From IV Hydration to Whole-Person Care: Stephanie Miles’ Journey to DPC

Send us Fan MailBeing the first direct primary care clinic in your city sounds exciting until you realize you also have to teach your entire community what DPC is and why a monthly membership can beat insurance-based primary care. We sit down with Stephanie Miles, nurse practitioner and owner of Smith’s Primary Care and Wellness in Winston-Salem, North Carolina, to share what it really took to grow a thriving cash-based practice with a clear patient cap and a plan to scale. Stephanie walks us through her story from nine years in a Level 1 trauma ER to becoming an adult primary care NP who wanted continuity, outcomes, and relationships. We talk about why she launched an IV hydration business first, how that experience prepared her for practice ownership, and what changed when she discovered direct primary care while researching a traditional clinic model. If you’re searching “how to start a DPC practice” or “direct primary care for nurse practitioners,” you’ll hear practical, specific decisions you can copy. We also dig into the day-to-day mechanics that make membership medicine work: how she set pricing, what she includes for members, when she charges small supply fees for procedures, and why she offers a one-time visit option for non-members. Stephanie shares what’s actually driving growth (hint: word of mouth and Google), what marketing spend didn’t pay off, and how she keeps operations simple with an all-in-one EMR like Atlas MD. On the business side, we cover collaborating physician agreements, lowering overhead through smart real estate moves, hiring her first medical assistant, and the tough contractor lesson that taught her to keep personal and business separate. If you found this helpful, subscribe, share it with a clinician who’s considering direct primary care, and leave a review so more people can find the show. What’s the biggest barrier between you and opening your own clinic?Thank you for joining us today!Be sure to follow and share, and leave a review!If you have questions, comments or want to be part of our community, follow us on Facebook at The DPC NP!