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Episode 128: Dr. Nasser Mohamed (He/Him) of Osra Medical - San Francisco, CA [Part 1 / Re-Air]

Direct Primary Care Doctor



Dr. Nasser Mohamed of Osra Medical - San Francisco, CA
Dr. Nasser Mohamed

Dr. Nasser Mohamed is a family practice physician and a sports medicine fellow. He attended Medical School at Weill Cornell Medical College - Qatar Campus from 2007-2011 followed by Residency between 2011-2014 at the University of Connecticut - Family Medicine Program. He then went on to complete a Sports Medicine Fellowship between 2014-2015 at the Allegheny General Hospital (Drexel-Temple University).


He practiced Primary Care and Sports Medicine for three years after his fellowship in San Francisco with One Medical Group. He worked there as a Primary Care Physician, specialist, medical director, CME/medical rounds coordinator, and EMR consultant for the engineering team. After three years, he joined Circle Medical, another venture capital-backed practice, and was there as an operations lead.


Dr. Nas started Osra Medical in 2020, the most magical year!



LINKS/RECOMMENDED RESOURCES:

For the LATEST in DPC News: DPCNEWS.com

Osra Medical: HERE

Read about Dr. Mohammed in his San Francisco Bay Times Article: HERE

Read his INTERNATIONALLY POPULAR ARTICLE: The Benefits Of Seeing A Gay Doctor


RECOMMENDED BY DR. MOHAMED:

Score.org Website: HERE

Atlas MD EMR: HERE


CONTACT:

Address: 2215 Post Street, Suite 2, San Francisco, CA 94115

Telephone: 415-954-2220


Meet DR. Nas for free: HERE


SOCIALS:



Dr. Mohamed featured in the Golden Gate Business Association Blog:


 

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Transcript*


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


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


Direct Primary care is a model to practice primary care with autonomy, joy, and professional fulfillment. It is where I can be empowered as a physician, but more importantly, it is where my patients feel seen, heard, and empowered. I am Dr. Nas Mohammed of ASRA Medical, and this is my D P C story.


Dr. Noser. Mohamed is a family practice physician and a sports medicine fellow. He practiced primary care and sports medicine for three years after his fellowship in San Francisco with one medical group. He worked there as a PCP specialist, medical director, CM slash Medical rounds. Coordinator and EMR consultant for the engineering team.


After three years, he joined Circle Medical, another venture capital backed practice, and was there an operations lead? He started Ultra Medical in 2020, the most magical year.


Welcome to the podcast, Dr. Mohammed. Thank you. Thank you. So I wanna start with your Google identity in terms of when when I search for Ostra Medical, the search comes up as that you are a gay friendly private doctor. Can you share with us your own story of your identity coming out and your risk of being persecuted?


Yes, I know this may come off a little intense for some of the people listening to us, but this is a very important part of me and of my story, and I'm finally comfortable being in my own skin and not afraid of being found by those that want to hurt me for being who I am. I grew up in Cutter, also pronounced Qatar, which is a small peninsula of Saudi Arabia on the Persian Gulf.


It's between Saudi Arabia and Iran. In the Middle East. I spent the first 18 years of my life there. My mother was an orphan and my father was a second generation Iranian immigrant. This was the first thing I had to learn to be in the closet about my Iranian heritage. That is Qatar has a very classic system.


They even discussed having tiered passports for their citizens. At some point, I grew up extremely religious and of the Muslim faith that did serve as a pillar of strength for me during some. Really difficult times in my childhood after my parents divorced and me and my siblings faced a short period of homelessness when we were young.


The mosque served as a shelter in a way, and faith was a hope for me at some point. The story of me working my way through that life to a high school for gifted children is a story for another day perhaps. But I was a diligent student and following my high school graduation, my father and I were invited to the Royal Palace in Qatar with the other nine top graduates in the country.


And in the year I graduated, we were all offered royal scholarships to pursue higher education if we met the admission requirements. So that's where my journey, my pre-medical medical school journey started at Cornell University that also had a campus in Qatar. After learning about the needs, That QAR had in different areas within an outside medicine.


I chose to pursue sports medicine training as Qatar's very first sports medicine physician. Shortly after they decided to invest in the field locally, and all of that happened just prior to them winning the 2022 FIFA roll cup bit. There are a lot of. Issues and controversy surrounding that, and I chose family medicine as the baseline training before going to sports medicine to have broader scope of practice.


If I was going to go in as one of the first Qatari sports medicine physicians as I was going through my medical journey, which I mean, it takes 12 years at least, right? Of everything goes well to go through the whole thing. I learn more about myself and my sexuality. I also come to learn, unfortunately, that.


My home country, Qatar punishes homosexuality by the death penalty. There are very few countries remaining that still do that through some friends in Qatar also, I got to learn, unfortunately, that they have a gay police de division that finds and imprisoned L G B T individuals and force them into some sort of conversion therapy program.


I mean, I remember stories from the eighties and nineties of men getting lashed. Publicly for flirting with women, and this was just men talking to women. Things were much, much worse if it was found out that you were a man interested in o in other men. I decided to come out to my family in 2015 and move to San Francisco where, where I took political asylum, so that was my

background.


I've said this to you before, but I, I'm so honored to know you and you know, to ha to call you a friend. But I cannot even imagine the day-to-day what you had gone through, especially once you were more in, in touch with your sexuality and also finding out about the police. I just, I, I can't imagine. I, I'm so glad that you are here and that you are able to reflect on what you've been through as you take care of others who I'm sure have been marginalized as well.


Thank you. That's really kind of you. It took a lot of loving people to stay strong. Now

on your website, you have something that is definitely a hundred percent inclusive. Your tagline says, be seen, be heard, be you. What does that mean to you?


Thank you for asking that. So this is. This just happened like earlier in January and it was part of an exercise where following the recommendation of a lot of D P C physicians in the, on Facebook and through different meetings, recommended story branding and learning how we can be the heroes in our patient stories.


So this is where this come from. So I, after going through the content, I went back and looked through every single patient that I have. Right now and wanted to see why they're seeing me, why they're choosing to see me as their physician in my model in San Francisco. And it really came down to this. They wanted to be seen, heard, and be themselves safely.


And so I decided to change that to be the. First thing you see when you land on my website for patients, and you know, I have, I changed few more things actually on my website. I'm just trying to scroll through right now as we're talking. I ended up also, as part of that exercise, deleting two thirds of the words I had on my website.


Which was a risky move. I just realized I was being really wordy. It's really hard to describe a healthcare model, right, to a person that's not in it, even if it's another physician, right? Like that hasn't heard of D P C. If I tried to go and describe what I'm doing to them, it can get convoluted really quickly.


So I just basically changed everything to be about what I'm doing more than about how I'm doing it. And then I can talk about the how once I engage somebody. And yeah, some of the patients I have have really complex medical needs that just could not be handled in traditional system. Some went through traumatic experiences similar to mine and now need to stand on their feet.


I also had someone that was choosing to suffer in silence at home. With their medical conditions and not be on medications or, and not have them refill because they were just choosing to go through that and engage in another abrasive encounter in healthcare setting. So I would say, I would describe all of those with these three words.


It is a great book and I think that, okay. Did you go through it? Do you know which book I'm talking about? Building A Story Brand by Donald Miller. It's such a great read and I'm glad that it has helped tailor your website even further towards your patient population. Definitely. It's heartbreaking to hear about, you know, that the patient who would rather stay at home.


Versus facing the fear of being treated poorly by a healthcare professional. And a again, though, it goes back to your story and your history, teaching you empathy so that you can take care of your patients in a better humanistic way. Yeah, it might be also a good place now to mention that . Which is the name I picked for my practice.


It's also reflective of what this means to me. It means family in Arabic and a lot of my patients have lost their birth communities and sometimes even their birth families and are building or have built a new family. And themselves for themselves in San Francisco. So I wanted to create a fear-free setting for them to seek care where they can be themselves and thrive knowing that they're among their chosen family.


Now I wanna draw attention to the fact that you chose D P C after, uh, Coming from some pretty big names. So you were involved in One Medical, you were involved in Circle Medical and also forward medical. And the question that comes to my head is, why did you choose to leave to open up your own practice?


Yeah, so I worked at One Medical and Circle Medical. I'm familiar with Forward Medical, but I have not worked with them directly. I think my experience at One Medical and Circle Medical was overall positive and. Reflecting on it, it ho. However, it did not help me sustain my passion for medicine and it did not keep up with my pace for personal growth and professional fulfillment.


And one, medical was the first job I took, you know, after I came to San Francisco. So I definitely had a lot on my plate as well when I first moved to the city. And I think One Medical was a great place for me to start practicing medicine. And I got really to experience what it's like to not be in control of my practice as my panel built up over there.


Right? Because I was a primary care physician, but also I was a sports medicine specialist for them. So I had about like a hundred PCPs referred to me for their M S K cases in the city. But I also had like a large panel of patients that I was managing. I do love and enjoy innovation in healthcare and its delivery.


I believe that the DPC model though, is a setting where most innovation and primary care and delivery can happen with less obstacles. I still continue to work with startups right now on the site in San Francisco through VC companies and such, just because I was in the space and I love it a lot more, I have to say, like, Right now than I did when I was employed on One Medical and Circle Medical.


I just don't believe that this innovation should ever come at the expense of patient safety or quality and valuable care, and I also do not believe it should come at the expense of the ones that are delivering the care. So, It really comes back to like being in control, right? As you innovate and explore different things.


And I just wanna say, when I say that, when I say equality and valuable care, they're just such buzzwords, right? Like for us that worked in primary care and, and healthcare in general. And I just wanna say that I'm not referring to those set of metrics that are used to sellas, to employers and insurance companies.


I'm talking about things that. We as physicians and patients value, which unfortunately is different from the definitions of valuable care in traditional models. So this is why I left. This is why I left and started my own D P C practice. I left to maintain my craft skills and passion for medicine. I also left both companies with the best feedback.


That they have ever given to physicians in their systems. Just, I'm putting that on the record, so I wasn't a pro troublemaker on my way out. That's fantastic. No Nas. You have been open, uh, at the time of this interview, almost a year, and you are bringing value to your patients because you're growing steadily.


And so like you clarified the value that we're talking about is not the value that c m s is talking about. Can you share with us about your patient population that you're bringing that value to?

That's, um, that's a really good question, and I'm still going through this exercise, right? And the reality is, There is no one definition for value, and I'm coming in terms with that.


I think value is defined differently by the people receiving care and whatever cookie cutter you create, it's not going to fit everybody. It's just not, and I think I have the time and resources. To adapt to that definition of value for each person that sees me. And it just, I tried to find con grounds, like among my patients, right?


I actually sat down and put them all on a spreadsheet and really tried to like, Try to find what is it that they all seek and it's just, it's just different. Everybody has their own life story and their own reason. See me. For some of them, it's that they're going to get MD led care in my practice. For some, it was about knowing that I will read the specialist notes when they come back to my office.


For others, it was about. Knowing that I'm not gonna treat them differently because they are who they are. For others, they just needed higher touchpoint that I can afford. Right? Like, and they can afford themselves too in my setting. So these things are not measured, right? Like when you look at any like value-based system or metrics in traditional system, they really like, they end up having a small list and check boxes and a lot of people are just, Are left and seen when you do something like that.


So yeah, it's, it's very true. When in p for Swiss, you get presented with your monthly, you know, how did you do summation if your a1c s are not on average below a certain number. Does not say anything about. You know, a wife just lost her husband and so the diet went out the window and exercise stopped altogether.


It doesn't talk about the, you know, male not getting to the patient with their medication, so, yeah, exactly. It is so, so true. Also, The fact that you're saying, you know, value is means different things to different people. That's as it should be. I think in that, you know, you, you as a doctor with a growing successful D P C are fulfilling that value for all of your patients because you haven't had a single person leave since you started.


That is correct, yeah. And I operated almost exclusively during a global pandemic. And you know, in my seven by seven area, there are at least 50 different primary care offices that I know of. And I keep like learning about new ones. I just found out a new one just like yesterday. But they're all event, they're all accepting patients.


They all have different models. Cash based, fee for service, membership based, you think of it, all of them exist around here and they're all accepting patients. So for me, before my one year anniversary in San Francisco to reach a point where I'm covering all my business expenses is. A huge milestone for me, and I'm really grateful that I was able to achieve that.


I wonder, NAZ, have your patients, did any of them follow you? So, that's a good question. So when I left, I did have a wait list when I left my old job of patients that were gonna follow me, but then Covid hit right. A lot of them just left San Francisco. Because that's another thing. San Francisco's not really home to a lot of people.


There are people that have been here a long time and I, I to think now on top of my head, I think the far majority of my patients now have lived in San Francisco for a long time, which is different from what I had. Well, at my old job I had a lot of people that were transient in San Francisco, so I'm like in a one different population.


I have like maybe less than five people that were with me before. So it's a small percentage I would say that, that I used to care for. Uh, one medical, but then the new ones that joined me now and to seek my care are also utilizing one medical and other practices for various reasons, but still choose to see me in my model to compliment what they're getting.


Just to be clear, you have patients who, who didn't follow you but who have one medical coverage and still choose to see you? That is correct. It's about 80% of my panel right now. That's That's amazing. That's just amazing. Congratulations on that. That's again, speaking to your value as a person and as a physician.


Thank you. And three months ago I got an official referral from one Medical to my practice, so I feel very accomplished Now in your practice, you, I I can just imagine that your, your demographics have people who might be struggling to, you know, put food on the table to people who are. Seven figure earners.


And do you have anything set up to help those who have less financial means to pay for their healthcare so they can still access your care? Yes. So this is something I, I was hoping we would touch base on. So I wanted to start my practice. I did attend some of these courses through like. The Small Business Administration and SCORE, and which is a national nonprofit for people to go in and learn basic business skills, because I had none at all.


I never owned a business before, so I needed to learn how to write a business plan, how to write profit and loss statement, how to keep. How to, um, do basic bookkeeping and QuickBooks and all these things, and marketing and, and it was really helpful. It was not extensive at all. Like some of these workshop, like the most helpful workshop I attended was a one day workshop for 50 bucks, and I learned so much from that was the highest skill thing I've done.


And through that I got. Really helpful information just about San Francisco demographics, right? Like it's, this information is public, even through the public library, like you can go and just access so much information. And it was interesting to just learn about my city. Uh, it was very different. A lot of people don't live in it for more than two to three years.


A lot of people are young, they're under 40. Years old and a lot of them work in tech. And there is the huge income disparity that you mentioned, right? So they're the people that are millionaires, millionaires and billionaires. And there are the people that live paycheck to paycheck or not even. And the cost of living in San Francisco is really high.


Like, so it's probably the highest per square foot for commercial lease space spaces in the country. And also there are a lot of associated expenses of opening and operating a business in San Francisco. I learned while doing this, so I had to include all of that in my business plan when I was designing my model.


Right. And then I also had. To prepare to see what my value proposition is. A lot of startups do that when they like go and compare what's in the market to what they're going to bring to the market and why you would attract people to you. Right? So there's those 50 plus primary care offices, like within seven miles from me.


Why would people come and knock on my door and not other people? So I had to think about that as well, and so I decided to. Use the D P C model in premise and cut it differently to fit what I think going to work for me in San Francisco and for the patient population that I chose to focus on. So I decided to open a practice that would serve everybody, but I wanted to focus on an niche market.


Um, and that's the L G B T people and specifically gay men that live in San Francisco. And the reason that I narrowed it down to this is because one. I'm super empathetic and passionate about caring for this population. Um, and brings me joy actually, before quitting my old job, I had a spreadsheet for maybe a year where I, um, you know, there's like, there are like all these moments when you're working and the moments of joy and moments of deep frustration, right?


And you're like, you can't tell what doesn what, so I just put it on a spreadsheet over a year. And really wanted to know, like at that time I actually was questioning even if medicine was like right for me. Cause I had a lot of days where I just felt very defeated. And after putting it on a spreadsheet, I realized that my biggest moments of joy come from caring for patients.


And a lot of my frustration had to do with the system. I probably didn't have to do a spreadsheet to like out description. But I had to, and sometimes, sometimes it can get clouded, right? Sometimes you can really be like so absorbed in a case and you're like, this case is so frustrating. But then once you analyze it, you realize that it's not the case.


It's not the person, it's not the conditions they came in with. It's how the two of you engaged. The premise of the engagement and the restrictions that were around it. So like it really was really, um, about that. So anyway, so that was one reason that I picked that population because I really had a lot of joyous moments caring for them and helping them with a small.


Twins. But also when I was put on the menu in, in, in my old job and was presented to a large segment of the people, gay men chose me as their primary care physician. Disproportionately, I had like maybe 80% where of my panel was gay men, women in general were like, Not likely to chew as their pcp. And I think it's because like they're just more likely, like in my old office, I was the only male, uh, physician.


Um, I had five females. So I think, I think in that office they just chose to see the other, uh, women. I had like very few. Female patients that chose to see me for their care. So I decided to use this information to my advantage. So I was like, I wouldn't have to swim upstream, red go with what people would naturally select.


So that was the one idea I had. And then I was like, okay, so now I know that that patient population is probably going to be seeking me even without me trying to find them. And then when I look, look at that population, you definitely see the disparity in income that we mentioned. So I decided to create a Robin Hood model, I, I don't wanna really call it that, where I wanted to offer the value and even more, and even more than what, like a traditional D P C model may offer to the patients that can afford it. But I still didn't wanna be cost prohibited, so I know some huge.


Practices in the city charged close to 20,000 a year in, in, in retainer and such. So I, I'm not there, but I'm also more expensive than the traditional direct primary care model. So my pricing is around two 50 now. I'm considering changing that, but I'm around two 50 now. And for each person I have, that's a pain. I try to take on one local artist, self-employed person, or an asylum seeker for free so that they don't have to pay me anything to get medical consultations and they can still like take advantage of the wholesale on apps Medicine imaging right now, like I grew my model with one-to-one.


Ratio, and I think I'm going to continue doing that. I have a wait list for people to join my free membership. I'm trying to be conscious of that because I don't wanna be too busy doing free things and then like have my business die because I'm just too busy doing things that are not revenue generating.


So my check is to ba, basically try to compare how many pain members I have to the ones that I'm caring for, for free over time. And. The vision is to eventually hire somebody once I'm busy enough, once I hit a critical mass of patients that are, uh, paying members, and then I would be able to take probably more patients on in one to two ratio.


So that, and then a mature model, like I would still have the average price per head in a way, gonna look at it that way of caring for a, a patient, but, I am not getting all that membership fee from everybody. I don't know anybody that's really doing this model. I'm not sure if it's going to continue to grow, but it seems to be working.


I am not marketing it that way. I'm not saying, oh, sponsor a person. By being a member of my practice. The way I'm looking at it is that I am offering this valuable experience for you for, and. Primary care setting that you value for your own reasons, and I'm delivering it for you for this fee. And now I have this time available and I'm choosing to give it to these patients.


And this is really helpful. Like it's, it's been really great because a lot of the patients that are in the free program are, are also micro influencers in the community, so they get the word out. About me, which adds to my credibility in the community. And I just started a thing with a couple of them where they actually, one of them approached me asking for like a business to business kind of agreement between us.


It's a local drag queen. She wanted to use the space sometimes to phone, like video drag shows and things like that, and use the internet and turn They would feature me to their audience. So I thought that was a good idea. It's easy marketing for me, right? And it's reaching my emographic, so I just started that.


Um, we'll see how it goes, but this is where I'm at right now. So I think with this model, I can read most people that live in San Francisco full-time.


It's, it's definitely unique and I think that, you know, the, again, going back to that marginalization idea and the, the income disparities, how wonderful is that, that you know, you are becoming known as like your Google search, you know?


Provides a gay friendly private doctor who allows people to be seen, be heard, and be themselves. And you know, at, at some point as your model changes, that your, your numbers might change, but you still have that at the, at the core of your mission. And, you know, it's, I I love the, the. Spreadsheet. I love that you did that.


I'm sure looking at practice now, compared to what you, your model was at One Medical or Circle Medical, I'm sure that that just makes you so happy. Just thinking about you're, you're, you're doing this, you're doing this model and you're, you're thriving. Yeah, I'm definitely happy. I'm super happy and delivering what I was delivering before, but.


I'm being rewarded for it and I have the time for it. Like I remember, you know, I'm sure like a lot of listeners that our physicians would relate to this, but like a lot of us stayed after hours, right? Like for the one person that's sick, that needs to hear that they are dying or have terminal or like whatever it is, like when you break bad news to a patient, like they just, you just, that can't fit right In that traditional model, 20 minute with template.


And I got a lot of pushback in like just getting. Time to care for such patients. So I've had to come from my own time. So I, to me, I always de delivered this kind of care to the best of my ability, but now I can do it without it, like taking too much out of me, um, every day. So that feels great that I'm in control of that.


And on control of delivering valuable, defined by the patient, right? If the patient wants to pay for my time, for me to hear them talk for three hours, then they can do that. You know, I don't have to come up with a billing code for that. Like, it, it doesn't matter. And that, that just feels good. I love the centralized billing and I love not having that be an agenda like in like every half hour.


It just more authentic, you know? And I patients see that, see that it's different. Absolutely. As you're saying that, I think about those situations where I am running behind and I feel so bad and I, I'm rushing, or I'm choosing not to chart or choosing not to log into the broken computer because I don't wanna, I don't wanna be late.


I don't wanna be, um, anymore behind. Mm-hmm. Mm-hmm. Yeah. And when. Absolutely. You need to give that the care that the patient or their family deserves when, you know, like, uh, terminal illness. Yes. A person who is coming in from out of town because their mother or father is having memory issues and they're not sure what to do.


And that is not a 15 minute conversation, not a 30 minute conversation filling out your, um, Post form. I mean, even that can take 45 minutes or longer depending on how much a patient has questions. And so I, I just, I I absolutely empathize with, with what you're saying. Exactly. Exactly. And I'm sure like we all have stories like talking just about valuable like value and how it's perceived by the patient.


I remember once I had a patient with wrist pain and like to me the patient had very classic carpal tunnel. Like there's no question about it. And I did the whole thing and I was like, I explained to them why it's carpal tunnel. And then I went through the treatment and just like went through their exercises and how we're gonna make it better and everything.


And then the patient left and gave really bad review and I was so shocked because I thought I did a really good job and. Then reading the, like following note from somebody else that they saw in the system. The patient was really upset that I didn't tell them why they, they don't have a mess. That, that was the thing that they were scared about.


And to me that was a good thing that I now, like, I always think of the, the story and always try to define the patient's agenda. Like I ask that very, very, very directly and just to know where they're coming from and what would help them sleep at night and would, what would make them. Feel better, not only actually be physically better, right?


Like you need to take care of the whole person. And that I just didn't have time to do that. The system there was just, there were too many people every day, so it was really hard to deliver every day on every single person. Um, but now I can. Easily do that. I can completely deliver a hundred percent on all levels for every single person.


Now, I wanna, I wanna draw attention to your website because you have this amazing video, very up to date because you're in your mask and you're, you're meci gown, um, cleaning and turning the room over, opening the door for a patient, basically representing the patient. Experience when they come to your clinic.


And I, I, I noticed that it's just you. So I wanna ask you, um, in terms of, you know, surviving in San Francisco, I'm assuming you're doing, I'm assuming by that video, it's just you, there's no staff and has, I'm guessing that has also helped with your overhead.


Yes, that is correct. So I am a solo doc and I have been like, that's if I had, if, if somebody is thinking about starting their own business, this is.


Definitely the most valuable lesson. Everybody says this everywhere. In any setting, you would go and attend hearing about starting and maintaining a business. Keep your overhead low, especially when you're starting, because surviving is really the name of the game and. 2020 definitely proved that right during the pandemic.


And so for that reason, I really like when I designed my overhead, I kept both my personal and business overhead in mind. And I wanted to come up with a model that would not need to be rushed or compromised in any way for it to grow. Wanted to stay strong and maintain what I was promising to everybody over time, um, without having to come up with.


Alternative methods of revenue. So in, in that journey, I decided to be a solo doc with no staff. So I do everything on my own. Um, I leverage technology to help me with booking for the patients and scheduling and triaging. And I do everything on my own for the referrals, faxing, and imaging. I draw my own blood in the office for the for blood work when patients come to see me, and it's been great, have time to do all of that, and it's helping me grow and helping me just continue to deliver it.


Deliver the care that I promised Agent and Naz. Yeah. In terms of you wearing all the hats for your practice mm-hmm. How are you going about marketing? Um, because that's definitely something that you, I mean, you touched on it with regards to the micro influencers, who are your patients in, um, in the local community, but are you also doing your own website design?


Yeah, so I did my own website. Like a lot of DP six probably did, uh, used Squarespace. And the one thing, one technical expertise I needed a little help with was search engine optimization. So that was the one marketing effort that I invested in. I, I paid $1,600 for that and for six months worth of work, which I thought was completely worth it because it already paid at least fines what I paid.


Um, already from direct results from that effort. And most of my new patients come from organic Google searches, and that was the one exercise I had to go through. So I had to think of what terms my patients would look for in the Bay Area, in the saturated market in like trying to find me. So I started blogging and writing a lot of articles that are relevant to them and use keywords that I think they would use.


And whenever I have my initial intake call with somebody new, I asked them how they found me and most of them have used the search terms that I thought they would use to look for me. So that has been super helpful. But now I'm looking into other ways to market myself as well as social media. I'm just learning from other D P C docs.


And yeah, marketing can be like an easy way to lose a lot of money. I, I think whenever you just have a moment where you're frustrated with the rate of growth, it's just so tempting to go and just drop a lot of money on Google ads or Facebook ads. But in my small area, like that can easily be wasted, right?


Like I really need to reach the people that are likely to use me, and that's. That has been the tree part in a way, but I think, I think a good, um, lesson from other G P C docs and also my own experience. I think building, building webs like online presence is very, very important and you really need to think.


Like your patient would think when they need you and then just help them find you online.

I, I think that, you know, access to you as a doctor because they're a patient is important, but for those potential patients, that access is definitely impacted by your social media presence or absence, for sure.


Mm-hmm. Now, recently you wrote blog that, I can't remember the name of the, the blog

now. Is it that one A lot of people just landed on. The one you're referring to? Yeah. Yeah. So that was like a, it's almost clickbait, which I didn't love about it. That was Okay. I, I wrote it with, um, with the recommendation of the search engine opt automation team.


I gotcha. Okay. But the, the, the title of the article is The benefits of Seeing a Gay Doctor, and then it just goes, Over all the different items where like L G B T friendly or gay friendly clinical settings can be helpful to bring up different issues a person can go through. And that has like had so many hit internationally, like every day from all over the world.


Like I would get, like I'm looking at my square, uh, space analytics tool to see like how many people visit my website and more than like 70% of my daily visitors land on that article everywhere. So when you like look that up, you'll. Like, I would probably be the top number one hit, um, for that anywhere.


Um, and it's definitely helping my website rank locally as well. Um, so that was the thing, like when I first started, um, I thought that the most common term people would search for looking for me would be gay friendly, doctor, a doctor, um, in San Francisco. And when I first put my website out, that it, I was buried in page five or six, but then through blogging, I'm now, um, number one hit in San Francisco.


If you look that up. Uh, I'm competing with the number one. We keep like going back and forth, but his panel is full. So I'm the second option in a way. The only option, um, and I think people, a lot of people still, still skip the ads. And I, I mean, I do this personally, I dunno what you do. Like when you try to look for something like there's, I have the tendency to skip the ads and then I.


Try to see the organic head results. Uh, to me they're like noise. I make glance at it, but then I immediately go to the organic head. So my target was to be there in the organic search results because there is a thing like with, um, being found versus pitching somebody, right? Like I think it's just approached differently.


I don't know. That's at least my consumer experience. I see AD and I like that they put that so I know to skip them. I absolutely will. Whatever I'm looking for, I will read below those, but usually on the first landing page, and I think that it's funny, the people who are the pa, the potential patients, For doing that, so.


Mm-hmm. I'm, I, I suspect might be better fits for your practice too. Exactly. Now, what about community involvement? You mentioned increasing your social media presence and, and marketing with your SEO and blogging. What about like events did online? Or in person. Have you been able to, uh, participate in local events to also get your name out there?


Yeah. I am a huge introvert, so I didn't really used to go out a lot before opening my practice, but now I'm trying to show up in all kind of events just for people to see me and, and know me. And Covid hit. So a lot of these things moved online. So my drag queens are actually helping me a lot, telling me what's going on and where to go and where to be.


So I'm relying very heavily on them for that. But I'm also attending business Chamber of Commerce, uh, meetings. I gave a talk this past month and the gay Chamber of Commerce and I got got patients from that direct, from that talk directly, so that was helpful. So I'm trying to do. More of that. It's just, I think I'm getting to a point where I'm just like a little all over the place, so I'm gonna need to reorganize and probably put these events on my calendar at least two or three months in advance so I can actually make it.


But yes, I, I am definitely doing this. I think it's important to, to do that. I joined a lot of ORMs where my patients are online on Facebook and. Also attending these different events in the community, and I don't have to always say anything, it's just sometimes it's just a name tag or a passive comment.


I don't try to be very salesy about it all the time, but it's just good for people to know I exist so that when they need me, they know where to find me and. Yeah, it's been really helpful. I also tried giving a free initial visit. I think there's a huge barrier just with people getting to know you, to actually engage with you.


N c you, they date a bit in a way before they commit to you as their doctor. So they wanna just make sure you're kind, make sure you talk about things with sensitivity, and then they come back and. There is a little bit of that. So I think just being there socially helps with that. Helps for them to get to know you a little bit and see that you're not scary or scary and just not see you.


And yeah, I tried giving free visits to some people to help with that. And so far it's been really good. Like I did it with two patients to start with where I was. I just didn't charge them anything. I was like, we need, I'll take care of today, let me bring you in. And then both of them came back and signed up as, Hey, ancients.


So I think that was, that was helpful. Still thinking about risks and benefits of doing more of that because of malpractice and such, but I think attending events is definitely helpful. I don't have direct lead Jen from that yet, but I think it's helping with just recognition the community. And

like you said, seven, seven square miles is a a, a densely populated area where there's 50 plus primary care practices, accepting patients.


That visibility is so important. Exactly, and after going to Story branding, I really do think it's more about how I'm going to help each individual with their own stories than sitting down and talking about me and my business and how I do things like, in a way, nobody cares, right? Like they just want to care about how you're going to help them when whatever they're going through and why they should knock on your door and knock those other 50 doors.


Because you are a solo practitioner in San Francisco and a gay doctor, do you have any safety concerns when you go to work because you don't have staff or a resident artist there all time with you?


I have safety concerns living in San Francisco. There's all of kind of unexpected events that happen, like. My business did get broken into, or like at least there were attempted breaks couple of times at least. So there's that. There's definitely an element of that going on in one, one Medical. When I used to work, I was basically on my own, to be quite honest. Like in the model we have. Some staff to help, but we don't have nurses or MAs or anything like that.


So I was doing a lot of things on my own and a lot of times I was in the off, like over time, seeing patients with no staff. So I basically practice in that setting for a while without having anybody else be there with me. The the one thing that like did come up. It, it came, it did come up when I was a one medical, and it was the issue of having a second person in the room, which is a chaperone, right?


When you do sensitive exams and things like that. And the founder of One Medical, Tom Lee trained in Mass General and in their training, they don't have chaperones in their, in their practice settings. And he, he had a lot of opinions about that and he. Basically, I see definitely the arguments in both ways, like for and against, and we all know the arguments for, it's a good practice.


It protects you legally from any claims or anything like that that may come up, but the counterargument is everything is relationship based, right? You as an individual need to evaluate your strengths and weaknesses and see if you think you would be able make each person comfortable if you're going to perform sensitive exams.


And obtain a consent for them to see if they would be comfortable with you doing that without a chaperone or not. And I think in a way it would even, I would argue, remove barriers for people to come and seek such exams if they know they'll just have less exposure, if they're really embarrassed about just being exposed and you're choosing to expose them to more people.


So, In a way I, I learned from other people that were practicing in that setting, right? And learned from their lessons. And I haven't really had any issues. And I saw a lot of people at One Medical, I had like over 18,000 standard visits done three years and never had any issues. But I was also super aware.


So if I send something fishy going on, I would terminate that immediately. Right? So I was good. About setting boundaries as well. So I kind of know where I am with that and how I can practice safely. But it's definitely a thing, it's a thought, but I also like, in terms of safety, I'm also thinking about like physical safety is combative and physically threatening.


That happened once in my old job. And I was alone. And they were between, between me and the door. So that wasn't awesome. I don't have a plan for that right now, but I probably should. I probably should think about that. But like it's such a rare occurrence. And again, like with that specific example, That wasn't a model where somebody was inserted in my exam room without me having any introduction, didn't know who they are, didn't know why they're there, didn't know what they're expecting, and they were upset because I didn't deliver what they were asking for, which I would not have scheduled that visit if I was the person in charge.


Right? So I was set up for failure there by the system in a way. So I, and I would not do that to myself in my own practice. So I just don't think it's big enough of a concern for me to say I can't practice alone.


You're weighing, you're weighing the pro, the risk and the benefits, and you are making decisions based off of that.


And I think that's the, the best we can do. I mean, yes, so we, we can have some contingency plans, but I think that's part of weighing the, the risks and the benefits. Yeah, and it's not only about this topic, you'll find yourself answering so many questions when you're trying to start your own practice.


Thinking about what's an ideal setting. And for us as physicians, we're super like risk averse, right? So we want an environment where nothing has a chance of going wrong and it's, it's great. That's why we're good physicians and that's why people trust us with their health. But as a startup and a business owner, you can easily bankrupt yourself like sitting there and like over-planning of basically, Investing in everything that could possibly go wrong in the future and just spending all your resources, building this place where theoretical risk can be handled before it happens.


And I think you, that would not be a wise approach to. A startup, especially if you're like me and self offended like you are, practice fully. So I didn't have to spend a lot of money to open my practice and didn't take that. And that just having that mentality, the startup building a minimum viable product that can deliver the care and understanding what my personal limits are in that setting has been really key.


And just making sure that I don't fail even like whenever the global pandemic hits. Very true.


Yeah. You said it already, but yeah. What a year to open. Now, where do you see OS R Medical going in the future?


Good question. I think about that a lot, and it's exciting, right? Because. Right now, like my goal is to reach, to get to a place where I have a full panel or a close to a full panel, a step number one, but then I'm like, my brain is going crazy.


I'm thinking of all the awesome things I could be doing. I'm stupid about technology in medicine and I love seeing innovation and like things that. Solve problems for community. Look at Atlas, like what's doing for our community, for the D P C community, they created an m r product for us. That's good. And it's just good to see things like that.


Like they innovated and took risk and went and built this one product. And I, I love seeing things like that. So I'm trying to do things like that on the site because it just is part of my professional fulfillment. But I also love medical cases with boundaries to access to care. Like I love caring for patients that have that and solving that puzzle for them.


It's super rewarding. So in a way, I feel like I would be super happy just caring for my patients and doing like couple projects on the on the side. Also in a way I think of how I could scale what I have to care for more people that are marginalized in other places. And I don't know today where I would be in like two or three years, but sometimes I think about create, expanding the local family and.


Hiring more docs and sometimes I think about having small getaways in different cities where the L G B T population access sensitive care. So I don't know, maybe I'll continue to just operate in San Francisco or maybe I'll just pop up in your town next. Who knows? Na, did you wanna talk about your New York license?


Yeah, so I, I had a patient that was carrying, was here with me and I was carrying them and they moved to New York and during the pandemic, And they were not comfortable seeing somebody else, so I actually ended up getting licensed in New York to continue caring for that patient, and I learned how to become really comfortable with telemedicine and thinking differently and innovating in that space.


I definitely got like that patient pushed me to care. For my current patient remotely as well in San Francisco. So I really got into building a metabolic program to take care of patients remotely with the blood pressure and with hypertension and impaired glucose tolerance and things like that. So using freestyle, Libras and remote monitors and Fitbits that think that sync with your phone for me to get all the information remotely and just.


Have telemedicine visits where I can view the data remotely has been a really good addition to that practice for that particular patient. They had some cardiac issues and it was pretty easy to look for a local cardiologist and connect them and then follow up with the consult note and continuing to deliver on the care.


Whenever I, they needed the physical exam, I just found a specialist basically for them to see. That specialize in that area. And to them they were, they had good income. They had a good P p O access plan, so that wasn't an issue. Their boundary to access was feeling comfortable talking to somebody about everything that's going on with them.


So they, they decided to continue to see me from New York City after moving. So that's, that could be a direction that I. May continue to grow, but I'm not entirely sure yet. Still exploring

the space. Now, when you talk about innovation and using technology that integrate with a cell phone, for instance, do you have any tech or tools that you use in love in your practice?


So I'm in conversations now with couple of. Startups in in San Francisco and they're creating different tools. Think of the butterfly, right? Like the ultrasound machine that a lot of DPC docs use. There is like one ultrasound company, like that's local here that's reaching out to ask if I would use their machine and do free echoes.


In my office to test their product or somebody else that has AI-powered skin cancer screening. I haven't conversations with them and I may start doing these, but I love being in control of all of it. If I use something like that, patients would 100% know that this is a startup that I'm using, and they would for sure know that it's not in place of seeing a dermatologist.


If I'm worried about melanoma, right, or like sending a biopsy or anything like that, I wouldn't, that wouldn't be a replacement for patient care. But I think my current patient population would actually enjoy seeing things like that. And I think that's the population of practice, like forward medical is attracting.


I think they are building their own tools and I think that's what of people, it's just thinking that, uh, Or just seeing that you're open to different solutions to their problems. And what people don't see is that we're keeping up with like literature and guidelines and things like that on the backend, but there isn't something visible in front of them that tells, that gives them this signal that you're, uh, Somebody that's not stuck in their way, basically, that you're somebody that's open to innovation, that's open to change and that will continue to deliver the best thing that you can get for them.


And to me that would be like the main reason I would get into that space. It would be like intellectual curiosity and also just like being like there is just some, some excitement think like being around different people innovating in in a space and just, it's like there's some contagious excitement about it.


And I think I would love to keep that energy around. I don't use like tools right now in my office that are completely startup, like I'm using like traditional products that all have been on the market for a while, and especially like starting up right now, I have a lot of kinks to work up just with my new practice and running it.


So I think I need to get all of these things worked out first before I introduce. New tools that are not validated or anything like that. You know what I mean? Definitely. And that totally makes sense, especially for patient safety. And that's completely, yeah. That's the number one goal of, of all of our practices.


What about for those people who might be listening? Mm-hmm. To you, sharing your story, where you've come from, how you're treating patients, and where you might go in the future, what advice would you give to those folks who are considering D P C or about to open up their practice?

So that's a good question.


I would say just reflecting back on the one year and doing this, I would say mid greener than continuously look, looking for the greener side, especially like right now after I opened my practice, was always easier to be comparative. Then cuz on what's on your plate. I would say you really need to, to take care of yourself physically, mentally, and financially.


Do that first. Be strong because you are like your own business guest asset. So you definitely need to invest in that. And then your family is gonna be going through this journey with them. So definitely get their buy-in. It's gonna be a family journey for everybody. I think that would be my, my biggest advice.


And then I would just say one more thing for anybody that's thinking about venturing into the space is that right now I'm working many hours and I work on weekends. I work in the evenings, especially in this stage. About three years ago I had my nine to five with decent income and the ability to climb to higher leadership positions.


But I woke up one morning, I got ready, I sat on my bed and I just said, I can't do this. And today I'm working a lot harder and I'm full of joy. I love medicine and I'm excited to grow personally, professionally, and to help innovate the space. I'm just so full of energy and joy, and I just thought that's.


Just worth sharing with anybody that might be struggling or sitting with just dark moments questioning if they find joy in practicing medicine anymore, because I know I at least had a moment where that was a thought, right? Where it was a crisis moment and it doesn't have to be the way it is. And as as somebody that changed their realities several times, you can change your reality.


Get up and do something different. Don't just be helpless where you are.


On note. Do you have any resources, not only about medicine, but also just about physician wellness that you, or personal wellness that you used along your journey to recreate your reality and to keep moving forward?


Yes, so I would say that the DPC Docs group on Facebook honestly had everything I needed to open my practice.


I didn't say much most of the time I was there, but it's because I didn't have to, any thought I had was easily searchable on in the group and I was able to just get everything that I needed. It's really an amazing community, so definitely if you're not there, you definitely need to be there to operate your own D P C practice.


But I also found my. Local score chapter, the nonprofit organization that's, I believe it's national nonprofit organization. I find them really helpful. I love learning the, my basic business skills from them. So I, I would recommend that as a resource. And personally for me, my, I think my social support was my strongest asset and just helping me remain well.


So if you don't have that, I would really recommend investing in that because a sense of community in a way that you find meaningful and, and supportive and empathetic to your own journey is really, I think has been the biggest help for me to remain strong. Like with everything that's going on that I went through and that's going on right now.


I think just having my colleagues that I worked with before that are now my friends. And then the different friendships that build. It just helps you like go through every day, like it's just part of life and not just spiral down your own head.


Yeah. And that's, that sentiment is so important, especially after 2020,

right?


Mm-hmm. Yes, definitely. Like. Filling that cup is really important in it. I think it's just, it's going to be really important in different phases of life. What is the best way for others to reach out to you if they wanna connect after the podcast?


Mm-hmm. So you can, um, definitely find my contact information on my website.


It's sra medical.com, os medical.com. My email is MD. Dot com or you can also find my Facebook and Instagram pages. My handle is SRA and Orco Medical can find that. But if you go through my website, I'm pretty responsive to my emails. That would probably be the best way to reach me. Awesome. Thank you so much, Dr. Mohammed for joining us today. Absolutely.


Thank you for having me and thanking about me in my practice on your podcast.


Next week as we all get ready for the DP C Summit in Minnesota, we'll bring you a Special Father's Day episode filled with wisdom and inspiration from some incredible D P C dads. Until then, if you've enjoyed the podcast and you haven't yet done so, subscribe today and share the episode with a physician you may know who needs to hear about dpC, leave a five star review on Apple Podcast and on Spotify now as well as it helps others to find all these DP C stories.


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





*Transcript generated by AI so please forgive errors.

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