A Nurse Practitioner Left the System During the Pandemic. Now She Runs Leesburg's First Direct Primary Care Practice.

Amanda Gaskin spent years in healthcare knowing something wasn’t right. She was a nurse practitioner moving through a system that kept asking her to see more patients, chart faster, and spend less time on the problems that actually needed time. The pandemic didn’t create that tension. It made it impossible to ignore.

When she finally broke from the traditional model, she didn’t go to a larger health system or a corporate practice. She opened a direct primary care practice in Leesburg, Florida — the first one in Lake County.

Inside Lake covered her story this week. What the coverage makes clear is that this wasn’t a career move that happened overnight. It was a deliberate build, starting with a business plan, an SBA loan application, and a consultant she found through the Florida Small Business Development Center at UCF.

The Business She Built Before Opening the Doors

Most DPC origin stories focus on the clinical decision. Gaskin’s includes the business architecture behind it, which is rarer and more useful for practitioners still weighing the leap.

She worked with a consultant through the Florida SBDC at UCF, a network that helps small business owners in the state navigate planning, financing, and launch. Her consultant helped her translate clinical ideas into a bankable business plan. That plan made the SBA loan possible.

DPC practices are fundamentally small businesses. They run on membership revenue, manage overhead without insurance billing, and depend on economics as much as medicine. For nurse practitioners and physicians who’ve spent careers inside institutional systems, the business layer can feel foreign and paralyzing. Gaskin found a resource designed exactly for that gap.

SBDC networks operate in every state, typically housed in universities and funded in part through the federal Small Business Administration. Most practitioners don’t know they exist. Gaskin used them. The result was a professionally structured, funded practice in a county with no DPC history.

What Direct Primary Care Looks Like in Leesburg

Ultimate Health DPC operates on a monthly flat membership fee. Members pay monthly instead of billing insurance per visit, and in return they get same-day access, direct communication with Gaskin, and appointments long enough to address what actually brought them in.

The practice is designed to cover the large majority of what patients typically need from primary care, and it goes broader than most people expect from a DPC clinic. Services include routine and preventive care, sick visits, chronic disease management, weight loss support, hormone therapy, and 24-hour access via phone, telehealth, email, or in-person visits.

What makes the model work clinically is panel size. DPC Frontier data shows most DPC practices carry 400 to 800 patients, compared to roughly 2,500 for a typical fee-for-service primary care physician. That ratio change is what makes the deeper patient relationship possible.

“At Ultimate Health DPC, we put the patient back in the center of care,” Gaskin said. “Personal attention is what we offer.”

That’s the promise DPC makes. What made Leesburg an interesting test case is that nobody had made it there yet.

When the Doors Opened

The patient response was immediate. Ultimate Health DPC reached 50 percent of its first-year patient goal within 30 days of opening.

That number is worth pausing on. Gaskin wasn’t converting patients from another DPC practice. She was introducing the model to a market with no existing DPC culture. Patients were choosing DPC for the first time, which typically requires more explanation, more trust, and a longer sales cycle. She hit half a year’s target in a month.

It’s a data point that challenges the assumption that DPC needs an established market to thrive. Unmet demand existed in Leesburg before the practice did. When the practice opened, the demand showed up.

What This Means

Amanda Gaskin’s story matters for reasons that extend well beyond Lake County.

For practitioners still inside the system, feeling what she felt during COVID, the story is a form of validation. You don’t need a tech-backed platform, private equity backing, or an existing patient network to open a DPC practice. You need a business plan, access to capital, and a community that doesn’t have one yet.

That last requirement is easier to satisfy than it sounds. The DPC Frontier mapper still shows large gaps across the country, including many mid-sized communities that would support a practice at the scale Gaskin built.

For residents and NPs approaching the end of training who are already feeling the friction she described, the SBDC path is worth knowing about. Free or low-cost small business consulting is available in every state. SBA loans are accessible to healthcare providers. The infrastructure for starting a DPC practice is more accessible than most clinical training programs suggest.

The pandemic broke something in a lot of healthcare workers. For some of them, what it broke was their willingness to stay in a system that treats speed as the primary metric. Amanda Gaskin found a different answer to that question. Thirty days after she opened the door, half a year’s worth of patients had walked through it.