Direct Primary Care Doctor
Dr. Kyle Adams is a Board Certified Family Medicine Physician. Originally from Leesburg, GA, he graduated with a Bachelor of Science degree from Georgia Southern University. He attended medical school and received his MD from Mercer University School of Medicine in Macon, GA. After medical school, Dr. Adams completed a year-long internship in OBGYN at Mercer University / Navicent Health in Macon and then went on to complete Family Medicine residency at Wake Forest Baptist Health in Winston Salem, NC.
He married his high school sweetheart, Laine, in 2011, and they now live in Auburn with their three kids. Dr. Adams enjoys powerlifting and anything outdoors, but he often gets made fun of for his lack of football knowledge. In his professional career, Dr. Adams enjoys getting to know his patients and spending time helping them learn to lead a healthy and active lifestyle. He also enjoys procedures and offers them for free to ADPC patients.
He opened Auburn DPC in March of 2021.
RESOURCES MENTIONED BY DR. ADAMS:
-UCSF Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People HERE
-Endocrine Society Guidelines on Transgender Health HERE
-FB: Doctors Groups focusing on transgender and gender-diverse care
-FB: DPC Docs Group
-Startup DPC by Dr. Paul Thomas
Facebook Page HERE
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Direct primary care is an innovative alternative path to insurance driven health. Typically a patient pays their doctor, a low monthly membership and in return builds a lasting relationship with their doctor and has their doctor available at their fingertips. Welcome to the, my DPC story podcast, where each week you will hear the ever so relatable stories shared by physicians who have chosen to practice medicine in their individual communities through the direct primary care model.
I'm your host, Mary L conception, family, physician, DPC owner, and former fee for service doctor. I hope you enjoy today's episode and come away feeling inspired about the future of patient care, direct primary care.
Great memory care to me is freedom and salvation for physicians. And it is the solution to a crappy broken system for patients. It allows me to take care of patients the way they deserve to be taken care of unencumbered by the tyranny and oppression of corporate medicine and the insurance companies.
And it allows my patients to have access to a physician who really has their best interests in mind. I'm Dr. Kyle Adams of Auburn DPC. And this is my DPC story. Uh,
Dr. Kyle Adams is a board certified family medicine physician. Originally from Leesburg, Georgia. He graduated with a bachelor of science degree from Georgia Southern university. He attended medical school and received his MD from Mercer university school of medicine in Macon, Georgia after medical school, Dr.
Adams completed a year long internship in OB GYN at Mercer university Navicent health in Macon, Georgia, and then went on to complete family medicine residency at wake forest Baptist health in Winston-Salem North Carolina. He married his high school. Lane in 2011 and they now live in Auburn with their three kids, Dr.
Adams enjoys powerlifting and anything outdoors, but he often gets made fun of, for his lack of football knowledge in his professional career, Dr. Adams enjoys getting to know his patients and spending time helping them learn to lead a healthy and active lifestyle. He also enjoys procedures and offers them for free to Auburn DPC patients.
He opened Auburn direct primary care in March of 2021.
I wanted to start by reading a quote that you had written in a blog post. Uh, right as you're opening Auburn DPC. And so the quote is doctors in the mainstream fee for service world are not truly working for their patients. They're working for the insurance companies who will do anything in their power to refuse coverage, or at least pay less than what a service.
Because of the huge financial and time constraints placed on these doctors, they are forced to see 20 to 30 patients per day, spend hours on documentation and carry patient panels of 2000 to 3000 patients. Each don't get me wrong. These are not bad. Doctors are good doctors trapped in a bad system. So I decided to step outside of that broken system and do something different in my practice.
I can accept whoever I want. Even the tough and time consuming cases. I can take text messages from patients since I don't have to force them to come into the office to get paid. I can spend time on educating my patients, listening to their concerns and treating them as a whole person. And I can do it all without putting my patients into debt over their healthcare.
So with that, welcome to the podcast Dr. Adams. When I saw that quote, uh, or those lines of, of your, you know, your story on your website, on your blog. I love that you've pinned it to your Facebook page. So it's, you know, prominently there for anybody to see, because you know, some, some of the posts on your, on the responses to your blog post are people who are like, this is a scam.
This is not real. And so, you know, I, I love that you are, you are embodying in your website and in your community. Now what it truly means to be a direct primary care doctor. So, uh, as you mentioned, I pin that to the top of my Facebook page, because I think that particular article kind of encapsulates everything that I'm trying to do here.
And, uh, I want anybody who's interested in, um, our practice in, in me as a physician to, uh, be able to. To see, to have access to that information and really understand what we're trying to get done and prove that it's not a scam. It's not a scam, it's the real deal. And I still get patients there almost every day in here, um, that we see for the first time who leave and are on their way out the door and say, I can't believe that this is actually a thing.
You know, that, uh, that y'all were actually doing what you're doing here. Um, and people just love it. Absolutely. And definitely that, that's something that I know for me, it fills my cup every single time I hear that. I heard that on, uh, from a patient yesterday when I did a home visit, she's like, I slept better.
That's because you listened. And I was like, that's amazing. I'm glad you slept better. So let me ask you when, when your, your focus is quality over quantity, I want to ask about what was it that led you to even choosing this path in your career of medicine? Um, well, you know, I think if you, if you, if anybody has read that particular article and they've got a decent idea of what it was that that led me to this, but, um, I had been, uh, employed as chief medical officer of, uh, a growing urgent care chain here in Alabama.
And I was overseeing, um, nine and then towards the end of it, 10 clinics, um, and led that company medically, uh, through the entirety of 2020, which was, as you can imagine, a ton of fun. And, um, toward the end of that, I kind of looked around and realized that I had become a. COVID testing technician. And, uh, that is not what I wanted to do with my medical license.
Um, so I decided to become a real doctor again. And, uh, toward November of 2020, I was on an urgent care shift and I established my LLC on my cell phone between patients. Um, yeah. Um, and then, uh, put in my notice, um, the next month and the following March 1st, we opened and, uh, you know, it's, it's been the best decision.
Professionally, um, that, that I think I've ever made. Incredible. And I love that. I hope that, you know, other people got a kick out of that as well, just because, you know, this is, this is something that is real, it's something achievable and inner, just developing your LLC and, you know, establishing it between patients is, is one way to prove that.
So that's amazing. No, one of the, one of the big questions, um, that people have when they're thinking about this model, and I just had a conversation with a local doctor about this is, is the fear of jumping in because of the finances being so different. So I want to ask when you were going, you know, in your mind from, you know, being a CMO, doing, being a COVID technician, so to speak, as you just said, um, to becoming a real doctor again, um, what were some of those fears and how did you overcome them financially when you transitioned to.
Um, yeah, I mean like anybody else, of course I was worried about it. I mean, I finished residency in 2017, so it's not like I had a huge stock pile of money sitting around. Um, and I've, I've got a family of five to take care of. Um, and so I definitely, that was one of my major concerns was how am I gonna, how am I going to make money?
How am I going to keep my family fed and pay off these student loans? Um, so I've always kinda been the kind of person who, you know, once I get an idea in my head, it's probably going to have. One way or the other. And so, uh, you know, uh, through my experience at urgent care, I was pretty familiar with how locum tenens work goes.
And so I thought, you know, I'm a family medicine MD. If I need money, I can find a shift tomorrow somewhere. So there was really nothing, um, concrete holding me back from doing it. Um, because I knew that if, if it came down to it, I could make money. You know, if you've got an MD or a Dio, you can make money.
Um, and so I decided to do it, um, and, uh, just jumped in and, um, I kept my side gig, you know, which the urgent care became the sad gig, uh, for quite a while, , Until the DPC practice was really, um, making a little bit of money for us. And, um, I still actually serve kind of in an advisory capacity for that company, but I'm no longer working urgent care shifts.
And, um, I go home at five o'clock every day.
Spoken like a true doctor entrepreneurs. So I absolutely love that. And one of the things that I learned about you just through research before our talk today is that you also have successfully paid off your student loans.
So please share about, how you, , are a doctor on, on fire for that, for the people, you know, familiar with that terminology. Yeah. Um, now my wife told me not to talk too much during this interview. You may not want me on that topic, but, um, uh, yeah, I started getting interested in personal finance and, uh, the concept of fire financial independence.
Um, at some point in medical school, uh, after I had already racked up a ton of debt, of course, um, And I kind of carried that mentality with me through residency and into my early medical career. And so when I finished residency, uh, I had around $360,000 in debt. Um, and that was in, uh, November of 2017. Um, and so my number one goal coming out financially was, uh, to get that squashed.
So we, thankfully my wonderful wife was completely on board with that. Um, so we did not go and buy a doctor's mansion. We did not buy BMWs. Um, I'm still driving a, uh, Ford focus, um, which is fine. So, um, every, you know, basically every, uh, spare penny, I had went to paying off their student loans. And, um, so, you know, we finally got it done and it's a huge.
Huge huge relief. And with your kids being so little and with you guys being so young, this is just it's. Congratulations. It is, it is a, it is not an easy achievement, but you have, you've worked your tail off to do that. So congratulations. It's amazing. Thank you. Um, yeah, there's a, there's a lot to be said for financial freedom.
Um, and of course I'm not completely there yet because I do still have to work for money. Um, but I don't have to work as much as I am working. Yeah. And you're not, you're not, you know, digging yourself out of that hole as, uh, like you were before. So, um, definitely words, words to take the heart. And for those people who aren't familiar with the fire movement, just Google it and you can find out a ton more, um, just, just stopping there.
Do you have any resources that you, really latched on to when you were learning about the. Oh, absolutely. Um, so Mr. Money mustache is, uh, kind of my man crush and, um, If, uh, if I can encourage anybody to read any blog article, uh, my favorite blog article of all time is the shockingly simple math behind early retirement on the Mr.
Money mustache blog. And that one really opened my eyes to the power of frugality and saving and what you could really do and what, what kind of freedom you could buy with that. Um, so Mr. Money mustache is a big one. Um, physician on fire is a great one. That's targeted specifically to doctors and other, uh, traditionally high-income individuals.
And then the white coat investor is, is awesome. That's Dr. Jim Dolly, I believe, uh, an emergency physician and he comes at things from a little bit different angle. He's not, um, totally on the fire train. Um, but his, his financial advice is super sound and it was one of the first financial books I ever read.
Wow. Um, definitely great resources. And thank you for mentioning those. Now, as we talk about finances, you have a physical space for your clinic. So can you tell the audience about how you worked finding a space into your budget and how did you actually transition from being in your former work to being at Auburn DPC?
Sure. Um, so real estate was actually fairly hard to come by. Um, that was the most challenging honestly, piece of putting this business together was finding a place to do it. Um, and I, I kind of knew right off the bat that I did not want to go the straight up micro-practice route. Um, I didn't want to do everything myself because I hate paperwork and I hate answering phones.
Um, so it's awesome to have somebody doing that for me. But, uh, uh, contacted a commercial real estate agent here in Auburn. And, um, he was able to, to show me around this place and it just happened to be perfect. I mean, it just came together and this place was available, uh, right when we needed it. And it's, um, I've got my, my office room right here.
Right, right. Next door is my one exam room. And then I've got a nice big lobby and I've got a little kitchenette and, uh, uh, there's a storage room that had all this built-in shelving and these cabinets, which is perfect for a supply room and pharmacy. So it just, I mean, it was kinda serendipitous there.
Um, so we jumped on this one. Awesome. And in terms of, um, transitioning, did you take some time off between jobs or did you overlap the two? How did, how did you do the trends. Yeah. Um, so in early 20, 21, I was, uh, I was still working, uh, like three shifts a week and the urgent care, um, I had stepped down from the CMO role.
Um, but I was still working shifts, uh, to pay the bills and to accumulate a little startup fund for this business. Um, So, you know, working three shifts a week, I still had a pretty significant chunk of time to be over here. Um, getting things set up, you know, setting up the space and the order and what I needed to order putting furniture together.
And, um, this whole clinic is, uh, it's thanks to Amazon. Everything we got in here from Amazon. That's amazing. And so now a big question, because in Auburn, there was no DPC before Auburn DPC opened. And so I want to ask, as you made that transition, you have your clinic, you have all your Amazon orders, you know, set up.
Um, how did you, how did you open, what was your experience with opening day? Had you done a waitlist beforehand? Did you do marketing pre opening day? How did it work for you? Yeah, so, uh, prior to this, I had zero business experience, zero marketing experience. I had no idea what I was doing. Um, so I really just kinda dove into the DPC docs, Facebook group and ADA, every BPC resource I could find, I read Paul Thomas' book, uh, which was bright.
So a big shout out Paul Thomas for that. Um, and, uh, I decided to start with Facebook advertising. Um, and I didn't even know that you could run an ad outside of your actual, just boosting a post. So, um, I just started up the Facebook page for the business and, um, boosted a few posts and did my best to kind of explain what it was in a tiny little square.
Um, and anytime I, uh, encountered a patient in, on one of my urgent care shifts that needed a primary care doc, I would, um, kind of, you know, slip them a card and say, Hey, here, here's what I got coming up. Uh, if you're interested, I'll put you on a little wait list and I wound up having, um, Eight or 10 patients pre enrolled.
Um, but I had a patient at 9:00 AM when we opened on March 1st and he's still with me. Wonderful. That's so cool. And I do appreciate you sharing those numbers too, just because, you know, there, there are, um, amazing examples. Like, I don't know how Dr. Cassie Blackwell did her 278, uh, waiting lists on day one.
Uh, it's incredible. But I will say that, you know, for people who might be new to a community, if they've moved somewhere where they didn't train or, um, they haven't been practicing hearing, you know, eight to 10 on, on, on day one, that that's definitely a number that, um, doesn't sticker shock people. Um, and also gives a, you know, a realistic number is in terms of like, what finances could you expect.
So I want to ask there, um, did you have a pre enrollment signup fee so that you had some money on opening day? Nope. Um, I've never done an enrollment fee because I think that scares patients off a lot of times. Um, so the way we work it is your, your first month's membership dues are due, upfront. They're due on, uh, upon enrollment in order to schedule your first appointment, that's gotta be paid that covers you for the rest of the calendar month.
Um, and so everything is paid in advance and that way, you know, if you see somebody and then they never come back again, at least you were paid something for your time that you spent at that first visit. Absolutely. And so important. I mean, I remember Dr. Vans last, seen his podcast, talked about how he, uh, took a patient for a one-off visit and it ended up being a really significant pathology finding and the patient had to get a significant workup and he didn't really get paid for the time that he invested.
So I totally hear that. Now, uh, you know, over a year later is when we're doing this recording, you are in a very different position, patient number wise, and you still have not opted out of Medicare. And so I want to ask what, when you talk about that, you, you know, you didn't know you hadn't been trained in business and marketing, but yet here you are more with more, with more than 300 patients now.
Um, how did you continue to, you know, get the community exposed to DPC understanding BC and how did you grow your practice? Yeah. Um, so, uh, I will mention Rob about, um, you mentioned Medicare, uh, and I actually did just complete my opt-out like three weeks ago and, uh, we've already gotten like five Medicare patients.
Um, so that's definitely needed in our community. Um, and I was finally able to get that done. But, uh, as far as, how did we, how do we get the word out? How did we grow? Um, there were several, several different avenues that I took. Um, one of the things was I did my best to reach out to as many non-traditional groups as I possibly could.
Um, and, and really try to like talk to people that, um, a lot of times doctors are not actively pursuing. Right? So, um, one of my, one of my, uh, goals for Auburn DVC is to really be LGBTQ affirming and to provide, um, gender affirming care. And, uh, you know, if you're not from the south, you've probably heard a story or two, um, about how things tend to be down here and they're not wrong.
So, uh, As far as, as far as I'm aware. And we talked about this a little before we started recording. Um, I think I'm the only doc between like Atlanta and Birmingham, who's offering gender affirming hormone therapy. Um, but that has been a, a big source of patients for us. And that's not why we do it, but it's, you know, it has helped.
Um, so I started reaching out, like I said to, um, the local pride group, I reached out to, uh, an LGBTQ non-profit out of Selma, um, that we've partnered with to take care of their clients. Um, and of course I've done some more traditional things like, uh, going to chamber commerce meetings and just talking about what I'm doing and what DPC is at those places.
And then honestly, uh, as far as marketing goes, Facebook is about all I have done. Um, very recently I've worked with a marketing agency to try to promote my, my new, um, virtual primary care track. But, uh, prior to two weeks ago, it's been just me boosting some Facebook posts. And we've got a huge response from that.
It's it's, uh, I think it was Dr. Phil Boucher who had mentioned that, you know, the investment was not too much in terms of putting those ads, the independent ads, not just a boosted ad on Facebook and the return on investment for his practice as well was just incredible. So can you share, can you share some of those financials in terms of like, how much do you budget and what do you get to expect, uh, from Facebook ads in your.
Sure. Um, to begin with, I think I was spending like 40, 50 bucks a month on Facebook ads. And toward the end of last year, I wound up increasing to somewhere around 200 bucks a month. Um, and that's about the most I've ever spent on advertising. And, you know, just, just with the return on investment there, like, like, uh, Dr.
had said, you know, that's, that's incredible, especially if it's a monthly membership and they are with you for the lifetime of your practice. Um, and not only that, but there, you know, social media. So, so many free opportunities to reach your community members. So, um, in the beginning of last year, I was, uh, I was posting in the Auburn opelacka what's happening page and stuff like that, that, you know, my wife was posting in the local moms groups and stuff like that.
Um, and I've gotten a couple of patients from her, uh, moms of preschoolers group. So, um, you know, they're, all those things are completely free. Um, and they were they're legit. They weren't. Wonderful. And can you share a little bit more in terms of details as to what your patient panel is like now, in terms of, uh, you, you mentioned how you are providing gender affirming care, but in terms of like demographics, age groups, uh, who's insured, who's not, can you give a little, can you give us a little bit of a picture of, uh, who you're taking care of?
Sure. Um, and I don't have any exact numbers to give you because I really just don't track anything like that. Um, but kind of spitballing it off the top of my head. Um, I would say that the majority of our patients are, uh, mid thirties to mid fifties. Um, as far as, uh, You know, race, uh, socioeconomic status, things like that.
We really run the spectrum. I mean, I've got, uh, Auburn university professors. I've got business owners. Um, I've got, um, mechanics, um, people who dig ditches for a Linden, you know, I I've got anybody you can think of. Um, and there are different reasons that these different demographics, um, appreciate DPC and, you know, want to be a part of it.
And you've, you've, uh, you've read my mind in terms of, that was my next question. Why do these patients join your practice? Um, so I would say that the most common, um, thing that I hear is I can't afford health care anywhere. You know, I've been, I've been living with uncontrolled hypertension and diabetes for the past.
You know, 10 years and I've seen a doctor three times, um, this is incredible. I can't believe that this something like this exists. Um, so those are, you know, most often my patients who were, uh, lower on the socioeconomic spectrum and have had great difficulty with access to. Not only health care, but good healthcare.
Um, and, uh, and then of course on the opposite end of the spectrum with my more affluent patients who have Cadillac insurance plans, um, they're here for the, for the access and the convenience. You know, they wanna, they want a doc, who's going to sit down with them and talk through whatever they want to talk through for an hour and take good care of them and, um, know that, um, you know, a text message.
Absolutely. And I'm so I'm so happy for you that so many people understand what you're doing and have joined your practice. I want to ask in terms of when you were starting out and growing your panel to what it is today, um, one of the, the, you know, th the avatars that is hard for people to, uh, to convince sometimes, or to help understand the model is the well young person.
Why, why does a well young person who has insurance need a DPC doctor? What, what do you have to say to those people? Well, um, the first thing I tell him is my model may not make sense for you. Um, so I mean, I, I'm not trying to sell everybody on BBC. Um, I, I say here's what we are and what we have to offer.
And if it makes sense for you, we'd love to take care of, um, So, but, um, to answer your question for specifically, why don't, why do I think, um, that even somebody who's who's young, relatively healthy, um, may benefit from DPC. Um, I get phone calls from people every single day who have a problem they've never had before they've previously been completely healthy, but now they need a doctor and they can't find anybody that they have called every fee for service practice in town.
And there's, uh, you know, four to six month wait list. Um, and they're, they're relying on urgent care to try to diagnose the, these crazy symptoms or whatever it is that they've got going on. Um, and they have no access to care, but I can see them tomorrow. Yeah. And, uh, you know, if they had been signed up with me the whole time, then I could have seen him two weeks ago and you have such a unique perspective just because of your time in urgent care and looking out for, you know, nine clinics or nine urgent cares under your wings.
It's just, it's an incredible perspective to pull from when you're, you're talking to people. And absolutely I don't, I, I'm hard pressed to think of any community where people, where patients can't relate to those similar stories. Yeah. Now, one thing that I noticed, and I don't know if this is because you, like, you should shared, you have recently added this virtual practice, but I want to ask about, um, when you were deciding to incorporate this virtual practice, what was, what was the thought process there and how have patients, um, utilized that.
Yeah. Um, so we, um, we just started offering the, this new virtual primary care option. And, um, my, my thought process, there was, um, we're doing pretty good job at reaching patients here in Auburn, OPA Locka, but there are a whole bunch of patients, uh, out in the middle of nowhere, between here in Birmingham that have no access to care.
And, um, you know, in the same goes between Birmingham and Huntsville or, um, a lot of these other places, um, around rural Alabama, um, and even, even in the seas, um, where we're folks don't have access and we can provide that for them. There's, there's no reason to limit ourselves just to our little, you know, 30 mile radius right here.
Um, And not only that, but, uh, we're getting to the point now to where, um, our schedule is pretty full. Um, you know, we're seeing six to eight patients a day, depending on how many new patients I've got coming in in a given week. Um, and new, especially new in office patients take up a lot of time. Um, I think a lot of effort and, um, not only on myself, but on my, um, my everything, Marcy, um, and I'm not really interested in hiring more staff.
Um, so this is a way that we could potentially gain more patients, um, certain, you know, on my end, Gain more business and increase revenue and on the patients and take care of more people, um, without utilizing so many resources and taken up so much time in the clinic. Um, because if, if anybody has experienced telomere before you probably are aware that usually those visits run a little quicker, um, than having somebody sit down in the office and collecting their vitals and chit chatting about whatever they got going on.
When you're on a telemedicine visit, people tend to get to the. Um, so things just run a little quicker, a little smoother. Um, so that's, you know, that's kinda my thought priceless process behind, uh, offering that membership option. Wonderful. And yeah, it's so true. And you know, even just the idea that telemedicine with a DPC model allows also for both synchronous, as well as asynchronous care, it definitely allows you to be able to manage your time differently than if you were, you know, in a driven world of you have to be seen in person or virtually in person.
You can, you know, you can respond to people's questions by an email or by a portal message where it wouldn't be as easy before. Um, so now I want to ask, uh, with regards to your membership, because I saw on your website, I was like, where's his price is I can't find his prices. So tell me, um, in terms of, if you're, if you're able to share the pricing for your membership, as well as how did you come to your.
Um, so the processing is lifted, is listed there on the website. Um, but for, uh, no, it's fine. But, um, for adults, um, historically it has been $75 a month. And for kids zero to 18, um, or lyric 17, who sign up with a parent it's $25 and independent kids are the adult price, 75. Um, we actually just increased our membership prices, um, to 80 bucks for adults and 27 for kids.
So I used the 7% inflation rate over the past year to calculate that. And while a $5 increase, wasn't quite 7%. I didn't want to go too much more than that. Um, so, uh, that's, that's kind of where we landed and, um, to be honest, I didn't have a great reason to set the prices at that level. Um, but, uh, doctor.
Oh, Shonda Lou in Birmingham who owns Birmingham. DPC was one of the, one of the folks that I talked to before opening up and I went and visited him and check his practice out before I opened. And those were his prices. So I thought I looked pretty good. So that's where I'll set mine. Yeah. That's wonderful.
And I love that. You've also been able to pivot, to adjust for inflation. And yeah, I remember when I was developing my own practice pricing, I was like, well, I know people are going to use their credit cards most likely. So I was like, I'm going to bump up to expect credit card fees right now in my pricing, because you just, you know, I, I think I got that from Dr.
Julie Gunther's book sparks start fires, where she spoke about, you know, you think you're gonna like, uh, calculate for your overhead this way, and then add a certain percentage on top of that, just to cover your, your fees because you never know what to expect. So thank you for sharing. Um, now in terms of.
Your your numbers. You said you see six to eight a day, and I'm sure some, you know, fee for service doctors or people in residency who were working in an FQHC type of clinic, or just like what? That's not real. So they're like, is that a quarter of a day or a half a day? So, um, on that, I want to ask how do you strategize your schedule on an everyday basis so that you have time for you, you have time for your family, you have time to manage the practice.
How do you do it? Yeah. Uh, so our, our office is open nine to five, Monday through Thursday and seven to 12 on Friday. And, um, so when the office closes. And it was really as simple as that. Um, so as far as, uh, in terms of patient scheduling, um, my, uh, my office manager usually schedules most patients, um, and for new patients, we do an hour and 15 minutes and for established patients for most visits when you're 30 minutes.
Um, and so we just put them in whenever they want to be seen for the most part. And there's rarely a time when a patient calls and wants to come in on a particular day that we can't accommodate that. Um, and as I mentioned, um, you know, we, a lot of this depends on how many new patients I've got coming in on a particular week.
And that fluctuates, um, based on what time of the year it is, um, How much we've been advertising. Um, and, and, and some other just, uh, factors that I'll never understand, I guess, because, um, because someone's will, you know, we might get 30 or 40 new enrollments and then other months we might get 12. And, um, so in, in weeks where we've got lots of new patients coming in, we're a lot busier and those are more of like the eight patients sometimes non-patient days.
Um, but if we haven't had that many, then it may be more like four to six patients. And that leaves me plenty of time to fill prescriptions, to take care of business stuff, to answer emails, answer text messages. Uh, I really haven't come up with any issues. Um, as far as time goes for all those things.
Wonderful. And you talk about that you are still accepting new patients, so what's your ideal panel size that you envisioned for Auburn DPC? I don't know for sure. Um, I'm not, I'm not much of a planner. I'm kinda like, you know, we'll know when we get there. Um, I think, you know, like, like I mentioned, we're starting to feel a little busier and Marcy is definitely starting to feel the pressure as the phone's ringing more often.
Um, and, uh, especially as our kind of organic SEO has improved over time and people are just seeing us on Google when they are looking for PCPs, um, that has really increased the phone traffic. And so, you know, Marcy's is feeling that pressure. And of course I'm feeling the pressure of seeing more patients and responding to more messages and things like that.
And, uh, I figured that here pretty soon, we'll probably just come to a point where we're like, you know what, this is enough and we'll stop. You know, just as a dad of three young kids, I, I, the, before we started the recording, I'm just like, I, I want to know how you do it because you have one more child than I do.
And I'm just like, wow, he's, he's doing it with, with, uh, you know, 300 is what I ideally is my full panel size. So I would love if you have any, you know, things to think about for parents who are potentially with young children or who are going to expecting children in the future, who are thinking about DPC.
Um, first off is have an awesome spouse or partner of some kind. Um, because that, that is how it works for me. Um, my wife lane is incredible and she stays home, um, with our. Definitely with our youngest two all the time. Um, and my boy is in preschool five days out of the week, but that's only like a half day.
So, um, she, she kind of handled everything at home when I'm not there, which is awesome. Um, but as far as making sure that I've got enough time to spend with them, again, it goes back to at five o'clock we close. Um, so we don't have visits after that. You know, if patients call and want something that we don't offer, you know, um, my work schedule does it, uh, I don't get off work until six o'clock and you do visits after six.
The answer is no. Um, because that's when I'm with my family. Right? So it's setting there's there's boundaries and sticking to them. Yeah, absolutely. Boundaries is a, is a very good word to be familiar with and to love and entrepreneurship, for sure. And I love that even when you said, you know, and I go home, like it was, there was no hesitancy there.
I was like, that's the end of the sentence. I can't see you at six because I go home at five. So I absolutely love that. And, um, I think it's so important for people to hear that because setting boundaries early is definitely something that, you know, people comment on a lot about on the DPC doctors, Facebook groups, and whatnot about like, oh, you know, this, how am I supposed to, to control the texting or, you know, whatever it is.
And so really envisioning your practice as you, you know, um, as you go into the future, if, you know, re-evaluating periodically to say like, am I happy with this? How do I, how do I pivot if I'm not, um, it's really important to hear those words.
Yeah, well, of course I'll get text messages after hours and emails and my phone would ring, which I never answer. Um, let it go to voicemail and if it's an emergency, I'll call them back. Um, but, uh, as far as text messages and things like that go, if it's after hours, I'll look at it. If it is an emergency, I'll respond.
If it must be responded to then I'll respond. And if not, I'll respond when we open. Um, so if it's, you know, Friday at 1:00 PM, we're closed, you don't get a response on Monday. Um, and if, if patients aren't satisfied with that, and this may not be the practice for them. And I really think that's, uh, that's how most docs should look at it because I think most DVC docs are going to provide excellent value for their patients and they're going to take really good care of their people.
And, um, if there are particular patients who don't see that, then DPC may not be for. Sure. Sure. And just like you're saying, DPC is not for all patients. The same thing with physicians who are looking at this movement. Um, one of the, uh, one of the other pieces of copy that I had read on your website, um, when you talk about texting made me think about this is, uh, you, you had written, you know, included with, with membership is free telemedicine visits, uh, free procedures, free in-house labs.
So I would, I would love to hear, uh, in terms of the mindset that you were in, when that copy was made, um, some people say included, but I love, you know, I was like, oh, he said, he literally said free because it is included. And that's another way to say it. So how did you, um, how did you, you know, eventually get to that copy specifically and how do you changed it over to.
Um, I think, I don't think I've ever changed it. I think I started with that phrasing. Um, and anytime I'm putting any media together or, uh, advertisement, or when I was writing all the copy for the website, um, my thought is always I'll write it. And then I'll try to read it as a patient and think like, what would make me want to buy this?
You know what I mean? I mean, from a business standpoint, you have to, you have to do that. You have to look at this as a business. Um, and uh, people want to get things for free. Uh, they wouldn't want to get things included. They want something for free. So, um, you know, using that, that terminology, I think he was just a little, just a little, a little teeny, tiny monetary.
I love it. It's like, it's like the nines. Um, you know, the, the idea that it's 139 versus 140 it's only makes a, it makes an impact. Um, so now with regards to the procedures that you provide free with your members, what types of procedures do you think. I think probably just your run of the mill primary care stuff.
So a lot of skin procedures, you know, assist excisions, IMDs suturing, you know, toenails, uh, toenail removals, things like that. Um, biopsies punches, shaved excisions, PACS mirrors. Of course I don't charge anything to perform the pap. Um, but the lab charges to analyze that and give us a result. Um, so I'll make sure patients are aware of that upfront, trying to think of what other procedure, far body removals, you know, pulling bugs out of people's ears and stuff like that.
Um, um, nothing, nothing crazy, nothing special. It doesn't, it requires, uh, you know, an Orr or anything like that. But, um, I try to do as much as I can here in the house. Awesome. And that's, you know, that's the care that your patients value is like you're doing as much as you can. Um, and, and giving them that service at a, at a great rate for them.
So that's amazing now, um, I want to ask about your in-house pharmacy. You do stock medicines. Did you add on as more patients were needing particular medications? Um, yes. To both. So, uh, I kind of put together an initial, um, inventory with what I thought I would need, and I've just adjusted that over time and, and mostly adjusting means expanding.
So, um, I've added a ton of stuff, um, that I didn't anticipate needing at first. Um, my mental health sick section. It looks like a schizophrenia brain right now. Um, so, uh, yeah, I've added a lot of stuff. Um, but I have taken away some things that, uh, that I didn't use as much as I thought I would to. Um, and, but I think I S uh, initially when I was setting it up, uh, I spent about $2,000 or so on the initial inventory.
And then of course, you're gonna recoup that slowly over time, but you are continuing to buy more inventory. So, um, that I look at that as just an index, that initial investment in the business. Yeah. And you know, there definitely are, are many reasons to, as to why to keep overhead low. But I mean, for things like light a cane, the, at the time of this recording, there's a shortage Enlighta Canaan.
So I was like, wow, I see light again. And I can afford it. I'm going to buy two of those because I, I can't run it a lot of canes. So yeah. That's, that's awesome. And in terms of, as you mentioned before, you are sadly in the minority when it comes to, um, people who are looking for gender affirming care and in your area, you provide prep as well as, , when you were researching gender affirming hormone therapy, as well as prep, what, what resources did you use that other people could look to? Cause like I use UCF, uh, quite frequently for, for care, um, recommendations, but what were your, what were your resources?
Yup. Uh, so I ran through the CSF guidelines as well. Um, the indifferent society guidelines are kind of my that's like my handbook. Um, that's what I always go to as far as hormone management. Um, The, uh, trend transgender physicians, Facebook group, I think is what it's called. Um, there's a ton of great information on there and, and just so many knowledgeable physicians who are willing to help with any specific questions, um, because the topic can get fairly complex and I'm not a specialist in that area.
Um, so you know, sometimes my patients will have questions about certain things like, Hey, you know, some of the, some of the other girls are getting, um, X, Y, or Z hormone from somewhere else. What do you think about that? And I'm like, I don't know. I've never heard of it. Let me go, let me go talk to some people who know about it, um, or look up some guidelines.
So there's a, there's a great reason why. And I love that you have the time to do that. I mean, it's so it's, so it's such a common thread that people talk about when it comes to being able to work in the DPC model. You have the time to say, I don't know, but I will get back to you. I, I see that quite frequently on things that I, you know, I, I'm not, I might know a little bit, but I don't know as much as I would like to, to be able to share, you know, a full scope picture.
I mean, today I'm having a talk about crest syndrome and it's like, oh yeah, I got to do a little bit more reading as to current treatments for that, because I haven't dealt with somebody with crest syndrome in quite some time. So I love that. Um, and then in terms of when you are, um, when you're doing prep treatment, how is that managed, uh, through your practice as well?
Um, so prep is it's included in membership. Um, so it's obviously something that I'm going to take care of for anybody who needs it taken care of. Um, we actually, uh, worked really well with a specialty pharmacy out of the Bronx in New York, which is a place I've never been. Um, but, uh, maybe one day, um, And they, uh, they're awesome about getting folks, uh, prep, medications for free, whether they have insurance or not.
Um, if they have insurance, then they'll, you know, obviously build that and then work with the insurance companies to get that taken care of. If they don't, then they're great with getting patients set up with the, uh, pharmaceutical company's patient assistance programs, like ideally program. Um, so then the patient, you know, all I have to do is send the prescription up to Boca pharmacy, and they talk with the patient and they send me a little form of sign and then the patient gets their print delivered to their door.
It's super easy and it's very convenient for the patients. Um, and then of course we're also, uh, managing their HIV screening and, uh, and hepatitis screening and watching their renal function, all that good stuff. That's great. And, um, thank you for mentioning Boca pharmacy. What has been your biggest challenge so far?
My biggest challenge. So, like I said, in the beginning, the biggest challenge was spanning a space since then. I haven't had too many challenges. To be honest with you. It's really been smooth. Um, I have, uh, an awesome employee who, um, just goes above and beyond in everything she does. Um, I have a wonderful wife at home.
Like I said, that manages all that stuff at the house. Um, we have been. Extremely fortunate to have a community who has responded really well to what we're trying to do in our message. And we have super appreciative patients. We have, uh, an awesome EMR and billing platform, which is Atlas. Um, so it has really just come together and, um, we just kept on trucking.
And like I said, at some point we'll just look around and go, you know what? This feels like enough. So. That'll be it. When you, when you share that, I want to ask two questions. One is how did you come to find Marcy? And how did you convince her that, you know, this is, this is the way of the future for patients.
Well, it's money, I guess, because Marcy and I work together at the urgent care that I was with. And so she was an ma there, and then she, uh, she was promoted to a trainer position. And, um, so throughout the planning period, um, my wife and I, you know, we're always talking about things and, and I said, well, you know, we need to hire somebody.
Uh, wouldn't it. And we both said, wouldn't it be so awesome if we could get Marcy and. But I said, you know, I, I'm not gonna, I'm not gonna try to snipe her from this other company because they've treated me well, I'm not, you know, I don't, I don't feel right going and trying to pull her away from them. Um, and so we weren't really sure what we were going to do.
And then I get a text message from Marcy out of the blue that says, Hey doc, I heard you were leaving to do your own thing. If you would be willing, I would love to come with you. And my response was not. Yes, but hail. Yeah. So, um, at that point I was like, all right, this is her decision she's coming. So, um, then I have, I'm not having a bunch of folks from that company that, uh, that wanted to come along.
When I said, look, that positions field, that's amazing. And I'm so glad that it's worked out so well for you. That's awesome. And to follow that up, when she came on, did she make any comments about how this model is so different compared to what she's seen in other places? Oh, absolutely. And she still does like all the time, um, when she talks to patients on the phone who are calling, um, and have no idea what, what we are, and they're just looking for a primary care doc.
Um, I hear all the time up there of their talking to them. And she says, you know, I had no idea what this was before Dr. Adams, uh, started it up, but I have been absolutely amazed. And this is the coolest thing I've ever seen. Our patients love it. And I love it. So, um, yeah, I, I don't know that she fully understood it before she decided to come on.
Um, but she knew that she wasn't super satisfied where she was at and she thought that, uh, that. We would probably work pretty well together, which obviously we do. And, um, so, so she wanted to be a part of it. And have you, have you had any, you know, people to, to help out when you reach your full panel, other, you know, medical students or residents or other physicians who are interested in joining Auburn?
Um, I haven't had any, uh, any other positions interested in employment or anything like that. And I do get an occasional call from, you know, a pre-med student or something like that, who, who would like to come shadow and I've done that once or twice. Um, but usually I feel like I'm letting them down from a, you know, a medical experience standpoint.
Cause I'm seeing like sometimes I say three pages in a day, so that's not a great educational experience for them. And they, at that level, they don't understand, um, What the difference is between what my day looks like and what a fee for service they looks like. So they're, they're not really going to get the value at that point.
I don't think, and I, I hope that when they look back and see all of their rotations, I hope then at least they see the value of a happy doctor and a happy mercy are, are very different. And you don't necessarily see that in all fee for service practices. So now I asked you about your biggest challenge. I want to ask what's your biggest win.
Um, I would say my biggest win is when we got to the point to where us it, uh, I looked at the finances and realized that I could quit all other side gigs and I could support my family with just my income from over and DPC. Amazing, amazing. I had a physician who was asking about, you know, how, how does, how do you guys get reimbursed?
Like, because you're not taking insurance and, you know, the, the model, when I shared, you know, it's, it's like a gym membership. It's like a Netflix subscription. You have so many people paying that you this much per month and that equals X amount of dollars minus your overhead taxes, et cetera. And she's like, oh, that's it.
That's really it. Wow. It's so streamlined. And it's like, yes, this is why we get so excited about this as a, as a real way, to be able to practice medicine autonomously and be fiscally sound so, or be financially sound so. Awesome. Um, and so as we close, I want to. I want to share another quote with the audience that you had written, um, you wrote, do I worry about whether my new practice will succeed?
So clearly this is early on in your, in your journey. Every day, I worry about whether my practice will succeed. Direct primary care is a new concept. That few people in our area have ever heard of as with any new idea, it's a risk, but I believe in what we're doing and it's a risk worth taking. I get to practice medicine the way it should be, the way every bright eyed, new medical student thinks they'll practice.
I get to put my patients first and I've got no one else dictating how that needs to look. I believe that direct primary care is in solution to so much that is broken in our current system. And I'm thrilled to be bringing this new model to our community. So now I want to ask, do you worry now about if your practice will succeed and how does it feel to be your own boss?
Yeah, I think those worries are gone at this point. Um, you know, my worry now is when did we stop? Um, and being your own boss is great. Um, uh, I get a lot of questions, um, from people who hear about this practice, you know, will, are you going to continue to expand? Are you going to hire another doctor? Are you going to bring on a partner?
And I'm usually like, no, I don't think so. I don't. I like just being able to come to work everyday, do what I want to do, run my business the way I know it needs to be run and take care of people the way they need to be taken care of. Wonderful. And Dr. Adams, just in terms of you shared amazing resources so far the Boca pharmacy, uh, the, uh, money Mr.
Money, mustache, um, what other resources would you, would you say people should definitely look into if they're exploring the space about DPC? Well, again, I'll mention Paul Thomas' book, I think is in it called startup BBC. That was a, a really comprehensive guide. Um, that helped me out a lot. I read that book in the delivery room, a rival tour delivered my third baby.
And then, uh, continued to read it in the postpartum room. Um, so that was a great resource. Um, the DPC docs Facebook group again, is awesome. I can't say enough about that. So many helpful, uh, voices there and tons of guidance. Uh, so many experienced DPC docs there. They can answer questions about anything involving this whole process.
You know, I think that that's just about all I need not needs to get this. It's it's incredible though. Right? We think about how many, you know, hundreds of thousands, if not millions of dollars were spent to go to medical school and you just broke it down to, you know, maybe a book here and there and some Facebook posts, but this is a different community where, you know, when you need help, there's somebody who can help you.
Um, you just have to ask for it. So I encourage people if they're even thinking about how I should probably learn some more about this, you know, Google your area DPC and see if there's somebody in your area who you can talk to or go on, you know, the, the mapper, the DPC Alliance website, there's listings of physicians who are doing this all over the country.
And so on that note, how do people contact you after this. Anybody that wants to get in touch with me is more than welcome to email me. And my email is D R as in Dr. D r.Adams@auburndpc.com. They can go to my website and do a little a message at the bottom of the website if they want to do it that way.
Um, but those would probably be the easiest ways to get ahold of me. And, um, I would be more than happy to chat with anybody that's, uh, you know, looking to make a DPC practice happen. Perfect. Thank you so much, Dr. Adams for joining us. Well, you're welcome to play for having
next week. Look forward to hearing from Dr. Tiffany Blythe, Glu Lotus family medicine in Lee's summit, Missouri. I hope to meet many of you this week at the hint summit. And if you haven't yet registered, but you can make the event register firstname.lastname@example.org. And for those of you who are unable to make the hint summit, but are looking for an in-person networking event, the DPC summit in Kansas city, Missouri, this July 15 through 17 is your next opportunity.
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Transcript generated by AI, so please forgive errors.