Episode 45: Dr. Rosana Lastra (She/Her) of Head2Toe Pediatrics - St. Petersburg, FL

Direct Pediatric Care Doctor

She is wearing a Cat In The Hat Costume
Dr. Rosana Lastra of Head2Toe Pediatrics

Dr. Lastra is founder and lead pediatrician at Head2Toe Pediatrics, a concierge style direct primary care practice. Dr. Lastra is the first and only pediatric direct primary care provider in the Tampa Bay Area to provide house calls for all pediatric health needs. She can handle all pediatric primary care needs that a pediatrician would handle in the office, in the comfort of the family's home. Dr. Lastra is directly accessible to her patients 24/7 providing care that is not only convenient and accessible, but also personalized to the needs of the family.

In today's interview, she shares her story of how she always dreamt of being a pediatrician and how the fee-for-fervice model was not a good fit. She shares about the tools she uses and loves and how she is able to be a pioneer by being the first pediatrician doing virtual care and a house call-only practice for all pediatric needs in the Tampa area. Through her own practice, she is also able to let her creative side shine. Watch the video below to see more on this!

Dr. Lastra chats about her practice... with some of her friends!

Resources Mentioned by Dr. Lastra

Charm Health


Immunize.org - Vaccine Declination Document (pdf)

The Rainbow - Pulse Oximeter by Masimo





Dr. Rosana Lastra of Head2Toe Pediatrics - St. Petersburg, FL

[00:00:00] Direct primary care is an innovative alternative path to insurance driven healthcare. Typically patients pay their doctor a low monthly membership and in return build a lasting relationship with their doctor and have their doctor available at their fingertips.

[00:00:30] So direct pediatric care, how I like to call it instead of direct primary care to me means that you have direct assessability to me, a board certified pediatrician. This means that when a parent calls, no matter the time they get me, when a parent emails. When they need an appointment, same day, they get me.

[00:00:52] And that means that I get to build a community with my families, for, we get to know each other, and this really [00:01:00] opens a lot of doors in order to be able to learn more about them and what their kids need to keep them healthy. I am Dr. of head-to-toe pediatrics, and this is my direct pediatric care story.

[00:01:23] is founder and lead pediatrician at head to toe pediatrics, a concierge style direct pediatric care practice. Dr. Lustra is the first and only pediatric direct primary care provider in the Tampa bay area to provide house calls for all pediatric health needs. She can handle all pediatric primary care needs that a pediatrician would handle in the office in the comfort of the family.

[00:01:47] Dr. Lustra is directly accessible to her patients, 24 7 providing care that is not only convenient and accessible, but also personalized to the needs of the family. She opened head to toe [00:02:00] pediatrics in October of 2020.

[00:02:12] One of the pictures that you have on your website is the multitude of badges that you have had over the years as a doctor. And I wanted to start with, how did you end up transitioning from corporate medicine to your own direct pediatric care clinic? Yeah, so I will say that it was definitely a process when I was in residency, when I was doing residency, I kind of had the idea that I wanted to open up a clinic or do something that kind of.

[00:02:47] My own, but when I would talk about this to other people, or just commented, I got a lot of that. That's very hard to do. You gotta be really [00:03:00] sure that you want to do that. A lot of private practices are kind of dying and going, you know, being bought off by corporate systems. So I kind of put that aside and I really, what I really liked about my residency was the relationship that I got to build with the patients.

[00:03:16] So during residency, I was like, okay, I'm definitely going to be doing outpatient pediatrics because that's where you really build the relationships. But every time I was at the hospital, I really liked the thrill of the hospital. Like, oh, maybe I should do some hospitalists, but then I was like, no, but I won't get that connection that I feel when I'm in the clinic.

[00:03:36] So I ultimately decided to go outpatient, pediatric route. And I started working at a practice in San Francisco for, uh, a big corporate organization. And I was doing mostly outpatient and I was enjoying it, but I definitely noticed that after the first year, uh, it was different. [00:04:00] Definitely working outpatient as an attending versus a resident is a completely different view, a different perspective.

[00:04:09] I didn't like. Being feeling like I was rushing through appointments, especially like if a patient showed up late, but you're booked into certain time slots. You can't really spend the time to really get to know the families and build that community that I really appreciated during my residency. So I started to think a little bit more about, you know, why I really liked the hospital setting.

[00:04:34] And one of the benefits of a hospital setting is that the patients are at the hospital all the time. So you could spend time with them because he can kind of dictate your time versus having the time being dictated for you. So I started. Um, picking up extra shifts at the hospital and doing Noubar rounds or seeing patients, they also had some like [00:05:00] NICU shifts that I could picked up.

[00:05:01] So I would do those during the weekends or if it was during the holiday and they needed additional help. And I started to really like that. But over time, trying to do that, plus trying to have a clinic, it just, you just have no time for anything else. And I didn't like that lifestyle either for being able to spend time with my husband, talk to my family, take trips.

[00:05:25] So that's when I decided that I was going to quit and try to figure out what I was going to do. I remember I was talking to my husband and it was completely ruined. I was like, I am not feeling really happy. So I think I'm going to quit. And he was like, okay, go ahead and quit. And I think like literally the month right after I was like, I'm quitting.

[00:05:50] So yeah, that was a big moment because I did not have any plans as to what I was going to do other than I was going to quit. So I was like, I'm going to quit and I'm just [00:06:00] going to travel the world and I'm going to take this time to just really enjoy it and figuring out what I'm going to do, but I'm very type a, so I really like having plans.

[00:06:11] So that was really, really, really hard for me to do. And I started applying with locums companies and I applied to a few. And then that's kind of when I went on, like this full-time locum tenens, uh, path. And through doing that, I started to really understand more about what I liked and what I didn't like.

[00:06:33] And I think having all of those experiences together was kind of what led me to understand what I wanted to do for my own practice. So, um, I was doing locums 10. I was traveling off of the United States. That's where that photo of the multiple badges come from. Um, then 20, 20 hits and here comes the, so we can't really travel.

[00:06:55] Although at the beginning, pediatricians weren't very much thought off. So a lot of the [00:07:00] travel assignments got canceled and I actually started. Helping a clinic in the area and I was needed leading someone coverage. And by this point we were now living in St. Petersburg, Florida, because my family lives in Tampa.

[00:07:15] So when we decided to travel, we wanted to move closer to family. So when the pandemic hit, I, um, like I said, some of my trouble assignments got canceled. I wasn't really feeling comfortable with traveling side. Didn't want to continue to apply to more. And I decided to help add this outpatient clinics and why I was helping at this outpatient clinic.

[00:07:38] To see a lot of the struggles that families were having a lot, patients were not coming in. Parents were scared to bring in the kids. They felt unsafe in the clinic setting. And that kind of really opened my eyes into what can we do to provide better care for these families, because we're doing a lot of telemedicine and [00:08:00] transitioning to telemedicine that doesn't cover everything that families need at times.

[00:08:04] And it doesn't help alleviate the stress because there's definitely something different when you're talking to a doctor by telemedicine versus when you're talking to a doctor in person. And now some of these patients, I obviously was a covering provider. So it wasn't that they knew me as a physician. I was just discovering covering provider.

[00:08:26] That's never met and giving them advice for telemedicine. So it's like, how do I know that this is good advice? Or why should I trust this doctor that I've never met? Or I don't even know. In addition to all the stress that I'm feeling because of the pandemic. So, um, a lot of those barriers just kind of started to pop up more and in thinking about ideas, I thought of, well, uh, families are scared to leave the house I don't.

[00:08:56] And then in researching how that could be [00:09:00] possible, then I started to hit a lot of hurdles in terms of insurances don't cover house visits, and we can't do house visits and there are too many patients that we may need to be available in clinic for. So that's not a possibility. And just thinking through all of that, I started to look, yeah.

[00:09:21] I initially, I was like, well, what fits a concierge model where families are paying for the service in addition to like maybe using some of the insurance. So I went down that route and in doing a lot of Google search and posting on some Facebook groups, that's how I learned about CPC and what the drug primary care movement was.

[00:09:41] And then I got connected to a pediatrician's specific Facebook group on DPC, and that was super eye opening after seeing what some other colleagues around the United States telecoms do the DPC model, um, knowing, you know, thinking [00:10:00] back to my residency days when I was like, maybe I do want to open up something on my own, but not knowing what that could look like.

[00:10:06] All the kind of windows or doors started opened. And Alex is like, okay, this is what I'm going to do. And I think I can do this. And so. And you are a pioneer in your area because there's no other physician run pediatric practices in St. Petersburg, is that correct? Yes, that is correct. So I there's no other ones that are doing all house calls for well and sick kids in the area.

[00:10:38] Uh, through the DPC group, I did meet another provider who opened in Pinellas park, which is about 20 to 30 minutes from where I am. But they're in a clinic setting, um, primarily doing in clinic. They do offer some house calls. Uh, I'm not sure of the extent that they're offering their house calls, but, [00:11:00] um, they started, I think shortly right after me.