One month shy of five years. That is how long Big Trees MD ran on the electronic health record it opened with, and this month, that ended. Not because Dr. Maryal Concepcion went looking for something shinier, but because the terms under which her patients' data lived changed, and she could not accept them.

In this solo episode, Dr. Concepcion documents the switch in real time from her rural Direct Primary Care practice in Arnold, California, which she owns with her husband, Dr. Jeremiah Fillo, and runs with a fully virtual team. No vendor names, on purpose. The names change. The framework does not.

Built from The Toolkit's Battle of the EHRs issue, where over 200 DPC EHR users shared what they use and why, this episode walks through how to choose an electronic health record that grows with your practice instead of boxing you in:

• Why an EHR is the memory of your practice, and why the DPC version of this decision is nothing like the fee-for-service version
• The 10 categories to score every EHR on, from membership billing and charting speed to support quality and scalability
• The 5 questions to ask before you switch, starting with "what problem am I really trying to solve?"
• How to run a demo on your terms: build a fake patient, count clicks out loud, ask about migration before features, and ask the question nobody asks, which is "how do I leave you?"
• Why you should research who owns the EHR company, especially as private equity and venture capital creep into Direct Primary Care
• Running the real math: subscription, add-ons, switching costs, and exit costs over a three year horizon, plus what an hour of your life is actually worth
• The hidden costs no spreadsheet captures: patient trust, the emotional weight of change, and the 90 day post-switch reality check

Things have changed since the Summer 2025 issue published, and the second Battle of the EHRs opens for voting in Q1. The only way to vote is through the My DPC Story newsletter, so sign up at mydpcstory.com.

FREE from The Toolkit at mydpcstory.com:

• How to Interview Electronic Health Records comparison worksheet
• Patient handout on choosing healthcare vs. health insurance (perfect for open enrollment season)
• The Lean Startup Business Plan
• The First Year Roadmap
• Every issue of The Toolkit, including the new Battle of the Support Stack

Follow the full switch in real time: demos, migration answers, the four-bucket spreadsheet, and the second guesses, all inside the My DPC Story Patreon community. 

Leave a voice message with your question, challenge, or win at mydpcstory.com/contact and you might hear it on a future episode.

If this episode helped you, a five star review on Apple Podcasts helps other physicians find these stories when they need them most.

Support the show

GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD

Become A My DPC Story PATREON MEMBER!
SPONSOR THE POD
My DPC Story VOICEMAIL! DPC SWAG!
FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube