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.

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Burnout is one of the most talked-about topics in healthcare — and still one of the most misunderstood. In this SNACK episode, Miranda Dorta turns the mic around and puts Tracy in the hot seat for an unscripted conversation about what burnout prevention actually requires. Not the surface-level version. The real one.

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Tracy breaks down why the self-care checklist approach misses the mark, how practice ownership compounds burnout risk in ways that employed providers rarely face, and why real prevention is a structural decision — not just a personal one. She also shares where most practice owners skip the prevention work that costs them the most long-term, and what to do right now if you're already in the thick of it.

This conversation is built on research, grounded in Tracy's CME-based content, and refreshingly practical — no platitudes, just real frameworks for building a practice that doesn't burn you down.

Don't miss The Prevention Paradigm masterclass on April 28th — the link to register is in the show notes. To schedule a consultation with Tracy, visit thrivingpracticecommunity.com.

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

Sign up for the Prevention Paradigm Masterclass.

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What if your practice is one of the last true neighborhoods your patients have access to? In this episode, Tracy Cherpeski sits down with Lisa Prior — leadership and change consultant and author of the forthcoming Rubber Avenue: When Work Was the First Neighborhood — for a conversation that reframes where practitioner burnout really comes from.

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Lisa grew up in Naugatuck, Connecticut, the world's first rubber town, and has spent years researching how the collapse of company towns and community institutions has quietly shifted an enormous emotional burden onto frontline healthcare providers. She shares her father-in-law's remarkable story of standing up for 750 retirees' medical benefits, why she believes we're at 'a fork in the river,' and what a new social contract between work and community could look like.

This one went places we didn't fully expect — and it's exactly the kind of conversation that helps practice owners understand why this work matters so much, and how to sustain it.

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What if burnout isn't really about overwork — and has more to do with being stuck at the wrong altitude?

Join us for our upcoming Masterclass, Prevention Paradigm: Catching Burnout Before it Catches You. https://www.tracycherpeski.com/prevention-paradigm

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In this solo episode, Tracy introduces the Altitude Shift: the skill of moving, on purpose, between zoomed-in execution and zoomed-out vision. It's the practice that sharpens your decisions, protects you from burnout, and keeps you connected to the reason you built your practice in the first place.

You'll hear the story of Dr. M — a thriving solo practice owner who couldn't remember the last time she wasn't in firefighting mode. Tracy shares the two altitudes, why most bad decisions come from the wrong one, and a simple audit you can use before any significant choice. She also gets into the neuroscience of why slowing down isn't optional — and the daily practices she architects into her own life to keep the horizon in view.

If you've been running on will power, feeling reactive, or sensing that you've lost the thread of what you're building — this episode is for you.

Is your practice growth-ready? See Where Your Practice Stands: Take our Practice Growth Readiness Assessment

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With acquisition offers arriving, reimbursement cuts looming, and colleagues selling, a lot of practice owners are quietly asking: is staying independent even worth it? In this SNACK episode, Miranda Dorta sits down with Tracy Cherpeski to get her unfiltered take on that question.

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

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Tracy shares her framework for helping practice owners separate burnout from a genuine readiness to sell—and why making a major life decision from a place of exhaustion or fear is never the right move. She talks about what independent ownership actually gives providers that a hospital employment contract can't, why cash reserves and a 12-month plan are non-negotiable right now, and what due diligence looks like if selling really is the right path.

Tracy also opens up about the personal story behind her mission—her daughter's health journey and the independent provider who changed everything—that explains why this work is more than professional for her.

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What if the biggest obstacle to your health isn't time or willpower—but the fact that nobody ever taught you how to take care of yourself? In this episode, Tracy Cherpeski sits down with Dr. Hannah Brandt, a doctor of physical therapy and founder of Physique Triage, who helps women in healthcare build sustainable fitness and nutrition habits without turning their lives upside down.

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Dr. Hannah lost over 60 pounds herself—and discovered that even with a doctorate, she had to figure out healthy living the hard way. Now she helps other women in healthcare do it smarter. Her approach: find your gaps first. Assess your hydration, movement, and eating before changing anything—then make small, sustainable shifts that actually stick.

In this episode, you'll hear why healthcare providers are conditioned to put themselves last, what a realistic first step really looks like, and why 'okay' and 'fine' are a lot closer to 'great' than most people realize.

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

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

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