Metronome Family Medicine

09/07/2026

I talk about Direct Primary Care every single day. And every single day — often more than once — I meet someone who's never heard of it.

"Is that concierge?" they ask. "Do you take insurance?"

Here's what's strange about that: DPC membership has grown 837% per capita since 2017. There are now practices in all 50 states, and Colorado is one of the most concentrated markets in the country. Longmont is actually where Colorado's first DPC practice opened, back in 2009.

So it's a real movement. It's just been hiding in plain sight.

What it actually means: a doctor you can text, call, or email directly — no call center. Same- and next-day appointments, instead of the 31-day average wait for a new patient appointment. Visits that run 30, 60, or 90 minutes instead of a seven-minute sprint. And one doctor who knows you, so you're not retelling your whole story to a stranger every time.

Is it a replacement for insurance? No — and it's never claimed to be. Think of your car: you carry insurance for the accident, not for filling the tank.

But here's the part I find most compelling. A brand-new meta-analysis of 28 randomized trials — 18,046 patients — found that better doctor-patient communication produces measurably better physical health outcomes. The researchers deliberately threw out patient satisfaction and looked only at hard medical data. The relationship doesn't just feel better. It makes people healthier.

New blog post. 🔗

DPC membership grew 837% since 2017 — yet most people still ask "is that concierge?" A Longmont physician on the model, the growth, and the evidence behind it.

09/04/2026

· Sponsored by Guava

Your health story comes from a lot of places at once.

There's the story you tell me in the exam room. The one in your electronic medical record — or in several records, from hospital systems that don't talk to each other. There's the story in your food journal, your Oura Ring, your Apple Watch, your heart rate when you exercise.

Pulling all of that into one coherent narrative is hard. It's nearly impossible if your doctor has never met you before.

Direct Primary Care gives me the time to actually learn my patients' stories. And a tool that's helped enormously is an app called Guava. (Guava asked me to share my experience and is sponsoring this video — but they have no say in what I tell you and don't see this before it's posted.)

Guava pulls together outside medical records, wearable data, symptoms you log day to day, and your medications, and assembles them into one picture.

Recently a patient — who has kindly given me permission to share this — came to me with insomnia, abdominal pain, and a lot of anxiety. We plugged her into Guava, and it surfaced records that had never been visible at my old practice, including a history of hyperthyroidism she hadn't remembered, had never been treated for, and that had never shown up in her labs with me.

I don't know yet how it'll pan out. We're still working through a few things. But it opened a door that wasn't open before — and that's a rare thing to say about an electronic medical record.

It's included with membership at Metronome Family Medicine. You can buy it on your own, but it's one of the many things that comes with your DPC membership.

If you want a doctor using every tool modern medicine offers to put your story together — come see me. Let's talk tech:)

📞 720-856-4058 · link in bio

09/03/2026

🎸 DOCS THAT ROCK 🎸

Sunday, September 13 · 6:00 PM
Nissi's — Lafayette, CO

A bunch of physicians who play music are getting together to raise money for Bal Swan Children's Center in Broomfield — a fully inclusive early childhood center that's been serving kids of all abilities since 1963. Neurotypical and neurodiverse kids learning side by side, with therapists working right in the classrooms. It's a genuinely great cause and this is the fifth iteration:)

I met most of these docs back when I was in corporate medicine. They're all still there. I'm the one who left to open a Direct Primary Care practice and stopped taking insurance — so come find me and say hi:)

Great cause, great people, and there should be some pretty good music too.

See you there!

08/30/2026

Years ago, a patient handed me a list of labs from a doctor she was seeing outside my system — because my system wasn't helping her — and asked me to order them.

I was indignant. Why should I order tests I didn't know how to read? If they mattered, wouldn't I already be using them?

But the requests kept coming. And I started paying attention to what my patients were paying out of pocket to chase: hormones, thyroid, nutrient deficiencies — answers for the fatigue and chronic pain that conventional medicine so often shrugs at.

Here's what I've come to believe about my own field. We're so driven to find a solution that we reach for the protocol every time. Diabetes? Metformin. Blood pressure? Losartan. There's comfort in having an answer — and real discomfort in not having one. So the unexplained stuff becomes the thing we groan about when it lands on the schedule.

I stayed skeptical of functional medicine for a long time. Some of it I'm still skeptical of. But when I actually dug into the studies behind mainstream fears about hormone therapy, I found some badly flawed foundations — including a 2013 testosterone paper that 29 medical societies asked JAMA to retract after nearly 10% of its "all-male" dataset turned out to be women.

So what's the actual root of the fight between functional and conventional medicine? I think we're all judging in each other the thing we fear most: that we don't know enough. It's easier to call it out in someone else than to admit you're the one with the knowledge gap.

New blog post. Link in bio. 🔗

A family physician on functional medicine, flawed hormone studies, and why the fight between camps comes down to a fear every doctor shares: not knowing enough.

08/28/2026

Take your weight in kilograms, divide by your height in meters squared, and you get a two-digit number: your BMI.

That number has been used for years to decide whether you qualify for medications. For surgeries. Whether you get counseled about diet and exercise — or whether your doctor will talk about anything else at all.

But BMI doesn't account for skeletal muscle. It doesn't account for body fat percentage. It doesn't look at what you're made of. It just looks at what you weigh.

And it was never designed for this. It was created in the 1830s by a Belgian mathematician — not a physician — who measured western European men to find the "average man." He said outright it shouldn't be used to judge individuals. Which means it was never built to apply to women or people of color the way it's been used on them ever since. Even the AMA acknowledged its limitations and historical harm in 2023.

So I don't care about your BMI. Honestly, I don't care about your weight — unless you care about it and want to talk with me about it. Then I'm all in, and I've got real tools to help.

But you will never walk through my door and get hassled about your weight before I've asked what actually brought you in.

I'm Dr. Brian Juan at Metronome Family Medicine in Longmont. If that's the kind of doctor you've been looking for, come talk to me:)

📞 720-856-4058 · link in bio

08/27/2026

Here's something modern medicine gets wrong: quality metrics.

Your doctor gets graded on how you're doing. Screenings all completed? Blood sugar in range? Good grade. Missed your colonoscopy? Numbers not ideal? They get dinged.

Now think about what that does to the conversation. If your doctor is incentivized to get you to complete a screening — and they've got five to seven minutes — how well is it going to go when you say you have reservations? When you're not sure you want it?

And what if something else entirely is in the way? What if it's not diet or medication compliance at all? What if it's grief? Stress? Something real that isn't on the page and never makes it into the chart?

Quality metrics leave no room for that. No room for the relationship.

Here's what I believe: if a patient doesn't want the colonoscopy, or their sugars aren't well controlled, but they still want you as their doctor — you've done a great job. You can take it one day at a time. You shouldn't be racing a clock to satisfy a corporation or an insurance company.

That's where Direct Primary Care comes in. It restores decisions about you being made by you, after a real conversation with a doctor you trust.

I'm Dr. Brian Juan, Metronome Family Medicine, Longmont. If this is the care you want — or you're a doctor and this is how you want to practice — let's talk.

📞 720-856-4058 · link in bio

08/22/2026

Metronome Family Medicine hit 100 members today. 🎉

I didn't even know until I just looked — I'm genuinely stunned!

A year ago I left corporate medicine to build something different here in Longmont. No insurance billing. No seven-minute visits. No third party looking over my shoulder when you and I make a decision together. Just a doctor you can actually reach, with the time to actually listen.

To the 100 of you who trusted a brand-new practice with your health — thank you from the bottom of my heart. DPC is all about a doctor deciding to run their own show, and I'm thrilled you're all here for the set. :)

And to anyone still on the fence: I'm still accepting new members. I'd love to hear from you.

I wrote the whole story — why I left, what I found, and how I got here — on the blog.

Photo of Sprague Lake, last Wednesday's hike to Rocky Mt National Park :)

A family doctor on why fee-for-service medicine is failing, how DPC is different from concierge care, and the day my Longmont practice reached 100 members.

08/21/2026

"Is Direct Primary Care the same as concierge?"

I get this question constantly. The answer is no — and the difference matters.

Both involve doctors who left the traditional system — the one where a physician carries 3,500 patients, sees 20 a day for seven minutes each, and burns out by age 48. But concierge doctors still work with insurance. They bill your insurer and charge a membership fee, usually $250–$350/month but sometimes much more. It's a great service if you can afford it.

Direct Primary Care costs half that or less — about the price of a cable bill. And here's the key difference: I don't work with insurance at all. Your care is just between you and me. No third party in the room, no decisions bent around what an insurer will reimburse. There's real freedom in that, and it's a big reason I'm here.

Every DPC practice is different, and the relationship is the whole point — so if one doctor isn't your match, another might be. What makes mine unique is a focus on midlife vitality. As a 52-year-old myself, I'm genuinely curious about what evidence-based medicine offers for longevity and health span — peptides, GLP-1s beyond weight loss, functional approaches to thyroid and hormones — and I share everything I learn with my patients. Plus all the everyday family medicine, all under one membership.

Want that kind of doctor? Come talk to me.

📞 720-856-4058 · link in bio

08/20/2026

If you've ever felt judged at the doctor's office — this one's for you.

The workload a conventional fee-for-service doctor carries leaves very little room for grace. So if you're someone who doesn't want to do a screening, forgets or doesn't want to take your meds, or doesn't want a particular vaccine — that hesitation often gets met with frustration. Patients who don't follow the evidence-based plan can feel like a problem.

I think that's a real shame. Because the last thing we should do as Western doctors is push people away from Western medicine. It isn't the only healing tool out there — but it's a powerful one, and I don't want anyone closing the door on what it can offer because they felt judged.

So I practice differently. I try to meet the things you're hesitant about with an open mind and real respect for your point of view — walking through the risks and benefits of doing something, and the risks and benefits of not doing it. And if I don't change your mind that day? That's okay. I leave the door open. You'll come back, and we'll talk about it again.

That's the whole idea. No lectures. No shame. Just an honest, ongoing conversation about your health.

I'm Dr. Brian Juan, Direct Primary Care family doctor in Longmont. That's how I practice.

📞 720-856-4058 · link in bio

08/18/2026

The numbers employers pay for health insurance are staggering.

In 2025, a single employee's coverage averages about $9,300 a year — the employer covers roughly $7,900 of it, the employee about $1,440. For a family? Nearly $27,000 total: the employer pays around $20,000, and the employee another $6,850 out of their paycheck.

That's nuts — especially when you look at what people actually get for it. Long waits to see a primary care doctor. Problems triaged to the ER that primary care could've handled. And a deductible — often several thousand dollars, much more on high-deductible plans — to meet before the insurance you're already paying for covers a thing.

All that money disappears into an insurance vacuum. And premiums climb next year anyway, because of all the ER visits and marked-up drugs the system drove people toward in the first place.

This is no way to take care of people.

Direct Primary Care is part of the solution. Wholesale-cost labs, medications, and imaging. Direct access to your doctor with same- and next-day appointments. Problems get handled with a text instead of an ER visit. Employees miss less work, their conditions are managed before they blow up — and they genuinely love the benefit. That keeps people engaged, happy, and loyal.

If you want to take better care of your team — and do healthcare the way it's supposed to work — let's talk. And if you're wondering about catastrophic coverage, there are real solutions that don't run through traditional insurance. I've got a lot of levers to pull, and I'll walk you through all of them.

I'm Dr. Brian Juan, Metronome Family Medicine, Longmont. Give me a call.

📞 720-856-4058 · link in bio