Updated: Mar 5
Dr. Christa Springston is Originally from Fort Worth, Texas, But has called Georgia home since 2015.
She is an advocate for whole-body health and helps guide her patients in behavioral, dietary and habitual improvements to maximize energy and functionality as well as to prevent life-altering disease processes.
She practicesmedicine based on continually evolving scientific evidence, safety and efficacy while always taking into consideration the entire individual in front of her.
She graduated Magna Cum Laude from Texas Christian University with a bachelor of science in biology, and received my medical degree from the University of Texas Health Science Center at San Antonio in 2006. She did residency training at Christiana Care Health System in Newark, Delaware and SSM St. Mary’s Health System in St. Louis, Missouri where she started on as a fourth-year chief resident and continued to teach fellow residents.
Her experience also comes from her (now retired) husband’s military career, and she has worked as a (hospitalist), (intensivist), occupational medicine provider, acute and urgent care physician and primary outpatient Internal Medicine provider.
She is certified to perform Class 1, 2 and 3 Federal Aviation Administration (FAA) Exams and Department of Transportation (DOT) exams.
She enjoys time with my family, Horned Frog football and especially, living and working through Him.
In today's episode, hear how Dr. Springston found her executive suite location and how she helps her patients understand Tricare insurance. She shares about her 2 and 5 year plan and how she is still able to do things like aviation exams even though she is opted out of Medicare. She speaks about how tech like Hint OS has helped her practice as well!
Resources Mentioned by Dr. Springston:
- DPC Alliance & DPC Alliance Masterminds ($50 Discount on DPCA Mastermind registration with code: MYDPCSTORY)
TRANSCRIPT:* Welcome to the podcast. Dr. Springsteen, thank you for having me. Absolutely. So you are in Tyrone, Georgia, and 30 minutes outside of Atlanta. And I wanted to start with, if you could share about your community, what are the demographics and what's unique about your community? Tyrone is great because it's, we call south of the perimeter STP and it is very convenient to the airport, but it has a smaller town feel. And I serve many of the smaller communities nearby Fayetteville, Peachtree city, and Noonan. Tyrone specifically is about 8,000 people. And there is a strong population of. Airline workers because the airport is so close. It's a good distance away from the airport, easy commute, but still has that small town feel. I love it. Wonderful. And how long have you been in the community? I live just south of Tyrone in Peachtree city. And I have been here since 2015, after many moves all over the country with following an air force spouse. And that was fun, but really happy to settle down, not move every three years and hang a shingle, always been my dream and really happy to start working as a primary care provider in the community and be an integral part of the committee. Recently you had posted in Facebook group about, about Tri-Care insurance. And I'm wondering if you can share with the listeners about how Tri-Care comes to play a role in your community and in the healthcare of your community, the airport being so close, there are a lot of former military pilots in the area. And so a lot of the. We're retired from the military and it could be any branch, but they have Tri-Care as their benefit for having served 20 years in the military. And that includes myself and my family. And it was a great benefit until we wanted to have more choices with our healthcare and especially. When I wanted to be a better doctor and went into the DEC realm. So not only was it frustrating as a patient, but it was super frustrating as a doctor, not being able to care for the people in this area, because it was, as it turns out one of the most restrictive HMO's in the country, super frustrating that the sky's work and women worked so hard. For 20 years and they are provided sub-par healthcare without the choice to, to expand it further. And when you mentioned it being restrictive, extremely restrictive, can you give us an example of how it is restrictive for its benefit? So in order to be a Tri-Care provider, you need to enroll in the Tri-Care system. You have to be opted into Medicare and you have to submit any referral for imaging specialty. To Tri-Care and get it approved before the patient can be assured that they will get reimbursed by Tri-Care and they will not allow any other financial models outside of exactly what they will reimburse. I was a Tricare provider at my former fee for service practice, where I was an associate physician for five years before I opened up my DVC practice in January of this year. And so I. Was able to do a little bit of referral after I left. But as soon as I opted out of Medicare, they shared the data, the government, and I received a letter saying, thank you. But no, thank you. You're out as a Tri-Care provider, which limited a lot of what I was able to do because I started in January and the people with take care of crime cannot opt for Tricare select until open enrollment. So that was part of my post. Frustrated that we're so close and I'm still having patients go to my former employer just to be able to get referrals, Bentley. And can you share the difference between the two options? There's a lot of differences. Some significant intricacies. And it depends on when you restarted in the military when you were hired. If you retired from the military, if you have family, if you don't have family, but mostly Tri-Care select allows you to the option of self-referring. And the biggest downside is higher hospital bills. If you have to be an inpatient and higher copays for each specialty visit, which really adds up when you're talking about physical therapy visits. $30 a visit, which I know is not much compared to cash pay, but it's still something that they felt like shouldn't be there with the benefits that they were promised. It was a hard conversation to have with so many people, because initially I didn't ask them what they had. It was don't ask, don't tell, but. It was required. And I learned that the hard way by jumping in and I was like, oh gosh, you know what, which one do you have? And so many of them had already seen the light and switched to Tricare select, but there is a handful that we had to wiggle around and they're all planning to switch to Tri-Care select so that they can stay with the care that BBC provides for them. So let me ask you your previous practice, how far away was it from your current DPP? My former practice lives a six minute golf cart ride away from my house. And so that made a hard, we live in a golf cart community. There's 90 miles of golf cart paths. I like to refer to them as running paths of people use their golf cart and they go to school and they go to the grocery store and it's fun. The. Living life at 15 miles an hour. And it's pretty nice, but it made it a really hard decision to move because one of the other big lessons I learned was non-compete non-solicit. I had it. I had talked to my former boss about removing it as a negotiating factor when I renewed my current. And he politely declined. And so I am now 10.02 miles away from my former practice and will be for 24 months total until October of 2022. So it's actually been really nice to have the two year plan where I didn't have to take a loan out. I saved my money, I scrimped. And so got the necessary items and I've slowly grown the practice I actually got. Plan on it being so big so quickly. So there's a couple of things I would have done differently, but yeah, 10.02 miles. And by measure about eight times online. Fantastic. And that's, it's so important and thank you for sharing that because when it comes to especially people who are planning, DPC, As they're signing their very first contract, it can be something very important to pay attention to. It can be imperative to their practice, especially depending on their locale that they wish to practice DPC in. So thank you for sharing that. Just go in and say, I'm not going to do this. This is not a part of it. And I know that the president was talking a couple of weeks ago about getting. The non-compete clause and I was all for it. We'll see how quickly that can get in still. I, again, very happy where I am. And that was the other thing is I am in an executive suite situation, which everybody talks about subletting from other physicians. I have had an amazing experience. With the executive suite, there's a receptionist at the front. She calls me when the patient arrives. There's a bathroom. It's really nice facilities. And I have this really large 12 by 17 foot room. It has everything in it. It has everything I need and it's perfect of a closet for any medications that it has dispense. And I don't, I guess I want to emphasize. If you have an executive suite situation in your area, it's a really awesome opportunity for a low overhead unique space. That's all yours. And with you mentioning this executive suite, how did you end up finding this 10.2 miles executive suite away from your previous practice? Found places for lease. There was an executive suite situation closer to me that I was looking at doing, I knew I had the non-compete for internal medicine, primary care, but I also do FAA physicals for pilots and really enjoyed doing that. And so I was just going to get the executive suite situation near me. And my former boss kindly reminded me that I couldn't even practice out of my home doing home visits and telemedicine services because my home was within the 10 mile radius. So I said, I'm good, 10.0, two miles. And I found an executive suite right at that perimeter. So had the idea of it somewhere else closer, but then I found one and it was a little bit luck, but there was a couple of other options in the same range. And ultimately, why did you go with, I know you mentioned how. You're finding these conveniences to be extremely helpful for your practice, for the space that you need it to be functioning out of. But how ultimately did you make the decision to go with the executive suite? Having not been in an executive suite before versus the other options, slightly humbled with the response and how quickly I grew. I had a panel of about a thousand patients, cause it was three quarters time before in the fee for service. I was an associate and I didn't solicit at all. It was. She just left and they told everyone, I went home to spend time with my family. And, but those patients are pretty scrappy. They find you and Google's pretty amazing. And so I had done really well with the small space that I'm in. It's nice because I have the ability to reserve conference rooms. So. I need to do a family meetings. I can do that if I need to do classes or there's a classroom with video AAV capabilities. So I'm able to teach classes, nutrition, lifestyle, modifications, a lot of anxiety talks lately. And so that's amazing. And then I recently hired a. High school. She's amazing. I don't want to call her high schooler. She's an amazing office assistant. She's a senior and she's doing a work-based learning program. She wants to be a nurse. And so she helps me a time with the practice is a lot of administrative stuff. But then in turn, I get to teach her and we have enough time to do that and space within the executive suite. When you say executive suite, I have no idea what that means. So the fact that you put out those details, like the amenities that you have that go beyond just an office space, it's super, super helpful. The last thing is that it's all. Bright it's airy and I didn't spend a dime on the shouts. And so it's nice that yeah, I'm renting. I do have a two-year plan and a five-year plan as far as expanding and it'll come when it comes and it's coming faster than I thought it would. And I'm so thankful. With you mentioning that your patients have found you despite the false hood that was implied when you left your previous position is it through Google that most people are finding you? Or is it also by word of mouth? How have people shared with you that they found. your DPC. Yeah, I did my own Facebook or my own website initially just using Google sites that took me about a day and a half and it was not fancy at all. And then I did a Facebook page and then I did a launch and it's been two weeks to get my own name back from Google, from my prior practice, because they mailed the old practice, the confirmation code to claim it and they wouldn't get back. And so that was fun. Yeah. And. They found me mostly through Google. And at first I just had my cell phone. In fact, I think my cell phone still on Google, if it's under my name, but it was my initial ways of communication. I have another business number now and that's through the executive suites. That's part of it and slowly transitioning over to that, but yeah, they find you from. Hunting you've done at the grocery store. They find you from talking to who? Somebody knows somebody who's on my kid's little league team, parent. And it's fun in that the small town feel, you all take care of everyone and you're able to have the whole relationship. My dad was a dentist. He grew up or I grew up watching him really be involved. And I knew I wanted to do something like that. I didn't want to be in people's mouths all day. And so I have it and I love it. And I'm so happy with the whole eighties and the deemos. Whereas HMO's for doctors who didn't opt in and kind of did his own DPC, but as a dentist and I really look up to him and I'm proud of him and I hope to achieve what he did someday. So here you are. You're doing it already. You are. This is so exciting. And I'm sure that mind shift will happen the more and more you're out in your two and your five-year plan. But now with you mentioning the small town feel that Tyrone has, when you were mentioning the fact that you do FAA physicals, did that have any restriction in terms of the non-compete as well? No, because that wasn't a direct competition. The exact wording was not able to practice family medicine or internal medicine within a 10 mile radius. The urgent care was an option. I, but I really enjoyed doing an ethics physical, so I could have just done that. But then I losing two years of potentially being able to maintain the relationships with people that I already started to work with in the fee for service location. And they found me. It's been great. And so a lot of the pilots are like, tell me more about this when they come in for their FAA physicals. And part of my membership includes the FAA physicals. And so the captains for the airlines, they need two per year. And the airline reimburses them up to $500 a year. And so that's two thirds of the membership right there. It's been a good selling point and they appreciate that. I have the ability to not only. Excellent primary care, but advise them and how that might affect their FAA medical certification and what the FAA requires and what you're allowed to take medicine wise. If there's any hoops, I'll be like, yeah, maybe we'll do Claritin instead of Zyrtec, because it's not on the approved list. You've got your allergies. I think that I'm able to provide a little bit. I guess it's my side gig, but it's a good service and it's all based. So that's nice too. That's wonderful. And you can throw in that little bit about Tri-Care prime versus Tri-Care select when you're talking to them. Now, going back to how you mentioned that you were in a family moving around every three years and that you've been in your you've been in beer locale for longer than that. Now, how did you come to learn about DPC? It had been on my radar for about. For years. And I think I first started hearing about just the cash based model with Pamela weeble and physician burnout, her trying to prevent that and being a big advocate to prevent position suicide. And what I can do that she talks about having a smaller. And the two balloons and that's it like, okay, let's do that. And so then I think from there, I got onto some other Facebook pages and then found the DPC docs page about a year and a half ago. And I was hooked my, I have really good friends and that I grew up in college with. And then she ended up going to medical school and she was the first person I called. I'm like, I think I'm doing this. And she is a pediatric DPC. For a Dallas area, I call it Fort worth Dallas cause I'm from Fort worth. So it's not Dallas Fort worth. And she, she spent, I don't know, two hours on the phone with me one night and was like, this is this. And this was helpful. And this wasn't, and that was just the first introduction to the DPC community. And then it was just this flood gate of amazing information and wealth of knowledge. And. Support and compassion. And it was a complete breath of fresh air from even the small practice. I came from fee for service, but the hospital systems and the, the corporations I've worked for is all the business money, bottom line and patients where they're in somewhere. And it's been. Great to be able to be a part of this community. And I really hope to give back as much as I can and you're doing great, but just there, my DPC story, I love it. Awesome. I am glad. The people like yourself. When you talk about that, you really learned more by being in the community and talking with other people in the community. This is another branch of that idea because it's your words. Being shared to hundreds of people that are potentially thinking about DPC in DPC and just love hearing about DPC. All these people who are in the DPC ecosystem can benefit from your story. So this is definitely another branch. Way of hearing other people's words. When you heard about it about four years ago, like you said, And you were in your fee for service job. What did you do to plan in terms of your exit strategy for opening health Springs direct. I figured out a name and I figured out I got made sure that it was. Taken with the domains elsewhere. So I started with the online community initially, because I was thinking I was just going to do telemedicine and home visits and keep it simple. Initially I got the LLC, I talked to, I didn't say her name, but Andrew wildly was, is an amazing pediatrician in Texas. And then I actually went to two direct primary care doctors that are in the area and they have been doing it since 2014. And. I sat and had lunch with them and they were amazing as well. That's Erica Harris and Jacqueline Harris. They're both in Peachtree city as well. And then online DBCA has been amazing. And I just got back from the Greenville, South Carolina mastermind with chamber style to Amy Walsh. There was some, I was super fan girling over some of the visitors there. I was like, I can't say hi, but it was fun. And yeah, I think the most fun of the weekend was a meeting Vance Lassie's wife. She's amazing. That's awesome. No, that's fantastic. And I know that non-metal was there as well. So you guys had this like little Georgia group going to South Carolina. So for those people who are not aware of the mastermind, I'm just going to drop this here, the code, my DPC story, one word. Is still valid for people who aren't part of the Alliance and who want to register for future events, you can go to DPC alliance.org for the calendar of events to sign up and then DPC Alliance members get a hundred dollars off, but Christa, while we're on that subject of the mastermind run by the DBCA, can you please share. What the actual experience was like in addition to fan girling up. Cause I love that, but what were some of the things that blew your mind at, by going to an in-person event? Because there was about 15 of us. In every single stage of DBC from very well-established multi location practitioners to, I may do this Sunday. I'm just feeling kicking the tires and looking under the hood, seeing it, this is what I want. And we all talked about different things as far as marketing and supplies and how to do. The business part of DPC, which is something you'll learn in medical school. And yeah, I've had a crash course drinking through a fire hose, business alone in this adventure. One of the nice things was we got to tour five different direct primary care offices and huge in some really modest. And how do you know, how do you set up the, where does the centrifuge go really at just little details that. I just don't want to have to learn on my own. And they've again, been so forthcoming with the, do it this way, because I learned the hard way, and it's just made starting this so much easier than it would be. And I there's tons of other people out there that are also helped through DBCA Tiffany Lehner Julie got there. They there, it's just, it's a great, it's a great community and I'm really happy and thankful to be a part of it. Wonderful. Thank you so much for sharing. Okay. So, because you had been in your community in your previous fee for service job already, what type of market research did you do? If any, before, and I love the laugh that's most of us, including myself. What market research, if any, did you do. Zip zero zilch. Like I said, I found my location using a protractor to pick 10.02 miles away from my other practice. And one of the other doctors in the area had recently moved from near where I work now because she had done market research and determined that it wasn't an ideal location. Although I have found it to be amazing. The ideal, I recently brought on someone to help me a little bit more with social media. Website maintenance. And so that's taken a huge burden off, but it's not in a lot of patients as well. And so I think just word of mouth and getting out there online and that search engine optimization stuff that they talk about. We even women too, that a lot with the mastermind again. And when you mentioned this other physician saying. Area and your building wasn't in an ideal area. What was, what were some of the reasons that physicians said that I think she had looked at her patient demographics and noticed that they were mostly coming from more south regions. And so she just moved her practice about, I don't know, eight miles style. I love that you mentioned this two and five-year plan earlier, so. When you look into the future and you envision your two and five-year plan, what does that hold? It would entail getting more than one room. And the nice thing about executive suite is I could rent four rooms in this place and I can expand. And so. Do that actually sooner than two years, I have some really great staff that I'll be able to hire after that 24 month non-solicit agreement has been up and expanding staff or medical assistants, office assistants, but also potentially a physician assistant that would be nice to be able to help and expand with marketing to employers. So I have done three pitches to different employers, and at this point they're all waiting for. Open enrollment situation. I would like to be able to offer that a little bit more. I've gotten involved with the local business women groups and chamber of commerce. And so it would be nice to be able to help the commercial aspect in the area as for healthcare to provide a little bit better options for healthcare for employees and in January. And now you've been opened at the time of this interview nine. What you just shared that you even talked about, like the business aspects of running a DPC at this last mastermind, what was your workflow like when you opened and how has it changed or even been impacted by things like this recent master. Initially, I wasn't needing to go into the office every day. And so I was able to bundle the appointments in person together. And lately I've been there Monday through Friday. And it's really nice because I can be a whole lot more flexible with kids' activities. I have an eight and a 10 year old boys and they have the. I need to do to help them. And sometimes my husband's out of town flying and so we I'm able to be a whole lot more flexible. And I love that. I know my patients so well, so I can say, Hey, have a PTA meeting. I'm really sorry. How is 12 instead of 10? And everybody is so amazingly understanding and there are several state. Are you taking care of yourself? I think you're not charging enough. Are you getting enough sleep? Thank you so much. But. Other than anything, people are like, you just look so much happier. You just have this glow and you didn't have it before. And I can tell this is where you need to be. That's so wonderful. So wonderful. And I'm so happy that it's common to hear that is the difference between a fee for service job and running one's own DPC. So that's one. When you were opening, at what point did you make the decisions for an EMR and billing software to be the tech running in the background for your DPC. I had a grand plan to just use Google workspace because I wasn't going to have that many patients and I wasn't going to have a brick and mortar and started off with that. And I just got way overwhelmed. And so I ended up going with servo as the electronic record. I have been again all over the country. And so several of the hospitals I worked with as a hospitalist, nocturnists even the companies they had. I think I've done 12 different electronic records. Epic's amazing. It's like what? $40,000. So not an option. And it's just way too busy because if you don't need that, we needed something simple. So I really vetted the. Four main options and everyone is again, really helpful and supportive. I did end up going with servo. I think it's because it's really colorful kind of superficial, but it makes me happy when I open up and the rainbow is right there and it's just, it. But it's all very functional and easy to use. It integrates with hint. I got hint, probably the very first thing after I did my website and that's been really helpful. Servo does automatic billing, but looking forward and potentially working with employers is, is going to be a better option because they'll have their own portal. And. Again, we talked about all the other resources. Hint has been a great resource with direct primary care. They really, really support and encourage the DPC community. And I enjoy learning from their videos. And I think there's going to be a hemp summit coming up as well. So this is just a side note, the hint summit was my very first summit that I ever went to. And it was like, I don't even know what hint is, but Janine wrote on so many to go. So I'm here have really jumping ship from fee for service on my radar until COVID hit and needed to have a lot more flexibility and just was ready to be my own boss. And so I didn't get to go to any of the things in person. So it's been, I guess that's why the mastermind this past weekend was again, so amazing is because I haven't been able to network in person and there's just so much EMS. Having to be online and I'm looking forward to when it doesn't have to be online any longer with you using servo and with you using hint in terms of making the EMR work for you, rather than you working for the EMR. Because as a Cerner user of too many years, that's the biggest contention point for me in that I want. The tech to work for me. How are you personalizing your Serbo to make it work for you? So I customized it and put all the specialists in, but I put all the physical therapist and I put all of the home health agencies and I put all the high schools in for return to school notes. And then I took all my macros that I had at the other practice. I type those in and I have made a ton more. And the nice thing is that it's not just a macro in servo. It can pull in diagnoses. The ICD 10. I know that's a cuss word, but it doesn't automatically, and it can include orders and it's it's really, if you can get it, it takes again, a lot of upfront work, but that's one thing that I probably should have done the month before I was opening was really focused on that instead of just doing it. And my office assistant has helped me significantly. She's learning that there's a lot of admin, not always fun nursing stuff, but I'm very thankful for her. So shout out to. That's awesome. And being a servo user myself in that build-out stage, it's just the idea of, oh, including the high school fax line, like that's a gem. So I'm really glad that you shared that. And I definitely will say that like, just from personal experience, the responsiveness to the support. Yeah. The support is just. Within minutes. Sometimes I'll get a, an email response and my support person at servo. Marie is always open to meeting as that as I need to. So I'm sure you've experienced the same onboarding process and they were. Hourly emails initially, and then they let you go on your own, like a grown child. So you know, every now and then I'll need to reach out to them. The one hiccup I did have is that I guess, five months in, I woke up on a Sunday morning and I had. Eight emails from Facebook saying your password had been changed. You've been removed as the business administrator and you've been taken off all, you know, access to Facebook. So it took somebody hacked and took away my entire Facebook personal, but also my business. And so that was really disconcerting and Facebook really doesn't have any sort of support along those lines to help you. And. I was really mad, mostly the pictures, and thankfully they weren't posting, they hadn't been posting, but in that process, I was like, you know what? Parents have been saying, I want you to take kids. I want you to take kids. So in that five-year plan that I have, I needed to drop the internal medicine and potentially that there changed the name to include kids down the road. And so I was like, you know what, my Facebook's got, I don't have access to it. I can't get it. Let's change the name now. And so hint and servo were all really very helpful with that process. And I appreciated it and yeah, don't go to health Springs, internal medicine, or don't go to hot Springs and you can actually go report it if you want to. That'd be great. But my new, my, yeah, my new, the new practices helps Springs direct and that's been going wonderfully and I have all the security measures in place. The first thing I did was to a name change with the LLC. Then you had to go to the banks and the credit card. And then I went with more online presence thing. And then I still use some of my old internal medicine cards for reminders, for upcoming appointments. That information is still the sam