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.

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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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