If you've ever looked at your fee schedule and felt a knot in your stomach, you're not alone. Fee setting is one of the most avoided conversations in private practice — and it's not about not caring. It's about the discomfort that runs deep in helping professions, where talking about money can feel like it conflicts with the commitment to care.

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In this SNACK episode, Tracy Cherpeski sits down with Miranda Dorta to cut through that discomfort and get practical. They explore why so many practice owners undercharge, what that pattern has to do with burnout, and what it actually takes to build a fee structure that reflects your value and keeps the lights on.

You'll hear Tracy break down the numbers every practice owner should know cold — from burn rate and cash flow to how insurance versus out-of-pocket decisions shape your entire business model. She also shares the one number you can pull up right now that tells you a lot about where your practice stands.

Whether you're just starting to look at your finances or you know it's time to raise your fees and keep putting it off, this conversation will help you take off the clinician hat and put on the CEO hat — without losing what makes your practice worth running.

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What if the physician best positioned to help women through perimenopause is the one they’re already seeing — their GP? In this episode, Tracy sits down with Dr. Danielle Hunte, a general practitioner from Barbados and founder of Midlife Meridian, to explore exactly that.

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With nearly 30 years in medicine and over 20 in private practice, Danielle went through perimenopause herself — and even as a physician, it caught her off guard. That experience sparked a new mission: closing the gap in menopause care and education, for both patients and the GPs who treat them.

In this episode, you’ll hear why GPs are uniquely positioned to manage menopause (it’s not a one-system problem), the simple screening tool Dr. Danielle developed that revealed a silent cohort of symptomatic patients, and her vision for a “practice-in-a-box” digital resource for other providers. You’ll also hear a really honest conversation about sustainability — what it means to build a second revenue stream, protect your time, and keep showing up creatively so the practice doesn’t swallow you whole.

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After more than 18 years in insurance-based healthcare, Dr. Samantha Mekrut made a decision a lot of physicians dream about: she left to build something better. The result is Meristem Family Medicine — a direct primary care practice in Medfield, Massachusetts, where patients pay a flat monthly membership fee, appointments run 30 to 60 minutes, and the administrative machinery of insurance billing is nowhere to be found.

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In this episode, Tracy sits down with Dr. Mekrut to unpack the real difference between direct primary care and concierge medicine, what it actually takes to make an affordable membership model work, and why eliminating insurance billing overhead is the key that makes it possible.

They also get into Dr. Mekrut’s specialty: menopause care for women in midlife. From the flawed rollout of the Women’s Health Initiative study to the community library talks she hosts to educate patients without selling them anything, Dr. Mekrut is approaching women’s health the way more of us wish the system would.

See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

Read the full show notes, memorable quotes, and key takeaways.

Connect With Us:

Be a Guest on the Show

Thriving Practice Community

Schedule Strategy Session with Tracy

Tracy’s LinkedIn

Business LinkedIn Page