Updated: Oct 17, 2022
Direct Primary Care Doctor
From Dr. Buenostro:
Being born in Turlock, I am proud to now serve the community I grew up in. I am committed to providing high quality, patient centered care with compassion and dedication to each one of my patients regardless of race, religion and socioeconomic status. I am proud to be able to do this by taking part in the Direct Primary Care movement which makes healthcare more affordable and accessible.
I am a first generation American, the son of two Mexican immigrants. I went to Medical school at Universidad Autonoma de Guadalajara and attended residency at UCSF Fresno Family and community medicine program. After residency I worked three years at an FQHC and later started Buen Vita Health.
I am a entrepreneur at heart. I have three businesses which started after residency. My first business involves farming 20 acres of almonds which I highly recommend doing as it grants many taxes write offs, and as we all know, Dr's need write offs. It also taught me lessons in business and how to manage employees. My second business is a wedding venue and my third business is my DPC clinic. The purpose of bringing up my first two businesses is because I feel this was something that prepared me for my dream business which was to start my own practice.
I used to joke around in residency that I was going to do a fellowship in starting my own clinic (which I personally think should be promoted).
In my free time I love spending time with my 2 children and my amazing, supportive wife. I enjoy playing basketball with friends, farming, horseback riding and learning more about DPC and how to be a better leader in my office. I am blessed to have the right people around me who have taken part in making my dream come true.
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A note about today's episode, there is some language that may be inappropriate for young listeners, so please consider this as you listen today. Thanks for tuning in.
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 DPC Story podcast, where.
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, Maryelle conception, family physician, DPC 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.
DPC for me is a way to be able to have an open door policy to whoever comes through the door. It doesn't matter if they have insurance or not. It doesn't matter where they come from; be able to do your best to provide healthcare to them and help 'em get to their best possible health.
So that's my mission from when I started medicine was to provide care to anybody that came in and asked, asked for my help. So this is the way that I, found out that I could do it. And it's been a blessing to be able to do this model and provide care to anybody that comes in through my door. My name's Dr. Buenostro from Buen Vita Health and this is my DPC story.
Hello everyone. My name is Carla. I am Dr. Sr's wife. It is an honor for me to introduce to you, my husband, and read to you his bio. Being born in Turlock, he is now proud to serve the community he grew up in. He is committed to providing high quality patient-centered care with compassion and dedication to each one of his patients, regardless of race, religion, and social economic status.
He is proud to be able to do this by taking part in the direct primary care movement, which makes healthcare more affordable and access. He is the first generation American, the son of two Mexican immigrants. He went to medical school at LA
and attended residency at U C S F Fresno Family and Community Medicine Program. After residency, he worked three years at an fqhc. And later started Buni to help. He is an entrepreneur at heart. He has three businesses, which started after residency. His first business involves 20 acres of almonds, which he highly recommends doing as a grants, many tax write-offs.
And as we all know, doctors need Writeoffs. It also taught him lessons in business and how to manage employees. His second business is a wedding venue, and the third business is the DPC clinic. The purpose of bringing up the first two businesses is because he feels this was something that prepared him for.
His dream business, which was to start his own practice. He used to joke around in residency that he was gonna do a fellowship in starting his own clinic, which he personally thinks should be promoted on his free time. He loved spending time with his two children. His amazing wife. I promise I'm reading his bio.
This is what he said. His amazing, supportive wife. He enjoys playing basketball with friends, farming, horseback riding, and learning more about DPC and how to be a better leader in his office. He is definitely blessed to have the right people around him who have taken part in making a stream come true.
to the podcast, Dr. Buenostro!
Thank you for having me. Maryelle it's a pleasure to be here. I think it's kind of cool cuz you, you talked to me when I first opened my doors and reached out and I was like, there's somebody out there doing DPC too.
So it's always cool to talk to you now that things have been moving along almost two years.
Absolutely. And November will be two years for you. So it's so exciting. And I remember that day when we first chatted and it was all because I saw your Instagram post and I had no idea that there was a DPC in Turlock.
And so I'm really excited to get your story out there on the airwaves and for people to know what you know care is like in your neck of the woods.
I want to open with the fact that you are practicing in your hometown.
So when you shared in your opening statement about how, your mission that you always wanted to fulfill in medicine is really coming to life in your DPC. What was it that made you wanna practice in your hometown? Specif?
So I think that always was my dream was just to come back home and provide care where I came from.
So that's always been my, dream ever since I started was to come back over here. And it, it's kind of crazy. I met when I was in, I wanted to be a doctor since I was a little kid. My elementary teachers always go, oh, you always say you wanna be a doctor type of thing. so it was funny cuz in high school I met a, a doctor.
His name's Dr. Rual kava and he's an attending doctor at the U C S F Fresno program. And My, uh, grew up Catholic and my mom knew of the priest and he knew his family and he said, Hey, he should connect with him because, I know he wants to go to medical school and it'd be cool to, talk to him.
And so that way he could kind of guide him or give him some advice. And uh, we went over there with my parents and I met his family and man, he was uh, they're outta Houston. I don't know if Houston, it's a small town close by here. And I just, I saw my family there. I saw his parents looked like my parents.
They're like, they were humbled. The dad worked in the fields. His mom was really hospitable when we got there. Brothers and sisters were out there, played in the yard, they're having a barbecue. and he was really nice. He's like, Hey, yeah, you could do it. You know, You could be a doctor. I went to Stan state here in Turlock.
Then I went to LA he's on then I, right now I'm in Fresno doing my, my residency. And if I could do, you could do it. And that kind of lit up more fire in me to be able to, follow him. And he was my mentor. I I only applied at one college, which was Stan state and only applied at one medical school, which was and then I applied to two residencies actually, which.
Modesto, I think you interviewed me there which is kind of funny. But like, I know you interviewed me. I was like, I think I have a clear picture of you interviewing me in my head. And then I also interviewed at Fresno. So Fresno was my number one. And then you guys were number two in in the match.
And I mean, things, I don't know how things were gonna line up with the match, how it's crazy. So I got, I got picked, know, I put them number one and they got me on, so I went over there. And you guys were green Modesto. So I, I remember getting some calls from some of the really like, what the hell aren't they gonna go over here?
And I was like, oh, I felt bad, but he was my mentor. So I was so happy just to be there. And, you know, he, he. When I graduated from residency, he said, man, this guy's like my mind me. He followed me through my under, he went to college where I went, he went to med school. I decided to stay here as a, as an attending.
But you know, when I first did this, I thought I was gonna go back home and serve my community where I came from, but he's gonna go back and do that, and that's what I did, and it's, it's been it's been cool. It's been cool to be, be back home and serve the community.
I grew up in and serve some, I mean, I have friends that I went to high school and have kids and they bring them into the clinic and, , when they say, Hey, man's really cool to see what you're doing, and it feels good. And.
It's humbling, you know, it's humbling. And we try to do things like I do free physicals for like all the football kids from Peewee, and then I do all the physicals for some of the wrestlers cuz one of my good friends is the wrestling coach. So I do free physicals cuz that's one of the things that Dr.
Bava kind of was doing out there in Fresno. We would go to the high schools and do free physicals. So I was one of the things that I really enjoyed doing going out there and doing that once we did it once or twice a year. And so when I started the practice, I started. You hook up with some friends and that were out there doing like, Tring football.
And I told 'em, Hey, if you need help, let me help you guys out. These, to the kids need physicals. I'll do 'em for free. We'll do one day from, 12 to four, bring them in and we'll take care of 'em, you know, and, and that kind of helped to spread the word too with the clinic and stuff like that.
So it it's, it's a win-win one cuz I like doing it. I played baseball and I played sports. So for me it was one of those things that was important. Cuz sometimes my mom had trouble taking me to get my physical or I don't know, things might have been tight, and maybe they were like sometimes like, oh I gotta pay a hundred bucks for this physical again.
So it's cool just to be now, you know, every kid should be able to play, play their sport. And it shouldn't be because if they don't play it shouldn't be because it can't get a. So that's one of the things that we did. Yeah.
Awesome. And I love it because, you know, just like there shouldn't be any kid who can't play because of a physical, there shouldn't be anybody who is told that the can't be a doctor.
Right. So, yeah, I think that, that's amazing just going back to your story with Dr. RO kava um, to have that special meeting and to have a special mentor like that. And absolutely my husband used to work in Houston, so I, I totally know. And for the audience, it's a very small, rural, farming type of town.
very close knit community close knit. Yeah, yeah, yeah. So that this is incredible to, Take your story again on the air and you don't know who you're going to inspire by sharing your story.
And I love that, just your little nuggets there of how you've been incorporating yourself into the community as the community needs. I think that's so amazing. And whether you're from the spot that you're practicing DPC in, or you've just moved there, you become part of your community because your're practicing relationship based care.
So incredible. Now I wanna ask you on that note, how did you even learn about DPC and decide to get started in your
clinic? So it's kind of crazy, you know, I worked in the clinic out in Atwater and like I said, my mission was open door policy. So when I went out and interviewed I actually interviewed in Modesto.
I talked to some of the faculty there. I came back home and I just started interviewing with the locals. And then one of my cousins His wife now, anyway, she was working there as a nutritionist at this, FQC lookalike practice. And she said, Hey, check out this place. You think sounds like kind of what you wanna do.
So I, I went out there, interviewed with them and, and and it was cool. I like, I enjoyed working there, the patients and I enjoy the people I work with, but the thing that got tough as I was there for three, four years, was that the, the overwhelming just load of patients that I was having, you know, I was seen up to 40, 45 patients in the shift, you know, so 10 to 10 to 12 hours, as it was a heavy load and I'd never practiced fast medicine, I always took care of each patient.
So I was at then running. An hour and a half, two hours behind luckily the patients liked me, so they were, patient with me, but I didn't feel it was fair. You know? So as I talked to them about changing some of that culture they would nod their head and say yes, but nothing would change.
So, I think I'm an entrepreneur at heart. my mom's a, a big entrepreneur and I look, up to her she worked in foster farms here for a lot of years and then she branched out to start her own travel agency. And then they started buying land and did farming.
So that kind of influenced me to take my own path. so that's kind of how, how I, initially started working at, this clinic. I got overwhelmed and with kind of Ty back up into like my mom, I said, I always wanted to do it. Right. So the way it kind of just started the ball started trickling was that I had my baby my baby girl, my, I have two, two kids.
So my baby girl was born. I had bought a ranch, 10 acre ranch of almonds in Delhi and the real estate guy that I did my deal with. We became good friends, awesome guy named Al shout out to high. Cause he's, he's been part of this journey with DPC, because he's, he's the one that, that I found my place, where I, where I practiced now.
So what happened? He is, he came over when my daughter was born. He's like, Hey, I'm gonna come over and we're gonna bring you some food. So you guys don't have to cook and. Great guy. So when they came over the way I am, he came over like just to drop off the food. And I was like, nah, you gotta stay, stay and hang out.
Let's, let's chill. So he, and it is like, nah, just came. This is all about you guys. Like not come in. So we, he came in, we ate, we, we made some. Bomb food and we were hanging out and he, he's the kind of person that he, he's very um, passionate and very uh, positive. And he's always aspiring to do good things and then do great things.
So, we kind of feed off each other and I was like, man, you I've been working for about three, four years and I gotta start my practice. I wanna start my practice and I gotta do it, and he said, oh, okay. So what are you looking for? Like, what do you, what do you, where do you wanna be?
Whatever, whatever. And I told him, Hey, well, I don't, I wanna be in Turlock. You, that's why I grew up. That's like my home base. And I had a strategy. I even went out to Atwater for that reason. Cuz I didn't, I wanted to be like enough far away to, I already heard about these, claws and not his bullshit.
So so I'm like, it's not too far away, but far enough. so anyways, that the whole thing was that once I told him. Like right after that, like the, like the next two days, Hey, I found a place here. I found a place there. We went and looked at these places and I'm like, now I started feeling real.
Right. Cuz somebody, he started taking action and now I'm the kind of guy that I just, I go with my gut. So if I feel it, I'm gonna pull the trigger and let's go. So we we went and looked at some places, but they wouldn't line up cuz you had to build them out and all this stuff. And it was like, okay, maybe this is not the right one.
And he's the kind of guy that wants the best for you. So he's just like, yeah, I'm gonna keep looking. You know, He's not looking for that dollar. He's looking to make sure that, you find what you're looking for. So anyways, all of a sudden he's driving by this building and it's on the corner of Colorado and OME it's right next to the hospital.
And it says like for lease. Right. And so he hits the guy up and he says, Hey, like we're interested. And and I said, Hey, like that place is, looks perfect. Like. Bug this shit outta him, like tell him, like we wanna see it. Right. So actually we were the first ones to go see it. And we walked through the building and the guy's name's mark mot, shout out to mark Mott, because he's made this dream come true for me.
Because he gave me the opportunity to rent this building out. when we walked through the building, he told me the story his wife, they actually opened it together because he was a construction and she was a chiropractor.
She was practicing. And then she wanted to open up her own practice and he helped her take this commercial building, turned it into a, a practice. So when they built it out, she had a great practice and it was doing great. And then she, she got hit with cancer, with breast cancer, , Pretty much, she fought it for like five years and, and the cancer, the cancer finally won.
So she passed away, but mark told me so many great things about her. And everybody that I ran that I've run into that know her always speaks very great about her. So pretty much when we, when we went through the building, he was telling me the story about how they built it out and, and how, that period of time, in his life.
And you could tell he loved, her with all his heart. So he, he really wasn't about, making sure somebody didn't come in and wanna take out fault walls and mess up this building. And the building was perfect for me. I told him, Hey, this is per, this is what I'm looking for.
there's three rooms and that's all I need. The only thing we're gonna do is change this carpet, cuz it's pretty old. But other than that, I think everything's is good, and then he shook my hand. He said, all right, you wanna lease it out? And then I said, yeah. And he said, okay, you got it.
How, how long you wanna lease it for? I'm like, I, I don't know, like what, what, I've never done this before. And I said what's normal, like five years. Okay. So we shook hands. He said, okay, I'm gonna call the other 15 people that were gonna come today to look at the place and tell him that it's already it's already done, the deal, we got a deal, a done deal here.
and yeah, as you was telling me that story, my wife was there and I was there, my two kids and he said, you know what? You just kind of remind me of me and my wife just starting off. And I wanna give you the, the building. And you don't see that no more. You don't see people do that no more.
You don't see people just shake your hand and make a deal. And cheer for you, cheer for you. Not knowing me. He was cheering for me. you know, And so we're, we're friends now. So sometimes I have a ranch and I have some cows and we go out there and I invite him out there. Cuz my dad loves.
Milking fresh cow milk. I don't know if you ever heard about that, but my dad loves that. So he's a country guy, so I invited him out and uh, he's like, NA, I thought you were crazy when you told me that you weren't gonna take insurance and all that, but something about you, I believed in you he said you're lucky all that together.
So anyways, it was just that the, the, the thing that I'm like, man, he could have been, reading it out to somebody else getting more money or, or whatever, I think he was really fair. And I think he values friendship and getting to know somebody. And now all his family is my patience, all his family his kids, his, everybody, so it's, it's, it's a cool thing.
It's a cool thing that. He gave me that opportu.
That's so incredible. And, , I really love though, that you highlighted how you went with your gut, because I think that's a really important, piece for people to, to, listen to and to pick up on because whether they do or they don't follow that if the listener is, potentially looking for a space to grow into with their DPC not only looking at the terms of the leasts, but also like, thinking about, am I feeling anything that makes me hesitant to do this?
If you're deep down, having some second thoughts it might be a good thing if that place falls through or whatnot. but I love how your story ended up in your practice and this amazing place it's right across the street from the hospital.
No. Thank you. And I, I think to add a little bit is I pictured a place that was like I told my, I came my picture. I said, Hey, Hey mark, what I'm picturing is I want this to be like a home, like when you go into your home, what's the first thing you see is just pictures of your family.
you've you have your, your nice, couch or, or a, a chair that's that's comfortable. So that's what you see when you come into the practice. That's what you see. And on top of that, when he shared a story about his wife, you know, I believe in like my grandma passed away early, but I got to know her.
I feel like she's looking after us. Like an angel and I believe in that stuff. So I, I believe that we, we continue to try to make these people proud, even though they're not here. And his wife, I really felt that she was, she was there, just through him and, and that, and sharing that story.
And I felt like she was such a great person that was doing the same thing that DPC does, which is trying to provide care to the community. And her as a chiropractor, she was doing that, she was doing that for people that, if they couldn't pay for something, she would help 'em out or she would just make sure they were able to get it.
And just, really wise, word. So, I asked him, Hey, Is there any way I could have a picture of Karen. And then can we put like a little cuz a breast cancer awareness? So in the, in the, in the waiting room, Karen's there with her picture and there's a breast cancer awareness and there's some, some awesome quotes that she used to have a journal and write just words of wisdom that, that she would always kind of write down and pass on.
so those things are in the clinic. Cause I like to tell the story of the clinic and then like in the hall you have the, the first picture with like mark and Hedo, which is a real estate guy that we, when we shook hands that pictures up my buddy, Rob, Mel, his family is his pictures up.
And everybody that's involved in the clinic, there're pictures up there, so it's not only our pictures, but everybody that's involved and that's kind of the idea is to share the story of the, the people that are involved in the clinic,
so cool. So cool. Now I wanna ask when you were dreaming about, Hey, I.
Want to have my own practice, wanna follow my mission of having an open door policy when you found this building and this amazing space with an amazing history behind it, had you, at that point, decided that you were going to do DPC or were you looking to do a fee for
service clinic? Yeah.
I just had an open door policy in my head, but not DPC came right in that moment. I can't remember if it was like, we already had it like in mind but what happened was that it's kind of crazy cuz I, I have to backtrack to really make sense of this is that so when I moved to that where I lived that ranch that 10 acre ranch there was a neighbor that lived behind me and he had a ranch for sale.
Okay. And I went over there to try to buy it cuz it butted up against the lip to make it like 28. He's like, nah, this is already sold, but I have another property over by the river. I said, oh, well, that'd be good. I like, I like to check that out. He's all. Well, if it's Versale, I'll let you know, we'll go check it out.
I think I'm gonna sell it. He gave me a call like two months later. And we went over it and I ended up shaking hands with him and buying that property and I made it into a venue for weddings. And that was my first like, almond ranch was my first kind of like entrepreneur kind of thing that I was doing.
And then I made that into a it's been five years that we opened up that venue, but that's where Roel comes in. Cuz Roel was my, my good bud. So he was the one that I'm like, Hey man, like I'm doing this, I'm doing that. And he's a CPA. So he knows the numbers. so I had a pretty much I was trying to do all this stuff and my wife one day goes.
You're missing a lot of time with, with Roman, he was a baby and I was working like trying to go to work at, my job and then trying to balance this farm and then the venue. And I was just getting, I was leaving early and I was getting home late. And then my wife, I go, Hey we're just starting, I need a hustle.
Like I wanna, I wanna do this. cuz you barely get out of medicine, you start making a lot of money. Now you're trying to do something. but she made me reflect. She said, she said, we don't have to do this. You're choosing to do this. So you're choosing to do this and you're losing that time with your son, and she made me reflect on that and I think that's what DPC really connects with me because that's what DPC I wanted to do with it was get my time back. So what happened was that when that all that happened, I didn't know anything about payroll or how to keep QuickBooks. So Roel came in and I hired somebody.
To how has been working with me for five years. And he does all my maintenance on these properties, but Roel does all the payroll and he's already doing all the QuickBooks. So when, when the DPC came, we were ready, and it was like, it was like amazing. Cause we weren't, we didn't feel green. Roel was like, oh, I got you, bro.
Like, okay, what are we gonna hire? We gonna hire the ma and I got their payroll. All right. this is how we're gonna organize the business. This is your, you we had to open up the corporation of course and all that, but he kept all the QuickBooks and all that. So I, I was free of dealing with all that.
And then he would keep me in the loop like, Hey, this is what the expenses, this is, this is how we're doing. This is how many new members we have. So we meet once a month and go over that. But it was cool because the transition of what happened. Led to DPC actually being really successful and smooth because we were already like, didn't feel green and scared.
Now we were like, bring it on, like we, we could do this, so roels like my CFO, he's like the guy that does all the books and we have a dream that he's gonna come on. Like he's been working like for Gallo. And he's been working for them for a while, but he also wants to do his own thing.
you know, but he loves the number. So I'm like, man, if I could get this going big enough or, or get more DPCs going, cuz I think that's our mission is to get more doctors involved, but maybe I could be part of them helping them and then whatever way you know, I, I honestly, I listen to DPC story and I tell him, Ramel.
You just call these doctors and tell 'em to run their books and tell 'em get everything. I'm sure they're gonna love you, bro. Like, honestly, that's what makes me like really happy that I don't have to, like, I don't have the stress of that. So the, the backstory is that all these things led to the DPC and roels the one that found DPC.
He's the one. So I'm like, okay, Roel. We're gonna do, we're gonna do a, a cash practice. Cause I don't wanna deal with insurances. I don't wanna deny any patients from coming into the clinic and I just want it to be simple. You know what I mean? And then he started looking in YouTube and he found Josh Humber and Josh Humber started, Josh hums he's, he could, uh, he could really explain things in a, in a really logical way that makes sense and, and makes you laugh and he makes you wanna like follow him.
Right? So he, he has that. So he's like, dude, check this out, dude. This doctor's talking about kind of what you're wanna do. I'm like, what, what is this DPC stuff? and I listen, I'm like, man, that makes sense. That makes sense. You get everything at cost. How do you get that? He's like, oh, just call the quest people and they'll set you up and how do you get medications?
And I pictured like a pharmacy, all these huge, you know, it's like little coverage, you gotta carry that's it. You know? And So Roel set up a said, Hey, roels like, Hey, I sent a Josh email and he's, and he's gonna talk to us on on this day. I'm like, for real, he wants to talk to us. I'm like, for real, I'm like, okay.
So we talked to him and he had a glass of whiskey and he's like, Hey guys, how's it going? And we just started talking, and uh, and he told us about The EMR, he told us about Atlas I didn't know anything about that. And then we started telling him like my, what we were doing and everything like that.
Same thing, like Dr. Rockow, he just really made me feel like, okay, cool. Somebody's giving me like the this is, this is the right way to do it. And then from there we just followed his, like, I always have a saying if it's not broken don't fix it. Right. So he gave us the numbers on what he was using for some of the patients on charging.
He broke it down, on how you try to just make sure everything's like, pretty much really affordable and cheap, for the patients when it comes to extra stuff. So that's what we try to follow, just that blueprint. And it worked out, you know, it worked out perfect, and then his dad was cool, man. I called his dad a couple times cuz my, place I was working at, tried to Sue me. So I called his dad and he tried to, he helped me out on. Like what to do or whatever. So, but, you know, it's kind of crazy cuz I'm trying to connect the dots. Steve jobs says you can't connect the dots forward.
You can only connect them backwards. So I'm, I'm looking back and going, okay, like if this didn't happen, this didn't happen. If this didn't happen, this didn't happen. And it all kind of lined up, but I've had a great team, from, shout out to my wife, that's been really supportive.
Ramel, that's been like on top of the books. And then all my staff that just, makes this clinic run really well. But really it's, it's, like certain things I've done ha have led me to, where I'm at right now with this, practice.
And, and roels the one that found out about DPC. So I just pull the trigger. I'm like, this makes sense. The worst thing that can happen is I just go to insurance based stuff. If it doesn't work and let's just take off with it, you know,
love it. And yeah, I think that, if it doesn't work. You're still gonna be a doctor and you're still gonna move on and still, you know, if you have family, you're still gonna be part of the family and, it's nothing to be ashamed of.
I absolutely go back to Dr. Whitney Webster pack, who said, if it doesn't work or if it does, no matter what you've done this out of love, and you've done this out of wanting to be the doctor who you want to be and serving your patients the way you want to. So on that note, I wanna ask, who has joined your practice, who has found BU Vita health to be the clinic for them
in regards to like patients.
I think it's just everybody from the community, what well, how it started, like, when I talked about my mom, she gave me the blueprint on, on how to transition to, to opening up your business.
Because like I said, she worked for foster farms , and this is, this is a story that I have to tell. Cause I think some people have a hard. Jumping, shifting because they feel like, oh, I can't do it because if I can't, if I do it, then how am I gonna cover my bills? Or how am I gonna do this? so my mom, when she worked at foster farms she was climbing up the ladder.
She's always been like the kind of person that wants to keep on learning and keep on climbing. And she came from a generation where, as a female, they wouldn't allow her to go to school. So her mom and dad didn't let her go to school cuz she was a girl. And then when she got married, my dad didn't really support her going to school and she always wanted to learn.
So When she worked at foster farm, she went all the way up from the line, which is just the hardest work to quality control. And then one day when she tried to get another position that she was qualified through her experience, they gave it to somebody else.
And then my mom tells the story. She says, when they gave it somebody else, I talked to the guy, the, the manager that was gonna give his position, asked him, Hey, why, why didn't I get the spot? And then he says, well, Martha, if you don't have a degree, you're always gonna be cheap labor.
So that like lit up a fire in her, like, oh, screw you guys. you know, I have more value myself. So she opened up a travel agency. So, when I was a kid, I'm the oldest, she would work at the travel agency during the day. And then she would go to foster farms at night. She did that for like two years.
So I grew up in that travel agency. Know, with her every day. And I remember helping her sell tickets, I started learning and I was doing answering, and that's the thing that school doesn't teacher, I learned how to answer the phone. I learned how to talk to customers and that's part of my DPC too. Like I'm.
So I already knew that, right? So that came easy to me. I didn't feel like it was foreign and I knew how to give the customers options and, and, and, and how to greet them and how to make them feel like, know, they're your customer, you're taking care of 'em. So to me, I'm grateful for, for that experience that, that I got from there.
And I'm also grateful because that's the same thing I did. I saw her do that for about a year, two years to get to where she, the travel agency took off and it's done great. She's done that for 16 years and it's like, she did it through that transition and she never let her family down cuz she was always making sure.
That the family was taken care of, before she, she can jump to just doing it full time. So I worked at where I was working at 12 hour shifts. I did Monday, Wednesday, Fridays, 12 hour shifts, and then I would work Tuesday, Wednesdays, and then Saturdays at the clinic. So that's how I kind of build up the, the practice.
And it was crazy because that was in November and my contract was up in July. So I was like, all right. I don't wanna sign another contract. So hopefully in July, like hopefully everything lines up. Right. So I started I got on a radio show that's in Spanish and it's a radio station called Lafa and there was this guy named ex that would go on live.
So I would go on live and talk to him. And then pretty much we just put DPC out on the radio waves. Like, Hey, you know, this is Dr. SRO. He's doing DPC. And then he would the same. We were same thing. We're doing like, Hey, what's DPC. Hey, anybody could come here. It doesn't matter if you have insurance or don't have insurance, we can take care of you.
We're gonna get all the allows for you at a cost. We're also gonna do um, any procedures, you know, you get 'em at cost, so you don't live in the ER. So we would talk, have this radio show and as soon as I was done with the show, everybody would be calling and the phone on the clinic every day, like 10, 12 calls and appointments coming in.
So that kind of how it started. And it's crazy, cuz I got people from Sacramento Stockton cuz that radio's all over and I'm like where how's the people driving all the way over here and there still are patients, you know, and they're happy. They're happy cuz they can call me and I can send a medication with something simple and I guide them if they're not getting better.
And then if it's something in person, then they come in and I'll, I'll take care of it in person. So it, it it's, crazy, but that radio show really kind of took off and, and helped. but see, here's the thing, then you're looking at the return on, the customer acquisition cost and the return on your investment.
So the radio was pretty expensive, but it was worth it, it was worth it, so it, the thing is that, then what I found out is like, well, how can I get how can I get my customer acquisition costs within the clinic? Right? How can I get them to when they come to either like once day, but then also get me more patient.
So what I did. I charged a hundred dollars to like to sign on, but I included all their labs in that a hundred dollars. So there's like, oh, a hundred bucks. And I get all my labs, dang, that's a sweet deal. And then they would sign a contract for a year to be members. But then after that, then I would, follow them up for preventative care.
And they would call me a ball of a sudden when something else was going on and they would spread the word like, oh, there's this great deal. You pay a hundred bucks and you get all your labs included and he is gonna explain everything to you. And then if you get sick or anything, you call him and he doesn't charge you extra.
So they would spread the word. Like, so after you got like 100, 200 members, like it would, all of a sudden it was just, they were just, everybody was how'd, oh, my friend recommended me, family recommended me. And that, that just, we just kept hearing that, so the radio by July, we were already.
Good. You know, I was, I was good to quit. But I had to stay extra three months and I'll share this with the doctors because as I I'm a man of my work. So if I say, Hey, I'm gonna do this, I'll do it. So my contract was up. I said, Hey, I'm grateful for everything you guys done for me here, but I'm gonna be taking off thank you and peace out.
And I had told all my patients where I was too swift, they wanted roll to the clinic. So they had something called an evergreen contract. So they said that even though I didn't sign anything that the contract would renew on its own. And I was like, that's bullshit. So, they actually I said, look, I'll give you 30 days and I'm out.
But they said, no, you gotta give us 90 days. Cuz that's what the contract says. You gotta be. If you quit, you gotta tell us 90 days, if we fire you, we gotta pay you for 90 days type of thing. So. I was like, man, that's some, that's a BS. Right. I was like, I'll give you a month, but I've never heard about somebody quitting 90 days later.
so anyways, they, put the dogs on me that called the lawyers. I got this card, supposedly it said that I made the, and this is where it opens up your eyes. You're like it said that I made like, I don't know, let's say, I think it was like 130,000 a month for them 130,000 dollars a month.
So they would Sue me for 130 for every month that I was gonna be gone. Right. So you're talking about two, $300,000. I'm like, it's not worth, going through getting lawyers and all that. Okay. I'll just. Let's sign something that says I'm out by then. And that's it. So, it's always good to always say, if you're gonna do a contract, make sure that they say every year I have to sign it in order to renew it, cuz it's worth it.
And then always make sure that if there's that 90 day thing that it says that maybe if it's past your end of the contract, that it doesn't count, like, unless it's within the, the contract, because you have to do that. You know, You always heard about that in, in med school, like look at the contract.
And I thought it was a simple contract and then all of a sudden they did that, but it worked out. Everything was fine, but it just goes to show you that they didn't really care. They're like all about just their numbers and, and that's it, you know? so then it made me even feel better when I did the de I'm like, I'm so happy that I'm doing this and that nobody can do that to me no more.
Right. Nobody can push me. Nobody can tell me. What to do or how to do it and, and I'm gonna do my best for my, my patients, yeah,
absolutely. And, the evergreen contract is definitely something that corporations have trended to put out there more so than they did in the past.
Because realistically it takes a lot less time for one contract to be signed and negotiated, and then that's done, but the, there are so many issues with that when it comes to physician autonomy, physician, value and then the, the fair compensation just totally is at risk there um, with an, any evergreen contract, in my opinion.
So that's amazing how getting on the radio and not only just looking at the patients, but also the cost that went into that of the patients who have joined your practice, how many people are younger, how many people are older, how many people are insured uninsured.
Can you give us an idea about the demographics of your
practice? Oh man. You know, Our, our EMR doesn't really like pull that in regards to exactly. But I'll say it's, above 44 years old. I think we have probably, cause we're getting close to eight, like 800 members.
So it's getting really busy and I have a nurse practitioner that I'm training right now to help me out. And I'll tell you guys about that story in a little bit, but pretty much I think it's, maybe I'll say it's even, I have a lot of young patients cuz I, I don't, I can't give exact numbers. I have a lot of young patients under, like above 18 and 44 and then a lot of patients above 44.
So you know, and a little bit of the under 18 not to, not a lot of members, but a lot of families sometimes have their kids and they want to get 'em on because they're, it's easier to contact me. It's easier for me to send them something it's easier for me to get him in. but for the most part it's, it's mostly 18 to and above that's the patient.
Yeah. But I, I, You know, The way I could put it is Roel says a, the average on what you're doing per patient is like 67, 60 $8. So if you take the $50 and the $75 people and you put 'em together, it's like about 60 something. So I don't know if that tells you anything, but it does. That's what it averages out
That works awesome. And in terms of the enrollment when you chose to do an enrollment fee, what does that help out with in your practice in terms of, does it pay for administrative costs? For, the, the start of obtaining medical records, how does it help your practice?
You know, I'm gonna give you, I like to keep it simple. And, and I'm gonna go back to Josh umber, and I'm grateful to talk to him and I, and thank you again for sharing. keeping it real, he always keeps it real. And, and, and I think that's sometimes what we need.
Right. Cause a lot of times that's what we're talking about. When we work for a corporation, sometimes you feel like you're not like you don't know if you're just a number or whatever, so with Josh, I feel like that's kind of, when we connected, he, he made it simple. He said, you look, what you wanna do is get your members.
And then once you get your members, that's your honey pot, and to, that, that reflect I'm like, oh, okay. That kind of makes sense. So your goal is to try to reach a certain amount of members. So that way you could stay afloat, pay all your overhead, pay yourself, and then maybe, be profitable, as a business owner.
I mean, that's kind of, you know, I always always tell myself, I'm, I'm the doctor and then I'm the CEO. Right? So then I try to, Get those two things separate. So that way I can kind of in my head, I think about, okay, what are we doing as a CEO? And what am I doing as a, as a doctor in the clinic? Cause as a doctor, I wanna focus on my patients and I wanna stay focused on that.
And as a CEO, I wanna stay focused on the business and how we can make it grow and, and make it better and, and, and make it the best as possible. So, well, the way I look at it is my goal from the beginning was to quit my job. And I said, my, I always tell people if you're gonna open up a DPC you have to set your own goals.
But for me, my goal was I wanna earn as much as I'm earning at where I was working. And I wanna have as much vacation as I was having at my old job. But hopefully I get more time. Hopefully I get more time. That was my goal. So putting those landmarks, then my goal as I was working in castle and I was at that other clinic and I was also doing my practice those three days, I was just trying to build my patient panel.
Right. So I could quit and then just go there. So, I like the way Josh puts it. Just the better you make it, the more, the more juicier it is, the better it, the more value they have in it, pretty much then the more they're gonna. Like say this makes sense. Right? So for me, that's what it was about. It wasn't about covering anything.
It was about them staying on with me. And I knew that once I started seeing them that they were gonna wanna stay on because we were doing everything so much better than everybody else, and so that's what it was. this is one thing that might help somebody.
So it's $300 to sign on. Okay. But that's only if you don't sign on at the first time you come in. So the first time you come into the clinic, it's a hundred dollars and that's the first time visit. And the hundred dollars. Includes your labs. The labs for me cost me about for basic labs the basic stuff, CBC, TSH, LDL, we all know the basics for like a physical exam is about 35 bucks.
So maybe I was making about $60 on that visit and that I was just hoping that visit would cover the, the overhead and just keep the clinic open, but then from there we have a member that now is gonna sign on for that year. So we know we can count on that. So I wasn't really counting on like them signing on and getting that I was counting on, on them just coming on as a member, but then if they didn't sign on cuz they were like, oh, I don't know.
And this and that that's okay. But then next time you come, it's $300. Like I don't only get a one chance for the a hundred dollars, that's it. And you only get a one chance with a hundred dollars with the labs once. And, and then I have a great nachos, my ma Oh, man, he's an awesome guy. So, he's the guy that makes my life so much better because he's the one that takes care of all this, but he's the one that tells him, Hey, if you get it today, you get it for a hundred bucks, you get your labs included.
And then if you don't, then what's gonna happen. Is that next time, if you come back and you wanna do the membership is $300, right? So, really save a lot of money right now. So those $300 can pay for you. Three four months of your membership. So once they see it like that, it's like, okay, it makes sense.
And then, you see 'em and then they, it just, it makes total sense after that. So that's what I recommend. for me as a CEO of my, of my business, I say, that's my customer acquisition cost. It costs me about the loss of the $35 for the labs is what it costs me to get that acquisition.
But then now they're gonna do the marketing for you. Cause now they're like, man, there's this place you go a hundred bucks, include your labs. And then the doctor explains everything to you. And now, the other day I had a cough and I called him and he, let me know it was allergies. So he let me know it was an infection and he gave me antibiotic and I feel better.
So they spread the word for you. So you, that's your marketing, the word of mouth, cuz if they go and they go, oh, it's $300 and it's so expansive and oh my, that's the, not what you want. You need to make a good first impression. You know? So as a CEO, that's what I was trying to shoot for is.
What's the experience from that patient coming into the front door, my staff greeting them, making that experience. So, like, the EMR, a lot of people have to, they get 'em to go online and sign, no, come in. We'll take care of all that for you. So they help 'em just get it into the system, make it simple.
Cause a lot of my patients are Hispanic, the old school, some of 'em and they don't know about that. Somebody's likes that, then they can do it. It's it's there. But we try to make sure that if they come in we'll we'll help, 'em get all that squared away. So you know, all the forms and all that. And then from there, the ma tries to, get 'em in, take their vitals, make sure they ask all the questions, be hospitable, and I, I teach 'em that, treat them like it's your mom and dad treat them like, it's your family. Never forget that. And I already repeat that every morning, every morning, remember that we're here to help them like it's your family. And then. , once I see him and everything, then Jose, he's the one that then goes and gets them to go to the back and he's gonna get everything ready.
He's gonna give them their meds. I taught him about, the medications, which, I already explained everything for them in the room, but then he, again, he says, okay, this is your thyroid medication. It's for three months, he go, it breaks everything down, and then he breaks everything down on what's they're paying.
So it makes like, okay, that's what I'm, I'm not gonna get a bill later on. Right. No, everything's right here. This is what it is. So they leave. They're like, wow, they never got a bill later on. And then that's the experience they're having. And they're sharing that with everybody. So that's what DPC is. And, and once you focus on that, man, it's just gonna, it grows so fast.
You know what I mean? And, and that's kind of what, what I've been trying to do with DPC is just make it the best as possible in regards to experience, to the patients and, and it's
worked, you know, awesome. Now, in terms of you've been, you've been talking about Jose, you've been talking about Roel and you've been talking about and I, I love this because this is my DPC story. And so I I'm all about stories, can you share with the audience who exactly is on your team and just go over their roles again?
And , can you share how they came on board at BU Vita
health? Yeah, so talking about the team, I feel so blessed and the responsible for, know, everybody that, that works for me.
And I think that's one of my missions now, like med school was one of my missions when I was being young and, and choosing a career, you think that, oh, med school, that's the thing. Right. But now that all that's over, it's like, what's my mission. Right.
And, DPC, I think gives me all that back, right. That why we went to med school to help people, but also the employees, like to me, that's the, the people that I'm responsible for. And I wanna try to give them as much as possible. Cause they're the ones that are helping me. So, looking at that, I'm gonna go backwards too.
The venue has brought a lot of, a lot of the success to the DPC through different ways. One of my. employees. It's like my best friend. Like I call my brother his name's Jovanni and he's the one that I told you when I was trying to do everything by myself. He's the one that came on.
And then now he's like my right hand guy, when it comes to all the. The construction stuff, the maintenance stuff. So he does the stuff on the venue, but he also does the maintenance on the building. So he does all the landscaping, cutting the yard, keeping everything clean inside. He did everything in this.
He did the flooring, he did the baseboards, the painting he made it. Look how it looks now. And that's what people love that, that welcoming feeling. And we worked on that together, you know, he's the kind of guy that I, I, Hey, this is my idea, and he's like, oh, I got you, bro.
Let's do it. So we work together, you know? so to me, that's giving me success. Cause that's, what's hard for a lot of doctors. It's like, well, how do I get this place off the ground? You know, How do I make this place work? And he's given me that, right? So I I'm in, I worked at a home Depot when I was young.
I know all the materials and all that. So I'm blessed to that experience before college and med school that I know all that stuff, cuz I go get all the materials, bring him in and then he takes care of all the work. And then if he needs a hand, I'll give him a hand. But you know, that's the, the building.
and the maintenance GIOS, the one that takes care of that. So that's where it's a blessing for me. He's worked for me for five years now and I really try to take care of him. If it's his birthday, Hey, let's go have a birthday party, you know, invite all his friends and, I'm throwing the party.
Try to give him a raise you know, and take care of him. Every year, looking at how I, I can make things better vacation, all those things. And he has a, he's a single dad. So the way we work is your daughter comes first. So if you have to go pick her up, go, and then you come back and keep going.
And he, you know, I believe that you don't need a manager. You don't need a manager. Managers is just a waste of time. Everybody knows what they need to do. We're all grownups. So if you build a team that they know what they need to do, then. that's the key, right? Because if somebody, you have to be looking after then it's not gonna work.
So Geo's that kind of guy that we know what we need to do. He gets it done. And we all, it's a win-win with Jose he's my, my office manager. he's why DPC has been good because he he's so good at just taking care of the patients he's so patient he's so kind and he, he, he, he has everything to be a doctor, so I try to get him, Hey, go to med school, be a PA like you could do it, like you got the right things for that.
But his story is that he worked at McDonald's and he's my cousin. So he, his dad had bad diabetes, got dialysis, and next thing you know,. He would think helping his mom to take care of things at the house. So he was kind of stuck, you know, after high school, just working to help everything keep afloat.
And on the weekends I had that venue. Right. And he was helping me on the weekends, do security there, cuz I have, I have him watch it out, watch out at the, at the venue. And I just saw all these qualities in him. He really cared when he was there about how things were going and welcoming people. And I was like, man, on top of being my cousin, I was like, man, he has everything for better opportunity.
So when when I opened up the practice say, Hey, don't you come work at the clinic and you can work in the front. And then once you get your ma license and then you can do the ma and then I'll take care of you, And right from the beginning, I thought about the things I hated at home Depot and all that.
And like, dude, like when you were there, they gave you like 10 cents raise and they didn't give a shit about about you as an employee. So I said, I'm gonna change that. So the way I do it is like, when I hired him on, I said, Hey, I'm gonna pay you this much. Right? Like, let's say whatever, $16 an hour or whatever, you're paying your ma, but every year I'm gonna raise you a dollar.
Okay. But I'm gonna cap you out. 20 or whatever cap. And if you want to grow more than that, then I'm gonna say, Hey, there's this diff more position, but you, whatever way to keep him growing. And that was my mission to, to help them F feel like I could keep growing and they know what to expect every year.
And that dollar I say, law, you gotta do is show up on time, not miss any days outside of your PTO or vacation. And then just don't get any big complaints from the patients. you did something like you lost your temper or something and redo it, then that's gonna Nick you. But if you, you keep all that in line man.
I wanna give you that dollar, you know? so nobody gets like a dollar raise, right? No, not a lot of places do that. So that was my goal is like, let's help him keep going because why have somebody. And go somewhere else for a dollar that they gave him more. That's just dumb. Right. And a lot of people do that.
Oh, they gimme a dollar more. So I went over here. So I, to me, I was like already thinking about all that stuff. and then I, I wanted to help him with his ma so for me, like I gave him the side job at the venue. So he was working for me, full-time at the clinic. He would do that side gig and , he paid with his ma for that. And I tell him, Hey, go to school. It's like, he's not married. So go to school and, and I'll help you out. I'll help you keep growing. I say, become a PA nurse practitioner, whatever, and Hey, let's open up a DPC. I'll help you do that. Whatever.
So I'm, I'm all about helping you. I think that's my mission is to help out. And now I have I have another person that's not an ma she does the front desk fully. And I have an ma that she kind of does my, the ma role. But in my clinic, I want everybody to know every position.
So as a start, I want 'em to master like their, original position they got hired for. But then after like six months to a year, I say, okay, now you're gonna learn the front. And then as they learn that, then I'll give them a raise, and then that way they keep growing. And if anybody's sick or not there, we could run the clinic with just two people.
It might be slower, but everybody knows like how to do that. And that gets rid of that. anxiety of like, oh, we don't have an ma or cuz everybody can, we all can do those things, as long as they, they learn it. So that's kind of, my mission is they know all the three positions, they help each other out and they are a great team.
And then pretty much I just take 'em out. Like once a month we go out, we go out somewhere to eat or go out somewhere to hang out. it's on the clinic. If it's their birthdays, we try to do something for that. And so I just try to keep. That environment going I was telling him, Hey, look, I'm the doctor here when I'm the doctor.
I'm like, we're like coworkers. And then if I'm, if I'm the boss or CEO type of thing, then you know, that's, that's a different thing. So, and then if we're out of the clinic, we're not, we're just hanging out, you know, and, you know, it's good when you could build those relationships like that, you know, and they're responsible cuz I only go to the, I only work half days, so I don't work full days and they're there half the day and they take care of all the referrals and they take care of anything else that has to be done in the clinic.
And then I'm off like Sunday, Mondays, so they're clean, they clean the clinic, they do all that stuff. So they full time. So, Yeah, for, for my staff, I think that's the biggest thing. And then Ramel, he started off with me, like as my homie, he's like, he wasn't even charging me nothing, you know, I'm like, nah, dude, like we're doing good now.
Like charging me some money. just, so you can spend on your kids but you know, so it it's been like, it's been really cool, man. Just been surrounded by people that I wanna see you win and, and you wanna see them win. I think that's the recipe for something to do really good, you know?
awesome. And when you talk about the culture, I love how you've built in, making people feel valued, which is very hard to do in fee for service. Um, Like you've explained, it's not even just fee for service, it's big corporations that can make a person feel like they don't actually matter that they're just a number or a warm body.
But I wanna ask when you do have times when you have to, correct behavior or change a workflow change like the execution of a workflow, how do you approach that? Given how you just shared how you have, like the, this is me when we're out once a month. This is me when we're at the clinic, this is me when I'm wearing the CEO hat.
How do you piece out that part about correcting an employee's actions?
I think everybody makes mistakes or we all have our personalities, So your goal is, not to, to make that look as a weakness, but to, show 'em how can we improve that?
Right. We all can improve. So yeah, so I, I just talked to them about, Hey, for example, my wife, shout out to my wife, but like, Thank you for always being there for me and help me out, I wanna forget to say that, cuz I know she's gonna listen to this and I don't give her enough credit, but yeah, she's the one that actually, she does more of the, that part of it, so she says she's like the bad guy sometimes, but I also do it too. And what we try to do is just talk to 'em about like the why, so, for example, like my wife, she worked at a dental office before, so she picked up some of the things for the phone.
So, you know, anybody calls the office like, oh, when was the last time you were at our office? Because then you're picking up, was this a new patient or old patient? So we try to teach 'em that. So if they don't say, and they, if they say. Something different. Then we try to explain to them the why, but anything that goes bad, we usually just try to, find the right time, like after work or early or whatever, where not, not nobody else is around.
And then just to talk to 'em. Hey, or express what's going on. And then maybe why, how can we improve it? And if somebody does it. It's not doing it, then you're asking like, okay, maybe I'm the one that's not teaching. Right. I always look at that first and then, or maybe there's something going on in their life.
Right. Some people are carrying some heavy things in their life and you never want to put that off the table. So you'll, if you relate that if that's the case, they'll usually, fall through. But yeah, you just treat 'em like people, you know, I think you talk to him and, and, and like, like I said, they're all adults they all know what to do.
Even though I have a office manager, his role's just as assigned, like, Hey, we got a referral. You take care of that. I'll take care of this. And he's never like, you do this, you do. He's like, Hey, I'm gonna, I'm gonna take this, you take this and everything gets done. And I was asking, how's everything going?
You guys doing good? You guys need more help. Not Dr. B. We're doing good, man. We got everything caught up, cause I'm always thinking like at one point we might, we're gonna need another. Maybe somebody else to help, or maybe they don't have time to clean the office anymore. I think if we hire somebody else to come on, then you know, it's gonna be somebody else cleaning the office because my goal is to give them hours.
Right. And that's what they want, they need the hours, they want their time. so that's my goal. So, that's, I say I could give it to somebody else, but then I'm gonna cut you guys short. Like that's, that's not what you guys want. So they're like, no, and they don't mind, they love the office and, and every, they all work together.
And that's something that's just, it's like, it's like a relationship, right. You know, It's like getting married. Like that just happens naturally. Sometimes you got good groups and sometimes you don't, and I got lucky that they're, they're really good group. But they're, they're all young.
So I want them to see 'em if they stay with me and they, that's what they love. And I'll keep, 'em helping them as much as I can. But if one, they decide to do something different, I wanna be supportive, you know, and. Bring somebody else onto the team that hopefully would be good chemistry, you know? so I think that's, my goal is always trying to look out for them. Even though they're great, like, oh man, I would suck if one of 'em left, but . I wanna see the best for them too, yeah.
Awesome. And in terms of when you mentioned your wife Carla, is doing the aesthetics branch of your practice.
So can you share about how that works in terms of your space? Does she have a separate space that she practices in? How does that work in terms of the aesthetics branch of your.
Yeah. So I think we have a video somewhere where we kind of check out like the practice and stuff, but we have four rooms, three rooms are primary care and that's kind of what I focus on.
And then there's a back area. That's the aesthetics and it's really nice. there's like a desk and some chairs where they can talk to Carla and express kind of, Hey, well, this is kind of what's going on. she can explain to them like Botox and cause a lot of people, sometimes they get the wrong impression.
Like, you know, if you have wrinkles, that doesn't take 'em away. It's to get 'em earlier, before, so you don't get those wrinkles. Right. So, given a lot of patients like what the product does, how it works giving them expectations all those things. And she, she loves aesthetics.
So she, is a nurse and she worked in the floor and she loves patients too. She's. Pulling on the rope, like, oh, I wanna go back to the hospital. Cause I love helping patients there too. But then she's, I think she wants to do nurse practitioner to, you know, see patients with me in the office.
Cuz she has her bachelor's in nursing. So she's like right there to just jump on that. But we have two little kids and one on the way. So she's the one that keeps everything balanced. She always from the beginning she's the one that says. Keep this balanced, don't start overworking.
Don't, don't go back to the old days when you were working, balance it out. Um, So that's what we do, she does um, aesthetics. So the, for coming from the, her passion, she went to uh, she always had a passion for it. She met a nurse that did a lot of the aesthetic procedures that worked in the surgical floor, but she did that on side and she got interested in it.
So she went to Beverly's Hills and did the training to do all the procedures. She does a lot of the lip, fillers and fillers for the cheeks training for the Botox chemical pills. We do P R P for a lot of the scarring on the skin. And I do a lot for the joints, but she helps me draw the blood and get all that ready.
So she, she really liked that. So she got training and then what we did is , the whole DPC thing was let's balance out our family life with what our mission is in life, right. With our career. So what we. did is once I quit my job, I, took off Sundays and Mondays because people like those Saturdays and PE people, there's a lot of people that sometimes don't have the weekdays, cuz they go to work early in the morning and they get off really late.
And the only way they could get in is on a Saturday. So I didn't wanna, I didn't wanna take out that Saturday for my benefit cuz I wanted the patients to have that there, but I only do a half day. So we do from nine to 12. So the way our schedule works is we're open Monday through Saturday, the clinic's open nine to five and Saturday's nine to 12, but the staff is there for the whole time.
I'm half patients scheduled. I do alter alternate. So I do Tuesdays. Let's say nine to 12 cuz we're close from 12 to one for lunch. And then I do another like let's say Wednesday. One to five and then we alternate that and then the next week we do it the opposite. Cause in case somebody needs a Thursday morning or whatever, it's all there.
Right. And then Carla just works on Wednesdays and Fridays. So Carla goes in and she has her patient scheduled a half day on a Wednesday and then a half day on Friday. So what happens is when I'm seeing patients, then I get off and then she'll go in and see her patients and then the opposite.
And then on Saturdays I do two Saturdays a month and then she does one Saturday, a month. And then one of the weeks in the month we work on Monday. I work on Monday and then what I do is I take off that Friday, Saturday, Sunday, Monday. So we have a four day weekend on one of those weeks. And then and not every it's three Saturdays a month.
We're there, I'm there two Saturdays. She's there one. And then one Saturday, we. Have a Saturday off. So that's kind of how we balanced it out and it's been great, you know, just half days works. Perfect. We see three patients an hour. That's the max that I, put on there, if there's something serious or something that's like a UTI or something sometimes I'll have 'em come in, get a UA and tell, Hey, okay.
Yeah, it looks positive. Or, or a cut, I'll squeeze 'em in, you know, um, before I leave but we try to keep it three patients an hour. We try to get that, that going. And then they're triaging. the staff is triaging as they call in and I'll have, I'll see if they need to be seen sooner or not.
If there is something going on. And if not, then sometimes when I get home we call 'em purples, but it's like messages. And before I give him 48 hours to answer those messages, and then I go on there and, I'll do either refills or I'll
it's not like, I could do it at the very end of the day or whenever I. Whenever it fits in there and that works out. Perfect. So it's not like I'm at the office all day. Yeah.
Gotcha. And with you sharing how you're approaching 800 patients at the time of this podcast, and you also have a third one on the way, congratulations by, by the way.
I'm that? Okay. Thanks. And with you sharing of as to how you guys have built balance into your schedule to not go back to the old ways, how are you guys planning in the short term?
Because you mentioned, if Carla becomes a nurse practitioner or you have another nurse practitioner who comes on to cover you, that's not in the short term. So do you have a doctor covering you for paternity leave or how are you guys future planning coverage of all of your patients?
When baby comes.
Yeah. so, like I said, we, since we just do half days, Carla will take time off because aesthetics is not like an emergency type of thing, so she can kind of block out her schedule for a little bit and just, the patients will schedule they'll let them know when the next appointment is.
and for me the goal is, you know, things, I always say, man, this is kind of crazy how life works, but I wasn't thinking about bringing on anybody initially, but as things start to get busy, it was like perfect timing because one of my brother's wife, Her cousin works at doctors as a ICU nurse. so he worked at ICU and she did nurse practitioner school right now and she needed to do her hours. So she asked my brother's wife, Hey, can I do my hours with Dr.
Moro? So I met her and, I said, I trust my gut. Like, she seems like a cool person. Cuz that's, that's the last thing I want. Something bad comes to the clinic. So she's been great, man. She's just a quick learner. She's all about helping underserved. A large part of our community is Hispanic.
Cuz I speak Spanish. So a lot of Spanish speaking patients our clinic when it comes to primary care. And she's a DACA resident, so she's very passionate about, helping the community and, and it's kind of her, her background kind of fits with, the culture of the clinic and stuff.
So, I've been teaching her, you know, I've I went through initially shadowing and then you know what I try to do. Go through how I break down before I go into the room, like what's going on with the patient what I'm thinking and my diagnosis. And then as a patient talks to you, you know how to do a differential on, what's gonna be your top differential going down and then how you're gonna work it up and what you could do to get something better while you're waiting.
Right? So you get results and stuff. And I, taught her like that. That's the way I. Kind of process my thinking and, she's picked up on it right away. And now she's, as a student she's seeing the patients and the patients are having a good response, you know, always tell 'em my check out, Hey, ask them how the experience was, ask her, how she's doing.
it's always a good, good experience, you know? so they come back and I say, oh, I saw you saw Iris. How was that? Oh, she's really good. Doctor, she was really nice. She she's kinda like you, I'm like, okay. So she kind of follows the, the thing, you know? so I think she'd be a good fit.
And that's my goal is since we do the half days, it's like, she'll do the other half. And then the goal is to try to fill those other half days. And then she would probably cover one of those Saturdays. So then I would have just one Saturday and then she would have one. And then now you get rid of working two Saturdays.
So then everything's kind of balanced out, and that's the idea is just to grow it organically and then. have Just work, help each other out, and that's what we, that's what I wanna do. So I, I think we got a plan in place and she wants to come on. So actually this month we're gonna sit down and I'm gonna give her like a, an offer.
So so that way, if she says, yeah, this sounds good. Then when she's done, then she'll right away. Have like a job. So kinda, she knows kind of where, where she'll be going. So that's kind of my, position on it, in regards to my practice. And, and now that I have DPC, that's what I'm seeing, I'm seeing my future is if I could get it to the point where I get it really dialed in, then I would love like another doctor that wants to be somewhere else in Merced, Stockton, wherever, and say, Hey, I'll help you build it out.
I'll help you with all the stuff that is hard for us to do. Like I have like geo can go and build it out, like when it comes to flooring, all that stuff out. And then I have Ramel can do all the payroll and help you get Everything lined up, so you don't have to worry about that.
And then just, get all the right team. And I have a formula for that. And then we can get all that. So you can just focus on medicine, but what I'm thinking is like investing, right? So if we invest 50 50, then. I'll be half partner, you'll be half partner, and then you get paid as a doctor, but then if you do good, then, we all win.
So that's kind of my vision for the future, cuz I, I I'm all about like, like the way you see DPC, it has to grow. So, if nobody jumps into it, we're never gonna grow. Right. So I'm kind of looking into how can I help other people grow? And maybe showing 'em, Hey look, I did it. Let me show you all my numbers and how it looks, how I kept my half day.
So you have your balance. Like we actually went to a birthday party in Fresno with one of my co-residents the other day I was talking to a lot of my buddies cuz they're out there and um, and I only work a half day. What, and you're, you're making as much money as, as you were, when you were working.
What? and you only see three patients an hour. What, and they're just like, how can I do this? Like, I I'll help you out, man. Like you wanna do it? Let me know. You know? And I don't have to be a part. I mean, I'll help somebody out. They just wanna do it. But I feel like that's the part that's missing because that's the part that.
. I mean, it was scary for me, but like I said, I got lucky that all these things have lined up and, and, and it's gonna be a win-win for the people that are gonna be involved in it, so that's kinda my hopefully long term kinda vision, you know, in the next may I have a five year lease and that was my goal in these five years, I'm gonna find out if I could either keep growing this or just stay where I'm at, or, decide kind of what, what I wanna do, you know?
And when you talk about, training and bringing in more people and growing BU Vita, have you had residents shadow at your
clinic as well? Not yet, but the, like at U C S F they've been they have a community rotation and they, every time they have 'em call me and ask. What's DPC here.
What are you doing? Like, cuz they're supposed to connect with different residents and find out what they're doing out there. So you know, a lot of 'em like didn't know anything about it, so I think that if I just like Iris came on and she just like fell in love with the way that the way things are going at the office.
And I think she likes it, you know, I think she really likes it and she's a good fit. I love to get more residents like that. If they, if it's the right fit, because it's not about just working half days, it's about loving what you're doing, you know what I mean? And, and then \ it's a win-win from every angle.
So that that's kind of what I'm looking for. And if it's a right partner out there, then I'd love to have a doctor. Cuz I feel like that's the only way you're gonna have success is if the person that's in the clinic loves the clinic and is passionate about the clinic and the employees and it doesn't become like everything else, like in the states that it's just like.
Nobody owns any of it. So you get there and nobody gives a shit . So I want it to be where somebody's there and, and they're giving, they care, care about what's going on, so that's the only way I kind of picture in my head. and then, there's a saying, put your money where your mouth is.
So if we're gonna open up a practice somewhere and take that risk, it's a win-win right. It's I think uh, a lot of people that are into this, sometimes like entrepreneurs. So like, people invest into houses to get their return on their investment, into this.
Like, why not invest into yourself? Like, that's the best bet. Right? So I'm like, if I believe in this doctor, well, I'm gonna, I wanna help him out, but then he needs to be there to make sure everything takes care of it. Right? So like my home base is Turlock and I'll take care of that. And somebody else's home base can be somewhere else.
They can take care of that, but we can invest into that and, and win. . That's my vision for this, this thing. If, for the future, I think for it to grow.
Awesome. And yeah, I think that that really at the end of the day always highlights how we are relationship based doctors in terms of, we have a relationship with our community.
You are, absolutely crushing that goal that you had with an open door policy and being able to serve anybody wherever they needed help. But , so when we, when we think of that space of, loving your practice, and we also go back to, that, that spot that you were in, where you were like, I wanna open my, private practice, but I didn't really know if it was gonna be DPC or another model.
What words of wisdom do you have in addition to what you've shared for those people who might be in a place where gosh, like, I really wanna do this, but I, I have some hesitancy about, finances or space or whatever it might be. What, what additional words of wisdom would you have to share with those people?
Yeah. I mean, I feel like the story of my mom is the one that I followed is never put your family at at risk. That's something you don't wanna do. And we always talk about it. You hear the DPC story, somebody was doing locums or different things, find out how to make it work, but where you're gonna be the best time you're gonna be putting it into what you really want.
Right. So for me, I was lucky that where I was practicing, I had the, the upper hand to say, Hey, I'm gonna work twelves, and I'm gonna work these days. And, and that's it, you like it or not. That's what I want, do it, and that's what always my, my belief was to have that, right.
So you gotta, as doctors, we have to define what we want, man. We have upper hand, we put in the work, so nobody should like, that's why for me, sorry. if I don't offend anybody Kaisers or whatever, That's what they have. They have control. They tell you when to work, how many hours you could work, and then all these emails you have to answer.
And, it's kind of like, okay, well, where's your autonomy, so for me, it's like, don't forget your autonomy and then set your, goals on what you want in your life with your family. Like your time is the most valuable thing. As I got, when I first started, I just wanted to work and I wanted to kind of get out there.
And now it's like, I want to have my time, you know, and I read a lot of books and a lot of books talk about that is the most valuable thing you have is your time. So I think as doctors, you can't practice good quality medicine and have time. And I think to me, that's what I wanna offer in the future is that is say.
You know, I can help you be the doctor you wanna be and have the time and all that line up together. So just figure out how to keep on working. You know, It's gonna be a grind for a little bit maybe, but also how to invest into yourself and your future. And that's the only way you could do it sometimes is you have to have two jobs for a little bit, but then once you unlock, then you're free.
You know, You got so much more. I take my kids to school every day. If it's not me, it's my wife. We don't have any babysitters cuz if I'm working she's not. And if she's working, I'm not. So it is like, man, you only got kids for a little while, especially if you have kids like. Do everything you can to make sure you don't lose that.
Cause that's one thing that my mom always said is like, she's like, man, I always regret that I had to work so hard and I lost all that time with you guys. And, but I'm like, mom, you don't even know how much I learned from what you did. You know what I mean? So I'm grateful for what she did. Like I honestly, I have no regrets but every story, there's always something behind there and that's what I think for my kids.
Like. What can I give to my kids too, as they get older, where they're not like feeling like a silver spoon in the mouth. And I'm very like humbled down to earth type of dude that I love to hard work. And that's the kind of people I like to surround myself around. And that's where I ask. I think that's the key surround yourself around people like that.
And you're gonna win, man. I'm like, I talk about Ramel. I talk about geo the staff, nacho, my wife, they're all like part of the team, know, and I feel so blessed. I feel so blessed and sometimes, gets emotional, like damn how to get this lucky, you know,
I love it. And I hope that everyone is as lucky as you are on their journey. You've shared so many amazing stories and words of wisdom, but I wanna ask in closing, do you have any other words of wisdom that you'd like to share with the.
for me uh, I think the best words, wisdom is we only have one life, so don't waste it really take advantage of it. And that means go out and, reach for your dream, and, and some people, it is just something simple, having a a job and that's a blessing and having the, the things you want, but when you have a dream and you want it, just go out and do it, because you don't wanna look back and go, dang, why I do that?
don't regress, just go out and do it and, surround yourself, good people. And, and you're gonna, it'll come. It'll, come true. If you put in the work and even when things don't come true or don't, don't happen. They're supposed to cuz then they do happen down the road.
Sometimes out of something bad comes something good. That's the only way I could put it. Sometimes things that seem bad are good. So even sometimes when you're like, just keep reaching for what you want and you'll get it. And even if it's not happens like in a straight line you'll curve around it and you'll come to it, so that's the only thing I can say. Just reach for your dreams so far. I've everything I've wanted to do has come true. So that's what I can tell you, man, just reach for your dreams and take care of people, Don't forget that we're here to serve people. And I think that's the main thing, know, it not only patients, but if you do a DPC, your employees if you do good, your family and your kids, and just as long as you do that, you're going to, be happy.
You know, They say money, doesn't buy happiness until you start giving it away, so you start doing stuff with it. That's good. Then it, it brings all the happiness. So that's all I can say, man. right now I feel so uh, emotional because it's, it's been uh, It's been good.
It's beautiful. It's beautiful.
So thank you so much, Dr. Bero for joining us today.
Thank you. I appreciate you letting me share. And um, and I wanna say, thanks one more time to everybody that helped me get here.
And thank you for doing what you're doing. I think it's bringing awareness and not only that, but I it's so cool to hear everybody's story, know, I think everybody's story is, is unique and thank you for, for doing this and putting the time. And I appreciate, appreciate that.
*Transcript generated by AI, so please forgive errors.