Why U.S. Medical Education Needs a Rethink with Dr. Laurel Fick

Redefining Medicine: My Conversation with Dr. Laurel Fick on Building a Micro Practice and Beating Burnout

Hi everyone—Dr. Rob Beck here, host of The Interesting MD. I’m passionate about sharing the stories of physicians who are rewriting the script for what it means to succeed in medicine—without sacrificing wellbeing or the love that brought us to this field in the first place.

Recently, I sat down with Dr. Laurel Fick, founder of Niche Medical in Indianapolis, for one of our most thought-provoking and uplifting conversations yet. In this blog post, I want to unpack what I learned from Dr. Fick about micro practices, physician burnout, and her deeply personal journey to building a career—and life—that actually works. Whether you’re a doctor, a patient, or simply interested in the changing landscape of healthcare, I hope her story inspires you as much as it did me.

What Is a Micro Practice? Dr. Fick’s Radical Reimagining of Patient Care

Let’s start with something foundational: What is a micro practice? According to Dr. Fick, it’s exactly what it sounds like—a truly solo practice. No virtual assistants. No administrative staff. It’s one physician in command of everything from answering phones to sweeping floors.

At first, Dr. Fick set it up this way to keep costs low after leaving her salaried job and all its security (think: health benefits, 401k, and that all-consuming sense of corporate predictability). But as her new practice evolved, she realized that the autonomy and simplicity were more than a practical solution—they were the ingredients to rediscovering her joy in medicine.

She told me, “Everything about it is mine. I don’t have to worry about how others are interfacing with patients or how business decisions might affect care. There are no apologies for the system—because I am the system.”

Burnout, Ethical Crossroads, and the Courage to Walk Away

Not everyone is ready to make such a leap, and Dr. Fick’s journey wasn’t without its turbulence. Before launching Niche Medical, she was a successful medical educator for over a decade, serving as a residency director and sitting on national committees. By all external measures, she’d made it. But below the surface, chronic frustration with the “systems of medicine and corporate medicine” was eroding her ability to serve patients and residents.

“My job was to stand in front of residents and pretend things were okay when they weren’t,” she explained. “When the educational mission was no longer a priority for the institution, I couldn’t ethically continue playing a role in harming future patients.”

If you’re in medicine, I know you’ve felt that tension. The slow steady drip of exhaustion, paperwork, and compromise—the creeping sense that the system no longer aligns with why you chose this calling. Dr. Fick’s story is a call to action: you can draw a line in the sand and choose something different.

Prevention, Longevity, and a New Path Forward

So what does Niche Medical actually do? Dr. Fick’s practice is laser-focused on prevention, metabolic health, and longevity. Rather than managing crisis after crisis, she’s looking ahead—drawing a line from where her patients are now to where they want to be in their 80s or 90s. That means early testing, lifestyle medicine, polygenic risk assessment, and making herself available for high-impact, personalized primary care.

One of my favorite moments came when she described offering her patients a full hour of uninterrupted time, often sitting with fellow physicians who burst into tears—overwhelmed because, for the first time, someone had truly listened.

“This is how it’s supposed to be,” they tell her. If you’re reading this as a patient, imagine what it would feel like to have a doctor really focus on you—not for 10 minutes, but for as long as it takes.

Why Cash-Based, Fee-for-Service Makes a Difference

Let’s talk practicalities: Dr. Fick’s practice doesn’t take insurance. It’s cash-based and, uniquely, not membership-based—patients pay for the care they need, when they need it. This approach brings challenges, but also incredible freedom. She’s not beholden to coding, to pre-authorizations, or to jumping through administrative hoops erected by insurance companies.

Yes, it means she can’t serve every single patient—but she’s quick to point out that no practice can. What’s revolutionary is that by opting out of bureaucracy, she has flexibility to provide free care to certain patients or to subsidize those in need, because she’s the boss.

And here’s an intriguing vision for the future: Dr. Fick believes that as more physicians step away from overloaded systems, those who do remain will be able to offer better access to the patients who need them most. It’s about pushing back, together, against the status quo that’s left so many of us disillusioned and burnt out.

Healing Takes Time: The Power of Pausing to Reimagine Your Life

If you’re a doctor struggling right now, grappling with whether there’s hope for your career, Dr. Fick’s advice is clear: Give yourself space—a real pause—to heal and consider your next move. You don’t have to have all the answers before you leave a toxic or unhealthy environment. In fact, most physicians are so deep in the “pressure cooker” that they aren’t able to think creatively about what their future could look like until they’ve stepped away and given themselves time to recover.

For Dr. Fick, six months after leaving was when she finally realized how unwell she’d been. That healing let her build a life with hobbies, time for family, time for self-care—and, yes, even considering things like triathlons. She rediscovered that she actually loved medicine, once the oppressive weight of dysfunctional systems was lifted.

Advice for Physicians: Stop Accepting Burnout as the Norm

It shouldn’t be controversial, but it is: you don’t have to accept burnout as normal. You don’t have to see your physical and mental health, your family, or your joy as sacrifices on the altar of medicine.

Whether you’re ready for radical change or just thinking about dipping your toe in a new direction, remember that you’re not alone. There are communities and support networks out there (Dr. Fick recommends LinkedIn and women physician wellness groups), and there are as many ways to practice medicine as there are physicians.

If there’s one message I walked away with from Dr. Fick’s story, it’s this: You can choose something different.

How to Get in Touch with Dr. Laurel Fick and Niche Medical

Interested in learning more about Dr. Fick’s approach or connecting for support as you chart your own new path? You can find her on LinkedIn, Instagram, and Facebook, or reach her directly by email at laurelthickmail.com. If you’re in or near Indianapolis, check out Niche Medical for innovative prevention, longevity, and personalized care.

Final Thoughts: Let’s Change Medicine—Together

I hope Dr. Laurel Fick’s journey has given you as much hope and motivation as it’s given me. Whether you’re considering a micro practice, burnout is hitting you hard, or you just want to explore new paths in medicine, you have options, and there’s a community ready to support you.

If you enjoyed this story or have your own to share, drop me a line at rob@interestingmd.com or comment on our YouTube channel. As always, stay curious, take care of yourselves, and remember: we’re in this together.

Until next time,

Dr. Rob Beck
Host, The Interesting MD Podcast

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