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Episode 129: Dr. Nasser Mohamed (He/Him) of Osra Medical - San Francisco, CA [Part 2]

Updated: Jun 26, 2023

Direct Primary Care Doctor



Dr. Nasser Mohamed of Osra Medical
Dr. Nasser Mohamed

Dr. Nasser Mohammed is a DPC physician and a Qatari LGBT rights activist, and he is here today to share an update on his DPC story.


He opened Osra Medical, his DPC practice in 2020, and in 2022 he became the very first Qatari to publicly come out as an LGBT person on BBC News.


Since then, he has continued to fight for LGBT rights, especially when it comes to their healthcare.





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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 DPC Story podcast, where each week you will hear the ever so relatable stories shared by physicians who have chosen.


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


I have been a direct primary care physician in private practice for three years now, and direct Primary Care to me now is really the freedom to challenge yourself and allow yourself to not only practice medicine with freedom, but also. Allow your creative self to innovate in how you deliver medicine and problem solve life all the time for your patients.


There isn't like when I jumped into it, I thought there was gonna going to be this one template that I'm gonna have to follow, but it's really like, that's not what B B C is. It's just like, you know, you jump in and it's this. Live project that you're always on, you're always improving. And what I do now looks so different from what I thought I was gonna be doing and it's, it's great.


I'm Dr. Anas Mohammed. I'm based in San Francisco. I own ARA Medical, a direct primary care practice. And this is my D P C story, part two.


Dr. Nasser Mohammed is a D P C physician and a Qatari L G B T rights activist, and he is here today to share an update on his D P C story. He opened Ostra Medical his D P C practice in 2020 and in 2022 he became the very first Qatari to publicly come out as an L G B T person on B B C news. Since then, he has continued to fight for L G B T rights, especially when it comes to their healthcare.


Welcome to the podcast, Dr. Mohammed. Thank you. I'm so excited. Dr. Nass is my brand now since, since we all talked and love it. Love it. Dr. Nass. So I will tell you know the audience, just because this is so special on many levels, and Dr. Nass and I were talking about the signif significance of the date that we're recording this.


But I will say that I had the. Amazing pleasure of having a rainy day dinner with Dr. Nas in San Francisco. Just a couple of months ago, I, and what I loved about it, NAS, is that when we met, it's like, It was just an extension of our friendship that we've had over, you know, zoom and chat and whatnot. And I really encourage people, you know, as they're listening to these podcasts, to reach out to people to see if you can meet them in person, because it was just incredible.


Like, I, I already felt that, you know, we did know each other, but like knowing each other in person was a totally new thing. And what a treat it was. So again, thank you so much for being on the podcast and sharing your story part two, and you know, as a drop there that this is a significant time in your life.


Can you tell us what is significant about Pride Month 2023 and you coming onto the podcast on the day that we're recording? Yes, absolutely. First of all, it was amazing to meet you in person and I'm so proud of everything you've been doing, including this podcast. You know, it's just, You do such an amazing job and I got to interview with hundreds of people now since we lost connected.


And you are amazing. Honestly. You have like such good caliber, like you do this really well, you have a talent, and this week is very special because a year ago from this week, I came out publicly on B BBC world as an L G B T person from Qatar becoming the first and. Still the only publicly out L G B T person.


That's just incredible. And again, you know, think about you as an individual wearing that or bearing that flag, but also the fact that you are a physician. And I think that that is really, really what. Is so unique about your practice in particular, is that you are such an advocate for those who are marginalized, specifically in the LGBTQIA plus community, but also when people are looking to you and your practice, they're looking at.


How do I practice inclusive medicine under the direct primary care flag? How do I, especially for those who are LGBTQ a plus, there are I think, moments of empowerment when, you know, other physicians who are lgbtq a plus are seeing other physicians practice, you know, celebrating their pride, but also taking that shared trauma of marginalization because of their, you know, identity.


And that's so silly when I say that because we all have identity and yet somehow we see marginalization because people have certain identities, right? Like that's what I really love about your advocacy is it allows other people to hear how empowered you are as a person no matter what your identity is, but Specifically physicians who are lgbtq a plus, they are able to practice more confidently bringing their own identity to their practices. Because if you've seen one DP C you've seen one dpc. So I, I hope that that, you know, really opens our, our month of pride on my DP C story as we celebrate identity inclusion.


I'm not marginalizing our patients, no matter if they have insurance or not, if they're documented or not, if they're of a particular identity or not. They're humans just like you and I. So with that, I want to go back into this past year that you have been, you know, on this platform of. Celebrating who you are and celebrating freedom for, you know, to summarize the many talks that you have given.


But it, it's so interesting because when you came onto the podcast, uh, the first time you were talking about how you were Qatar's First sports medicine doctor. And then all of a sudden, you know that you're, you're there cuz they're prepping for the World Cup and now the World Cup has happened. So can you take us back to, you know, pre-World Cup, during the World Cup and Post-World Cup, what are some things that you saw that you know, you really either were expecting or not expecting to see now that the World Cup actually happened?


Yeah, I'll try to be as concise as possible and if anybody wants to learn more, About any part of what I'm talking about, you can just Google Dr. From Qatar. And there, there are a lot of articles online on different aspects. But what happened is, um, so after I left Qatar and finished my medical training here and decided to stay and filed for asylum because I didn't feel safe going back to Qatar.


I honestly have been just living my own life here. Right? And I have been focused on medicine. I got into D P C and at the same time I was doing some, a little bit of L G B T advocacy work with international organization. So I was still involved with the L G B T community in the Middle East in some capacity.


So I still had very good sense of the ways and the challenges, I should say, the challenges that the. L G B T community in the Middle East are facing. And then as the World, world Cup was about to happen in Qatar, what what was really striking to me was just the PR and marketing around it. I was sitting in a coffee shop one day and I just saw an ad on TV and I was like, this is not where I grew up.


Like literally, and I spent the first 24 years of white like there, and I was like, I know you wanna do a good job. I know you're putting your best foot forward to host a global event. But then it was really used to cover up certain stories and certain aspects. And I'm sure we heard many different issues around human rights violations that happened.


But from my lived experience, My story and my personal struggle was being erased by this rock up. And then the officials that were going on and speaking publicly were basically denying denying, first of all, like at at their first stage of denial, they were denying that there is an L G B T community in Qatar Target, which is insane.


But then they moved from there to then denying that they abused the L G B T community. And I was in touch with a handful of them that were living in Qatar and we were just kind of waiting. We were like, okay, one of us must speak up like at some point. And then I realized that it was gonna be me probably because there was nobody speaking and correcting the narrative, the false narrative.


There were just so many false misconceptions and narratives, and I really believe at their core, They all come from the belief that L G B T rights are not human rights really in, in their core. Like that's the core of the argument. People don't believe that this is a variation of humanity. That's a way that a group of the population is different.


And then that belief system is presented in arguments. In so many different gaslighting situations, they will talk to you about attacking religion. They'll talk to you about attacking a culture. They'll talk to you about attacking traditions. They'll talk about how your hijacking platforms, and when you really dig a little bit deeper, you realize that the core issue is.


Them not believing that you are just a different person and they believe that you are just out there to corrupt society or whatever bizarre like belief system that they have, or stereotypes about what an L G B T person is. And you know, I kind of dpcd the whole thing I should say because. When I came out publicly, I came out with an intention to do something about it.


I didn't just come out for the sake of coming out. I was like, I have few months. There is this massive global platform, and I have few months to go ahead and set the narrative right. So I went on BBC News and said, gb, lgbt Qataris do exist. I am one of them. I am also a physician. And then I held all my identities firmly.


I'm an immigrant, um, Arab. I'm of Muslim background and I am an L G B T person. And then, Everybody was confused cause all these different groups had, you know, their own views and they didn't want to necessarily include the other one. So me coming in and just owning all these different identities simultaneously did change the conversation and, and how we're holding the conversation.


When the World Cup was happening last year and over the following few weeks, like within three months, I was covered in most languages in most continents. Like it was all over the news. We were like, there is somebody gay from that region, which is crazy that it's breaking news, but it was breaking news because there is absolute lack of visibility of my community and people just don't know that we've been suffering in silence.


And then from the press, we were able to connect and by we, the local L G B T community be because what my BBC news interview was in both English and Arabic, and the Arabic segment aired in Qatar. So I got hundreds from Qatar, reach out to me, share their stories, share their experience. And then we got two, let me see three documentaries out since then, and I just filmed for the fourth one.


And in those documentaries, we were able to provide substantial evidence of the methods of persecution of the L G B T community, but we were also able to have members of the L G B T community and their region interview anonymously with investigative journalists so they, their voice can be heard. And then a, a very big milestone that happened was a country conditions report with the human rights watch.


And that's really the first country conditions report on L G B T people in Qatar with some sort of evidence attached to it that that's come out. It was done by us. It wasn't done by a big global research organization. It was just as a grassroot movement. We got together, we identified the elements of what it takes to publish an evidence-based country conditions report, and we did it with the Human Rights Watch.


And that to me is what it means to be a DPC dog. You just, you know, you're like this underdog. You come in and you execute and you deliver. And you don't have to be fancy to like deliver something effective. And that report got me connected to them, the second tier. So like from there I got to meet the presidents of football teams that were in Qatar.


I got to meet a lot of government officials, including the US State Department and got to speak to different governments in Europe. And like the conversation became more serious and then I decided to, Formalize it and open an ngo. I opened the first L G B T charity in the world that is focused on L G B T issues in the Gulf region, and it's based here in San Francisco, but it's connected to the local community there.


And I'm happy to say that within a year of me coming out, I was already able to give a scholarship for an L G B T person from my country to resettle safely in England and start a new life. So that's like a quick summary of like what happened, but there was just so much that happened within that one year.


So, so much, and again, you know, Dr. Nass is, we're, we're, we're, you know, airing this at the beginning of Pride, but the entire month of June, Dr. Nass is going to be one of the grand marshals of SF Pride, and he has a gamut of, uh, engagements where he will continue to speak and, you know, Naz. I really just love that how you talked about even, even in your opening statement like that, you have been able to be a physician who is able to, to do things like innovate and I, I totally get how you brought your skills as an autonomous physician, entrepreneur who has the medical training and who understands socially, not only from your experience, but also from the medical side of things.


You know what it means to. Be, you know, the opposite of what you had on your website. Be seen, be heard, be you. And so, you know, when it comes to your journey, I, I am so, so, so grateful. Not only for your, your advocacy, but again, for just the people who you've empowered with your advocacy. And I just love, you know, I, I totally empathize and relate to when you said, you know, you came out with a purpose.


It's like, When I think about when I started this podcast, this podcast was started with a purpose because there are so many physicians, uh, like yourself and myself who have been the, the brunt of physicians are actually just people to process the magic code so that we can get our money. Fill an X corporation name and there you have our healthcare system.


And so, you know, when it comes to you bringing all of your skills and your genius when it comes to networking, connecting people, sharing your story, advocacy it, it's, it's so beautiful to see and it's so appropriate that you are now celebrated as one of the grand Marshals of this year's SF Pride.


Yeah. Thank you so much for saying that. I totally agree with everything that, that you've said. And. I really feel like that's what D P C is too like to be seen, heard in bu because we're just such a diverse population, all of us, and we have such diverse skillset. Uh, the patients we care for are different and diverse, and they would want to see themselves in us as they're healers.


So it is only natural to have the first line of physicians caring for this super diverse population to also be diverse themselves. And be able to adapt to our own small bubbles where we practice.

And that truly is, you know, why independent practices are growing like crazy all over this country in every single state.


Because I mean, you know, we've had people on the podcast like Dr. Andy Burkowski, who's a quaternary specialist, who's doing direct primary care to, you know, the people who are pediatricians, family practice doctors like yourself and myself, and you know, primary care doctors because, Everybody in this country, everybody in the world, but specifically when it comes to direct primary care as a business model, everybody deserves.


This type of care, whether you are, again, fill in the blank, insured, uninsured, documented, undocumented, you know, it does not matter. So when it comes to the idea that you are bringing yourself to Osro Medical, how has Ostra Medical changed as a result of, you know, everything that's gone on in your life over the past or since you were on the podcast last?


Yeah, so like the talk practice just like keeps. Changing because, you know, I learn and then I integrate what I'm learning and then I just always evaluate what my patients are responding to and innovate again. And the thing about my practice is that I run a micropractice, even like in the D p C world, like I don't want people to like hear me here thinking that I have like, I don't know, a thousand patients, uh, that I'm taking care of.


I don't, I have less than 200 patients and. My pricing is different than traditional D P C practice. It is priced to meet the like economic bubble that I'm in in San Francisco and is also equipped to, to compete with local systems. I shouldn't say compete, but deliver what they don't deliver. So it's really like I'm positioning myself very differently and I like my competition is tough.


Locally and then the ones that seek my care know that they are not gonna get it somewhere else in San Francisco, honestly. So, and I can't say that now, and there were just a lot of like really big moments. I think for Ooma Medical. I wanna like, injectable prop was a huge moment for me. So in, I think when was, it was the end of 2021, the F D A approved another method for preventing H I V and it's long-acting cabotegravir.


Or also called aptitude, and I was lucky enough to be able to meet the researcher that was doing the clinical trial early on and then, When it got the f b approval, I was like, you know what? There are people that are not candidates for TAF or tdf, that's Truvada and Disco, and I would love to be able to offer this service here in San Francisco.


So I got ready and did it and give the first injection in Northern California. In my private practice, it was before the San Francisco AIDS Foundation or U C S F or Stanford or any of them. And that wasn't the news. And that got me some patients. And now I'm also like involved with the pharmaceutical company teaching other physicians how to do it.


And gosh, I would never have done this if I was an employed physician. I wouldn't have had the like bandwidth to just sit down and think and think about all the little steps. And that's what I love really the most about like P P C in general, that you, it's like it's alive. It's not this one thing that you just do on repeat till the end of time.


It's a living thing and it grows with you. It's like you're a baby and it's awesome. And I love the like passion. Just seeing like how different physicians are problem solving and really having their patient be like the person their problem solving, or to see how they can help them win their own story.

And that's just awesome to see.


That's a DP C physician right there. People. Oh my God. Like I, I'm just over here like, I'm on mute because I don't wanna interrupt. You know what you just shared, but I'm like, yes. Like if I had one of those, what are the, the, the things they bring to soccer games or like big, big horns, like that's what I'm like feeling inside of me right now that.


Because, you know, I just, I love it. And this is the stuff that people, when they hear about autonomy, that's one thing, but when they hear about how autonomy manifests in all of us as independent, direct primary care physicians, it's incredible. It's like, you know, this is your journey. And when I say that, that is your journey to every single person listening, but this is your life.


We only have one. Like let's live it big, you know? But when it comes to living it big, Yeah, you have under 200 patients by choice. It's not, you have under 200 patients and you're not successful. You have under 200 patients because like you said, like that's what allows you to be Dr. Nass. Yeah. And to do all of the things, including taking care of patients.


And I think that, you know, this is the type of stuff that, and I encourage anybody who, you know, whose kids are in medical school or who knows, you know, the neighbor's, uh, daughter is in medical school or whatever it is in residency, tell them about, Hey, did you know that there's a way that these doctors are practicing and they're like doing all the things, taking care of patients and they're doing.


Art, advocacy, you know, whatever the heck it is. But when we talk about, you know, the attraction of direct primary care practices to patients, I also wanna just go back to the fact that, you know, you were the first doctor, like you said, in Northern California to give the injectable. I I just love that when Aude came out that like, cuz cuz you and I had talked about this, you, you shared that with me over text when, when it happened.


But it was like, that is so flipping awesome that a pharmaceutical company that is bringing to market, you know, a, a type of medicine where other people cannot get treatment with. Traditional medicines, like you mentioned, like, uh, disco Truvada, but they would approach you of all people versus, you know, like the U C S F, the San Francisco AIDS Foundation.


So when you were talking with this researcher, you know, whatever you can share, I would appreciate like how. Do you think about how, you know, they, the company that that owns and runs aptitude, was attracted to you as a physician versus, you know, one of those bigger companies and decided to have, you have that amazing honor of being the first person in Northern California to do the injectable for patients?


So I just like, I'm the one that approached the researcher. So the researcher is not with the pharmaceutical company. He's a faculty at U C S F and he works with the Department of Public Health, and I knew of him actually through the community, and I just reached out and said, Hey, I heard about like long acting Cup, can I kick you out for a drink?


Literally. And I took him out for a drink and I was like, so this is what I read and I love your work and I would love to do this. So I didn't really wait for permission to do it, so I just was like, I'm gonna be the one to do it. And went, learned the steps. Learned from, because he had taken care like of patients for about four years at that time in the clinical trial on it.


So he had the experience, but then I was gonna be the first one in the community to do it. But then the only thing, the community is now gonna be a different animal, right? Because. Insurance because it has to be authorized. So I was gonna be the first one to figure out how to like, convince insurance companies to cover it, which was really part of the CHA challenge.


But also it comes from a, it's an injectable that comes from specialty pharmacy, um, and you need to have it delivered. And so there's like the logistics of getting the medication and delivering it. The fact that I was able to deliver that and give it within two months of f d a approval. And in other words, actually, so like the pharmaceutical company didn't even have it manufactured and ready.


Go out in January. It was the day April, in December, it was not ready in January. It got ready and was put on the market in mid-February, and then within two weeks of it being on the market, I get the first shot. And when they saw somebody able to give it to the community within two weeks, they reached out to me because I was like, quick and be, and they were like, how did you do this?


Basically because on their end they were trying to navigate how to help physicians get it and navigate. Operational workflow, like blood work orders, prior authorizations, the copay coupon, the shipment from specialty pharmacy, like all of that, like was still being navigated. But if you can and have time to figure it out, it's actually not, not that hard.


And the experience. I mean, you, it's like you're training every day as a direct primary care doctor because you like face these challenges that you didn't even think, you know, were there because you had the corporations, you know, for those of us who have been through fee for service, this is, you know, mostly who I'm speaking to, but like you have the other people who just like quote unquote handle it.


And then when you're a D P C and you're like, oh yeah, like. To do these things. These are the steps that I've taken with other workflows or other challenges that I've faced. And so like, oh, present me with problem. Great. I can give you said solution. So, you know, I think that that's so awesome. And you know, again, it's just like, You're developing your practice around your patients and you're developing your advocacy as well as your practice around your community, which I flip in love and that's what all of us, I feel are doing in our D P C practices.


But the fact that you were able to bring this, you know, treatment to your community as fast as you could, you know, it's just like that's so empowering. And whether that be, you know, like skin cancer screening and, and. You know, people's communities or you know, whatever it is, like your equivalent to Aude in Dr. NAZA's case. It's just incredible that like you can actually just do whatever you need to do to treat your patients the way they needed to be treated. So, you know, it's just so empowering. Um, when we talk about your practice changing, one of the things I wanna ask about is how you've. Proceeded to, you know, get to your happy number.


And how did you decide like, this is my happy number, patience and not, you know, go over that, not go under that. How did you continue to look at your practice and evaluate it so that you could balance your patience as well as your non-patient part of your life?


I'll answer this question to you very transparently. Like when I was doing this, I balance a lot of things. One of them was to sit down and. Really be honest with myself about what makes me happy as a person. I was like, you know, what kind of days do I wanna have and how much money do I need to afford this life that I want? And then decide like how much money I wanna make.


That was like two. And then like picture the life I want. That's what's like what was going, going on through my head. It's like this is the lock that I want and this is the money number attached to it. And this is what I'm gonna have to make per year to afford that life. And then once I have that number, I don't have to make all of it from medicine.


And I was like, how much of it do I wanna make from seeing patients? Because, you know, sitting down, for example, with the researcher, Who still he sees patients and like his happy combination, for example, is having a panel of 60 patients that are super sick with advanced HIV and doing inpatient work couple days a week or a month or whatever.


I dunno how often he does it. And then doing clinical research. And then advising some nonprofits on, on HIV medicine. And this is his combination, you know, like, so he's not seeing patients every day. And I was like, this sounds amazing because you use different parts of your brain and you use different things.


You're like, you lean into different things you're passionate about. So for me, I really am very passionate about human rights and advocating for the safety of my community, and I really love doing my nonprofit work. And right now, I wouldn't say that I have decided like fully. What the cut is gonna be. I thought I was gonna cap at the number of visions that I have now, but, and, and not take more, and then just roll my nonprofit.


But right now I think I will go and roll my practice a little bit more. Just to get to practice a little bit more medicine. And then I'm still just evaluating the exploring, I should say, like the nonprofit side, how much of it I wanna be doing. I had people straight up tell me to leave medicine and just go full-time.


Running this yesterday was a, was an insane day for me. That is not a regular day by any means, but I started my day at three in the morning. I woke up, was on a conference call with London. I was talking to corporations that wanted to open in the Gulf region and they wanted to hear about the safety of L G B T employees and also using their platform to help L G B T rights in their region.

And I was one of the people they invited to that panel in London to speak about local issues and how to navigate them, and that was really an awesome experience. And then from that call, I was on a call with Berlin to talk about advancing L G B T ranks in Europe and asylum policy, and also like a follow up segment on the World Cup.


And then after that I got my breakfast and got ready and went to the office. And had a full day of patient care. I saw eight patients, which is a lot for me in one day. It's not a typical day, but I saw eight patients and then did some intro calls with possible new patients. And you know, that was just like a full day.


And then one of my patients got really sick, so I had to be like on call for him and help him. So I ended up working from three in the morning until eight in the evening, which was a really long day. But I loved every single hour of it. It was like everything I wanted to be doing and do I have days like this every day?


No. This is just a very unusual day, and it's just like something that I really wanna say, like it's really not about the volume of work that we do, it's about the quality of the work that we do. And it's just like I had worked just. One third of that amount and a job I didn't like, I would be worked out.

Like, I don't think I can do it. I, I quote you all the time when it comes to what you said in your first podcast episode where you said, you know, I've never worked harder in my life, but the work that I'm doing is so much more meaningful. And I'm not quoting you exactly there, but that it, it is not hard work.


Like, you know, you're a hard. Laborer who is like struggling with getting through each day. It's your baby is, you know, it needs attention and how your kids grow. Our clinics grow. And so, you know, I, I think that that was really powerful to hear you say that. And I know that other people have, have taken those words to heart because it tr it is so true.


Like we were not. Trained in medical school to think as independently, I feel as we are now as D p C doctors. So it's, it's just wonderful to hear, you know, you work through like how you are approaching patient care as well as non-patient care. When you were, were mentioning how you had a couple of, uh, potential patients, uh, that you were.


Talking with LA yesterday, I wanna go to your initial meet and greet, because when I think of meet and greets in my practice, in the very beginning, I would set myself 30 minutes. Like it would be a really big struggle to achieve that, you know, that conversation in that time. And then now it's like 15 minutes.


This is a free visit period, and I'm, I'm much more confident in my ability to get questions asked from the, the potential patients as well as provide them answers. And like right now at. In this season, my husband is joining my practice, and so, um, oh, I He's didn't know that. Yeah, yeah, yeah. He, um, well, because he got replaced by non-physician model at his old clinic.


That's, that's a whole, whole nother. Dinner conversation that we will have shortly. But, uh, when it comes to, you know, learning how to do the meet and greet, he's learning, you know, by physically being there on the calls and watching, but because you've been able to learn from yourself and change your practice, how have your meet and greets looked different or changed now compared to when you opened?


I feel like it's a hundred percent, a lot more concise, a lot more confident. I feel very secure about my product and what I do, and I also feel very okay saying this is not a fit and the way I structured them now. In San Francisco is that I call them, um, a free primary care consult, and in that free primary care consult, I present my practice as a solution for the primary care for the patient that's seeking care.


But I also tell them about other models around with. Like honest, I, I'm trying my best to remain, uh, neutral and tell them the pros and cons of each model and say, you know, this is what I do. This is what one medical does. This is what forward does. This is what this person does. This is what you're gonna get from in each model.


Pick what's best for you, and they know all of these options and choose something else that's, that's okay. Because I feel like the ones that know all of this and pick me. End up staying and it ends up working out really well. And it makes me just even more confident when I go back out and tell the next person about what I'm doing because now I have been delivering really good care in my model and I have been taking care of patients, and I've been hearing feedback and changing the practice in a way.


That meets the expectations of the people that are seeking my care. So, yeah, so I, I would say I, I present in my sales calls, if you wish, with authenticity and with confidence and with a message that's really concise.


I love that, and especially for those listeners who are, you know, thinking about planning D p C or have just opened and are in that, you know, place of, it's new.


I'm not really sure how to, you know, do the elevator pitch or the, the meet and greet in a concise manner. You know, just taking from your story and my story. I love that, that, you know, we've, we've both become. You know, more like solid in our shoes when it comes to this is what I'm bringing to my practice.


And if it's an alignment, like you and I are both decision makers in that journey and not just, oh, a patient signed up and now they're on my schedule and I don't actually know who this person is, but I had an open panel and my corporation told me that I had to take them. You know, so it's, it's really great because you're right.


You know, when it comes to the people who. Invest in us as physicians, and yes, financially because this is a business model, but also that they invest in us in that. They all of the care that they could have sought, they're choosing you as a physician. That is so empowering and I, I encourage people to remind themselves of that if they're ever having days where it's like, oh, you know, I mean, we just heard Dr. Jennifer Allen's story where a patient paid for her to go to medical school because that's how much she believed in what Dr. Allen was doing. Like that does not happen in an everyday fee for service clinic where your patients. Are, you know, that invested in you as a physician because like we see, you know, I talked with somebody who was, uh, she's a Kaiser doctor who worked for 15 years.


She had, uh, gotten her benefits. She tried to, you know, go back as a, it's like a mentor doctor, you know, to do locums type work. I guess it's how it was described to me, and it was like, no, and there's, you know, the way she described it was that even if you left a model, You know, there's six to seven people who are like waiting to take your spot.


So you don't feel that pride. For our physicians, we are so proud because don't think of us as the company. Think of us as the individual physicians who are actually giving you the everyday care, but you do see that in D P C, so I think that's incredible. When you talk about balancing everything, how you've, your practice has grown and changed and how you've, you know, continued to do advocacy.


How do you pick and choose? Like we talk about patients picking and choosing, how do you pick and choose what to say yes and no to when it comes to anything that you are approached with in your life?


I'm still working on that. I don't think I do a good job. I think I take, I, I do find myself saying yes to a lot of things still, and then end up just.


Really overwhelmed at moments, but what I'm working on right now is trying to stay true to that same vision that I told you about and be like, Okay, what's my objective? What do I want? How much of it do I want to really reach the goals that I set? So defining these goals, I think is going, is really key in deciding what to take on and how much of it to take on.


And that happened, like for example, with the activism thing. It happened with like a lot of journalists like wanting to speak on and a lot of news outlets and things like that. And. I said yes to a lot of them at the beginning, but then after like 200 of them, I was like, I need to like dial it down now and then like pick which ones I need to talk to.


And then that's what I learned PR people do. And so like, it was like, you know, the, the, there are these things that you just face and then you realize why there's just professionals that do certain things full-time. And so I got, and, and the same thing with. With my practice. Like I, as I take things on, you can easily hire a staff member and then keep adding and then hire another one and keep adding and like, you can just keep doing that.


So you need to just like, yeah, like sit down and see how busy you want to be. What does your ideal day look like? Right. And I'm still, I'm still working on that. I need to sit down and like really try to revisit my, my vision and. Trying to see like what direction I wanna keep pushing.

I love it. And you know, like I think about how other physicians have shared about how do they maintain culture in their practices.


And this is, you know, another way to address culture because you're bringing yourself to the table. And if yourself is, if you're, you're sort of stressed out or you know, irritable, whatever, it changes. Everything. I feel like how you handle unexpected situations or how you present yourself with patients, et cetera.


So I think that that's awesome that you know, it's that you're being transparent, but also you're constantly working at it. Like you said, that you've never worked harder in your life, but this is different than, you know, work is People normally think about it. But I will also like give you a ton of credit because when I was like, Hey, like.


Can we do a reunion, um, episode, especially to celebrate your being honored as Grand Marshall, uh, at this year's SF Pride. Your text back was Yes. Like I will have my assistant reach out with scheduling, and I was like, boom. Like, to me that like, when, when I get that from people, I think that as family doctors especially, like, we're not used to seeing like a family doctor not do it all right.


But at the same time, when I see that now, It makes me so happy because it says to me that Dr. Nas is functioning at the highest level of his ability and training and scheduling does not have to happen by Dr. Nas. And so I was glad to, you know, communicate with your VIR virtual assistant and get myself on your schedule because.


Like that to me is a sign of ownership of your life. And so when you think about there's, you know, some questions about like, what can my virtual assistant do? It's like one of them can be handling scheduling because that does not require medical education specifically to do. You can do it, but do you have to Right.


It was, the scheduling part itself was just such a huge time suck. Like this, the patient, the activism, things, lunches, dinners, it's, there's just so many of them. And now it's, it's just like there's one person that's just taking care of that, among other things that she's doing. But yes, outsource learning to outsource is where I'm at now, like outsourcing some of my tasks.


I love it. And again, you know, it's like, it's so different from the world of, I, I think it was Dr. Burkowski who also said, you know, like, oh, you need one more thing done for compliance or to get the magic codes. Like just have the physicians do it. Like just say them more work. And it's like, no, we're not gonna do that anymore.


No, we're just not. So I love that when it comes to. Your presence when you know, and I, I will highlight how you shared with me such a powerful post. This was, I believe, new Year's, and you were saying, you know, happy New Year's on your social media and you were showing me all of the engagement from Italy, from, you know, the Middle East, from Asia, you know, from all over the world.


People were saying thank you and Happy New Year to you back because they were, you know, being seen and being heard and celebrating everything that you've done. When it comes to social media presence and when it comes to the power of your platform, can you share with the audience any lessons you've learned about social media that can help specifically DP C practices grow their own, uh, presence?


So that's like a tough question to answer because. I learned a lot of things about, about social media and there it's like literally a, another area where now I understand why there is like a, a whole type of expertise that goes into it, right? There are people that do this full-time and my platform, like when you look at it, like I have, I don't know, like not many followers, like maybe 17,000, but.


My 17,000 people that follow me are 17,000 real people, and that's very different from bots or whatever that people do to give an illusion of being followed by a lot of people. And then the 17,000 people that I have are very engaged. So if I post something, it can be amplified very quickly. And that happened through like the entire campaign last year, but.


What happened too is that now I became like a public figure basically. So I had to take my own personal social media accounts down and there was just a frenzy like last year of trying to find information about me by journalists. So everything that's online about me is just so public. And that's going to be like, that's a different journey and I'm, I'm okay doing this because of the work that I'm doing.


And as people now, as I'm talking to D p C docs on this podcast wanting to open their own business, they don't, you really don't have to have this level of visibility for you personally and this level of exposure, but you can really ha, have really high impact in your target populations without. Massive number of followers.


Really like I think for a DPC doc in a small community to engage people successfully with social media. If you had like a seed of like one to 200 people that are strategically selected, that are engaged, then you have a really good social media game, and you do this by really trying to find them in spaces where you think you all would overlap, for example.


Like for my patient population, for example, I would, I have an event next month where I'm going to be talking about advancements in HIV prevention in San Francisco, and it's going to be at a local venue and it's gonna have a. A lot of the target patients really that I want. So sharing my business, social media handles in that context can get me like that seed number of followers.


And there's so many D P C docs that I heard talking about social media engagement and tips and tricks that they do, and they're all great. I think it's just like what I do with the activism thing is a little bit different because it's a global platform and has just like a different mission. And I think that it's important to, you know, keep in mind, Your story, because if somebody is, you know, continually highlighted, like I will, uh, mention the direct care physicians of Pittsburgh, how they're highlighted by magazines and radio shows, et cetera, et cetera.


Be prepared for what happens if your practice goes, you know, beyond the, the core. People who are engaging and following, but what happens if you are, you know, asked by a reporter to talk about your practice? What is your presence on social media? Adding things to social media purposefully so that it's already out there when it comes to, you know, highlighting work that you've done in your community, whether that be with your practice or as a volunteer or as a physician.


You know, those are things to strategically think about. And then another thing is that if you do. Something like, you know, you incorporate a new hashtag or a, you work with a partner. There are ways for free to look at your Instagram analytics, Facebook analytics, for example, where you can say like, has this, whatever I did, made an impact and did that lead to people joining my practice?


Like, you know, especially in the early days when. People are growing their practice. There's more time. I definitely will say that typically, but that's a a way to also, you know, figure out how your social media can be more on point, um, going forward.


So I absolutely, and you can totally, like also like speaking on this topic, like you can, like you will learn this just as you do it.


Like you just start with all of these things that we're talking about. Just start, evaluate yourself and learn because you will learn like what? Type of posts and messages your audience really cares about and what kind of things they would are more likely to use, save, share, and naturally give you more exposure because of the quality of the content that you're sharing.


Love it. One fact about you, that is, I, I don't know if many people know, but you are licensed in more than one state, and so when you have decided to, you know, we, we talked about how you. Figure out how to take things on or not. When it comes to taking on other licenses, specifically like California New, new and New York, for example, how did you decide to take on New York as a medical license and how has it benefited you as a doctor at your practice?


So I made the decision, um, during the pandemic. Um, I had a cohort of my patients move to New York City and they, a couple of them wanted to attain me. As as their physician and we, I was able to still care for them via telemedicine at some point and then more and more left. And then at some, when I reached a certain number where my membership fees from them would cover the overhead and give me profit is when I made the decision to go ahead and get licensed in that area.


And I haven't gone out of my way to market and get more patients over there, but in New York City and San Francisco just. For my patient population seems to be the two spots that are people are going back and forth from. So it, it made sense for me to go ahead and get license and now I may pick Massachusetts up, but I, I'm still waiting to hit that threshold.


I love it. And when you have, you know, seen people in San Francisco as well as in New York, how have you paired your patients with services that will support their care? Like we, we talked about Aude, but, but when it comes to like social services, when it comes to mental health services, how have you curated your list of recommendations for your patients?


So this is a good question. Some of them had their own specialists that, that they reached out to and they just introduced me to. So I then got to meet those couple specialists that way. I did my training on the east coast, so I do know some people in that area as well. But then if something random happens and I'm looking for certain expertise, some of my virtual nurses help with that too.


So like I ended up having them do some research for me and provide me with a list of physicians in a certain zip code that do certain things and learn more about their practices and just do all of this background research for me and present it. And then I would help pick the specialists off of their lists.


And the ones I have so far did not require like, They didn't require anything very, very intensive. Like I can see that it can get out of my hand being far away. I can see me asking them to just find a primary care doc where they are. But then once I have, have such simple needs that can be addressed via telemedicine and by having them see you specialists where they are.


Love it. And it goes into my, my last question that I wanna ask in closing, when you talk about. Developing your practice and changing your practice and bringing yourself to your patients as an individual. I wanna ask, how would you advise the audience to think about being a more inclusive physician at their practice as they're, you know, practicing in D P C or opening their D P C soon?

Yeah. So the, the answer to that question, like, I wanna say in its core, like when people wanna feel like you would be inclusive towards them, they're like, all of these things, we get lost in the messaging a little bit. Some people think you lost, like in the gestures, it's like, oh, you need to have this workflow, use this language, or use these signs or use these colors.


But, What people really wanna know when they come to your space is that they're not going to be persecuted and they're not gonna face discrimination because they're, they're, they're under your care. That's what really people really wanna know, which I know seems like such a basic thing, but they just wanna know that when I come and seek care from you, you're not gonna treat me differently because I'm a woman, or you're not gonna treat me differently because I'm an l g bt, or because I'm immigrant, or because I'm a person of color, or because I'm whatever it is.


And these thoughts come from prior mistreatment. So it's trauma based really. So when you come in, I would say just be you yourself. Be comfortable in who you are, and just lead with love and listen and be open to feedback and just find your own way of letting people know that they're safe in your space.


Absolutely love that. Thank you so much, Dr. Nas, and good luck with everything that you're doing as and i. I hope to see you in person at SF Pride this year.


Me too. I'm so excited for it. Thank you for having me again.




*Transcript generated by AI so please forgive errors.

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