Episode 2: Dr. Neeti Kapur of Devoted Family Practice - Fayetteville, NC

Updated: May 11, 2021

Direct Primary Care Doctor



I met Dr. Kapur at the last Nuts and Bolts conference in November 2019.

She was walking around the different vendor tables and I somehow got to chatting with her about the Butterfly IQ ultrasound. For those who might know me, its easy to see how I could look like I am vendor for the device because I love using it so much and I tend to get very excited when I meet someone unfamiliar with the Butterfly.


Dr. Kapur attended undergrad at the University of Toronto where she graduated with High Distinction and then went on to do research in atherosclerosis at the State Univ of New York, Buffalo.


She then continued her education obtaining a Masters of Science and Doctorate from Chicago Medical School/Rosalind Franklin University.


For Residency, she trained at St. Joseph’s Hospital in Chicago where she was Chief Executive Resident, received the Roger Nodal award for leadership excellence and stayed on to teach the family medicine residents after residency.

She moved to Fayetteville, NC in 2013 and recently opened her DPC doors!


Photos of Devoted Family Practice in Fayetteville, NC.


CONTACT:

https://www.devotedcaremd.com


EPISODE TRANSCRIPT*:

Dr. Maryal Concepcion 0:05

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


Dr. Neeti Kapur 0:26

Direct primary care is the freedom to do the medicine, I envisioned medicine that is simple, thorough, holistic and personal. I am Dr. Nee pika poor, have devoted family practice. And this is My DPC Story.


Dr. Maryal Concepcion 0:51

I met Dr. Copper at the last nuts and bolts conference in November of 2019. Before all of this pandemic business, she was walking around the different vendor tables, and I somehow got to chatting with her about the butterfly IQ ultrasound. For those who might know me, it's easy to see how I could look like I'm a vendor for the device because I love using it so much. And I tend to get very excited when someone I meet is unfamiliar with the butterfly. So a little bit about Dr. Gabor. She's a graduate of the University of Toronto. And then she went on to do research at SUNY in Buffalo, and then received her doctorate from Chicago medical school, Rosalind Franklin University. She went on to train in residency at St. Joseph's Hospital in Chicago. And she recently moved to Fayetteville in 2013. And opened up her DPC doors within the last few months. So welcome, Dr. Gabor, thank you so much for taking another leap today as the very first interview for the podcast.


Dr. Neeti Kapur 1:55

It's my absolute pleasure to be here.


Dr. Maryal Concepcion 1:58

So I wanted to get started with the key to pretty much Everyone's story. How did you come to learn about DPC?


Dr. Neeti Kapur 2:08

So the interesting thing about that is, is that if I try and pinpoint a time where I can say, this is where I heard about DPC. I can't do that, because somehow it came into the picture when the clinic I was at in Fayetteville closed down. And I really started to think about my next move. And I don't remember exactly how I heard about DPC. But at one point, I did start watching old conferences, the nuts and bolts, old recordings. And there was something about the content and the energy in those conferences. That just got me so excited. And yeah, it was it was just it was something about that, that that the energy in me changed. And I started looking to find out more about this model. And the more I learned, the more I wanted to learn. And after a point, I just, I jumped in, and it's been a great journey.


Dr. Maryal Concepcion 3:25

That's, that's fantastic and very inspiring, especially to those folks who are considering jumping into DPC. I want to ask you, when did you open? Exactly And how has it been going ever since you did open your DPC doors.


Dr. Neeti Kapur 3:44

So I opened about two months ago with telemedicine. And really the idea was just to get the ball rolling to get the idea of DPC and a new paradigm in medicine out into the community. And the reason I started with telemedicine is because I didn't have a brick and mortar clinic to actually move into the place that I decided to lease and needed a bit of an aesthetic gut, which is what I wanted to do just to make it my own comfortable space. And while that was happening, I wanted to just do one time telemedicine visits just to number one help out a lot of the folks who couldn't afford or couldn't get into or didn't want to go to a regular doctor for whatever reason because of the COVID pandemic. And so my rates were very low. But it was just to really give a community service while I was set up my DPC. So about four weeks ago, I actually opened my my clinic doors and although I'm still doing a lot of telemedicine, it's it's now a Pure lead membership model in the telemedicine one that I was doing it was kind of one time visits. But now I have a membership base that's being built up, and people that are coming into the clinic and as well as people that are taking advantage of the telemedicine when and if we need to do that as well.


Dr. Maryal Concepcion 5:18

That's, that's wonderful it for, for those of the listeners who are also because of COVID, or other reasons doing telemedicine primarily, but who are looking for location, can you tell us a little bit about your experience in looking and finding a location looking for and finding a location.


Dr. Neeti Kapur 5:39

So when looking for a location, when I initially started, I was a few things on my checklist. I didn't to be too far. I wanted it to be in a safe suitable area, maybe where there were some other medical practices around, I know that I needed to have a low overhead. And so all those things were kind of on my checklist. It was it was a journey, definitely because I've been looking for the past five months. And I was frustrated at times, thinking that I wouldn't find the place that was best for me. But with patience and with persistence, I found something that is just a few minutes drive from my home. And the rent is extremely affordable. And so I don't have to lose sleep over paying the rent, even if I don't have a lot of memberships at the time. And I was able to make the clinic my own with, you know, the money that I saved perhaps in in a higher rent. So I think in that sense, this clinic is exactly what I wanted, for a lot of different reasons. But it did take me a while to find what I was looking for.


Dr. Maryal Concepcion 7:07

Me too, when you were making the transition to from having a telemedicine exclusive membership or pay as you go type of service to also incorporating a brick and mortar. Can you tell us a little bit about your experience in looking for and finding a location?


Dr. Neeti Kapur 7:28

Sure. It, it was a process it took about five plus months. And the reason is because I didn't want to rush into a location that I would grow out of quickly. I know some DPC physicians will start at a smaller place that they can lease and then hope to grow. But I wanted something that would grow with me in the next few years and give me that flexibility of having more space. So that was one, two, I wanted something that was close to my house, this clinic for me in my mind is going to be like my second home. It's it's a place that I knew I was going to make into a warm, welcoming, welcoming space that wouldn't feel like a clinic for my patients. And I had the same feeling for myself, if it was going to be somewhere where I'm spending time at, I really wanted to make it comfortable for myself. And for that, you know the vicinity was important. I also wanted to have a space that believe it or not my kids could also come to with this COVID pandemic. I didn't know if they were going to go back to school, I didn't know what the school year was going to look like or how it was going to change. And because I don't have full time help with them at home. Having a space for them at my clinic was important to me. Sure. So after a five month search and going through a lot of frustrated moments where I was doubting if I was going to find the right place. I did find a place that fit me perfect. The other thing that is on probably or should be on every DPC, Doc's chest checklist is keeping the overhead low. And the rent, as you know is is a fixed cost that really needs to be kept low so that you don't lose sleep if you don't have members initially. And for me, that was super important. Definitely. So I was fortunate to be able to do you know to get all those Things that I wanted and and I did a little aesthetic gut on the clinic because it was an older space, but it had the rooms that I wanted, and I could make it into a space that was my own. And that was clean and warm and welcoming to patients.


Dr. Maryal Concepcion 10:18

Absolutely. I'm a huge believer in things happen for a reason. And so it sounds like you know, you, you, you paid the price, you waited the five months. But in return, you got something that ticks off all of your boxes. So I'm really happy for you in that sense. So I love that your space is individualized, especially to the fact that you have two kids. So can you share with us? How old are your kids? And in terms of balancing being a mom and opening up your DPC? How is that working out for you?


Dr. Neeti Kapur 10:54

That's a great question. And that was one of my concerns. When I was contemplating the idea of DPC, I really thought that if I had my own clinic, I wouldn't be able to spend as much time at home. And I would be very preoccupied with trying to run my own clinic and my own business. But it's I think it's it can be the exact opposite. My children are eight and 10. My daughter is 10. My son is eight. And I had my daughter when I was about a year out of residency. So after my first year as an attending, and when my son was born two years after that I did take off a few years to raise my kids. When I was contemplating DPC, being in a two physician households, and my husband is in a subspecialty I knew that I would still want to be the primary caregiver for my kids. And although running a clinic is going to be a priority. Having a family is also just as important and being able to have time for them. Being able to see them and being able to have a flexible schedule. So I can be available when I need to be available for them that that I knew was going to be on the forefront for me. Absolutely. Yeah. When I went to the nuts and bolts conference, I think there was one talk that was an all female panel. And they talked about this exact thing, running their DPC practices out of their house, doing it part time and arranging it so that they could still be there to care for their children. And that I think is just the beauty of the model. Whether you're a parent or not, whether you're a female or not, I think the DPC model allows you and promotes having balance in your life. And having the physician understand that they need to look after themselves so that they can look after their patients. And in a fee for service model where burnout is so common, and we're hearing about it more and more. We need to realize that the providers also need time. And they need to have balance so that they can continue to do what they do.


Dr. Maryal Concepcion 13:35

Definitely. And I think that that's a huge poll for people who, especially in these pandemic times are being treated as they never thought of a physician could be treated by corporations. And so in that sense, you know, you're you're you're taking a stand for your own health and your family's health and being able to be there for your kids as they grow up, which happens way too quickly. As a mom myself, I know that that is painfully true sometimes. I think that's wonderful that you that you've, you know, been able to incorporate your family into your DPC plans. That's


Dr. Neeti Kapur 14:14

fantastic. Thank you.


Dr. Maryal Concepcion 14:18

I have become a huge fan of podcasts. Ever since Sarah kainic hosted the first season of cereal I was hooked. Now creating this podcast has become part of my daily life. While it is an exciting new hobby, I also see it as a privilege that I get to interview so many DPC and direct care doctors. If you're interested in starting a podcast Let me tell you a little bit about anchor. First of all, it's free. There are creation tools that allow you to record and edit your podcast right from your phone or computer. Anchor will distribute your podcast for you so it can be heard on Spotify, Apple podcasts and many more. You can make money from your podcast as well with no minimum listenership. If is basically everything you need to make a podcast all in one place, download the free anchor app or go to anchor.fm. To get started, I want to shift to your actual practice, specifically, that you have a special interest in complete patient wellness and homeopathy. And I want to hear a little bit more about where this interest stemmed from. And where were you able to get training for this? So if other people are interested, they can have a resource to refer to.


Dr. Neeti Kapur 15:34

Yes, absolutely. So I was introduced to homeopathy, actually at home by my grandfather, who lived with us when when we were growing up. And he was a homeopath. And my parents were regular Western medicine doc. So my father was a family practitioner, and my mother, an anesthesiologist. And I never really looked at homeopathy as a very legitimate form of medicine. I used to think that my grandfather was just trying to, you know, keep himself busy. And just practicing what I thought was a Hocus Pocus medicine, actually. And really, the legitimate medicine for me was Western medicine. So that's what I pursued, I'd never really learn anything more about homeopathy. I did my medical training, and I did my residency. However, once I started practicing, within the first year, I quickly realized that I couldn't get patients healthy, like I envisioned, I would be able to, I would put them on a medication. And although I'd be able to control their symptoms, if they were on this medication for a long period of time, I knew it wouldn't cure them in the thought that in the way that I thought I could cure them. And so it was that short of, you know, dissatisfaction, I think that made me search for something more. I say that, you know, in family practice, we see things that kind of make life miserable, but they don't really kill you, you know. And sometimes I feel that Western medicine in those respects, or in those instances, falls short of true healing. And I found out that there was a course in Chicago, which is where I was at, offered through the CDH, which is the Center for Education and Development of homeopathy. And it's a course taught by physicians, for physicians. And I took this course, and it was everything that I didn't know about homeopathy, it's scientific, it's based on pharmacology, you take a very thorough history, and do a physical, and you're able to come up with alternatives to sometimes areas that we lack in in western medicine when it comes to treatment. After I started integrating homeopathy, I came to a point where I questioned what I was going to do, because I felt like I was torn between my Western medicine training and homeopathy and I felt at times that I would need to pick and choose which medication to give. And so I really went through a phase of hardship in trying to figure this out. And slowly I realized that they actually are very synergistic. They work well together. And they make up for areas where the other one is lacking. They also work on two different levels, which means that I often prescribe them both at the same time, and I tell patients, hey, you can start with this and add this or you can start with the other and add this if occation needed. So it's it's been amazing with the healing and the amount of options that it gives my patients when Western medicine lacks in certain areas. Of course, there's areas that homeopathy lacks, as well. And I think the the practice and the art of the practice comes in when you can use both and use their strengths as well as understand where their weaknesses are when you're prescribing the medications,


Dr. Maryal Concepcion 20:01

that is wonderful that you're able to find a place where you're able to use both types of medicine, Western as well as homeopathic medicine together for your patients, I think that not only is your clinic personalized to what you need it to be, but also your practices individualize? That's absolutely wonderful. Have you been able to get out into your community, since you've opened your doors or even your telemedicine doors to speak about VPC and how has that been perceived?


Dr. Neeti Kapur 20:35

It's, it's been great. I actually have gotten a few opportunities. The first opportunity I had was with a radio station. And it was for a local church group. And I did get to speak with the posture. And it was, it was a lot. And I've also spoken to a number of small businesses who have signed up their employees and their employees, some of them have not had regular medical care in decades. And I think it's very kind. It's very supportive of the employers to want to look after their employees in that way and realize that this is really a need that can be filled in a very affordable way through DPC. I've recently also spoken to the family medicine residents and at the hospital, in our town, and a lot of them are aware that DPC exists, I think the word is spreading, I think the interest is growing. And they are much more informed that I ever than I ever was during that phase in my career. Belt the other options about the other practice options and models that exist in primary care. So I've gotten some opportunity and I think just looking to get more and continue to educate people because, again, I'm, I'm the only practicing DPC in my town. And making people understand that there's a different paradigm in medicine and why we're doing it is is really important for them to know.


Dr. Maryal Concepcion 22:32

Absolutely. And it's a sign of the times. Right. Well, I didn't know about DPC until about a year ago, little over a year ago. And there's people who were jumping into DPC a lot more frequently now out of residency than there were before, which is a fantastic new hope for the future. You mentioned that you are the only DPC in your town. In terms of geographic location, how close is the nearest DPC to you and how have you been able to network within your within your area or your state?


Dr. Neeti Kapur 23:08

The closest DPC is in apex. And that's about an hour from me. And we do have some up in Raleigh as well. I'm about an hour and a half south of them. And they have been great in terms of support in terms of answering questions that I have when I was setting up and I still have now. And I think it's it's just it's amazing how much people are willing just to open up their hearts and their clinics to a stranger who just wants to open another DPC practice and is struggling to figure out how to do it. So I'm really grateful with that support. And no matter who it is, I think just the DPC community continues to just give that support out and that's what's fueling the mute movement.


Dr. Maryal Concepcion 24:08

I can't agree with you more. I absolutely find that when you start picking a DPC doctors brain, the floodgates open and you could talk you know, endlessly about DPC and how everyone is managing their their patients and their practices. So that's fantastic that you have had that experience I want to ask you some rapid fire questions and myself. You know you already know very well that I'm in love with my butterfly ultrasound but do you have any tips or tools that you personally use and or love that you'd like to share with the listeners?


Dr. Neeti Kapur 24:48

I hope to be as good as you are with the butterfly one day. But I have to admit I'm not as tech savvy. Although I I really strive to be, although my favorite tool has to be, and I'm in no way, you know, paid by these these folks, but is my EMR and they are Atlas MD. And I would have to say they're really kind of my, my tech tool because my whole EMRs is at my fingertips. And if I'm, that, for me is like a one stop shop, you know, I can, I can make patient appointments, obviously do my notes, I can put in my inventory, I can receive faxes, I can send out emails, I can do tell them at calls, I can put out prescriptions. And for me, it's it really does everything. And for somebody who is concerned about having a number of different programs run and how to integrate those and how to learn those. This has really been a lifesaver for me, the fact that if a patient calls me and I'm out and about and I need access to their information, or I need to make an appointment, I can I can do that over my phone. It's I think that that's just a great thing.


Dr. Maryal Concepcion 26:17

Fantastic. How about in terms of resources that you might recommend to others, you've mentioned already, where you receive training for homeopathy? as well as your just mentioned, Atlas? What other resources would you recommend to others?


Dr. Neeti Kapur 26:37

Well, I'll tell you, all the stuff that I'm going to say the majority of it is free, but it is invaluable. So the conferences that are online, they just they lit a fire in me that was I couldn't put out the people, like I said, were brought across a message that resonated with what I was searching for. And I just never thought I could bring forth up to the surface. The books you know, Douglas Ruggles book, direct primary care. Think the first few paragraphs I mean, I was, I was convinced that there's there's another path for me. You, I have to thank you and all, you know, the support group that that I met in made at the nuts and bolts conference last year, I mean, just having people to share the journey with you. I never thought there was I never had a support group for for anything, and I wasn't sure how useful it would be. And I don't think we went to create one. But I think we formed one. And I'm so glad we did. Because when you go through the ups and downs, which you will go through, you will go through the downs, sometimes more so in the beginning, then you do kind of later on as things kind of stabilize out. But it's a really vulnerable time, in our career in our lives. Because I didn't think I'd have to go through this, you know, 10 years out of residency, I thought I put in my blood and sweat. And, you know, I went through the stresses that I needed to go through. And once I was done, really, you know, I, I wouldn't go through that again. But turning to DPC, I say, you know really rocked my foundation of what I thought I would be doing in medicine. And I'm glad that foundation was rocked. But when it is rocked, you know you need people around you to really help you build up that base, again, where you feel confident and comfortable with the direction that you're going in. So for me, that was big. And of course, the DPC, Doc's Facebook page, there's always information on there and just even being a watchful bystander will give you so much information from the questions and the answers that people are posting.


Dr. Maryal Concepcion 29:05

Absolutely. And touching on that, that that place where people can get to where you're, you're exposed and you're feeling vulnerable. If you don't have the same you know, same old same old job or the RVU generating job in front of you as your your only option. And when you're thinking about making such a dramatic change, like opening a DPC, it can be quite unnerving and I completely agree that that support is key in helping a person get confidence to open up their their doors or their telemedicine doors. I want to ask especially because now in pandemic times when we can't even participate in conferences as easily in person. If you were meeting someone at a conference and you weren't talking to someone who was right on that


Dr. Neeti Kapur 30:03

cliff of


Dr. Maryal Concepcion 30:04

of jumping off with regards to jumping into the DPC world, what would you tell that person who might just need that one little push that one little bit of information to help them make the transition?


Dr. Neeti Kapur 30:19

I would tell them, it's not as scary as you think. So I grew up in Canada, where the health care system is very different. When I was in high school, I used to go to my father's family practice clinic and do his billing. And it was straightforward. You know, in Canada, you know, everybody comes in with a health card with their name and their date of birth, which I put in and, and the health card number and the charge and we submit their billing and, and the payout comes. So why thought was when I came to the US and the whole system was was very different and insurances, and payouts were really complex. I just never thought I could open my own clinic here. I thought number one, my overhead to start a clinic and Giovanna clinic would be beyond my capacity, I thought the complexities of it would be beyond my comprehension, and management. And so I really just put bide, DPC makes that very doable. Because you're back to simplified medicine, you're back to a medicine where you're focusing in on the doctor patient relationship, and everything else becomes simplified and secondary. And in this model, you can do it, you can absolutely do it. You don't have to set up a large clinic. It's whatever you want it to be. And that's the beauty about DPC clinics,