ROUNDS

Issue 02 — July 2026

After a year of building — it’s real. B2 Direct Care is open.

A monthly check-in from Dr. Brian — practice news, something to cook, and what's on my mind.

From the Practice

Introducing: Hospital-to-Home

The hospital is good at getting you better. It is not built for what happens after you walk out the door — the new medications, the follow-up that never quite gets scheduled, the questions that surface at 9 p.m. on day three. That gap is where people get readmitted.

This month B2 Direct Care is launching Hospital-to-Home (H2H): a structured, hospitalist-informed program for the first 30 days after a discharge. If you or a family member lands in the hospital, H2H means someone who actually knows the system is reviewing the discharge plan, reconciling the medications, and reachable while you recover — not a portal. Me. It runs as a short-term add-on for the month it's needed, then steps back down.

If this is relevant to someone you love, just reply — I'll walk you through it.

In the Kitchen

The protein-and-fiber sweet spot

Protein is having a moment. Fiber, as usual, is not. A recent New York Times piece (Sophie Egan, June 24) lands on something I say in the exam room all the time: most of us get plenty of protein and nowhere near enough fiber — the targets are 25 g a day for women, 38 g for men, and most Americans miss them. The catch is that very few foods bring both. Meat is protein with no fiber; most fruit is fiber with little protein. The overlap is a short list, worth building meals around:

• Beans, lentils, and other pulses — top of the list. ½ cup cooked lentils ≈ 9 g protein + 8 g fiber.

• Tofu, edamame, soy — ½ cup edamame ≈ 9 g protein + 4 g fiber.

• Nuts and seeds — 1 oz almonds ≈ 6 g protein + 3.5 g fiber; chia ≈ 5 g protein + 10 g fiber.

• Whole grains — 1 cup cooked quinoa ≈ 8 g protein + 5 g fiber.

Practical version: anchor one meal a day on a pulse, keep nuts or seeds somewhere you'll actually reach for them, and make “whole” the default when you pick a grain. No supplement required — this is the corner of nutrition where boring and effective happen to be the same thing. 5 Foods That Contain Both Protein and Fiber

Field Notes

From hearth to hospital

This month I published the second piece in my How Did We Get Here series — the history of how medicine left the house. For most of the 19th century the doctor came to you; he sat at your kitchen table, knew which stair creaked and which grandmother hadn't left the back bedroom in three years. By 1950 that was gone. Anesthesia, antisepsis, X-rays, and the 1910 Flexner Report pulled medicine into the hospital, and the gains were enormous — but we traded continuity for capability without ever naming the trade.

I'm not nostalgic for kitchen-table surgery. But direct care is, in part, an attempt to win back the part of the bargain that got lost: one physician who knows you and is reachable when you need them.

→ Read “From Hearth to Hospital”

Currently Reading

I confess I’m still reading Theo of Golden — thank you to everyone who wrote in telling me how great it is. I'm about halfway through and won't pretend otherwise; reading for pleasure fell off my list years ago and I'm slowly rebuilding the habit. I've got a flight Wednesday — my old reading ritual — and plan to finish by week's end.

On the Calendar

A bit of context before the list: the practice is still in its soft-launch stretch, growing the way I'd hoped — word of mouth, friends telling friends, people who've actually talked through what direct care is. If that's how you found your way here, thank you. It means more than any ad could.

Hospital-to-Home — launching this month.

DPC Summit — I'll be there at the end of this week, learning from some of the best in direct care how to make this practice the best it can be for you.

Culinary medicine sessions — in development for early 2027.

• Meet & Greet — book here

• Membership info & pricing — check out the new webpage

Reader Challenge 

This month's challenge: reclaim your mornings.

Pick one small thing and hold it for 30 days. Mine: no devices for the first five minutes after I wake up, adding five minutes each week until I'm at thirty. Start almost absurdly small — the point is the streak, not the size. Reply and tell me what you're trying; I'll report back next month on how mine went.

Know someone who needs this?

Forward this email. Word-of-mouth is how a practice like this gets built. No mass advertising. No gimmicks. If you’re receiving this email, you know me and the level of care I give to patients. That’s the best advertisement I have.