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Episode 85: Dr. Tiffanny Blythe (She/Her) of Blue Family Medicine - Lee's Summit, MO

Direct Primary Care Doctor

Dr. Blythe is a DPC physician
Dr. Tiffany Blythe, DO

Dr. Tiffanny Blythe grew up in rural Alabama idolizing the rural country docs. She had an early passion for medicine and dreamed of providing simple, life-saving care for everyday people. While getting her degree in biomedical sciences from the University of South Alabama, she held multiple leadership roles and volunteer positions. She went on to get a Master of Educational Psychology from the University of Alabama simply for the joy of learning. In medical school, she wanted to focus on how to care for humans, not simply how to cure diseases. She found that at Kansas City University of Medicine and Biosciences. Here she also learned to use her hands in what is called osteopathic medicine to diagnose and treat what the body knows is wrong but what cannot be detected by labs and xrays. Simultaneously, she obtained a Master of Business Administration in Healthcare Leadership from Rockhurst University.

After this solid foundation in business and medicine, she was fortunate to learn from the compassionate, highly-skilled leaders at Maine-Dartmouth Family Medicine Residency to hone her skills and broaden her knowledge of primary care, including hospital medicine and obstetrics. Dr. Blythe is proud to offer superior, full-spectrum primary care for everyone in the family. She finds all aspects of medicine fascinating and loves the variety that family medicine provides. But her greatest joy is in providing women’s health and helping a family welcome it’s newest member into the world.

She opened Blue Lotus Family Medicine in July 2017.





FB: @bluelotusdpc


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I decided to open a DPC clinic, quit my well paying corporate job because there was no other option for me at the time. My options were leave medicine altogether or find a better way to do it and so I am ecstatic five years later to still be doing Direct Primary Care because it allows me to be a full human, a mom, a wife, a as well as a competent engaged doctor and patients to simultaneously access, helpful healthcare and truly that's the way the system should be.

I'm so to be doing this. I am Dr. Tiffanny Blythe of Blue Lotus Family Medicine and this is my DPC story.

Welcome to the podcast Dr. Place.

Thank you so much. I'm happy to be here.

So I think this is such an exciting interview. You know, one, because, you are just outside of Kansas city where the summit will be happening, but also because you have roots in Alabama and our last podcast featured Dr. Kyle Adams in Auburn, Alabama, and as somebody who during pride month during this time of, you know, tumultuous everything in our country, I love that you're coming onto the podcast to share how you've applied your training in business, your training

in psychology, you're training in medicine, you're training in osteopathy and taking it all and making your DPC a place where you can practice all of those things for every single patient. So again, thank you for being here.

Thanks. And as I mentioned, you're in Lee's summit, Missouri.

So for those people who are on, are not familiar with the geography there, can you share a little bit more about Lee summit? What's the population like and where, in terms of where your practices are there other DPCs around you or other corporate medicine, locations around you?

Yes. So I feel really fortunate to be in the area that I'm in.

I call Kansas city DPC. Because there are tons of other DPCs within a very short drive and we actually do get together quite frequently. So there's a lot of communion. There's a lot of sharing of resources. Teaching, you know, from the older, the people who have been doing this longer than we have.

So, this community is so great to do DPC, but it's also, I was a little worried when I first started DPC because there are also a lot of hospital systems. And they've purchased, you know, pretty much all of the private practice doctors at this point. So what I was most worried about. When I was thinking about transitioning to DPC was actually losing community with other physicians.

Because I was like, well, I'm going to be by myself. It's going to be a solo office. I'm not really connected to anybody. But it's fine. I'll just have to figure it out. You know, I have to do this. And so, and now I have a better community of physician colleagues and friends than I ever could have imagined otherwise.

I totally agree. And you, before we started recording, we were talking about our why's and in terms of this podcast, that the community, I feel it really is so lively and so supportive because one, we have a shared, experience in fee for service. For the most part. Some people don't have experience after residency, but still they understand the hamster wheel, the golden handcuffs.

And because we have this shared background to build off of, plus we have the time and we love our practices. We have the time to be part of the community versus in fee for service we're.

So I got to do my charts. I can't talk to you. I have to be done with them in 72 hours. So I totally agree with you there.

And I find that actually is a really surprising, valuable piece of DPC because. As we know primary care has been devalued extraordinarily over the decades. But when primary care doctors were more integral, there was a community doctor and everybody, you know, they were part of boards and volunteer committees.

And, you know, everybody knew a doctor and we rubbed elbows regularly. But now corporate medicine is so grueling. Literally nobody has time for that anymore. And anytime we do show our face, it is mandated and it's usually unpleasant. And we're usually, uh, having to burn the candle at both ends to make that happen.

So I really enjoy that. I'm able to be a physician and a voice for the community and a resource for patients for good medical information.

And now you mentioned, you know, what, what medicine used to be like for the primary care physician. And I want to go back to your roots specifically, because like was mentioned in your bio, you grew up in rural Alabama and you were idolizing the rural country doc.

So can you tell us about what you saw when you were growing up that made you idolize these people who were rural

doctors? Yeah, we grew up in a really small town. And so, you know, it's one of those places where everybody knows everybody and the doctors were revered.

And so they were always like, oh, Dr. So-and-so is my doctor. And we're like, well, Dr. Sue is always like team Mullins or, you know, somebody else. And so it was, it was really nice to have that connection and it was very easy to get an appointment. You could just. Hey, Dr. So-and-so, I have such and such going on, I needed appointment and you'd have usually that same day.

And anytime you needed something, it felt very accessible to just go have a real conversation with a real person, with real resources and answers and then come out the better for it. And so I was like, this is magical and I have to do this when I grow up.

And I'm sure that there's some people listening who are just like, yes, yes.

She understands me. So now let me ask you, can you paint a picture as to how your exposure to that, that doctor who you could easily access and your training with your MBA, your educational psychology masters, how those impacted your training and residency?

Yeah, that's it, it was a little bit of a twisted Uh, Turney road for me, I suppose the truth is I was one of those kids that when you said, what do you want to be when you grow up? I literally always said doctor. So it's kind of honestly felt like just something I was born with. It was a calling that I just knew that that's what I had to do.

And it's the thing that felt the most right for me. But I graduated undergrad in biomedical sciences and, you know, the whole point of graduating undergrad in biomedical sciences is to launch into med school. And that was my purpose and my goal. And I very much wanted that, but I didn't feel done learning.

I just felt like. So many other things that I still needed to like explore. And so that's literally why I just decided to go get a master's in educational psychology, partly because I knew that in order to treat humans, you have to understand them. And a lot of times humans don't understand themselves.

And so knowing that piece of how to get to the deeper level of what somebody needs to heal, it would make me a better physician. And so that was Expanding my self and my worldview, but also still preparing for that future career. And so then I went into med school and the funniest thing about this is yes, I did concurrently get a medical degree and an MBA, which now looking back on, it sounds absolutely psychotic.

I don't know why I did that. But the funniest part about that is that I did it because I hate business. And I said, I'm never going to own a business. So I don't know why I would get this degree, however it's hard. And so that means I should do it because it was something I didn't really understand.

It was something that did not at all come naturally to me that I did not gravitate towards. And so I felt that if I had the opportunity to learn something like that, that I should take that opportunity and, you know, look where I am now, I own a business. So

that's incredible. And especially for you to have that training with medicine, you know, it's, I, I love when I hear people talking about having the dual degrees, especially in business and when it comes to medicine, because yes, DPC is a as a model, as a business.

But I want to ask there, when you look back Uh, getting your MBA. What are some of the key things that you pulled from the beginning of your clinic, when you were in the planning stages that you would challenge other people to think about when they're, you know, doing the business side in terms of planning for their own

Yeah, thankfully I was pretty lucky that my med school partnered with a local university and they ran, a masters of business administration in healthcare leadership. So it was very healthcare systems oriented. And I think a lot of people use that background and information kind of to squeeze every penny possible out of the medical system and like make it more profitable.

But it really helped me to see ways that I could use that to my advantage and use that to the patient's advantage ways that we could cut out the middleman or make a system more efficient. And so. I didn't realize it at the time, but now looking back on it, I sort of absorbed that training, like a mole, like how can I take this information that they give me and spin it to my advantage.

And in terms of, when you talk about that, you didn't realize what are some of the things that you notice now where you're like, oh my gosh, that totally is my MBA being put to work in my


I can say that the biggest place is, leadership of your staff. As physicians, we wear many hats anyway, but as a physician business owner, it's a ton more hats. And I. Have learned how to fit into the boss, owner leadership hat in a way that I didn't fit so well into it in the beginning.

And so I think I fall most heavily on my MBA training with managing of the people and the staff and doing things like the actual book keeping and the procedural manuals, you know, like those like very business, like things that you have to do in order to run a business. And, and I'm, I'm glad for that because that's the stuff that doesn't come naturally to me.

I'd rather just sit in a big circle and have a communication. talk with people and, you know, just like, yeah, whatever you feel like doing today at work is totally fine, you know, but I found that that doesn't work. People need to be told what to do and how to do it and not in an authoritarian way, but in a, like, these are the expectations, however you get it done is fine.

So I've had to be a lot more structured than I normally comfortably would have been.

With that. I want to jump back for a second and ask you, how did you end up learning about DPC? Because I know you said that your areas at DPC Mecca, but When you were leaving corporate medicine fee for service medicine, and you decided, did you DPC? How did you learn about the movement?

Yeah, I

feel like I stumbled upon it actually. Like I was immersed in and didn't even know it. And so I just got to an intolerable pain point with my corporate medicine and I seriously was just considering being a janitor or literally anything else. Like I was like, if this is what medicine is today, I don't want any part of it.

And so before I jumped completely off the deep end I actually called up my osteopathic state medical society and I said, Hey, I hate my job. Do you have any ideas? And they said, have you heard about direct primary care? And I was like, I have not keep talking. And so he was like, oh, it's really great.

You should look into it. So I started Googling and I found somebody that had a DPC clinic, I think in Iowa. And I was like, oh my God, I have to talk to this person. So I stopped her and I got her email. And then I emailed continuously because, you know, it takes a little while sometimes to get to the person.

And then she was finally like, oh, okay, I love your enthusiasm. But I think all of your questions can be answered by getting on this Facebook group. And so I was like, I hate Facebook. But okay. If that's how I have to get this information, I'll do it. And so I joined Facebook literally just for this group.

And it's been an amazing journey ever since then. And so from that moment that I was told. Have you thought about DPC until I opened my doors was six months.

Amazing. I want to spotlight the moment that you gave notice. What was that like? Because for me, I know I literally, you know, this is me being a podcast.

I literally recorded my reaction after I sent I press send on the email. And so I want to hear what your experience was going into giving notice. And what did it feel like after you had said I'm done?

Yeah, I knew in my head, in my heart that I was done with that place before I told them. Right. Because my type a personality major breadwinner of the family, I couldn't afford to be flippant about it or, you know, like throw a temper tantrum.

So even though I was like, I have to get out of here and I knew that I would, I didn't really know how so I couldn't really communicate that just yet. So for about three months, I kind of like worked in secret. And that was my armor during that time, because once you make the decision to leave corporate medicine, it becomes increasingly uncomfortable to stay in that system.

It, it honestly just felt like, an abusive torture, a system where I was being held prisoner. And so, every day I have to go into work and leave my family. The only thing that kept me going was knowing that I had an escape plan. So when it finally came time, when I was like, you know what, this DPC thing, I've tried to poke holes in it every which way.

And I really, I think it's gonna work. I crafted my letter of resignation and I was before. Ecstatic and incredibly nauseated the entire time. And I was like, I cannot believe at the time I had four kids. I cannot believe I have four children and a mortgage, and I'm about to quit my job, who does that.

Uh, but I, I said, I don't know who does that, but I have to. And so I typed it all up and I felt really good about it. And I went in and I gave it to the CEO and, you know, I, I, I think he was just kind of really ho-hum about it because they turnover doctors left and right. Yeah. They'll just, they'll get another doctor or they'll get a mid-level and, you know, not really any skin off of their nose.

And when I realized it took me almost three entire years to realize that they really didn't care that I was there, they didn't care what ideas I had and how I wanted to make the community better and how I wanted to make the clinic better. And, and what resources I wanted to bring for my patients. They sold me in the beginning because they bought into all that and they're like, oh yeah, we're going to help you implement all of that.

But you know, towards the end of my third year, I was like, huh. Yeah, they really don't care. So I was like, okay, so now I'm in this system that I feel held prisoner to. My patients are not getting the healthcare that they are seeking and that they think they're getting my family is getting the short end of the sick because I never get to see them.

This is a lose, lose, lose for everybody. And then I started to have a moral dilemma about continuing in that system that I knew was so broken. So I was like, how can I, as an ethical physician, continue to go in and give lip service to this care that patients should be getting, knowing that they're not getting the care they need and then go home every day and try to lay my head on my pillow.

It was, it was intolerable. I couldn't reconcile that. And so while leaving was terrifying, absolutely terrifying for quite a long time. I knew that it had to be done. And

what happened after you gave the CEO your, your letter?

You know, my biggest concern was going in there and, as physicians, I think we're used to being people pleasers.

And so I was worried about. You know, what is this guy gonna think of me? And I had gone in not intending to leave a job. I don't think anybody does. And I had gone in, to this rural, underserved position saying I'm going to be different. I'm going to stay longer. I'm going to turn the community around.

And so to make that decision to leave it, it actually affected me a lot emotionally. And I was a little bit sad to leave, but then as soon as we had that conversation and that meeting was over, I was just ecstatic. I felt like a weight had been lifted from me that I hardly even knew I was carrying.

And, I could literally see a happy future and career where a few months before that, I didn't see that anymore.

So well deserved, you know, you, you put your, your heart and soul into learning how to take care of people and. You continued to have that desire. And then now you had the freedom to go along with, that desire.

Earlier, you said, and I love this, this phrase, you said helpful healthcare. When you quit your job, when you felt that static feeling, when you were like, okay, I'm doing this, you had the beginnings of your clinic already started.

How did you envision blue Lotus family medicine, providing helpful healthcare with all of the training that you were bringing to the table for your patients?

I've always wanted to go into primary care and I truly believe that good primary care should be the foundation of any healthy society because as primary care physicians.

Uniquely situated to sort of touch all of the things that can affect a person's health and wellness. And so my goal in, in starting a DPC was to have the time and the resources I needed to connect patients to whatever it is that they needed. If it was a social worker, if it was a lower medication costs, if it was a program that helps them pay their water bill if it was transportation to get to the clinic, whatever it was that was going to improve their commitment to their health and improve their health wellness.

I knew that that's what I needed to be part of my clinic in order for me to feel like I was being a successful physician.

And when you were planning the days before you were opening, can you recall, what are the things you had in place that you would consider MOUs for other DPCs as they're open.

So I really I'm very type a very typing. And so it was really nerve wracking to me to think about going from walking into an established clinic with a corporate job to now literally building something from the ground up. Like I have to make every decision about where to put the paperclips and where to fax the files to.

And so I agonized over that for a really long time. And the only way I got past that and was able to actually move forward was taking some advice from the veterans in that. it's my favorite my favorite quote from that is ready, shoot aim. So I was like, okay. And I had to say that to myself several times, because, so when I actually finally first opened, I honestly can say I didn't have much in place.

I had my. I had my billing system. I had my communication system and those things I was very sure about. And I had a printer and work and my stethoscope and, uh, I actually got really lucky that with networking and again, kind of talking to my medical society and figuring out how am I going to make this crazy dream work.

I stumbled upon this doctor who was in the, the later season of his career and was having trouble making his overhead and his private practice. And so we struck a deal where I rented a room from him. And so essentially I tried to stay out of his way as much as possible cause he was. He's an older generation male physician.

So, I was like, okay, so he's being nice enough to lend me this space for lots of money. I'm going to try to stay out of his way as much as possible. So my whole DPC world really revolved around this 200 square foot room.

And in terms of the 200 square foot room and the things that you have, including your printer, and I'm sure some paper clips are in there too.

You mentioned the favorite clips. But how did you then get the word out into community that you

were open? I did exactly what all the veterans say. You just have to like quote pound the pavement. And so, you know, in the beginning You have to just go to literally every community event possible. The F the thing that I found the hardest about selling myself was selling DPC because people did not understand what that meant.

And at first glance, a lot of people take it to be a money grab or yeah, like more like concierge medicine. And so it's like for the rich people only. And so to convince people that I wasn't doing this just so that I could buy another yacht or that I could be exclusionary to rich people. That was the biggest hurdle to get over.

What were the questions that you crafted answers to as you kept pounding the pavement, so to speak?

Some of the most common questions. Why would I go to DPC when I have insurance? I love to answer that question because people, especially Americans, these days are so attached to their insurance and they have no idea how toxic it is to them.

And so to just, you know, there's a small fraction of our. Population these days, that has what I would consider good insurance. It doesn't cost them a ton of money and when they need it, they're able to access services in an affordable way. Right. That's what, that's what good insurance should do. And a very small portion of people in our society actually have access to that kind of insurance.

Most people either have a plan that is very expensive and is either a stretch for them. So they have to cut out other things or go into medical debt or they can't get it at all. So they sometimes have it sometimes don't depending on their finances or they have one that may be more affordable, but really doesn't cover anything.

They can't afford to go to a specialist because they can't afford the high copay or they can't afford to have the gallbladder surgery that they need because they have a large deductible and or copayment that they have to pay. So. To actually help people understand that insurance is not healthcare access and it is not the safety net that they were made to believe it was decades ago.

Is really one of the best things about having a conversation about DPC with people. Because once you can find that thing, they're like, oh yeah, I actually do spend a lot of money out of pocket. Then they start to realize, and the light comes on. And once you get it about DPC and how broken the other system is, you totally get it.

Hook, line, and sinker. Like, There's no convincing at that point. So either somebody. Kind of easily gets to that place or they're not going to. And so I, and there are some people that are in love with the medical system and they really love their insurance. And that is great if they have that perfect.

You don't need me, right. There are plenty of people who do. So those people, I don't, I don't try to convince because they don't see the value in DPC and that's totally fine. I think there can be lots of different systems for different people. And it's the people that need me are the people that I want to sell to.


when you had just opened, when you were growing your practice and people would, would ask you that, did you ever feel any , , any doubts or any bad feelings about, well, gosh, , why doesn't this patient understand what I'm trying to bring to this community?

Given that you had for years already been trying to change your community in your fee for service job?

Yeah, that was actually really hard for me. And it's mostly because I take my professionalism and integrity very seriously. And a lot of times people's initial reaction is to call both of those things into question.

And so I had to train myself not to be immediately offended and hurt and just remind myself that patients literally, they just don't know. And so I had to know that in my heart, I, I knew what I was doing was not, profit driven, uh, and it was literally just about being a good community physician.

And so I had to let that be my guide, and if I could help a person understand that then great. If they weren't willing or able to understand that's where I was coming from. And that was my goal. Then there was really nothing I can do to change. but it was really hard for me at first to have all these conversations with people and then for them to immediately hate me or think that there was something wrong with me as the person when literally all I want to do in my life is help people.

Yeah. And like you talked about it, physicians, especially primary care tend to be people pleasers. But , I also want to pull from your earlier comments about the community and I definitely encourage people if you're ever in that spot of. What am I doing? Having guilt, having doubts, having fear of, you know, whatever it is, turn to the community and talk to another physician and just, you know, you can put it anonymously.

You can have someone post for you, or you can post on your own account. But in these Facebook groups that we have now especially when, when somebody posts something about, you know, I had, I had this happen and I'm not sure how to react to it, or this is how I'm reacting to it. You get a lot of feedback from all over this country as to how other people went through the exact same thing.

Um, This is how people have learned. And like you said, you know, you now love answering that question because you have heard the, the feedback, whether that be positive or negative from these potential patients or people learning about your practice early on.

Now going from the questions that you were getting from people as you were growing your practice, how did growth work for , blue Lotus family medicine?

Well, I can say that my situation is a little bit unique. However, I do believe it can for the most part be replicated.

So I was really quite fortunate to be at the right place at the right time because Sesame care, are you familiar to me care piloted their first program in Kansas city. And we actually knew the doctor that was in the ground floor of like working with the corporate people to get that ready. And so he came to us and said, Hey, you DPC guys, this is a really great opportunity.

You should do it. And we all thought it was a little hokey and like, I don't know why we would do this. And this kind of sounds like a hassle, but it's for you, my friend, uh, DPC doctor. So sure. I have some extra time and space. I'll go ahead and do it. And it was pretty Rocky for the first year, but after that platform, and that concept was built upon and started to take a foot hold.

I had to slow my growth because it was so exponential. And what they did for me that I wasn't able to do for myself in the early moments is advertise a doctor's visit for money. And, and that's when my thinking about DPC changed completely because there's a lot of exclusivity. Sometimes when we talk about the DPC community and like, if you're not in the DPC community, you can't see a DPC doctor because we don't want to give our services away for free.

And I believe in that, right. Don't undercut yourself, but people understand a cash transaction. Sure. They don't really understand a DPC membership. Like who are you? What is DPC? Why am I paying you all the time? That doesn't make sense to them. So the fact that Sesame was a platform where they could say, Hey, this doctor is willing to see me for a cash price.

And then they paid that price and came to see me. And then I was like, yeah, this was a really great interaction. If you do need healthcare. And you're interested in coming back, we have this membership program and here's all the reasons why it's great. It was the easiest sell you could ever imagine. Once people understood who I was and what I was doing.

It sold itself. And so what's interesting about the necessity platform. And I've tried to tell a lot of physicians this, a lot of times they don't believe me, but you have to basically give those appointments away. My prices on there are about anywhere from like $34, all the way up to 75 is a very expensive visit for me on that site.

But most of them are in the 30, 40 maybe lower fifties range. And people are like, well, how, like, why would you ever sell yourself so short? Don't think about it like that. If you think about that is that patient is paying you to market to them. And then they're able to market to all of their friends and family, which is exactly what has.

Then it's an investment and it's investment you're getting paid for. So don't think of it as losing money on the potential that you could have sold that appointment for. It's more that you're now capturing an audience that is right for DPC. It is a patient looking for healthcare that is willing to spend money on it.

Now, in terms of Sesame hearing about your experience, especially how to think about it as an MBA, I want to ask, does it cost money to partake in Sesame?

So currently it doesn't we are, I think they're in there for. Your and there has never been any doctor investment whatsoever. I imagine that they will continue to do that. They say that that is their, their goal their business plan to continue for that. So, I have yet to see any downfall, honestly, it's, it's been really great and it costs me really nothing other than some appointment slots that I'm able to control when I offer those.

Awesome. And when you talk about the price difference between a membership at your practice versus a patient, who's finding your practice via Sesame. I want to ask about how did your pricing start and where is your pricing today?

I struggled a lot with pricing. Partly because I grew up in a small rural area, it came from family with really no resources, very poor.

And so money was always a really weird part for me. And also because I feel like healthcare is a human right. And so it felt very counterintuitive to me to charge people. So I tried to say, how can I provide health care and really not make any money at all? Right. Like just barely cover my living expenses.

That's essentially what I did for a very long time. It was like, how can I just not really make any money? But like be a doctor. And so that's essentially how I calculated my prices and that's exactly what happened. But as you can imagine, that's not really a sustainable model because, you know, then there's like taxes and then your car breaks down and needs to get fixed.

And then your furnace at the office breaks, and you have to get a new one and, you know, all these fun things that happen in life. And there was like no padding for that whatsoever. And so I was like, this is not gonna work. And so unfortunately I'm going to have to go back to the drawing board and figure out where am I going to be comfortable?

What is a reasonable price to land on? And I realized. In order because I took what I was making and what I could tell was the deficit. As in, you know, the amount I had to put on a credit card or the amount I wish I had that month that would have made things a lot easier and did the math to figure out what I would have to raise it to.

I needed to go from an average of about per member per month to about 65. You know, it's, it's, that's not a small jump and there are some of my colleagues that really agonize over a $5 and they're like, oh God, I got to raise my prices by $5. I raised 85% of my patients prices from 50 to 75. We gave them notice.

We gave them three months notice, and then here's all the things that I can do for you. Look at all the things that this membership benefits you and all the skills that I have and the resources that I can give you. And if you think it's a good fit, we're happy to still have you. And if not, we're happy to help you transition to somewhere that fits you better.

But I think I lost maybe a handful of people in that transition. And most people have had no trouble at all, but the other thing that raising my prices has done for me, and this is the thing that makes me most happy. And I think this is the only reason I was able to make that big transition was because when I am able to charge people who can afford it a little bit more, I'm also able to give care way.

And so we have a pretty active scholarship program. And when I can tell that patients are having trouble making their payments, we just reach out to them in a very non-judgemental way and, and approach them and say, Hey, if you're having trouble, we'd be happy to put you on a scholarship. And what I love about our scholarship program, you have to understand that people don't value things very much, that they get for free.

So we make them still have a little bit of skin in the game, but they can give as little as $5 a month. So I say, what would be more comfortable for you? And you'll be surprised. I mean, sometimes people are paying 50 and they're like, well, it would be more comfortable if I were to pay $40 a month. Okay, sure.

Let's pay 40. You know, or if somebody says, well, I was really a lot more comfortable at the $50 a month. And then 75 is really stretched for me. And I'm like, okay, let's do 50, you know? And we can reevaluate that at any time. And so it allows me to feel more comfortable. Having availability for people who maybe can't get to that mark that maybe is a little bit more of a stretch.

And so I'm still serving that purpose that, that feels so integral to me in serving an underserved population.

Definitely. With your scholarship branch of your practice, how do you select the people who benefit from these.

Yeah, I just, they, they ask me or I see that they're not paying there's, there's no application, there's no criteria to meet because I didn't want to be the gatekeeper of all of that and make people prove to me that they could or could not pay because I've been in that situation.

Like I'm a physician and I make a pretty good salary, but I have very often been in a position where bills were hard for me to pay. And so the, a person's income doesn't necessarily tell you what a bill they have to pay on a month to month basis. All sorts of things can come up. So, uh, I'm not the gatekeeper of that.

I just, uh, believe that if I put Goodwill out, it will come back to me. And so if I can see that somebody is late on their payment, we try to follow up with them. And sometimes, you know, if they're having money. They, they kind of avoid you for a little bit and they won't answer your calls and they won't make appointments.

And so then we kind of get like, try to be aggressively helpful and we send text messages and say, Hey, we're very willing to work with you. Just give us a call back. And then that kind of pulls them out and there. And I've had a number of people break down in tears because they're like, I love it here.

I've never had such good healthcare. I just didn't know how it was going to continue to afford it. I'm so grateful to be able to continue care here. Well,

and especially given this pandemic and you know, Dr. is tearing up right now. You can tell, I mean, you can tell from your voice, but you can definitely tell, you know, your, your whole soul is in your practice and your, the care that you give to the people that you are, you know, fortunate to care for us.

So that is so awesome that they also see that value proposition that they value you as a physician as well. So that's amazing.

Did you also take out loans or did you work any side gigs to support your practice so that you could continue giving the care that you wanted?

Yeah, absolutely. I mean, that was definitely a crunch to make both of those things work at the same time, but I did not want to take out any more loans. I have plenty of them.

Um, And so I was like, I have to be able to sustain my family and find time to make this practice work, because this is, this is the goal, right? And so if I'm not nurturing this practice, I'm never going to be in a better position than I am right now, handcuffed to corporate medicine. So I was really fortunate.

I think that I have a lot of unique opportunities because I am in a fairly large metropolitan area. There are a lot of opportunities for doctors like locum tenens or part-time work. I eventually found this job where I was I was doing home-based care. But. The company that I was working for was contracted by insurance companies.

And so we ourselves didn't have to be opted in. So it was an opted out gig. And I wasn't paid by the insurance company. I wasn't reimbursed like fee for service. It was just a, a global care fee and it was really great cause I got to drive around to people's homes and it, it even working part-time about 25 hours a week.

I made as much money as I was making, working 60 hours a week at my rural corporate clinic where I was simultaneously being told to work more and work faster. And so it really put that into perspective. Wow. I was really taken advantage of, and I sort of knew it, but now I'm making the same amount of money working a third of the time.

This job in itself is more fulfilling. And so it was really nice to be able to have that not have to take out any more loans, make a reasonable living again, nobody was getting rich here. There was no yachts purchased. But I was able to pay my mortgage and have time to still nurture the business and get it growing.

when you were in that, that stage of really thinking about how you were nurturing your business. What, what type of structure did you have even within your week? Did you have days that you focused on certain things or days that you saw your patients versus, uh, other days where you would go and do these home visits for this particular


Yeah, so I had set days for the company and it was Tuesday Thursday, Friday. And even within those days, I'm, I'm either in with a patient for awhile or I'm driving to the next patient's house. And so I have some time to take a phone call or answer a text message that comes through, which is why those systems were so important to put in place as the number one thing. Even before I had a building, I knew that I had to have communications platform.

And because that is one of the tenants of DPC is healthcare access when you need it. And so I was able to still be a doctor on those days when I wasn't in the clinic. And that was very freeing and empowering. And then on Mondays and Thursdays, I would actually schedule patients. And then, because I live seven minutes from my clinic, I was often able to just like pop over on the weekend, which was very helpful if somebody had an accident and needed sutures, or it was very helpful for over the road truckers that were out of town all week, maybe only home for 36 hours on the weekend, and then we're out on the road again.

So, it was really very amendable. And I, I really loved every minute of it. It was, it was quite stressful to balance all of that, but I really was grateful for that time. And it obviously led me to where I am now.

Awesome. So what is your practice like now in terms of who works with you at blue Lotus family medicine.

So I currently have a actually I've recently had a structural change again, but currently what I have is a part-time office manager.

Who's really, an amazing stellar person. And I honestly think that she gets as much work done and half time as most people get done in time. I have a full-time RN and I recently hired another physician, but she hasn't, she hasn't fully started seeing patients yet, but she is now part of the group as well.

And so I'm also having to wrap my head around what it's like now to be a physician leader, to a physician.

So, so many questions come up in my head. When you, when you talk about the current structure of your practice. So, first I want to hit on the staff because as you continued and you've been open since the summer of 2017, who did you bring on first?

And at what point did you decide that this was the person, and this is the role that you needed help with at your practice?

one of the things that I found most challenging when I was growing my business and then trying to maintain it was trying to figure out what I needed from people and how to hire for that and, and how to communicate that to the people that I hired.

And that was way harder than I anticipated that it would be. So when I first started, I, one of my many kind of side gigs that I did to support myself I met this young lady. Who was not, I think she wasn't even technically an ma she had taken a lot of the courses, but something happened with her school and they couldn't get certified or something.

She was certified as a phlebotomist and was essentially working as an ma in the clinic where I was but she was a temporary worker and they were not needing her services anymore. And so she was really crushed and she was like, I just don't know what I'm going to do. And I was like, well, actually I'm starting this clinic and we get along really well.

And I think you have a lot of skills. And what I liked about the idea of having an AMA was that, you know, she's a phlebotomist, so we can draw blood. She knows basic vital signs and can talk to patients, you know, in that sort of way. But she's probably also, also still willing to fax papers and shred things, you know, and, and clean toilets if needed.

Okay. And so I was like, that's, that's the kind of flexibility that you need in DPC. So at first, when it became too much for me, I just hired her PRN, like a couple of times per week, I was like, Hey, can you come in for a few hours and help me do whatever. And then that kind of morphed into part-time then that morphed into, to full-time.

And as I got busier, I realized I kind of really need a more clinical person in this role. Simply because I have a very high touch practice. And so we have patient encounters all day, every day, I'd say probably. 40 patient encounters a day, at least. And so a lot of that has to be handled by the clinical person.

If it all gets shoved off on me, nobody's getting any kind of care, right. That's obviously not the practice that I'm building. So, I said, okay, well now I need a little bit, I need more of a clinical person and that person was ready to move on. So it was a good, it was a good fit. So my next person was an LPN and I was like, okay, this is going to be great.

It's gonna, it's a great middle ground. She's got more nursing background, but it's not going to be as expensive as an RN. So this is going to be really great, really flexible. And we're going to make it work. It didn't work, but I think it's, it didn't work mostly because it was just the wrong person. And not that she's a lovely person.

There's nothing wrong with her. But when you're in a small DPC office, You have to have a lot of very specific skills and you have to work together like cogs in a machine. And so somebody that does really well in a corporate entity where they have a very defined role and, and can maybe even work independently.

Some of their day is the exact opposite of what's needed in the DPC clinic. So I just found that, unfortunately we weren't, I wasn't able to get as much productivity out of her as I needed. Okay. So the next one I was like at this point, I think I have to go RN. I am getting to a point where I'm doing more procedures looking into doing IVF therapy.

I need to have somebody who can help me refill medications, you know, things that are fairly simple to do a per protocol. I need that capability and terrifying. To think about hiring an RN. Cause I was like, that sounds really expensive and I don't know how I'm going to do that, but I sat down and thought about the math and I needed 50 extra patients, only 50 extra patients to make the difference between what I was paying the LPN, who I was not getting much use out of it all to get a quality RN.

And I was like, okay, sold. That's an easy sell. And, and I've had an RN ever since, and I could never do it any other way now.

Have you had to let someone go as you were making those transitions and how do you recommend people do it, so to speak?

Uh, unfortunately I've had a lot of, uh, expertise experience, uh, letting people go, which was never part of my plan, obviously.

But you know, there's something really powerful that happens when you put on the business owner hat and not the friend hat or the physician hat, not the caretaker hat. You say, this is my business. And this is literally what pays my mortgage and helps my kids get the resources that they need. So I am going to treat this like a business and while I am compassionate and fair, I'm also very matter of fact about it.

And so each time I've had to let somebody go because that position wasn't being fulfilled as I needed it to be it was always a little bitter. I always think that it's a great idea to pay somebody for two weeks to help them transition. But the truth is nobody wants to work for you until you fire them.

So what I do now is just pay somebody a two weeks severance and then that way they have time to transition and get themselves back together. Cause it's usually a blow, you know, and, and it gives them some time to look for another position. And then there's not that tension that happens when, you know, inevitably you have to say, thank you for working here, but I no longer value you the way I did before I need you to move on.

So that makes for a little bit of an awkward work situation. So it's much nicer for everybody involved. Just pay them for two weeks. And then, and I can tell you that every single time I've had a staff turnover. It has upset the apple cart in my clinic and the patients feel it every single time.

And so I do not make those steps lightly. Every time I've had a transition it's because I couldn't have done it any other way. After I got, uh, my nursing position filled, I knew that I needed or actually right before I transitioned to a full-time RN, I was like, I actually also need an office manager, so it's not necessarily clinical, but can answer these phones and fax these papers.

And that person was really great in the beginning. But then as my clinic grew, those tasks grew, uh, the requirements grew and that person, unfortunately, wasn't able to grow with the position. And because that was one of my first major positions, let's say I had, uh, I felt very. Obligated to help her grow into the position to help teach her what I needed.

I felt like it was my job, my obligation to do that. So I spent a year trying to do that. And it didn't work as you might imagine. And so I finally, when I realized my patient satisfaction is suffering because of the, these interactions, I have to cut it off. And so then I did, and it was gut-wrenching because this person called them, considered themselves a friend, and we consider them a friend.

We hung out a lot. We'd been together for a few years and I had no malice towards her, but she couldn't hear, I value as a person, but I, this isn't the position I need you in. And what I've found after that was that people came out of the woodworks to tell me all of the uncomfortable situations and encounters that they had had.

Wow. And I didn't realize that at the time. And so, one, it helps solidify that I really did do the right thing. And two, I found that complaints against your staff are like roaches. If there's one there's a whole lot more,

such a very clear way for people to understand that. So I appreciate you sharing that.

I also want to now focus on the hiring part, because you mentioned that your practice is now growing with another physician. How did you find this position first of all, and how did you bring them on, like, how are you paying them?

Are they growing their own panel? And that's the, the funds that they will bring in. Did you start them off with a baseline salary and they're earning towards, more in the future as they grow their panel? How does it work? Yeah,

so just like many parts of my story. It's fairly unique.

And I don't know that it's completely replicatable, but I didn't find this person. This is one of my best friends from medical school. And I just got incredibly lucky that she happened to also stay in Kansas city. , she did residency in Alaska and I did residency in Maine.

And so we actually weren't really close for those years, but then we both came and settled back in Kansas city, but she decided to be a stay at home mom. So she went right out of residency to being a housewife. And I was like, wow, that is an interesting journey for a physician. Who's just paid thousands of dollars and many years, uh, training.

And so I always thought that was really interesting, but I always admired her for it. I was like, you know, do whatever you want to do if that makes you happy. Great. So we stayed in touch cause she's a lovely person and yeah. She over the past couple of years has kind of started talking about maybe wanting to get back into the workforce, but not really knowing how that might happen, because she does still have two kids and her husband's a physician, so she doesn't want to be, you know, both of them working all of the time.

And so it kind of dawned on us because when she first started talking about getting back into the workforce, my practice was still pretty small. Like there was nothing to offer her. And as time went on and she kind of took more time to think about it. My practice grew exponentially and then I started feeling like, Ooh, I feel like maybe I need some help here.

And then at the same time, she was like, I think I might want to get back into the workforce. And I was like, light bulb. I can hire you. And so we sat down and came up with something that was kind of mutually agreeable and. The great thing about this particular person in this particular situation is that she doesn't necessarily have to work.

You know, she's gone seven years since residency without working and has been fine with that. And she wants to get back into the workforce for all sorts of reasons. I mean, money being part of it. Right. It'd be nice to be able to pay some more bills. But part of it is just that she wants to be a physician as well, again, and a working mom.

And so we're in a unique position in that I was able to start her with a very low baseline guarantee. But then she'll make 60% of, uh, membership fees that are on her panel. So she will grow her own panel and have potential for procedures and things like that that do make extra money if she wanted to do that.

And so it's, it's really kind of great because she can work as much or as little as she wants. And, uh, once she hits 50 patients, I she'll be. Paying for all of her own expenses. So it won't cost me any money. And she will be able to be as flexible as she needs to be as a mom with young kids.

And when you say 50 patients, just 50 patients allowed you to get different staff in your clinic.

Just 50 patients allowed you to. Say, yeah. You know, at this point now you're able to pay for yourself, being here, other physician joining, and it's things like this that really help break down the barriers to getting into DPC for anybody, with loans, for anybody with, you know, just like yourself, like you're the primary breadwinner for people who are like, I don't, I'm just coming out of residency.

I still have all of the loans from medical school and undergrad. So I really, really love that you shared that. And when, when the physician comes on as your, as your staff has grown, what, how do you adjust your workflows? Because you said, you know, it upsets the apple cart when a person comes and goes, but what happens to your workflows on the day-to-day so that you try to minimize the applecart upset as much as possible?

I mean, mostly what happens is I just absorb everybody's job. So I work even more hours than I did before. And so, you know, I know that's not sustainable. And I don't always get back to people as quickly as they would. Like, he's very transparent. And I think this is where it feels good to be in a DPC clinic because I can be very real with my patients and say, I'm sorry that I didn't get back to you when you wanted me to, this is what's going on.

You know, like we're having some staffing challenges or, you know, whatever it is that I say. And then usually they're like, oh, okay, I get it. You know? Cause they, they realize that I'm a human cause we have a lot of human interactions and they're willing to forgive.

now in terms of your panel, you have over 600 patients and you are, you know, as of today, you're, you're the primary doc at blue Lotus family medicine. So I want to ask there are you still taking new patients or are your, is your panel full?

I am still taking new patients for, I think maybe a month or two. I paused a enrollment back in last fall just because we were having some staffing changes.

And so I was like having all of these staff changes, uh, and a full panel at once was a little bit much. And so I was like, well, let me just focus on that. But the phones were ringing off the hook every day for a waiting list for people wanting to get in. And so. I'm not going to be paused for long because it just doesn't make sense to my brain.

And so a lot of the new patients that I get mostly just makes up for attrition, which is, you know, natural. There's not really, not a lot. You can do about a lot of that. And so I, I have to make sure to make up for attrition, just so that, you know, the income doesn't drop too much in a month. But it, it does continue to grow.

And so with that said, I want to highlight on your website, you offer a 15 minute free meet and greet. But the verbiage that you have specifically, a free unconditional visit to discuss your health care needs, what made you choose that particular phrase? And what does it look like when a person comes on for 15 minutes to talk about your care and your.

That really started because, uh, it's the whole concept of people don't understand what DPC is. And in DPC you are very much selling yourself. And, and so, you know, with insurance, they just go to the clinic that their insurance card tells them to go to. But with DPC, they're picking a person that they want to interact with.

And so it's really hard for people to sign up for any kind of membership, especially a healthcare membership with a person they don't really understand or assist them. They don't understand, or an office they've never been to. It's a lot to ask of a person. And so I completely understand that. And so. I make myself available to people who would just like, let me peek behind the curtain.

Like what's, what's really going on here. And like, yeah, I get it. It sounds too good to be true, but it's really not like we're, we're real people doing real work. I have a real medical license. And so just ask whatever questions you need to about the process. I have to make sure that we don't get into actual medical care that appointment.

Right. Cause it's not a medical visit. But I do a lot. They oftentimes have questions about the generality as well. You know, if I did have a thyroid problem, like, would you be comfortable treating it? You know? So then we talk about philosophy of care and like give examples of, of ways that I have treated patients with similar diagnoses in the past so they can get, get an idea of the, the flavor of medicine that I practice, I suppose.

And then most people at that point are willing to say, okay, yeah, this is actually something that I've been looking for.

And in terms of. The free meet and greets in the beginning versus now, have you been able to really finesse how you go through these visits so that you're not going into 20 minutes, 35 minutes and then being late for your members?

Yeah. You know, I'm, I'm naturally a talker. I did very well in school and, but the thing that I got marked off on all of the time was talking too much. And so that was the thing that I literally got in trouble for the most in my corporate job is I was told that I was talking to my patients too much.

And I was like, uh, that's not a thing. So this is why I hate you. And I hate this job. And so I found that when I had that freedom and, and especially in the, in the beginning, when you don't have a full panel, I would just talk to patients for an hour. You would just put there gabbing forever. And a lot of times they would be going whew, for a really long time.

Are we going to wrap up anytime soon? And so I had to learn how to still be. A personable connected, engaged physician, but not have to spend 60 minutes with every patient. And so there is really an art to making yourself available and, uh, helpful and give the resources or the help that's needed in that moment.

Uh, but structuring the time so that you get the most out of that time in a structured way, because unfortunately we still live by a clock, you know, there's still a schedule. So we have to do the best we can in the time that.

I agree, it's an art. And just like we became physicians, you know, we went from book learning to clinicals and then to residency, it can be learned.

It definitely can be learned and it, it it's, I feel better that way because you know, what will work in your community and you know, what your communities, common questions are. One way that I like to start off, because I also am very guilty of talking. Great, great mix. Great for podcasts. But I started.

What are your questions that brought you here today? What can I answer for you? And I found that they already have some understanding in the fact that they made the meet and greet appointment and they are, are at that point, if I want to know more. So, you know, tell me what you have based on what I want to know.

Type of thinking. So I love that. And In terms of strategy and your week, how many of these do you offer a week and do you schedule them at certain times during the day, uh, for these free meet and greets?

I'm available almost any time. The truth is my staff is really so good at selling DPC.

Now that most people find that they don't need it, they'll call to get a meet and greet, but they'll wind up having a conversation and exchanging ideas. And then they're just like, actually that sounds like the greatest thing I've ever heard. And then they just sign up for memberships. So, uh, I would be available during any time, uh, because we have a pretty structured.

Scheduling systems such that, you know, acute patients have, you know, these slots on the schedule and, uh, chronic follow-ups have these slots. And so there's always time to fit something in if needed, but it's just not needed as much anymore, thankfully, because I hired smart. Awesome.

now I want to go back to when you said you are still taking new patients, how do you foresee yourself knowing that your practice is quote unquote full?

I mean, you've mentioned, when staff is transitioning, having a pause, but in the future, do you ever foresee yourself being completely.

I don't know, that sounds totally insane, but in my mind, this is the way my brain works. And so I'm sure it's going to work out exactly like this. I'm sure. The longer that I have a majority of my panel, the more settled in, they will be the more, you know, less high touch they'll need on a month to month basis that will leave quote room to add more people to the panel.

So I, I don't really particularly have a number. I mean, when I started this, the projections were set at 600 patients. And then before I got to 600 patients, I was like, oh, wow, this is way too many. Maybe I need less patients. But then I adjusted and I learned and things smoothed out and now 600, it definitely feels like a lot, but I don't feel like I need fewer.

And I really have no intentions of closing enrollment.

Perfect. And you have the, you, you own the business and you can decide that. So that is awesome. Now you also have five children and I'm like, I can hardly handle two. How do you make it all work so that, you know, you're achieving your goals of being present for your family, being present for your patients being present for yourself?

Uh, I mean, I will definitely say that that is still a work in progress, right. I don't think I have all of the answers, but the biggest thing, and this, this is one of the biggest key factors to whether or not you're going to be successful in DPC. I have an incredibly supportive partner, uh, even before I was convinced that I could make DPC work or that it was the right move for me.

My wife was my biggest cheerleader. She knew almost nothing about the actual business and she was just. That sounds awesome. You should do that. And I was like, hold on. I gotta like figure out how and she's like, yeah, you'll figure it out. It's fine. And so when I w when I was nearly vomiting over the thought of quitting my job, she was just like, this is awesome.

Get quit your job. I'm so excited for you. Uh, and so. I'm very grateful that we have gotten to a place in my clinic that she has been able to step away from her job, that she felt like it was time for her to step away from that. And so she's really taken on, uh, a more leadership role in the household with like running the kids around to soccer, if I'm still at work or, you know, doing a lot of the laundry and dishes and, you know, just that day-to-day stuff that keeps the house going.

So I try to be as present as possible. Mondays are our admin flex days, so I can do kind of whatever things I need to do on those days, whether it's run errands or keep kids home or go do fun things. I am the boss so I can schedule time off whenever I need to, uh, recently. My wife and I both went with my seven-year-old to her school zoo field trip on a Wednesday, just because, because we could, and it was just really nice.

And so, you know, if they have an early game or something, I schedule the last couple of patients. I just block that time off so that I can get out of the office on time. So, uh, I mean, my practice is very much. Tailored in a way that makes my family life functional.

I love that. And it really goes back to your why it really does.

And, you know, I, I ironically the day that we're doing this interview, I just had, uh, I just took my four year old to it's like preview to transitional kindergarten day. And I learned that they have an assembly where they'll, celebrate by doing a song or a little performance or a yeah.

Or uh, like class awards who ran the most laps in the jog-a-thon or who was the most helpful in the class. And I'm like, I literally stopped. You know, somebody asked me, are you doing it because it's your first kid going to school? And I'm like, no, I'm like so pumped right now that I'm going to be there period.

Like, this is exactly why you and I, and other people are saying like, and this is why we went into medicine to be humans and to be able to be doctors as well. So just love that.

So now I want to get into the services that you provide for your patients. You offer med spa services, you offer DOD physicals and you offer PRP and PRF. And I definitely want to hear on the ladder, especially because somebody had recently posted about a burn and you were like, I hope somebody is doing pear peer F on that.

So, can you tell us about, your services for your patients and how, and how that works out with membership or any of these services?

Yeah. So, you know, when I started thinking about what would make a good clinic I kind of always went back to, I want it to be a place where people feel comfortable going that is a Haven for them in this crazy medical system.

And so we have a very relaxing atmosphere. We offer a delicious array of teas. There's a lot of really soothing colors and inviting artwork. And so part of that sort of, uh, welcoming, homey feeling is that pretty early on, I connected with an aesthetician through a contact of a. And so we now offer facials and all like aesthetics procedures, but as well as, uh, fillers and Botox Dysport actually and laser hair treatments.

So, it's really a very interesting mix of things. Cause people are like, I need to get my blood pressure medicine. Oh, but you do facials. Okay. Going back for that. So it just kinda helps them connect to the clinic in a different way. And it's like, this place really means a lot to me and offers my life a lot.

And so it's, you know, it's, it can be seen as like a frivolous sometimes, but I just see it as another service and a way to honor the bodies that we live in every day and, and try to be kind to ourselves.

Awesome. And in terms of the things like the duty physicals and PRP and PRF do those come at, uh, extra costs of the members?

Do they get those included with their membership?

So for DLT physicals, I don't charge any extra because it doesn't cost me anything. I have to get certified for a job that I was doing right before I opened my clinic. So that had to be done. So I was like, well, if I have this certification, I might as well use it as a benefit.

So now it's literally just a free benefit that members get. And I have quite a few truckers and people that need that DOD physical So I find that to be pretty valuable because those can be pretty expensive or hard to get into sometimes. So I really enjoy doing those because it's not very hard for me.

It doesn't cost me any money and it doesn't take any more time than a regular physical does. And, and I love being able to provide PRP and PRF. The small caveat is those do have a small incurred expense and that's really just to cover my expenses. It's, uh, I'm basically giving it away, which is what I do a lot in my DPC.

But just like you talked about your investment and Sesame, I mean, you're, you're paying, you know, they're paying you 30 to $70 a visit and you get basically free marketing in a way of people finding you. I mean, can you imagine. I didn't have to wait for wound care or I didn't have to drive three hours to access wound care.

Dr. Blake just did it for me. Oh. And yeah, that thing sort of looks like the thing that I had. Why don't you go see Dr. Blake? So I think that, I suspect that that's also, what's helping grow your practice to infinity and beyond.

Exactly. And, you know, what's interesting because my entrepreneurial brain never really stops.

I was like this PRF and PRP stuff is miraculous. It's amazing. And everybody needs access to it. But I knew that I can't actually see everybody in the world. And so I was trying to figure out how do I increase my access without like totally burning myself out in DPC. And so I actually started a little side business that we call white Lotus wellness.

The website is. It's actually ready to launch. Whenever I tell them to go live. I'm like, don't open Pandora's box yet. I can't handle that much business. But it's, it's allowed me doing the PRP and PRF and my patient panel has added an immense amount of benefit for patients because it's, it's truly just miraculous work that PRP and PRF.

And so it's been a really great for my patients to be able to access it, but it's given me a lot of experience and increased my skill and comfort level with that in such a way that I can now present it to the larger community in a more streamlined way as sort of a side road.

And in terms of Missouri, do you have to pay additional fees for your malpractice to cover, uh, B to cover the PRP and PRF?

Uh, fortunately, no, because essentially the process is just like any other joint injection or, you know, soft, soft tissue injection. If I wanted to do stem cells, that would be a completely different ball game, but thankfully I do not, and I don't Pierce anybody's spinal column. So, uh, with those two exceptions, it's, there's really no incurred risk.

And in terms of this being pride month, I want to highlight that you continue to bring helpful healthcare to all who need it. And in terms of being a physician who is caring for everyone the same, including those who are in the LGBTQ plus community, I want to ask about how, in particular, do you care for that community in terms of, the type of access or in terms of, creating a safe space for people to come?

You know, my journey into being available for the LGBTQ community is actually, I'm going to say it was embarrassingly slow. And here's why I grew up in small town, rural Alabama. And so I, and I'm now in the Midwest, which has a lot of the same ideals and values. And I don't usually fit into all of those boxes.

And so I had to learn very early on that, who I was as a person didn't need to come into the clinic because that could jeopardize my doctor patient relationship and, or that could jeopardize my business. And so I was like, they don't really need to like me as a person. I don't need to like them as a person.

I just need to be able to therapeutically treat them. And so for the longest time I tried, I wasn't necessarily in the closet. I mean, I would have plenty of conversations with people, but I wasn't really very upfront about it. It wasn't a prominent part of my practice or a way that I interacted with the community.

But as I started thinking about other ways that I can grow my practice, I was like, well, you know, there's this whole community that I'm a part of that I could reach out to and just be like, Hey, I'm, I'm a safe resource for you. And so I was a couple years in when I finally kind of that light bulb went off for me and just meeting different people.

I started to get deeper into the community and realized that I actually really enjoyed just being part of that community, the LGBTQ community, that I wasn't really a part of before, just because I was too busy being a doctor and a mom. And I was just like, wow, this is really great to just have this community of people that I can share experiences with.

It aren't actually medical experiences, but then every now and then there'll be like, Hey, I need a really great doctor for XYZ. And I'm like, no pressure, but if you're interested, I do have a clinic, you know, and I'll, you know, put my website up and, and, and so doing that over, you know, a few years now I've got quite the reputation.

And you know, what's really great is one of my newest patients came from Seattle where they felt very comfortable being who they are and they are a transgender female. That still doesn't even fit into all of those boxes, kind of still kind of non-binary has really vibrantly colored hair dresses.

Very non-binary like, you know, still has some facial hair and you know, just really living very authentically, but not in a way that makes small town or, or Midwest values very comfortable sometimes. So they had to move to the Midwest for a partner's job commitments. And they were really very nervous about moving, first of all, but also trying to find a supportive, uh, community of medical providers.

And thankfully they knew somebody who knew somebody who knew somebody who knew that I had a clinic. And so they were just like, well, I hope this works. And they booked an appointment and came in. The relief on their face was priceless. At the end of the visit, they were like, I just can't thank you enough.

This finding a provider that I feel safe and comfortable with is a lot easier than I thought it was going to be. That was one of my biggest fears. And it just really means a lot to me to know that I have somewhere to go, that I can be myself and I don't have to, to censor who I am. And so I was like, it's so weird that it took me so long to get there because I was like, that's literally who I was like, it feels really great now to be as authentic as I want to be, or as I need to be in that patient space as well, and know that my patients aren't going to reject me because I happen to be in love with a woman, you know, it's so, it's, it's been really great for, it's been really rewarding for me as a person and as a physician.

And to know that. There are people who know that I am this bubble and this Midwest town and that they can come to me. And the word is spreading. It's, it's, it's really heartwarming to know that I can again, provide that safe space for an underserved community.

And a safe, a safe space. You can't hide that stuff. When you get excited about your practice, when you are like, we're talking about your healthcare today.

Like that does not come with with judgment of any sort. People really feed off of that. So that's so amazing. And you know, going back to the fact that you have this master's in educational psychology, you really are going back to treating the humans you need to by understanding them.

And so I love that. And it was such an honor to have you share your story as part of pride month. On that note, I want to say, and something I had shared with you earlier before we recorded, was that when I was trying to find DPC physicians to highlight during pride month, it was a very, very surprising struggle.

I had to go onto. Page three of Google search. And I tried many, many key words. You're, you're the one who reached out to me after I made a post about that. I was looking to feature DPC physicians during pride month. How can we change that? How can we change the, the, the struggle, if you are a patient and you're Googling DPC, uh, physician LGBTQ, plus, how can we change the, the issue of finding a doctor who is going to provide sensitive, safe care to people because they're people.

Yeah, I think that the DPC community is such a great place to expand the LGBTQ healthcare access, because we can be more personable and more committed to each person's needs. And so. I can say that from my personal experience, even being in the community it took me a while to feel like I could make a practice run and make a living being an out lesbian.

And so I think once physicians, it probably may feel easier for a heterosexual physician to create a safe space because our society tends to side more with heterosexual people who are allies.

They sort of, almost empathize with that plight if you will. And so I, they would be less likely to receive back lash and consequences. Let's say for. Uh, being a resource for the LGBTQ community with all of that said it is very important that if you at all feel led to provide care to this completely underserved population that you make yourself widely and visibly known because, uh, they don't have a lot of safe spaces a lot of times.

And a lot of times people can not authentically be themselves because they're afraid to do so. And they've just kind of accepted that as fact, like that's just how they live in this world and that's how they access their care. And so to find a place where they actually can be themselves, is it, it, it, there's no way that that doesn't improve their health and wellness overall.

And so, I think we really, as a. Primary care community need to do a better job of realizing where are the places that I am needed most because the people that have insurance and, and can go into any clinic will do that. But it's the people that are floundering that really need a health care access point.

Those are the people that we can make the most impact for. And this LGBTQ community is a great example of that. Absolutely.

And in terms of being part of the community, as well as helping others, you know, find a safe space for their healthcare, what resources do you recommend to others to look into? If they, you know, say they want to provide prep therapy and they're not sure where to go, or they want to be able to offer hormone treatment where they weren't able to before, where do you recommend people go to for resources?

So I can say that I have been very lucky to learn from a lot of my other colleagues who do these things on a regular basis. And so I just started asking questions. I was like, I don't know as much as I need to and I want to, so, helped me and one of the best resources that I have found and been guided to is called guidelines for the primary and gender affirming care of transgender and gender non-binary people that was published June 17th, 2006. Through this center of excellence for transgender health it is an extensive document that is incredibly helpful and sort of reads like UpToDate for transgender care, if you will.

And so it has really been very valuable to me as a physician. One of the things that I love most about being a DPZ physician is being able to fully live in my, uh, primary care experience and and training and, and just expand that in as many ways as I feel comfortable and interested in doing. And so I have time to look up all sorts of things and add new procedures and new offerings.

And one of those is transgender and non-binary gender affirming care. And so, if, even if you don't know something. That's okay. If you are even willing to have that conversation with a patient, you are already in a small minority of practices and physicians. And so whatever you have to offer is going to be valuable,

amazing, and I'll make sure that that resource link is included in your blog that accompanies this podcast.

So head on over to my DPC and look for Dr. Bryce, uh, interview and blog, and you'll find it there as well. So now I want to ask in closing, when you have people who you're interacting with on a Facebook group or locally in your community, what advice do you have to give people who are.

You know, DPC curious, but they're, they're having hesitations or for whatever reason they haven't yet made the jump. What are the three takeaways that you would say, like if you listened to anything today, these are the three things,

Um, I will say that I have a different perspective on this five years in than I did maybe one or two years in. And I used to think that any, and everybody should jump on board, the DPC bandwagon. And I definitely now know that that is not necessarily true. And that is because you do have to run a business in DPC and you have to sell yourself, uh, and that can be a very uncomfortable proposition for people but if you feel like being part of your community and being, uh, a resource and, and selling on a regular basis who you are, and what you have to offer is something that you feel comfortable with doing or can get comfortable with doing then DPC is going to be a great fit for you.

You have to be a little bit risk tolerant because you are starting a business. But if you listen to all of the veteran advice around you and do it in a way that is smart, including keeping your overhead incredibly low in the beginning and making sure that everything you add on board adds value to your practice or your patients, then it's a very rep uh, replicatable process.

And it can be very rewarding financially and professionally. I think that everybody anybody thinking about DPC needs to find their, why it needs to find their niche. Think about something that you can bring to the, medical committee.

That's going to make your patient panel the better for it because we all have those things. And I think, patients need as much variety as possible. We're all very different humans. And so, it just makes for a better healing environment when we can find somebody that we jive well with. So just, just feel free to be your authentic self.

Love that.

Thank you so much, Dr. Blake for joining us today.

Thank you so much for having me. It was really great.

*Transcript generated by AI so please forgive errors.

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