping, custodial, administration, and advisory costs—can silently erode your retirement savings over time.

In this episode, Dr. Disha Spath sits down with forensic 401k consultant Paul Sippel to uncover how these costs work, why they're so hard to detect, and practical steps you can take to protect your wealth.

If you're a physician, business owner, or employee relying on your 401k for retirement, this conversation is a must-listen!

Key Topics Covered:

1. The Hidden Price of 401K

• Why most employees (and even physicians) don't realize how much retirement fees are costing them

2. Decoding the Fee Structure

• Custodial, record keeping, administration and advisory charges explained by Paul

3. So Who Really Pays the Bill?

• How physicians often carry a bigger share of plan costs than their staff.

4. Defining a "reasonable" costs

• Benchmarks to know if your plan fees are fair or quietly draining your bank account.

5. Beware of the Transparency Trap

• Why statements rarely show the true expense and how the industry profits from the confusion

6. Proven Strategies to Lower the Fees

• From negotiating employer-level billing to exploring self-directed brokerage accounts.

Listener Takeaways:

• If you've never seen a bill for your 401k, that doesn't mean it's free—the fees are just hidden.
• Even "small" percentages in fees can compound into massive retirement losses over time.
• Physicians are often subsidizing their staff's 401k costs without realizing it.
• Shifting fees to the employer level creates more fairness and bigger savings potential.
• You have the tools to uncover and reduce your 401k fees—knowledge equals real money saved.

Resources Mentioned:

• Chatgpt
• Department of Labor's www.efast.dol.gov
• FreeERISA

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Host: Dr. Disha Spath, The Frugal Physician
Guest: Paul Sippel, 401k Forensic Consultant

Is burnout making you question your future in medicine? You're not alone. For many physicians, the pressures of traditional healthcare lead to stress, exhaustion, and a loss of purpose. But what if there was another way?

In this powerful episode of The Finding Financial Freedom Podcast, host Dr. Disha Spath sits down with Monica McKitterick, a physician who walked away from burnout and built a thriving Direct Primary Care (DPC) practice. Monica opens up about the real challenges and rewards of DPC—what it takes to start from scratch, how to set boundaries without sacrificing patient care, and the financial strategies that make this model sustainable.

Whether you're curious if DPC could be your dream job, or you're preparing to make the leap yourself, this episode is packed with practical insights, cautionary tales, and inspiring takeaways.

Key Topics Covered:

1. Is DPC a dream job or a disaster?

• Monica shares the truth about life as a DPC provider, from freedom to challenges.

2. The Leap from Traditional Healthcare to DPC

• Why she left a broken system for a model that prioritizes patients.

3. Financial Prep for First-Time DPC Physicians

• Smart steps to take before transitioning

4. Traits of a Successful DPC Provider

• The personality strengths (and pitfalls) that determine long-term success.

5. Building Boundaries Without Breaking Your Practice

• How Monica protects her time while keeping patients happy

6. Hiring on a Budget

• Tips for growing your team without overwhelming overhead.

7. Marketing Your DPC Practice

• How to attract patients while staying true to your values.

Listener Takeaways:

• Learn how to recover from burnout and rebuild a fulfilling medical career.
• Discover what it really takes to start a DPC practice from scratch.
• Get practical tips on financial planning, hiring, and marketing for your DPC clinic.
• Find out if DPC is the right path for you—or if it might feel like a disaster.

Resources Mentioned:

• DPC Dream Job or Total Disaster by Monica McKitterick
• Want to learn more about DPC? Check out: thedpcformula.com
• OnlineJobs.ph

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Host: Dr. Disha Spath, The Frugal Physician
Guest: Monica McKitterick, DPC Formula

Welcome back to the Finding Financial Freedom Podcast with Dr. Disha Spath. Today, we're joined by Carl Hall CFA, a wealth advisor at CapTrust who helps individuals and families manage their financial lives and achieve their unique goals. CapTrust specializes in delivering financial planning, portfolio management, and investment advice—helping clients navigate complex decisions with confidence.

In this episode, Carl dives into the often-overlooked connection between healthcare decisions, price transparency, and retirement planning. From choosing the right health plan during open enrollment to understanding how HSA's can strengthen your retirement security, Carl breaks down how your medical choices today can significantly impact your financial freedom tomorrow.

Key Topics Covered:

1. Making Smart Open Enrollment Decisions

• Why many people miss out on the optimal health plan and how to avoid common mistakes.

2. Understanding Health Plan Costs

• The real impact of premiums, deductibles, and co-insurance on your finances.

3. Affording Healthcare in Retirement

• Strategies to prepare for medical costs later in life.

4. The Shoeboxing Approach

• A practical method for tracking healthcare expenses.

5. FSA vs. HSA

• The key differences and why HSAs can be a powerful retirement tool.

6. Changes in the DPC Ecosystem

• What's new and how it affects both patients and providers.

7. Healthcare Price Transparency & Retirement Security

• How knowing the cost of care can protect your long-term finances.

8. Aligning Provider & Patient Interests

• Why DPC providers should have the same goals as their patients.

Listener Takeaways:

• How your healthcare plan choice can directly impact your retirement savings.
• Why HSAs are a game-changer for long-term financial health.
• The value of price transparency in protecting your future wealth.
• How to align healthcare decisions with your financial freedom goals.

Resources Mentioned:

• CapTrust
• Price Transparency Tools

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Host: Dr. Disha Spath, The Frugal Physician
Guest: Carl Hall CFA, Wealth Adviser at CapTrust