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BONUS EPISODE: The Business Side of DPC


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In this power-packed episode, we talk… BUSINESS.


Our guest, the remarkable Lauren Tancredi, is renowned for her Business genius - bringing over 15 years of experience in Practice Management and Implementation to support healthcare clinicians nationwide to launch, grow, and thrive in their direct care practices.


Lauren's insights provide a roadmap for clinical geniuses seeking to navigate the complexities of the DPC landscape. From conquering imposter syndrome to harnessing the potential of evolving practice models, and having the ability to walk the talk as a DPC entrepreneur - this conversation is packed with actionable advice.


“The complication is medical insurance, and taking it out of the equation… is like magic!”



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Transcript*


Direct Primary care is an innovative alternative path to insurance-driven healthcare. Typically, a patient pays their doctor a low monthly membership and in return builds a lasting relationship with their doctor and has their doctor available at their fingertips. Welcome to the My D P C story podcast, where each week you will hear the ever so relatable stories shared by physicians who have chosen.


To practice medicine in their individual communities through the direct primary care model. I'm your host, Marielle conception family physician, D P C, owner, and former fee for service. Doctor, I hope you enjoy today's episode and come away feeling inspired about the future of patient care direct primary care.


Lauren Reedy is a contributor to several successful ventures within the private medicine and wellness sectors. She's a serial entrepreneur whose personal experience is navigating complex healthcare systems. Led her to her current role as co-founder of Medica. Lauren's expertise in the business of private medicine matched with her astute perspective on the 360 degree approach to strategic planning and practice operations.


Has allowed her to launch, build, and grow retail-based clinics throughout the United States since 2008. Highly respected among her peers in the private medicine community. Lauren's contributions continue to influence the industry and be proven invaluable. Serving as both an innovator and educator, Lauren helps establish direct relationships between practitioner and patient.


Her style and scope of work are considered to be the gold standard, making her a highly sought After consultant, Lauren launched medic. The response to the rapidly changing healthcare landscape, recognizing the restraints that were being placed on physicians who were no longer able to achieve their dream of truly healing others.


Lauren's unique approach to implementing customized membership-based care and programs gives providers the opportunity to practice autonomously as an alternative to traditional healthcare systems.


Welcome to the podcast, Lauren.


Oh, I'm so excited to be here, Dan, with you, Mariel. It's always fun. Yeah,

it's, and you know, it's crazy because usually, you know, we're in a, a classroom setting, so to speak, you know, virtually, and like, you know, I'm just listening to all of your genius. But I'm so excited that you get to, you know, share your message and share like where you've come from in your journey and how passionate you are about the direct care movement with more people in the audience.


So, let's get started. So, When we talk about your involvement in Direct Primary Care as a business model, direct care for those specialists out there, the different clinics that you're working with, how did you even get started in working in the healthcare business?


I. Oh gosh. Um, well first thank you for being my number one student and like showing up and asking questions and being curious.


'cause if you're not doing that, then entrepreneurship is gonna be a really hard journey for people. And I think I did the same thing at one point in my life. I was asking questions because like many of you, I've got stuck in this. Really complex healthcare system. When I got in a car accident, got my appendix out, got my tonsils out with like in the short timeframe, and I literally remember being in the hospital thinking.


After they took out my appendix, they called me and they're like, Hey, your bill is gonna be like, it was like $17,000. And I was like 20 something years old. And I was like, this is not right. Like how is this happening to me right now? And I left where I had been living at the time in Florida, went out to Las Vegas and I started working for a clinic called Enogen Medical Institute.


And they promoted hormone replacement therapy. But I like wanted to help people. I've always wanted to really help people. And one of the beautiful benefits of. Working with them is that they actually would pay for college if I wanted to do something related to what they're doing. So I'm like, I'm gonna be a nurse because that's how I'm gonna help people.


And then I remember sitting in a biology class, like learning about the inner ear, and I'm like, what the hell am I doing here? Like I could give. Two cracks about what's in your ear. Like I am a business genius, you know, like, and so how do I use what I've learned in business and sales and promotion to support people in getting out their message?


And so that's when I started working with Dr. Life and he was writing books and we were going on tours. And while it wasn't direct care, it was like really a taste of what membership medicine was for me. And how we get to build relationships in order to cultivate sales and patients that generate outcomes in their life.


And so it was really, uh, my first kind of introduction to this private pay concierge direct care space. Um, and from there I met some really, really great people that were really trying to bring innovation and affordability into healthcare and makes it more transparent.


That's awesome. As people have heard on this podcast, when people are opening their, their stories with the story of where they came from.


Mm-hmm. It just really helps us all relate to each other, but also it helps us understand, you know, your why and why you're doing this, and why you're so passionate about helping everybody you've helped up to this point, and who you will continue to help going into the future. So with that, as you talk about, you know, that it wasn't necessarily direct Primary care as a business model that you were exposed to working with Doctor Life and doing, you know, and being out there as you were starting to to help people and help clinics.


How did you come to learn about Direct Primary Care as a business model, and how did you start shifting your focus to D P C focused clinics? Yeah, so, uh, during my time at Seno, I met a guy that started a company called N one Health. It was similar to like an M D V I P and what I learned really quickly was like when you're having to explain what concierge medicine is on top of membership fee, like it's so complicated.


And then all of a sudden this D P C thing comes into the world and it's like, actually, we're not gonna double dip. We're not gonna do these things. And it's like, oh my gosh, I've been speaking this language like cash is king all day long. Like, tell me like one flat price, how to do it. And so we started to, uh, evolve the practice models into more of a D P C type offering.


And part of my exposure to that was through Hint, I mean, I started using Hint Health back in 2013 when they first started, like bringing people onto their platform and then like coming into these places where I was going to medical conferences and meeting people, and also even functional medicine practitioners, like they all needed to do something differently and the complication piece was the insurance piece.


And so when we take that out of the equation, we know what, what happens. It's like magic. It makes so much ease and grace. And also there's an an education hurdle that we get to, to come across when we're like talking to consumers and like trying to educate them on what this thing is, right. And so I would say probably in, you know, five to six years into my kind of like more concierge style medicine and and background, I started to see direct care taking off and like really starting to, to make a way.


And I'm sure it was doing its thing before then, but it was like, oh, this actually simplifies the process even more. How do we make this work?


And I love that, you know, you're coming from it from, you know, a non, a non M D D O perspective. You know, clinician wise you are focusing on your business genius and looking at this model as a business model and, you know, a, a very.


Clean model in terms of like, we don't have to justify the fact that you talk to a family member about your dad or whatever because they, there might not be a code for that. And we don't have to like waste our time looking for a code to represent mm-hmm. How do we take care of patients. So I, I love that.


And when you come. Into the D P C ecosystem, thinking in your business genius space. I wanna ask about other things that you see in the direct primary care model. Uh, you know, in addition to everything you've shared so far. Accessibility, the, the cleanliness of just, or the transparency, I should say. Mm-hmm.


Of just, you know, we work for our patients. When you're talking to other business-minded people and not necessarily clinicians, what do you say to them are other pros and cons about the D P C model? Because I think that, you know, not everyone who has a business background understands the, you know, the differences between concierge and direct Primary care is a business model. But also, you know, they, they might, they, but they do understand, you know, when it comes to. P Ls. When it comes to efficiencies, when it comes to other things, how do you talk to people who are coming from the business perspective about D P C?


Yeah, so I like to say, you know, you save the life, we'll save the business because I don't like to step in the, the clinical genius space.


Like you guys have gone through years of training. You bring different expertise and so like, I think it's a really nice kind of melt when I bring like. Okay. Share with me like, what is the dream that you envision for your practice? And then we can start to look at all the tools and like, support that we get to put in place to make this thing work as a micro practice is a lot of the, the, uh, clients that I've worked with in, in my experience.


Right. So starting from there and then in terms of like, Looking at it through a, a business lens, looking at D P C through a business lens, it's like, how do we make sure that, you know, one, it's still affordable to the end, the end consumer, but it makes you guys money to pay the bills. And so what I've experienced is like this, is, this can be something that's done.


I mean, to your point and experience almost Marielle like with a very low overhead, like you could start with house calls, like you can dip your toes in the water here and also serve a population that still might be at need. We know that there's still a large pool of people that are uninsured and underinsured.


The other big thing too, and when I think about this is like. From a business perspective, like I've talked to friends and I was telling this story the other day and um, the DPC Accelerator through Hint was like, you know, my friend's like, I wanna quit my job from Amazon. I really wanna quit my job at Amazon, but I'm afraid because I don't have health insurance.


And I was like, well, lemme tell you about this thing called direct care. And this is how, no way, that's how much it would cost me. Like that's nothing like I thought I was gonna be coming out of pockets. And it's like you solve a huge problem for people that are, that are trying to do the same thing similar to you, which is remain independent and autonomous in their work and creativity.


And I think that's part of like what's really in the, in the setup pros about D P C is like, You can still be specialty within your family medicine niche, right? You can still take care and align with the patients that you really wanna serve and expand your focus and bring in new technologies and like.


You have time to like live and breathe the things that you're practicing and maintain a healthy lifestyle for your health, uh, uh, yourself as a practitioner, but also like you're walking the talk for the patient, which I think is huge. And when we're looking at folks that are like in traditional fee for service, like you're promoting, like we're decreased your stress, but you're in burnout yourself.


So how does that even work? Right? And so, Those are some huge pros. I think like in order to be effective in our leadership, like there has to be a way that we're like walking the talk and it gives you as, as D p C providers so much room to like do the things and have the experiences and almost be on the journey alongside the patients.


You're wanting to serve. So, you know, plus you get the things of like accessibility and you know, we've done really cool, innovative things with the, the practices that I work with, like building programs on top of it, having group walks. One of the things I'm a huge proponent of is like, Learning in groups, right?


It's like you don't have to do the one-to-one to keep, to, to demonstrate the value to your patients. Like do town hall meetings, go for one of my doctors did track walks for years with his patients and then they would go on their own little group and do it themselves and they became champions, like of their own health.


And it's like, it's so cool because. Like insurance doesn't pay for that. And if it does, like you said, you're digging through a book to figure out how to make it work and why, when you can be in like your creative genius and expression and, and like really evoking these feelings of health and creating outcomes for people, not just like in the context of like, take this and feel better about like, building community, right?


Building trust, allowing people to feel seen and heard and cared for in a different

way. See, this is why I could talk to Lauren all day. Like, I just, I just love, I love your history. I love what you're doing and I love that you know that you're free to do these things and there's people who have, you know, jumped off the cliff or whatever into the, the boat of autonomous practice and of freedom to be able to, to meet you there when you're talking these things.


Right? Like, it's so awesome because like you talk about like, If you're trying to tread water, like I think about my water polo, my single season of water polo. I was just like, I'm dying treading water here. Like, that's how it feels being, you know, you're, you're constantly trying to just survive in fee for service.


That was my experience. And so, you know, I, I love. Just being in this space where we can talk about, and then there's this other way of doing care. Yeah. So when it comes to D P C and physicians and whole clinics who are going from even fee for service to a d PC model mm-hmm. Or people are who are starting from the ground up, I wanna address the, it's, it's this big, you know, like discrepancy between.


I'm super confident to go to medical school, but I'm super not confident to open a business. How do you address that with people who are like, but I don't have a business degree?


Yeah, well that's, I mean, one why there's beautiful resources like you, your podcast, like the D p C community at large is so giving, and then I would say business is forgiving, right?


And so I think that one of the most challenging things I have with my clients who are predominantly physicians is like, get outta your own damn way. Like you are like creating barriers and obstacles where there doesn't even have to be any, right. And so entrepreneurship and somebody had written me an email this morning, like he is like, this has been like self therapy because all your stuff starts to show up all of your, like, like you said, like the chatter in the mind like, oh you, you think you can do this, you can't do this.


Right? And frankly, you guys probably took a beating in medical school. I don't know. 'cause I never went there. But I could imagine like, Not having to kill anybody is a big responsibility to take onto your shoulders. And so like there's a lot of folks that I have been working with in a consulting and coaching capacity where they're like worried that they're gonna break something.


And business it's like you can break it five times. It's totally cool. You know, like your customer's always right? As long as you're honest and transparent and you show 'em your humanness, like it totally doesn't matter. Then, you know, we're just become perfectly imperfect humans like everybody else that's walking the planet.


The only difference is like you're chasing your dream and you're creating impact in people's lives. Like remind yourself of that every single day. And so, you know, I like to work with intentions. I like to make sure that people are affirming what they want, and like sometimes we've gotta just like, Keep telling ourselves until we believe it ourself.


Right? Like, I can do it. You can do it. It's like Tom's the train. He's coming up the, you know, like, so yeah. I think, you know, the biggest challenge that I experience folks having is like, having you do it right. Having to do it perfect. This gets to be your playground. Like it, it is a sandbox. Build it, knock it down.


Like it is totally forgiving in business, it's just about your ability to get back up and do it again. When we talk about the, you know, showing up and being ourselves when people. I've already made the jump like myself. It's like, oh man, I know exactly what you talk of and that is totally real. Mm-hmm. I wanna go to the idea of, you know, how you say business is giving, but also we are seeing this like, but I'm not a salesman.


Like, I don't, I feel like ick about, you know, selling a practice. Like, I don't like to talk money, I don't like to talk finances, uh, but I do wanna do D P C. How do you respond to people who have those concerns?


Yeah, well, I would say one, it's all energy at the end of the day. Like whether it's dollars or hugs that you're asking for in return for your services.


Like there, I think that there's this mentality around being a healer, and I'm gonna call you a healer and I'm gonna get a little spiritual woo woo on you, but yes. You guys are here. Like you're here to heal. You're here to help support each other. And somehow along the lines of our thinking and our societal beliefs and norms, it's like, well, if we're helping somebody, we can't get an energetic exchange.


And that's all money is. It's like, Hey, I'm doing this thing for you and in in return, you're doing this thing for me so I can keep showing up doing this thing for you. Right? And so it's also really funny to me that, you know, physicians don't think they're salespeople, but guess who's writing the scripts?


Guess who's creating the care plans? Guess who's enrolling people in their journey to health? Like you are selling people all day long. And so what if we took that context that you show up in the room where it's like, Hey, I'm gonna stay here. I'm gonna ask you like, what did you come in here for? No different than like, how did you hear about me?


Let me, like, what do you need? Right? What are your, what are your chief complaints? Like, what are you looking for in a practice? It's the same kind of journey that you're going on, whether it's behind a closed door or over the phone or face-to-face with a prospective client. Like we're just getting curious.


And then at the end we get to make the recommendation of, Hey, I think you'd be great fit for our practice. Here's how it works. And it's like just moving into that money conversation. But for so many of us, what we weren't taught about money in school, we don't necessarily like balance our checkbooks like our parents did.


Everything's digital. We don't even touch money anymore. So our relationship with it, it's like out the door. And if you remember Mario, like one of the first things I said to you is like, start looking at your bank account. Remember?


Yep. Every Friday. Every Friday. Yep. No, I totally remember that. And it's, I literally, again, I was telling Lauren this before we started recording, like, I hear her voice, you know, not in the some crazy diagnosis code way, but like, literally I'm like, oh, Lauren said to do this, so I'm doing it.


So I I, I love that and I love that you're calling out all of us who are talking to patients about like, this is what I recommend, and you know, it's coming from that. Place of, oh yeah. Like, I actually do recommend things and people actually do understand, you know, where I'm coming from to recommend things specifically medically as well as, you know, socially, whatever, and they take that, that information to heart, that just being in that space has allowed me, you know, I don't know if this happens with other, with other clinics that you work with, but it's like, that's allowed me to not even focus on the, like, oh, I just, I'm not a money person, you know, in addition to checking.


You know, financial Fridays, I have come to talk to people during meet and greets about like, this is big trees, empty, this is the clinic we offer, and mm-hmm. Money doesn't even come up until the very end of the conversation because they've already gotten the, I want that care for me. Like I, I can, yeah, I can get that care.


Like you do that here in Arnold and, and so, When it comes to the meet and greet and people feeling confidence about going into this meeting where they're still, you know, they, they might still be getting comfortable with talking about what they're doing. There's people who open with the pricing of the practice.


There's people who open with. What is direct primary care? And then there's people who like, you know, like myself, I'm, I'm talking about like who I am as a physician because people are wanting me as their personal doctor. How do you talk to people about the finessing and the, you know, the envisionment of what is the purpose and how to effectively communicate the purpose of the meet and greet?


Yeah, so this is the art of enrollment, right? This is the thing that we were talking about before is like, How do you get people to believe in the vision? And even when you're writing the care plan, you didn't go say, Hey, here's your prescription. Now tell me what's wrong with you. Right. I mean, it's no different than that.


And so what really what we're doing is so many practices that I've been interviewing, they're kind of like, I ask a lot of the times, like, what do you want your patients to feel like when they leave the conversation or they leave the clinic from you? Right. And the majority of people tell me, I want them to feel seen and I want them to feel heard.


Now. And if I'm coming at you and I'm like, Hey, I'm interested in becoming a new patient, and all you do is tell me about the features and benefits and the doctor, do you think I feel seen or heard? Right? And this is the art of enrollment. It's like how do we allow ourselves to step back, hold space for who's showing up at our doorstep so that they can feel seen and heard, and then we can like, Provide a solution.


And to your point, Muriel, then they've experienced the essence of you. Then they know you can hold space for them and whatever challenges they are. Or maybe you guys decide like, Nope, it's not a good fit. 'cause personality wise, it doesn't work here. Right? But this is the art of enrollment. It's like you let them do all the talking because essentially they'll sell themselves. You just gotta show up energetically being who you are.


I love that. And that's, you know, the last conversation I had a couple days ago with a potential new patient. It was like, for me, I spend 15 minutes, it's been a, a work to rein it in 'cause I love to talk to get it down to 15 minutes. It used to be 21 minutes.


But what I would say is that for me, when I open the conversation, I'm like, I. What brings you to this meet and greet? Like how can I help you today? What brings you to even looking into, to this model of care? 'cause it's different from, you know, what you typically see in our area. And for me it's, it's things like that that help open the conversation and then you're right on in terms of like, I get immediately what that individual is looking for or that family is looking for.


And that could be like, We just want access or we just want a person who actually knows us, or we just want to know like, is there another way to do care in terms of, you know, do we always have to use our insurance because we have a, a high deductible plan? I'm like, mm-hmm. Like that's a sort of a loaded question when people ask that, because I'm like, that's perfect.


Yeah. Perfect pairing for that. But it, it is so true in terms of. Just the idea of like what brings you to the practice and giving that space to the patients or potential patients to share. And we make it clear, you know, and I I, I'd love to hear your recommendation this, but like, we don't focus on, give me all your diagnosis codes and I'm gonna treat you over the phone 'cause it's just a meet and greet.


But when it comes to like, what brings you here, what are you looking for in a practice? Like what's the time they had anybody in healthcare ask them.


Right. Right. Totally. And so it's like, to your point, like if you're showing up at with an attitude of service versus sales, the whole game changes, right?


It's just like, how can I serve you today? And that's really where I focus. Like when I was still in at Synergetics, it was $30,000 a year. Like it took me six months sometimes to get patients to be enrolled. But how did I show up? I served them, like I sent them articles. I like followed up with them and then all of a sudden when they were ready, they came back to us.


And so, You know, I, I like to think a couple things. One, every no leads you closer to a yes and every no doesn't always mean no, it just might mean not right now. So for those of you who are not taking down phone numbers and names and email addresses, you are losing out because you do not know when the time will be right for those people.


And telling Mariel before I got on the call, like the last two months, my team has been secret shopping, direct care practices across the country. The majority of you are not answering the phones. Some of you are not calling people back. And there was a few like real diamonds in the rough that really got it and got into it and asked us about, you know, who we are and what we're looking for.


But most of you didn't even ask our name and phone number. You just went right into pricing. And so to your point, Mariel earlier where it's like, Hey, I asked them and then all of a sudden they told me they were looking for access. Now I can solve the problem with access, but if I just come out the gate not knowing that's what they're looking for, how am I solving for them?


How am I serving them today?


And I love that. You know, I, as you talk about every no is closer to a yes. Like it's also a yes in your head that you can mentally and emotionally do these meet and greets because it's like every time you practice is another time you've practiced doing your thing. Like your representation of what you are bringing to your clinic and what patients will experience in your clinic.


And I love saying that because, I have all of these people who have reached out and are like, you know, I just like, I'm so bad at this. Like it's very self judgmental and self-deprecating. I'm like, but you are one. Meet Andre. You know, more experience than you were prior to that last mean greet that you just did.


Yeah, yeah. It's like everybody wants to come out the gate. Perfect. Guess what? You are gonna fumble and fall and you know, your tongue gets tied. I do it too. And I've been doing this for almost a decade and a half. Like I get tied up. And then sometimes I'll say something genius and they're like, what was that?


And I'm like, I don't know. Thank God somebody recorded it because I don't know, you know, it just comes out the tip of my tongue. But even one of the guys that's in our, our cohort right now was saying to me today, he is like, there's some people that are saying no, and it's hard for me not to make it mean anything about myself.


And it's like, dude, it's got nothing to do with you. If it's got anything to do with you, then. We gotta like seriously consider why these people were your patients before they were even at this new, new instance of your clinic. And what I encouraged him to do was, all right, like this, you're just a beginner.


So if these people had been your patients previously in a fee for service environment, why don't you ask them, Hey, I'm just getting started at this thing. I am not a business owner. I'm a really good doctor. Or at least I think I am. So I'm gonna take, like you saying no isn't about me, but I'm curious, where did I fall short in making you say yes.


And what do you have to lose? Right? We're so afraid, and a lot of times, like I get on these calls with doctors and they're like looking for the next thing, like, what should I be doing? And it's like, dude, actually it's probably been right in front of you all the time. Did you follow up? Did you get the phone number?


Like all of the pieces are coming at you. It's just a matter of like, how are you present enough in your business to see what's possible? Because what happens is, I know you guys too well. You get so busy doing the things, looking for the next thing that you're like, fail to see what's right in front of you.


The pasture in front of you. So this next question is, is about tech because I, as we are squirreling all over the place, I, I love to tell people like, I don't have an addiction to like drugs, alcohol or tobacco, but I do have an addiction to tech. Like, it, it, I'm, I geek out so much when it comes to tech and when there's so much tech out there and when we can squirrel all over the place with like, oh.


How do you think about tech Stack? Like what is a tech stack, first of all, in your mind, and how do you recommend that people. Approach building their own tech stack. Yeah. All right. So tech love it or hate it. It's here to stay and you might as well use a little bit of it, if not a whole lot of it. But what we find on average is most people in practice have between 12 and 20 pieces of technology that they're using now, the biggest mistake that you can make is that people aren't managing it on the other side.


So we're asking the patients to put in their data, And then nobody's responding. So what happens? You're eroding the patient experience. So I like to think of a tech stack, but more importantly, an integrated tech stack of one that actually starts to flow communication across. Across programs or softwares.


And while it won't happen for a hundred percent of all the things that you're using due to like different HIPAA compliance and APIs and all of that kind of stuff that get the majority of them working. So if we think about, you know, sprint, hint, and elation, they have like a little bit of a trio going on there.


That's what I've recommended for years to people, right? Then you start to bring CRMs into the space, which, so let me back up. So definitely we need our E M R, right? Preferably with a patient portable. Ideally, if you guys can limit your characters on it, that's been a big help for a lot of folks that I've managed because it's like, if you can't ask it in a tweet, you probably need to come in for an appointment, in my opinion, as a non-clinician there.


And then, you know, do you want self-scheduling? That's a whole nother thing in your, in your E M R. Then you need your, you know, HIPAA secure messaging through an instance like Hint, or, I'm sorry, hint all in one or, or Spruce. I've used for years billing management. Another great piece of tech. And then a C R M, like I feel like those four things, you'd be really good, like in, in terms of practice, c r m, questionable.


But in my opinion, again, if you're doing the sales piece right and getting people's phone numbers and names, like you want a database to store them in, or at least a spreadsheet. And a C R M, which is a customer relationship management tool. I like to think of it for those of you who are not techie, like Mariel and I like, it's like an E M R, but for sales and marketing personnel, right?


It's like it's got all of the things so I can get my follow up tasks in there. I can write notes on the people, how they heard about us. I could put out email blasts, right? And so, Highly recommend if you're somebody who really wants to grow, invest in that type of, uh, of technology. And so when we get all those things working, it's like really great.


'cause now our e m R can tag the patients. It can update our list and the c r m and like that's like fully integrated tech deck. I will, if it's okay, I'm gonna do a shameless plug here, but on our website, which will be in the comments below, below, we have got a free tech stack checklist, which you can go through and like figure out like.


What are the different tools that I need for clinical management, for patient experience, right? So then if we think about patient experience tech, like are you using like wearables or you know, an InBody scale? Like what are you giving to people to like manage on a day-to-day basis so that they're constantly reminded of their health and that you're there for them?


Right. So it goes through a, uh, several and then it goes through the accounting piece, like it looks at all of these different pieces of tech and then you can put like what you have. And we've got a list of like recommended partners that we work with a lot of the time so that you can figure out like what are the gaps in the tech and is there a place for this stuff?


And again, going back to my first point is like, don't add more than you could swallow. 'cause if you can't manage it on the backside, it's just gonna hurt the experience more than help it.

And this is something that I'm embodying, uh, Dr. Christina Dahl out in Pennsylvania where she was sharing her story and she was saying how like from day one she has a spreadsheet of like, this is how much I spent at Target today on these items and all these things.


And I'm like, you know, Marielle is, is in the process of like, oh yes, I need to like list the tech that I have. So that is because for me, I would just like, Get all this tech and then I'd be like, oh, those, these are so cool. And then I'd be like, I totally forgot that I bought that. So we'll have a link in the show notes also in addition to the click down below, um, in the YouTube video.


But you know, when it comes to helping your future self, I always think about like, how do you help your future self when it comes to even listing your tech stack? And like for me, having like a, when I buy something now, I'm like, this is my thought about, you know, Could I use this piece in the tech stack to do this so I can like, it's like my notes, when I read my own assessment plan, I talk to my future self in terms of like, this is what my intention was.


But also there's tech stacks out there that, or there's pieces of tech stack out there where like, you know, there might be like a 60 day trial and then you can try it out and see if it works or not. Like I can geek out on this all day. Oh my gosh.


Um, I know. And then, I mean, just to your point too, Mariel, like, Don't like set it and forget it, right?


Like if you are using tech, like go back in there, go through the patient experience, make sure that there wasn't any like feature updates or broken links. Like I did one thing once and it broke something and it took me like two months to figure out it broke. It's like no, test everything and. Talk to your tech or software providers because there's probably new features that they're rolling out so that you can get rid of some of the things that you might have had to integrate in because there wasn't a feature.


Right. On. One of the other things, I think one of the biggest challenges that we have in this space is like everybody wants it all in, like all in one, one dashboard. All of the things, and it's like, It's fairly impossible to get there, but you could probably get close and then just keep watching who's moving the needle so that you can like reduce, eliminate, change, upgrade, do, do your thing.


So, absolutely. And something for those people who are like, you know, exploring this world or new to the world of what tech you can find out there and what tech might be coming down. The, the pipeline is look for their roadmap. Like, that's typically the, the lingo that people use for, you know, what, what's on the short-term horizon in terms of what, what they're building out towards.


So now that we've talked about tech and harnessing tech to do what you need it to do so you have time to do other things like, you know, spend time with patients where that's where you're working at, the highest ability of your training and ability to think and, and operate when it comes to boundaries.


I wanna ask about how you. Talk to people about, you know, going from this place of you were expected to see potentially, if you're in fee for service, you know, like so many people per day and like every single little code that you can harvest money from, like you have to work your, your tail off versus a model where it's like, Nope, this is totally different.


Like this is a membership based model. This is, you know, a per visit model for those, uh, specialists who are not doing memberships, how do you advise people to set boundaries so that they're not also going into the rabbit hole of like, I work 24 7, I'm gonna respond to every single message. And there's those people who want to do that.


Yeah, great. But like, I got two kids under six, so like that is not in my wheelhouse.


Yeah, I mean, I think to your point, like there's some old dogs that can't treat new tricks. They're just gonna keep showing up and doing how they do it. And I think that, you know, there's a reason. There was something in your soul that was like, I gotta do something different.


And it's not just like for the patients, but it's like for you to be time with your family, for you to be home at night, for you to focus on your health again, right? The first thing is like, what do you want this to look like? 'cause it's your dream. And it could be anything. I mean, literally anything. You wanna work three days a week, cool.


Work three days a week. Like, I don't care what you wanna set up, as long as it's like communicated well to your patients. Right. And so a lot of the work that we do with our, our clients early on is really understanding what the membership gonna be like. But based upon like from a foundation of this is what I want my life to look like from a provider standpoint, right?


How much time I wanna put in, how much vacation time do I want? So that we can figure out like, what does utilization look like based upon this pathway that you put forward? And while people may only come in twice a year, like typically we say, you know, come in for an annual physical, a follow-up to acute care visits, a couple telemedicine visits.


It's like three, three and a half hours that we might see per member per year. And so how many people can I serve if I'm working part-time at a thousand hours part, you know, full-time at 2000 hours in a year, so that you can really start to shape your experience, right? And then you gotta carve out time for like admin and all this other stuff.


And so before you even get your first patient, I'm like, you know, meditate on what your days get to look like. Start to bring that stuff into light and then we'll start to put this framework of like, okay, what do I need to carve out so that I can operate with ease, grace, and have fun in this space and market my practice and look at my finances and, and, and, right?


Like there's a lot of little nuances and all you have to do is set time. 'cause from that place now I can say, Hey, when you're due for your annual physical, this is what happens. This is how it happens to follow up when you need same day, next day care. And for those of you who are worried about urgent care, are like, Text messages after hours.


Like this is what 9 1 1 is for, this is what I am for. And when you need your pharmacy refilled at five o'clock on Friday, good luck. Like that's not an urgent thing. You should have thought about that days before because you are being responsible and you are empowered for your health. Right? And you just like set these boundaries up front.


And we do it through an onboarding process, right, where we have a welcome kit and we put together all of these different things on how to be with the practice. And then we teach people, we teach people and we teach people and then we teach them again, and then we remind them. Then we teach them again because that's what the gold standard, like brands like the Ritz-Carlton and Nordstrom Racks, that's what they do.


They keep teaching their people so that they can be empowered to show up in a way that that serves.


I love it. And you know, just literally right before this call, we were doing a, a. A screen recording on my phone about how do you refill medications in our, uh, patient portal because for some reason, like we needed to change our, our YouTube video of this previous posting because our nurse has multiple people asking like, how do you refill medicine?


Or like, you know, where do you go to refill medicine? It's like, great, like when you get. Questions asked over and over again, or you know, that you're going to expect that patients will ask you like, how do you refill a medicine in this new practice that I have joined? You know, thinking about how can you do things like, like literally a, a screenshot video on the phone?


It takes a. A minute and 21 seconds officially of that last video. And then we have that link permanently so that we can embed it in whatever we need to onboarding, like you're talking about onboarding, um, welcome kit. Mm-hmm. You know, a auto reply to patients asking that over, you know, a portal message or texting app, you know, so thinking about.


If you were a patient experiencing your practice from the get go, how would you want it to be? Could you put yourself in your patient's shoes to see like, oh yeah, that could be frustrating. And you know, always think about that. You can change your practice because you don't typically have 16 administrators telling you like, we're gonna have to take that to committee.


And then 16 committees will have to approve it and then we will be able to see yes or no, or we will defer that to a, a different year. Right?


Right. Yep. When your advisory board is like your dog and your kids, like it's easy to get things done. You know what I'm saying? It's like, and this is the hard part, like we've been so conditioned to like show up and do for others.


Like this is the creative play space, right? This is where you get to make anything happen and. Like Muriel said, like, and I've already alluded to like, usually what you need to do is showing up right in front of you. When there's people asking the same five questions, solve it, right? It's like you're constantly being shown where you get to navigate.


It's your duty to respond. Your duty to respond to these folks and to build a thing that feels aligned. And if it's not feeling aligned, then get rid of the things, right?


Absolutely. So when we talk about being in alignment with our practice with our patients, I wanna go now to finding people who are in alignment with understanding what D P C is as a business model, what membership models are, and.


You know, for me, I had created this Yelp like directory of a bunch of resources that is actively being built out and added to all the time with people who are understanding of direct primary care, where people in within our space can leave reviews about, you know, my experience with so and so. And the reason I was inspired to do that was because I had so many stories that broke my heart of like, you know, I, I had my, my nest egg from my D P C and I invested it in, you know, Such and such vendor, such and such tech, and at the end of the day, it wasn't in alignment with D P C.


They didn't even understand D P C. The copy was so, so bad. I had to pay someone else to, you know, build my website again or whatever it is. And so when it comes to. Being in alignment with your own practice and reaching out to people who are in alignment with D P C and understanding of D P C, how do you advise people to talk to, you know, whether it be a tech company or whether it be a consultant or a marketing person?


How do you talk to people about these, of the strategies of how to actively find someone who is in alignment with the type of practice that you are trying to build or you are growing? Yeah. Well, I think that usually like when you get clear on what it is, What or who you wanna call in, it will start to show up for you, right?


Like, I believe that the, that things start to come and flow. You start, you know, they call it saturation and marketing. It's like, oh, when you think of a Tesla and you wanna drive a Tesla, then you see 10, 10 Teslas on the road, right? Like, so again, pay attention to those universal signs. And there's no coincidence that the people that you're meeting in this direct care space, like have likely been through the same challenges that you have.


Ask, ask the community, right? And then from there, do a greet. With the organization, go take a demo. Kind of to your point around tech, like play with the software, does it make sense and talk to people that have been through the experience? I mean, every single person that we talk to, we go through like a discovery call.


We interview them for the practice, we interview them for more for us than we do for them. Like I know I can help pretty much. The majority of the PR practices that come in, but it's like, who do I wanna work with? And so for me it's not just like the tool or the tech, it's like the energetic alignment.


Like are they serving in a, like do they wanna create impact? Are they cre, are they putting outcomes before they are putting dollars, you know, income. And so, you know, and I wanna work with people that are like, have on the mindset of like being a beginner again and being curious and open and you know, there's some people that.


Love being in this like, kind of startup space because they can be contributors and then there's, you know, other tech and folks. For a long time that understand the framework and can, and can go. So it's like, it's really about aligning your values with who you're working with at the end of the day. And to, to Mariel to your point, it's like there is a, a universe or an ecosystem and it's through like D P C Summit and the Hint Summits and the Health Rosetta Fest and like your directory and like.


There are in, you know, D P C Frontier, like there's things out there that can point you in the right direction. And when all us fails, ask, and if you're afraid to ask your peers, your colleagues, the folks in the D P C community, you're gonna have a hard time asking for the sale from your patients. Start getting comfortable, being uncomfortable and showing up in ways that you probably never thought you'd have to before.


'cause this is the goal. This is where the everything starts to unlock for you. And everything towards that goal is so meaningful and it really like returns. Like you, you, you've been saying all along, you know, it returns you to yourself. You can think about like, how can I show up to help others to put my intentions out there so that I am doing what I'm proud of at the end of the day.


And so that, As a physician, like we're, we're doing the best for our patients without getting the stressors of like, well, I wanted to do that, but it's not on your formulary. So, you know, I I absolutely love that. As people are growing their practices, something that's coming up now is, you know, what happens if you're a physician who's looking to retire in the next, you know, five, 10 years when it comes to how to value a practice.


This is, this is something that isn't talked about a lot. I was talking to my cousin who worked in a family practice clinic in Canada, and then she is now a hospital administrator. She was talking about how, you know, she understands direct primary care in terms of like what the model is, what it totally makes sense from a business perspective to her, but she was talking about how she would still think that it's important to do things like code your visits in terms of the I C D 10.


To potentially say, you know, like at the point now I'm ready to sell my practice, this is where I can say like, I have, you know, 75% of my patients have hypertension, or like 20% have diabetes. So this is what you would be expecting to, you know, take on if you were to buy my clinic. How do you think about and how do you advise people when it comes to how do you value your practice?

So that you could potentially have a dollar amount to be able to sell, not only, you know, go go from a space of selling to members, but also then to sell to other clinicians or other physicians your own D P C.


Yeah, I mean, that's a great question and I don't know that we have a ton of evidence or data in the space that will show that like, Show that there's a formulary for doing it.


And I think, again, like we're in this early adopter stage, I think, I feel like we're crossing the chasm. Like there's been a lot of momentum in the last couple of years. So like we're finally taking that leap in terms of business and awareness. But you know, traditionally fee-for-service practices would evaluate the assets within the practice.


And that's like, okay, you're getting paid for your computers and your chairs and that stinks at the end of the day. And so really I think that, you know, it's more of like creating a succession plan. Anything for, for folks? I mean, that would be my recommendation is like, don't just pull out and sell, like bring somebody in, start to transition your patients so that there's actually value and you can actually do like a formulary, like ebitda, right?


Five times your. Your EBITDA so that you can actually have a dollar amount at the end of the day, because if the patients don't stay when you leave, you're in trouble. So it's like, you know, it's like, I think that there has to be like a short-term investment from a, for a long-term gain, where you're like actually working and co-facilitating care plans for, for patients in order to effectively move.


I mean, that would be my humble opinion. I don't know that there's even a real, like, Solid answer to advise people on. But I think that once we start seeing these folks, like the first generation of practitioners retiring like they did so many other ways, like they're setting the foundations for like what we actually get to put into practice.


And you know, one example, uh, that's fairly recent as of the date of this recording is, uh, Dr. Allison Edwards, when she sold her practice to Dr. Kylie Vanneman, you know, there, there was a, there was a period of transition and she talks, it's episode 89 of my D p C story about how she transitioned her patients.


And, you know, I, I definitely think about. There, there will be be a point just for my own personal choice, where like, I, I would like to do more traveling than practicing of medicine. And so, you know that that is years down the line, but at the same time, thinking about. Your words, how you said, you know, in, in one of the sessions that we were on, what's your one-year plan, your three-year plan, your five-year plan, your 10 year plan?


And for me that would be potentially in the 10 plus year plan to think about. Because I, I think about how frustrated I get when I don't, you know, do things like record my tech like I shared earlier. But if I think about like, It's not today, but I'm planning for the future. Just like investments, you know?


How do you think about your practice to be able to address that issue in the future? I think it's super important for us as a movement, but also individually to think about so that we are thinking about alignment with our future selves.


Yeah, absolutely. I think that's a, a huge point. And, and at the end of the day, I think we all get to write our own story, like whatever that looks like in including like the sell of our practice, it's like, can you have the same amount of passion and excitement that you do for D P C when you're selling a patient, when you're, when you're actually offering somebody to step into a turnkey business?


Like it's, it's fairly priceless. Awesome.


So with that, specifically at Medic, What is coming down the pipeline for you guys and how do people get in touch with you after this podcast?


Awesome. So I think below in the show description, there's gonna be a link to our website. Go there, get your tech list if that's something that's exciting for you.


But you know, we're in the business of being practice architects or practice implementers. Like you dream it, we design it, build it, make it flow and go, whether it's tech or systems operated. Right? And then our sweet spot's been sales. We've been doing sales for. Half a dozen practices across the country where we take all of the inbound phone calls and what we've noticed, and to my point around like we've been shopping practices to find out like.


Hey, I keep hearing this saying called My practice isn't growing, but when you're not answering the phones, you're not doing the follow up, you're not marking down people's names and phone numbers, you're failing at sales. And so we're launching this sales mastermind, the art of enrollment in the the early fall September to really help hold you guys accountable to work on calls with you to do outreach, like to literally like be the mentor in terms of the sales game.


And so, That's the most exciting thing that I have on the agenda. 'cause it's like I never thought I was gonna be a salesperson and here I am doing sales all day long. It's like, how is this happening? It's like, oh, I just get to be the experience of me and like, and like I said, people will be like, what did you just say That was so awesome?


I need to like write that down. It's like, I don't know, I'm just being myself at the end of the day. So how do we show up authentically in sales and use the tools that we have so much access to at our fingertips? It's like so exciting. The, like the technology era that we live in and scary sometimes, but more exciting than not that we can really like harness these tools to help, help expand our reach and our impact.


Awesome. Well thank you so much Lauren, for taking the time and sharing about what you are doing at Medica and also just about, you know, empowering people to think about their practices and to grow in their practices that are in alignment with their why and their future. Yeah.


Thank you for having me.


It's always fun to, to connect with you and talk to the D P C family.


Next, we look forward to hearing from Dr. Stephanie Phillips of Front Porch Family Medicine in Royston, Georgia. If you've enjoyed the podcast and you haven't yet done so, subscribe today and share the episode with a physician you may know who needs to hear about DPC. Leave a five star review on Apple Spotify now as well, as it helps others to find all these DPC stories.


Lastly, be sure to follow us on social media. If you're wanting to continue learning more about DPC in the meantime, check out dpcnews. com. Until next week, this is Mariel Concepcion.



*Transcript generated by AI so please forgive errors.

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