Direct Primary Care Doctor
After studying anthropology and religious studies at the University of California at Berkeley, Dr. Lindsey practiced massage therapy and yoga therapy for 7 years. She then went on to earn her DO from Touro University College of Osteopathic Medicine in Vallejo, California. She completed her residency in urban family medicine at Beth Israel Medical Center in NYC along with additional training in integrative medicine through a joint program with Andrew Weil’s Center for Integrative Medicine at the University of Arizona.
Dr. Lindsey is certified through the American Board of Family Medicine, American College of Osteopathic Family Physicians and the American Board of Physician Specialities in Integrative Medicine. From 2013-2019 she served as the Director of Osteopathic Education at the Marian Regional Medical Center Residency in Family Medicine in Santa Maria, California and continues to serve the osteopathic profession through teaching and committee leadership.
Drawing on her osteopathic and integrative medicine training, Dr. Lindsey provides primary care with a focus on optimizing wellness and addressing her patient’s individual concerns. She treats patients with a compassionate and open-minded attitude and is particularly interested in managing a broad range of women’s health and pediatric concerns. She enjoys her practice as well as her time with her family on the Central Coast.
She opened SLO Health Center in November of 2019.
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Hometown Radio 05.05.20 Episode Featuring Dr. Faucette
Hometown Radio 01.16.20 Episode
Featuring Dr. Faucette and Her Patient
Resources Mentioned by Dr. Faucette:
NAWBO - The National Assoc. of Women Business Owners
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TRANSCRIPT*
Welcome to the podcast, Dr. Faucette
Thank you. I'm excited to be here.
I wanted to start with the fact that as was mentioned in your bio pre DPC, you were in a very different, place in life professionally. So could you please give the audience a little bit of a flavor as to what your life was like in fee for service and pre
DPC?
Sure.
So I grew up on the central California coast. I you know, grew up in San Lupo. I did my medical school training in the San Francisco bay area. Then I went to New York city where I trained in urban um, underserved family medicine and completing my training. I stayed in the city for about a year. I was working in academic uh,
medicine, supervising residents.
I also did a lot of integrative medicine and osteopathic manipulation, which we'll probably talk about a little bit later, too. And then due to some family health issues, essentially, I moved back to the same area and my father who's really well connected in the community, told me that in Santa Maria really close by, you know, 30 minutes away was a new residency pro program in family medicine.
And so I essentially just jumped on board there as founding faculty and the director of osteopathic education for that program. So I'd say about 60% of my time was spent teaching and the other 40% was patient. And that entailed primary care as well as osteopathic manipulation and being a new program and being not well understood by the administration of a large.
Healthcare organization, there were a lot of challenges in terms of the patient care aspect. And so I would say it was even more we were getting more directives about how much we needed to bring in financially how long our patient visits could be. And it was kind of like you, you know, people, the administrators who were nons would come into our faculty meetings and essentially shake their finger at us, like almost every week about how we weren't bringing in enough money.
And, you know, I just got really frustrated with that. And also we were in a clinic without really, like I said, any physician management. And so when we would try to correct things like. Making sure that there was continuity between a patient and their physician, whether it be a resident or an attending physician, it just never went anywhere.
And ultimately, I got really frustrated after being there probably six years or so, and decided I needed to do something else. And at that point in time, I didn totally know what that something else was going to be. But that's essentially when I said, I, I just don't wanna practice medicine like this anymore.
I don't wanna see a different person every time I, you know, see a patient on my schedule. I wanna have relationships with my patients. I need that in terms of the procedures that I do, the osteopathic
I mean,
It's the worst thing in the world to be switching different people, treating a patient every single time.
So yeah, it totally different than, than where I am now.
When you talk about that, you were like, Hey, I've gotta do something different. I can't be doing this for the rest of my life.
How did you branch out into other options in terms of your medical career, other forms of other models of healthcare and what eventually led you to learn about DPC?
Essentially, I was looking at a lot of different options and at that time I had. A five year old daughter. And my son was about a year old when I left Marion family medicine residency in Santa Maria. And it was very challenging to decide what direction to go. I was burnt out for one thing, having two young kids and also working in this system that was broken and the day to day frustrations of that.
So at that time, I really felt like I don't even wanna do clinical medicine anymore. And I think, you know, we see that in my, that, you know, if we're even looking at. Medical students are not going into clinical care it's because they're seeing all these burnt out doctors in their rotations and they don't wanna do that.
And, and so, yeah, I was sitting there saying, you know, I don't know. And what I ended up doing was a lot of different things. Um, I did medical reviews for um, essentially like social security disability applications. I shortly thereafter got credentialed with all of the various telemedicine companies.
So D doing urgent care from home. And the thing was, I had actually learned about direct primary care, probably about four years before I quit. And that was. Through a medical school friend and colleague Brianna C um, who's in Denver and I remember running into her at a conference and she was in the process of leaving her employed fee for service position to start a drug primary care practice with the intention of doing obstetrics as well.
I was really impressed. I was really excited to hear about it and started researching it. I remember getting on the AFP website and seeing the DPC toolkit that they had at that time and seeing really that endorsement from my professional organization saying this is a very legitimate and potentially game changing, alternative to fee for service model for primary care.
And so I kept going back to that. I mean, I was even talking to my colleagues about it and thinking through, you know, how could this work in a setting like hours where we are educating residents and you know, how could this even, and I know this is kind of a topic that there's a lot of disagreement in the direct primary care community around, like, can we get insurance to pay us in this model?
Because then you get transformation for the physician, the patients you get better outcomes at lower costs. And then when you have learners, seeing doctors practice in this way, you are creating this Situation where more people are gonna wanna do primary care. Those were all the things that really got me thinking like, okay, maybe I'll do this.
It seemed really daunting because as a resident, especially everyone tells us, never go into private practice. You just can't do that anymore. No one does that anymore. Just take a job, pay off your loans. I'd say well, half of my class went into academic medicine and stayed in New York city, but so many of my co-residents and people that grew graduated ahead of me came to California and started working for Kaiser, which, you know, has its pluses and minuses for sure.
Everyone's heard of the golden handcuffs and those are very alluring to people who have so much debt and just want something easy and they wanna buy a house and they wanna pay off their student loans. And yeah, I mean, I didn't have a lot of people around me encouraging me to do that.
And so I'd say it took me about six months and then I decided to jump in
I did not realize that Dr. SIFA was your, colleague in medical school, and and it's just such a, it's such a Testament as to how important it is to like dr. Onan meta says, you know, tell five people about DPC.
Anytime you get the chance because you never know what seeds you're gonna plant. And so whether it be, you know, telling someone about your practice, telling someone about your future practice, telling someone about a podcast, they heard, whatever it, it is. You never know what future effects you're, you're putting into, into motion by mentioning the movement.
So that's incredible. And when you talk about being involved in the residency and the residents seeing burned out physicians, it, it really makes people, question, what are they gonna do in fee for service and beyond. And so I really hope that the more and more we get the word out about how. In DPC, you can have autonomy. , you can plan out your financials to pay off your loans, but at the same time, you get to, as you're doing every day, practice medicine, the way you want to.
And so I hope that the culture does change as more of us are talking about direct primary care and every single practice featured on this podcast, every single physician has made an impact positively in their community by doing this model.
Absolutely. Yeah. If I think about our first class of residents, one is N nonclinical did a fellowship in informatics. Another one did, I think he did a fellowship in something, but anyway, he is uh, working in an ER. Another guy is medical director for a startup nonclinical. Another one is an urgent care only with dignity here in the area.
Another one went to a student health center at a local university, which is essentially like urgent care. And then one is working in an FQ H C up in Northern California. So one of the six is doing primary care.
Yeah. In my residency, I graduated 2015, but the classes of 2013 and 2014, I would say 80% if I'm guessing or more went to Kaiser.
Because I did residency INO in Northern California also. And I was so excited when my my former PS attending, he texted me, Hey, there's a resident who's wanting to do DPC. Can I get him in touch with you? And I was like, absolutely. I love, love, love that, you know, the, the conversation is changing more.
People are so much, more aware of. Oh yeah. DPC is totally a thing. Don't know if it's an option for me, but I, at least know it's a thing. And so it's sad to hear that that was the trend, but I definitely would say that that is where we can make it to difference. And so I wanna pull on your experience having been at Beth Israel and having exposure to underserved urban medicine.
I wanna ask about that because you're returning home to where you grew up and I wanna ask about something you had mentioned in a radio interview that. So many people are affected by medical expenses um, that cause 'em to
file for bankruptcy in this country.
So when you were thinking about your training in urban underserved medicine, as well as wanting to do DPC, how did you develop your model?
So I was getting started at a very unique time. in history, right? Like I really launched my practice full force in January of 2020. So I would say what my model was in my mind to begin with really shifted quite a lot because I needed to raise my prices to be able to pay my lease and really had to restructure everything financially.
But what I will say is that from the very beginning, for whatever reason, probably because of my training and just my background and my philosophy and my interest and you know, feeling this need to fulfill something in terms of social equity and justice around healthcare. I've just really always wanted to see DPC function in a Medicaid payer system.
And so that was always in the back of my mind, like, how can we do this? you know, And then again, in the DBC community, there's you know, just too many barriers, too many hurdles. But it's still a dream of mine in terms of financials right now, I'm, I'm still just a little bit above break even, and that has to do with a lot of different things.
I also teach halftime, so I haven't really tried to bump up my numbers and I feel I like my patient panel in terms of my time is right where I want it to be. But that's something that I keep saying, like buy it a million dollars I would do more in terms of trying to build those relationships and craft those solutions that are really focused on the, the community where we are.
And that's one of the huge things about DPC is that it is, it's not cookie cutter. People can decide what works best for patients in their community.
Absolutely. And this idea that we don't work for free. You have to make money to be able to fund your dream, to serve your community in the way you wish to serve it.
But also when you have the right price point, when you have your overhead covered, you can decide what happens with your time. A former podcast guest, Dr. NA Mohamed in San Francisco shared that, that sentiment exactly. That he is able to charge higher prices. And with that, he does not have to take care of, of as many patients.
And so he has the time to give his care for free to the G Q I a plus community in San Francisco. So it's, it's so true that you are the owner of your practice and you can design it to fit your community. Dr. Erica highlighted that as well in her podcast. Um, In terms of that that DPC. Evolves with the community as the community changes and its needs change too.
Yep. Yeah, I know we see that a lot.
With your osteopathic background, did you view your osteopathic services as a separate fee for your members? How did you work osteopathy into your
practice? I chose to add it on as a separate fee, like a procedure reason being that it's often done frequently. So many of my patients I'll see twice a month for a period of time, and it really just depends on the patient, the frequency of their visits.
So that would take me a lot of time because I'd say. Probably around 30% of my patients now are patients that I see for osteopathic treatments. And when I first started, I just recently raised my prices. I had them set at a hundred dollars. I spend a lot of time with people too, so that those are 45 to 60 minute visits.
So at some point it was like, I'm doing so many of these and it's taking so much of my time that I've gotta structure it in a different way. So then I essentially just com made it more compact. 30 minutes is I don't even remember cuz my front office person just changed to hit in January. But I think it's like 30 minutes is $75.
45 minutes is a hundred, like that, but it just kinda scales up like for every 15 minutes and. You know, I think that's gonna work a little bit better for our practice. And the thing is I can actually do quite a bit in 30 minutes and I probably, I just set that expectation in a way that wasn't really financially sound to start off, but, you know, we learn and change things and adapt.
yeah, I recently I've been, I've fallen in love with the, the idea that practice does not make perfection practice makes progress. Because you opened during the pandemic you had also. Included in your membership, an option for telemedicine membership with two visits in your clinic, which is it's very similar to my practice in that I do two home visits included with the membership per year.
So can you tell us a little bit about your strategy with the telemedicine membership and how has that gone for
you? Yeah, we wound up having very low utilization on that and I did some marketing outside of our area. So we did some Facebook ads in LA. We did some Facebook ads in San Francisco area and we really just didn't get a huge response.
It was mostly people looking for like kind of one off urgent care visits, but I've left it for my patients who are out of the area and really. It's only $120 savings a year, but I thought it just might be attractive to some people saying okay, I'm just mostly gonna do telemedicine and it's a little bit less expensive.
So I, gosh, I probably only have 10 people on that plan.
But still
though, it's great that you have it because it's not necessarily gonna take more time to provide that service. Like you talked about your osteopathy offerings but also you're licensed in the state of California. So I definitely challenge people to think about like, if you have a license for a state and not a city or a county, you have the ability to maximize that license as much as possible.
So I think that's, it's really smart to have that as a, as an option. now Lindsay don't with, if you are training through, in the under wheel Institute, do you offer integrative or functional medicine in your practice as well? And if you do do do it for a certain fee, or is that included with membership.
It's really part of my philosophy around healthcare. And so I would say it's included in the sense of, I'm always giving patients all options for treatment of any medical condition that they have. And I'm always talking to them about a wellness plan for anything that they have going on. And also just in general, talking to people about health and wellness, and some of that comes from my osteopathic training.
Some of it through the training that I did in residency with the integrative medicine and residency. And I went to just do more study and get my board certification in integrative medicine. And so within integrative medicine, there are a lot of different directions. People can go and I'd say most of my knowledge centers around.
Mind body techniques like yoga, meditation, I'm certified instructor in K yoga and have done a lot of different meditation practices. I was a massage therapist before medical school. So, You know, the manipulative side of sort of what is available to help with chronic medical problems and wellness is another area of focus.
So like the mind body techniques, the hands on manipulative techniques, I know a lot about traditional Chinese medicine. So TCM and referring to my colleagues in the area. And then I have a fair amount of knowledge around herbs and supplements. So that's kind of the breadth of what I talk with patients about.
I haven't delved. Too far into the world of functional medicine, but I know we're gonna talk about this a little bit later, too. My colleague Carrie Hughes who I met while I was in med school and I have developed a program called better than healthy. And so that's really focused on more. So the wellness plan in a integrative techniques, and she is at the tail end of getting her certification in functional nutrition.
And so that has a lot of the same concepts that some of the other functional medicine training programs have. And so a lot of people in our area are looking for that. We've had a lot of retiring. It's not something that I, at this point in time feel really. Drawn to studying and learning myself. But I do see the value for patients and the interest from patients.
And I think it's one of those things that draws people in, and then you can start talking to them about things that support wellness and, you know, perhaps uncover things that we wouldn't have uncovered through more traditional means. So, Yeah, that's how I build it in. Awesome.
And I wanna ask with, because yes, we are gonna speak to that a little bit more in detail in a bit, but I wanna ask with integrative health you know, Dr.
Micah, you, who's a rheumatologist, who's been on the podcast, Dr. Emily, Scott, who's nearby, you and Irvine. You guys have all been involved in the Andrew wheel Institute's so I'm wondering, in addition to the Andrew wheel Institute, if a family medicine physician were looking to start learning more about integrative health or wanting to, you know, to seek certification, what are some steps that you would advise them to take?
Just to learn about how to incorporate that into your practice and on whether you should get certified or not.
So for me, I got certified because I was essentially the director of this program at the family medicine residency. And I had the opportunity and the support to go through that process to get cer board certified.
But honestly, I think it's unnecessary and and really, it just has to do with areas of interest and what people feel like they wanna really focus on with patients in terms of, I'd say broadly integrative medicine is about supporting health and wellness and less so on focusing on disease. And that's probably a lot of my osteopathic training coming through as well.
But , you know, the residents would often ask me the same question and I would say, you know, We've done however many hours of training for the residents that were in our integrative medicine and residency track. And I would just send them with David Rael, who I think he's still in New Mexico, but he was at the university of Wisconsin and his textbook is the book that a lot of people use to study for that integrative medicine board exam.
And I know the requirements to get certified have changed, but that book is just brilliant. It's just great. So if anyone is sort of just interested in getting going there aren't to my knowledge, a lot of great web-based resources to look at sort of that point of care, patient oriented. Approaches in the moment when you're seeing a patient in the clinic and for many DPC docs, you know, you have the time to look things up and talk to your patients about it while you're with them in the office.
And so I just really like it in terms of that, that it's oh, what was that thing I read about for migraine headaches or IBS? And he just does a great job. There are these two little kind of sheets at the back of each chapter. And it goes through all the different mind, body techniques and supplements and all the different tr you know, more traditional approaches, medications all the different things.
And he talks about level of evidence and risk. So there's this thing at the beginning of. the book where he essentially, you know, ones like a number one's a letter and essentially want these things that are like low risk, high evidence, or at least low risk. No one's gonna do anything. That's low evidence, high risk, for instance.
And that's a really common concept in integrative medicine. Like when we're teaching add students and residents, it's something that I would always talk with them about and you just graph it out. And here are the things that have really no evidence because no one's studying them, but, you know, have this potential benefit for a lot of people and their low risk.
So go ahead, run with it, those things.
Thank you so much for sharing that resource. I'm sure that people who are interested are, you know, jumping online to go. Yeah. Awesome. And in terms of supplements on your social media, I've seen supplements that you have is part of the offerings in your practice.
So I wanna ask how do you choose which supplements that you, which supplements to support in your practice and does that allow you to bring in some extra income?
So I have always structured it, that everything that we sell in the practice to members is at cost. I've always structured it that way. Now that I'm working with Carrie you know, we're, we're having conversations around it and she's what if we just do a little bit more than cost and at least try to get, you know, a little bit of a revenue stream coming off of it, but we're not like the practice that's like, okay.
And now you're gonna go talk to this person. Who's gonna sell you every supplement under the sun. And you're gonna walk outta here with two, like hefty bags, full of supplements, which no one likes to see. And Carrie and I are so on the same page about that. And it, I find it's really unique. Like I get a lot of patients coming in who are just on a plethora of things.
They don't know why they're taking what they don't know if it made a difference. And it, sometimes it could take me like 45 minutes to go through all of that with a patient and. Now I have Carrie in the office. And so I can just say like, Hey, we're gonna get you scheduled with Carrie and she's, and, and she'll just like, par it down.
She's you don't need this. Why are you? Yeah. All of these things here are the five things that you can use. And often those are very similar. You know, patient to patient of things are good for everyone especially with immune health. And, and so in terms of brands, I have just found some of the brands that I like.
And some of them are just, you know, more reputable carry has been working as a consultant for supplement developers for decades. There are a few brands that we really gravitate to for that reason.
Gotcha.
You mentioned you have 250 patients uh, and you shared how 30% of your patients do have osteopathy.
Do you feel that there's ever a concern about losing your skills or your confidence and skills with a number like 250?
Not at all. And it's actually really perfect for me now. And I always in envision this practice as being, not even necessarily for me and just, you know, like we were talking about earlier, everybody's gonna have their own design for their practice, but I never wanted to like, make a ton of money from the practice and You know, if it, at some point is getting me to like 50% of where I want to be in terms of my salary.
Like That's awesome. And even less than that is great because I have that support financially from my teaching that has always been important to me. So when I, you know, going way back to 2019, when I made this decision, it was like, I was only going to do osteopathic manipulation and I was only gonna do home visits.
And I started that way for a few months and then realized, no, I don't want to lose my primary care skills. And so I think it's been the perfect number to just keep my skills up and be able to teach and be able to do all the things I wanna do in.
It's so important to hear. And I, I love that, especially because you've chosen this path to allow you to live the life that you wanna live and to practice medicine, the way you wanna practice.
And so, you know, the ability to take a step back, if you're at a transition point to say, what do I love about medicine, about life? What do I love about my community, whatever it is, and have those as the things that you're working to incorporate in your, in your life goal. I think that's so important.
And like you said, it can change at any time, but you have the, you have the ability to pivot if they do change. So I love that. I wanna ask when you made this decision within six months of opening, how did you find your physical space?
So my first base was mid 20 and that's when I was going osteo.
And I was trying to get malpractice insurance and they would not issue me a policy unless I had a physical space that was not my home. And I don't know, there's probably gotta be other possibilities out there, but at the time it was like, okay, so this physician calling in my, who does osteopathic medicine, I called her, I tell her this story and she is renting a room two days a week in this bigger office in San Lu Obispo, where there are all massage therapists, but then she's got her little room there.
So she made me an offer. I couldn't refuse. It was $150 a month for this place. Just to be able to have a place to call my office, to get malpractice insurance. And then ultimately I started seeing patients there like a couple half days a week. So that was my first base. And then. I outgrew that space. I took over another space in that same building, but it just, it was an old building.
It wasn't really safe for some of my older patients. And at that time I maybe had 15 or 20 members in addition to the osteopathic practice. And I just took this leap and was like, okay, I'm gonna get a bigger space and I'm gonna rent out. Some of the rooms was my idea. And I remember I'm, I'm on like a lot of different committees.
And one of them is the osteopathic recognition committee for ACGME. So I remember I was in Chicago for that meeting and I'm like looking for office space and I see this amazing space. It's like pretty reasonably priced for our area. And I'm sitting there. I'm like, there's no way I'm gonna be able to go see this place.
It's probably like gonna be rented by the time I get back. So I don't even call. And then a couple weeks later I'm driving by the office and I know this office cuz a N naturopath colleague of mine was in there. I actually had a friend who was renting there. Like I know the space really well. It's great.
I'm like, wow, that's that's for rent. And it's so cheap compared to all the other spaces available. And so I was driving and I saw this like rent sign. So I call like immediately and he is like, I'll show it to you right away. I went to see it. And he was like, yeah, these people sign from LA were gonna buy it.
And they just backed out like a week ago. So I was like, I went across the street, this friend of mine came to see it with me. We went across the street, got a cup of coffee. I'm like, I'm just gonna do this. And so I went, I called him, I signed the lease like three or four days later and that was. That was the end of January.
And then my move in date was going to be March 15th. And I started moving in around like the beginning of March. And so, as we know, there was a lot going on in March of 2020, and essentially I had done some, I'd say like minor renovations, like carpet and paint during that time. And then yeah, the pandemic went into full force.
We were you know, everything was shut down and, and kids out of school, all of that happening. And I remember within like a couple of weeks of the first shutdown I called my landlord and I was like, I gotta get out of this lease cuz I'm not gonna be seeing patients. And I barely could afford it anyway.
And I can't rent out these rooms. And he was like, he is the most spectacular person. And at the same time he was like, he didn't wanna lose that income either, but he's like, sure, like no problem, but you've gotta find somebody else to take over the lease. And I was like, that is not gonna happen. So I was like, I'm just gonna like roll with this.
I tend to go with my gut instincts a lot. and, and it usually like works out, you know, sometimes not in this case. It really like in retrospect, worked out and. So I was like, I just gotta like, make some money for a little while and, and just, you know, pour it into supporting this place until I can get the practice going.
And I had already been credentialed with all the big telemedicine companies. And and for anybody else that was doing telemedicine in March role and probably part of may, it was extremely lucrative. And so that really held me over for about three months until various things changed. Largely the whole fee for service system kind of like screwed the physicians again, pardoned my use of that language, but yeah, it it was, it's been great to have that bigger space.
And now I had that same physician, actually that first office closed down. Someone bought it and wanted to do something else with that space. And so she needed a new space, so she called me. And so I essentially am just kind of repaying the favor of she's there two days a week. And you know, my, my overhead there is probably about $3,500 and I'm charging her like $400 a month.
I'm kind of like giving back to her for helping me out, you know, in my first year. And it's great to have her there too. She, she does osteopathic manipulation, so we can, co-treat on, you know, more challenging cases, which come up every once in a while. And she's a great teacher. She's been a mentor of mine too.
So, um, So it's great. And yeah, I've got Carrie in the office now. And I have space for medical students when they're there. I have another physician who's doing osteopathic manipulation a half day a week, and I just hired a nurse practitioner. And I didn't mention to begin that I have what's called a hybrid practice.
So I still build Medicare. Um, So my nurse practitioner is seeing mostly Medicare patients and also more urgent visits for my membership patients when I'm not in the office teaching. For example, I travel a little bit for that sometimes.
And when you talk about Medicare is osteopathy uh, quote unquote covered service.
That Under Medicare or no,
It is. So the reimbursement isn't great. But when it's coupled with the E and M codes for an office visit, it's not bad at all.
And in terms of your practice being hybrid, do you have someone do your billing for you or do you do your billing yourself?
I have someone do it and it was actually passed along to me from, I cannot even remember because like probably other people have spoken about there's just so much support from the direct primary care community and physicians to people getting started that I can't even remember who that was, but someone gave me the name of their biller.
So I've been working with her from the beginning really
definitely, you know, if you're DPC docs group you know, you can search through the threads for medical biller or hybrid biller, whatever, you know, keep, keep Being creative with the search terms and you, you never know
what you're gonna find.
Yeah. And she's, she's working with other DPC practices for
Now I, I wanna touch on how you've really engaged with your community and I I'm highlighted at at the beginning, but you've been featured for example, on radio, you spots in your community and on, on hometown radio.
And for those of you who are interested in hearing Dr. Fut you can go to her accompanying blog post, and I've posted the interview she did in January of 2020 and may of 2020 there. So you can see you know, a little bit more detail, but as to what we're talking about. But I, I wanted to ask first and foremost, how did you get to uh, be involved with this radio station
locally?
Yeah, so it was actually due to this patient of mine who I will call Michael, I think He gives his full name on the, on the radio episode, but he has a longstanding relationship with Dave Congleton, who's the host of that show. And so he essentially, he is retired. I think he talks about how he's on disability for some of his medical condition.
And so he essentially kind of took me on his, his professional career was in marketing and brand development for organizations. And he had a lot of experience working previously with You know, large medical organizations and physicians, private physicians. So he had, he had a lot of really great um, insights and, and thoughts about how to help me get started.
And that was one of the, the original ideas that he had. And that was really shortly after he and I met, I think, in the summer of 2019. And then he started helping me in that capacity probably in like November, December of 2019. So that was one of the first things we sort of worked together on was that hometown radio at episode, it was really fun.
I had a medical student with me at the time, so she was there and then his friend did some photos and then we did some photos afterward. And so that was all really fun. And, and just, you know, I'm really grateful to all those people that helped me in the beginning.
And, and really like, you know, I probably could have spent a great deal of money trying to put together some grand kind of marketing strategy and plan and, and some DPC practices go that route and it, you know, pays off, but sometimes it doesn't. And there were times that, you know, I, part of his advice was really understanding your area and what works well in your area.
And I think across the board, Facebook ads are probably working pretty well for a lot of people. And in retrospect, I spent a fair amount of money on the creation and payment for running radio ads. And that was maybe in the spring summer of 2020. And so I would not do that again. It was really low year.
I think it broke even with the number of patients that I got, but, but pretty low yield. When I think about how much I've been spending on my Facebook ads, which I stopped running last month, cuz I just don't even need it. It's like I've hit this tipping point and I'm trying to figure out how to have enough time to see the patients that are
It makes me think about how. Dr. Doug FRAGO had recently posted on DPC news about finding your avatar, finding your ideal patient. And that's not necessarily new to business and entrepreneurship, but when it comes to marketing, especially like yourself, you opened in a community where there was no DPC prior to you opening
and you know, reaching out to people, talking around your community about how you're wanting to market, you never know what you're gonna pick up. And it's so interesting that you share that because. You know, Dr. Janine Rodes, who is in the Monterey area. She said that for her, the NPR radio spreads really helped her practice.
So it's definitely community specific. But I love that, you know, your experience with Facebook has really proven like that, that that type of advertising is really even to help your practice. yeah. You know, it, it gives people, you know, things to think about when they're marketing in their own community.
Yeah. And I wanna ask you there, in terms of, with you. You know, going on a radio show with your patient and to hear, you know, for a lay person who's not in medicine and who understands the frustration of, I can never get into my doctor's office. And to hear him say that he can text you, he can email you, you can do home visits if he ever needed that.
You know, it's so powerful. And I, I wanna ask about how was that going on a radio show with your patient? Was that, how was that experience?
By that point in time we were friends. And so it was just like talking to a friend.
I had heard essentially like a lot of what he was saying before, and it was very comfortable because also he gets called onto that show quite frequently. So like he and the host knew each other really well. He kind of gave me the lay of the land and was like, here's, what's gonna happen. And we'll go to a break and then we'll talk about what's coming up next and the questions.
And so it was all you know, really quite easy. And I, I enjoyed it. I thought it was really fun. Yeah,
I just wanna put in a piece here, Dr. Brian blank had on his episode had talked about his previous career in journalism, and he mentioned how frustrating it was as a journalist to sometimes not be able to find somebody to find quotes for your, you know, for his news article or whatever he was doing at the, his journalism pieces.
And so he mention, and in his interview, if you are the person who can drop what you're doing at a minutes, notice to be that person. That's how that's one way to get more and more mm-hmm media interviews. So definitely wanna drop that there. Yeah. Um, In, in terms of when you approach, you know, public speaking, public engagements, or just talking about your practice in your community I wanna ask what are some, high yield value proposition points that you, you drop , whether the conversation be one minute or five minutes with people who are not necessarily familiar with your model
so often.
And we hear this a lot in the DBC community, we get confused with concierge practices. So when I'm talking to patients who are calling about it, I don't really even try to do that much education around that anymore because you know, they, they have a general idea and it usually centers around like I'm paying something and I get, you know, this increased access is really, I think what it is about for most people.
So I tend to just highlight that and. Really the better outcomes and more time. And then if I wanna get into the financial benefits, it's like, okay, well we have, you know, our contracts with the lab in town so that we can get labs at cost. If patients have a high deductible, we can help them navigate the healthcare landscape so that they are likely saving money.
And one thing I always throw in as well is that, and it's true. And probably for a lot of practices that while it might not entirely make financial sense for patients who are having, you know, maybe three, four or fewer visits a year to establish what the DPC practice, when they've got commercial insurance and they're paying a monthly fee.
It just might not make financial sense when you look at all the numbers. However, there are a lot of patients who join my practice because of that access, because you're never gonna get as much time and you're never gonna get the access that we can offer as DPC physician. So that's a huge piece. And I got to the point where I can't even do those calls.
Like That was, that happened a lot sooner than I thought it would. I thought I could get to a hundred patients, but I had to hire someone. Part-time when I was like at, I think 75 patients and within if few weeks she's fantastic. She saves my life every day. Her name is Selena Garcia. If she listens to this, cuz I tell everyone when they meet her people that like know me well, and haven't met her.
They're like, oh, you're ele. Oh, you're a lifesaver. She talks about you all the time. My patients love her anyway. She got really up to speed in terms of going through all the basics. And every once in a while, someone wants to do a meet and greet um, which we do, but now, you know, we're getting, we're getting quite a few patients a month still.
So I think by the end of this year, I'll be definitely like profitable more so than I am now. Wonderful.
On your Facebook page. And I definitely encourage for people to go check out.
So health centered uh, Facebook page, but you have at the very top left. A set of questions. I thought it was magical. I was like, I've never, how did she do this? But it says, what is direct primary care? And it has a button to ask you that question, or what is the, what are the benefits of DPC what's included with the membership?
And is there more, so I'm wondering, in terms of, on the backend, do you have automated responses? What, how do you use that to help you get understanding about DBC and your community and how has that helped your practice?
Yeah, so that specifically, I think I set that up when I was doing all my social media management, myself, which again, changed pretty shortly into the whole foray, a of doing all of this because I just, it's not, it's not my strong suit.
I don't like it. And it takes a lot of time. So if you have that constellation of things, you probably just should step away from that activity as soon as you can. Cause it's not a good combination. But. I don't know that that helps me all that much. Oh, this was the big thing that really helped in terms of Facebook and kind of everything else. I did. Another one of my patients does SEO um, so search engine optimization and she just got that super dialed in for me. And then once that was dialed in like, if anybody puts like primary care or family medicine um, concierge, like all these different things, I'm always is like the second thing that pops up.
And the only reason that my friend Andrea and her practice is higher up is that I just haven't tried to get as many Google reviews. But that in combination with the Facebook ads is like the magic, right? And then I was trying to get like, leads, like where or whatever you call that, like the information of where they um, were coming to you from.
And, you know, people would say online, but it's you never really know whether they, you know, how they ended up seeing that ad what they searched for. If they saw me on Google and then, you know, saw the Facebook ad called
and in terms of social media, I think of you as like the queen of head shots and repurposing evergreen content.
You know, if you haven't been to Dr. Fu that's IG feed, you should totally check it out. But I love how you've been able to. Beautifully have, you know, your colors continually represented, but also with your headshots, you're able to put in little quotes. And so can you talk about your strategy there and, and how, you know, how often do you do head shots?
Sure. So I have a team that's working on this for me now, and they're wonderful. Daniella Moran is her name. I got in touch with her through, and this was at the advice of a lot of the DBC docs and the at Facebook group to just get out in your community, like go to meetings, like meet people.
Some people do. Um, The BNI groups, I kind of like tried a lot of different things, but what really aligned with. Me and my interest. And I liked the group of people, was an organization called the national association of women, business owners. So Nabo, and they were actually using this virtual assistant to do a lot of their social media and newsletters and emails and things like that.
One thing that I got going pretty early on was a newsletter. And I had all these different people. So I had one person doing my social media and then I had somebody else doing my newsletter. And then it was just like too many people to deal with. Like communication then things were like not happening exactly like I wanted.
So I transitioned over to Daniella and her team for doing my newsletter and my social media and. Essentially I don't know. I, I think I have an initial kind of group of photos done and then maybe three or four months later got some more. And then I was like pretty checked out from it. And then they, at some point were like, we need more pictures.
Um, So then I just have a friend here in town that does most of them. And then I did another set maybe a couple months ago with a woman here in town that I met through Nabo as well. I kind of just like jump on the specials when people are like, we're doing like a 45 minute headshot special and it's like $300.
And so I'm like, okay, that's, that's what I'm gonna do. But I, and, and for a while, I would say too, that I was really watching social media, cuz I'm not like a social media person. I don't like scroll. It's just not something that I do in my day. And so. we, you know, they posted it in the program called later and I was able to just go through and in advance, see that postings that they were gonna put up.
And so I, I monitor it for a while and now I don't. And sometimes when I do then look through I'm, like, I might have said that a little bit different, but it's no big deal. And it's not I don't think, I just feel like I like the consistency for my patients. And, you know, I probably could save a little bit of money by not doing it, but I just, I like it.
I think it's a good good way to just stay in touch with people, even if it's just a few people.
especially know, when we look at culture in this country, most adults are on social media and most of those people check social media every single day. So it's definitely you know, there's this argument, you know, should you, or should you not be in social media?
But I would definitely say, especially if you are able to pass off the management to somebody else and still fairly represent your practice, you know, that's, that's you making the most of somebody else's time to help you. So that with the 24 hours in your day, you're not, you know, overextending the ending.
And then Lindsay, can you say, cuz it, it glitched out. Can you say the national association working business owners?
Yeah. Yeah. The national association of women, business owners, Nabo it's a national organization and our chapter started four or five years ago. I was on the board. Of directors for that group last year.
And that that's been like a really great thing to do. You know, if people have the time getting started, I think you build even stronger relationships. And I would say in my first year, and this was the same thing for trying to crew employers as another sort of like some people really take off and they've got a ton of employers paying for the membership for their employees.
And I tried a lot of that in the beginning. Wasn't successful for me other than I would typically get in the business owner to join my practice. And I would say similarly
that happened in those boards that like people would join or their, you know, partner would join. They would sign up their kids.
But then at some point you just start getting so many word of mouth referrals. So it's like you just, after some period of time, start to see the, the ripple of the word getting out in the community.
So now you you've, you've mentioned, I'm so excited to hear more about, I, I wanna ask you about you're better than healthy program and better than sexy program.
What are those and how have your lessons from DPC helped you run these portions of your, your career now?
Yes. So I love launching new things. I will probably do it for the rest of my life and. I, like I said, I came to Santa Maria to start a residency program. So that was like a huge undertaking of all the curriculum development, building relationships in the community, getting the word out all of the you know, public relations and just, you know, getting everyth thing going with the new program.
And I did the same after I left with the new medical school in Clovis, California. And so, I like need a little bit of chaos or I don't know what to do with myself. So I, similarly, gosh, I think it was early 20, 21. I had this as like a goal that I was gonna do a coaching program because like everybody knows, like every doctor in the sun is a coach now.
And so I was like, okay, I'm gonna do this coaching program in a year. And then I'm like looking at something late at night. And I realize oh, I only, it really is only like, Five to 10 hours a week. And I'm like, okay, I could do that. Even though I have two little kids in this practice and like all the other things.
And then I had always had a really big interest in women's health and sexual health and wellness. And so as we started going through the, a program, I was like, you know, I think that's what I want to do, because I feel like there is really a lack of information and really it's one of those things that even, you know, talking to the residents about it, it's just so often not addressed for women or men.
And it's a big people, part of people's lives. So that better than sexy program, the you know, it's like catchy title, but, but essentially it's around talking to people about their relationships. Intimacy and any, you know, really specific kind of sexual health wellness, things that they're dealing with.
And really when you talked about like the avatar and the ideal patient, it's like for me it's, you know, busy women in their fourth fits seven decades of life who are having challenges in any of those realms, like relationships, intimacy, sex. And I'm really in the beginning phases of getting that launched.
And I have a few patients though, and that was really a big inspiration too, that we're just like, you know, I just start to talk to them about some of these things and they're like, no one's ever asked me that before. Or I just assumed that my life was gonna be like this forever. And you know, really not having their frustrations addressed.
So that is like really a one-on-one coaching kind of program right now that I have two people that I'm working with. And really it probably like a lot less, like I did with my DPC practice. I still have people that are enrolled in this kinda like dirt cheap for my air area membership plan.
So similarly I'm kind of getting that rolling that way. Better than healthy has had a lot of interest from my patients already. So Carrie Hughes and I, who I talked a little bit about earlier, but in a nutshell, to give you a little more information about her, she's an ethnobotanist. I had no idea what that was until I met her.
And that is the study of the relationship between people and plants. And so her focus has been, as I said earlier, As a consultant for supplement developers, she worked for pure Encapsulations, which a lot of people are familiar with that supplement brand. For a very long time, Shei like super cool things right now.
She's working with a company on, development of a beverage that has herbs in it that create a feeling of like relaxation focus, essentially like looking at different herbs that can create this you know, even like. sort of like low kind of euphoric state that people, you know, might expect from like a CBD drink or alcohol for that matter, like an alcohol alternative that isn't CBD. So she does a lot of like really creative, interesting things. She's great with patients. She hadn't done much clinical work until the past few years she got into more clinical herbalism.
And now she's working with flower essences and that's where this whole idea of better than healthy came from. And I won't go into this whole rabbit hole of flower essences, but you can definitely go to the website and check it out better than healthy.live or.live. Whichever helps you remember that.
And there's a lot more information there, but essentially it's like homeopathic. and what I started to notice with the patients well with myself, cause I think I was one of her first um, people that she worked with in this clinical way. And I remember her doing the intake. It was probably like 45 minutes.
And I was like, no way, do I have an issue with that? Or like, oh, that's so resolved. Like that has nothing to do with the fact that, you know, I'm having trouble with this or that. And I was kind of, I was kinda skeptical, you know, I was like, okay, flower, essences, whatever. And then I was amazed at how I started to see some of the things that she was telling me and, you know, whatever we learned a about placebo effect.
But one thing again in integrative medicine is that there's a meaning effect. So that is something very real. And if we're accessing that, you know, maybe it's the flower essences, maybe it's a meaning effect. Kind of doesn't matter. I think what a lot of it is is that relationship that she's developing with people that she sits with for 45 minutes and then gives them a pathway to look at these different things that are influencing their overall health.
So she'll even address like hypertension and then it back to like, oh, they're having this problem, like with their sister or their father, whatever it is. And let's put together this flower essence, that's going to help with like grief around the loss of this relationship or whatever it is to, you know, help with their, their hypertension.
I have a patient who had long COVID and had all these like GI things going on and got off of all of her meds for gastroparesis. got off of her meds for, she had like really severe gastroparesis had a lot of cognitive things going on and through not only the flour essences, but like the flower essences and supplements really got a lot better.
And I never would've even asked her about this though. I said this about relationships, but she had a laundry list, like 30 things on her problem list. And so I didn't when I saw her have a lot of, of time to ask her about her relationships, but after she started working with Carrie and she's so funny now she comes in and she's so happy to be there and to see Carrie and.
She's like started dating again, which she hadn't dated in like 10 years. And she's got, you know, some, some people that she's seeing that are like, you know, it's really brought a lot of joy and happiness to her life that, that wasn't there before. And so that's really where I've seen Carrie. And I know we're gonna talk about this in a bit too, but we're putting together or we have put together a workshop called becoming the family shaman.
And we did a little kind of intro to it uh, a couple nights ago and it was really fun. And, but Carrie even still is I'm just like new at the, and I'm learning, which is true, but it it's been really amazing to me, the impact that I've seen her make with patients.
You mentioned this program of becoming the family shaman and it's gonna take place in June. So can you tell the audience about what it is and if they're interested, where, where can they go to find out more information?
Yes. So this was something we started thinking about two or three months ago, and it really had to do with the fact that we both are professionals and trying to balance our home life with our professional life, like so many people are doing.
And I think initially we were really gearing it toward women, because that's our perspective, but really in doing this introduction you know, again, our avatar, like who are we targeting our program too on the better than healthy website. One of the first lines is like, we're we wanna work with women.
And then it's like in a few good men, but we really started to realize doing this intro, that this is really about how to take care of yourself and find your personal power through a variety of techniques that we talk about. But we are essentially sort of giving people the groundwork to remember that they can be a place of peace and refuge and healing and wholeness for themselves.
Because that's the integral piece is being able to be that for yourself. And when you can be that for yourself, then you can start to take care of the people in your immediate surroundings. So for instance, I have a friend who lives in what some people call a commune, but they, they have 20 people living in this big building and are two town.
And I was talking to him and he's like, well, I would, what do you mean? Like becoming the family shaman? Like, I don't see how that applies to me. And like, you know, I don't, I'm not like I don't have kids. And, and I started thinking about that afterward and I'm like, we do need to like rework the title, because it really is about like, your home environment where you live physically and the relationships you have in your home, because that really is like the foundation for how we then are operating in the world.
If we don't have that. That strong sense of being um, whole in ourselves whole in our relationships, then it's really hard to step out and make an impact in the world in the way that we want to. And Carrie's focus and my focus are a little bit different. So we talk about that too, where she's you know, the clinical, Herba the flower essence specialist, the ethnobotanist and I'm the family physician.
And so how, you know, we can really work together to help people develop their own personal program for supporting their health and making the impact they wanna make in the world. So it's been really cool to be able to develop this program with her. So it's based program, like my practice and. She is delivering most of the patient care. You could say in working with people around supplements and a wellness plan like I said, she's doing functional nutrition and a lot of functional medicine. I But the idea is that that the overarching thing is treating the metabolic chaos, which has to do with, diet, rest, exercise, stress reduction and supplements.
And, and supplements is at the end of the line. And why is that? Because they're medicine, they're just like pharmaceuticals in, in this model of looking at functional nutrition and health. So functional, meaning like get to the root cause of what's going on.
And our plan is to build it pretty slowly because she is getting a feel for what the balance is for her, between her consulting practice and this new, like clinical care that she's doing. And then we have essentially like weekly meeting where we go through our patient panel and talk about things that she might have questions about.
And then I'm learning from that too, so that I can educate my patients just in my practice. And so a lot of overlap, like sometimes people from my practice are funneling into hers and vice versa, and then we have some discounts when people enroll in both. And we're again, like getting the pricing right.
But we priced it kind of on the low side while we're getting started. And then I think a long term goal that we've talked about is marketing it to bigger communities. You know, perhaps employers though, I'm tending to think that's not probably, I just, haven't seen a lot of like wellness programs really have a lot of great success with employers.
Cause it's like a why would we pay for that? But where I see it might be helpful is even other DPC practices who want to offer something to their and and don't feel like they want to take the time to invest in learning all these things, but see the value. So that it's one possibility for the future.
And yeah, we're just excited to, to have it get going. It's been in the works for less than six months and we're, we're gonna get launched on social media in the next month.
So interesting. And there's been so much chatter that I've read on DPC docs about functional medicine, who does it, how do they incorporate it?
Thank you so much for sharing how you've incorporated more integrative functional nutrition into your practice and hearing, you know, these endeavors that you've taken on recently, as well as your DPC practice, if others were wanting to reach out to you, what's the best way to connect.
They can reach me@contactatshealthcenter.com and the websites, SLO health center, slow health center.com.
Perfect. Thank you so much for joining us today.
Yeah. Thank you for having me. It's been fun talking with you.
*Transcript generated by AI so please forgive errors.
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