Latest / DPC Life: Direct Primary Care Podcast / The Boundaries Queen: Dr. Michelle Cooke on Thriving in DPC

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The Boundaries Queen: Dr. Michelle Cooke on Thriving in DPC · DPC Life: Direct Primary Care Podcast

0:00
How can we be this busy, have this many patients to serve, and
0:02
we're still not financially sound?
0:03
There's something wrong with the system.
0:05
I didn't have enough time with my patients.
0:07
The 15 minute appointments were heartbreaking, and no matter how
0:10
much I asked or said how complex the patient was, there was no
0:13
wiggle room there. Second, I had no control over my
0:15
life. I think a lot of times we think,
0:16
well, this is what Healthcare is.
0:18
We just have to accept it. You know, it's so bad, but how
0:21
can we change it? We're just poor little doctors.
0:23
No matter what recommendations we give, nobody's listening.
0:25
My story is probably similar to most physicians.
0:28
It's like you, you go into medicine because you love it,
0:31
it's exciting, you want to help patients and you realize it's
0:33
just total, I want to say a bad word, but crap storm out there.
0:38
This is DPC Life, where we share honest stories, big ideas, and
0:43
celebrate the freedom to do medicine our way.
0:47
I'm your host, DPC physician Anne Gonzalez.
0:51
Let's get started. My guest today is Doctor
0:56
Michelle Cook, the founder and owner of Seoul DPC.
1:00
And this is your third. This is we're going into year
1:02
three. I just completed year 2.
1:04
Year 3. Wonderful.
1:06
Yes, great. Well, thank you so much for
1:09
being here. And why don't we start out with
1:12
telling us a little bit about how you got into DPC, how you
1:16
found it, why you came in? Absolutely.
1:18
I think my story is probably similar to most physicians.
1:21
It's like you, you go into medicine because you love it,
1:23
it's exciting, you want to help patients and you realize it's
1:26
just total, I want to say a bad word, but crap storm out there.
1:30
I think you can fill in the blanks.
1:31
And I, I feel like with most physicians and myself included,
1:35
I just wanted to keep leaning in like it's got to get better.
1:37
Maybe I can optimize my charting more or, you know, and it just
1:42
felt like the system I was in just kept getting worse and
1:44
worse. So I was an employed physician
1:46
with a large healthcare system. And like most docs there, a lot
1:49
of times it starts out of OK, you know, your panel's slowly
1:52
growing. It picks up really fast.
1:54
Feel like you have this team and have the support.
1:56
But it got to a point where it was just really unsafe for
1:59
everybody. I had way too many patients, not
2:01
enough time, no control over my schedule.
2:05
And like, I just felt like I was always in this whirlwind.
2:08
And it got to the point where I realized it just was never going
2:10
to get better. I feel like I tried all the
2:12
things. So, you know, I took a charting
2:14
optimization course and it got a little bit better, but I feel
2:16
like I got more resilient to sustain more abuse.
2:21
Like, you know, I could do more charts.
2:22
And so I got more patients. They tried to go into leadership
2:25
and that got really ugly. So they're just, every time I
2:27
tried to make it better, I feel like things just kept getting
2:30
worse. And the parts that were really
2:31
rough for me is 1. I couldn't enjoy patient care.
2:33
I didn't have enough time with my patients.
2:35
The 15 minute appointments were heartbreaking.
2:38
And no matter how much I asked or said how complex the patient
2:40
was, there was no wiggle room there.
2:42
Second, I had no control over my life.
2:44
Patients were booking for six months out.
2:46
I couldn't close my panel. I couldn't be at my son's, you
2:49
know, school updates, you know, like they tell parents three
2:52
weeks in advance, we're going to have a parent teacher meeting is
2:54
like, I can't block my schedule that quickly.
2:56
And so I feel like I was really missing out on levels in life.
2:59
And so I just felt trapped and I didn't feel like I worked hard
3:02
enough or I worked too hard for this to be what life is going to
3:05
be like from this point going forward.
3:07
So getting into DPC, where I feel lucky in some ways is I got
3:12
shut the health system that I worked for in metro Atlanta end
3:14
up shutting down. So I work in a community that's
3:17
very underserved. There's extremely high need, and
3:20
we're already behind the 8 ball. And the hospital system that
3:22
served this area decided to close their operations in this
3:25
part of Atlanta. The system is very large.
3:28
They still exist. They have other healthcare
3:30
systems like around the state of Georgia.
3:31
But in this area of Atlanta, they shut down to hospitals and
3:34
all their outpatient practices. So despite how busy we were, how
3:37
much we were working, they came to us and they said, you know,
3:40
we're going to be shutting this office down.
3:41
Got subbed into it because our hospital system was shutting
3:44
down in Atlanta and seeing so many patients that working so
3:47
hard, like the revenue was not there.
3:49
So they end up closing down my practice.
3:51
They closed down several other practices in the city of
3:53
Atlanta. And to me, that was a wake up
3:55
call because it's like, how can we be this busy, have this many
3:57
patients to serve and we're still not financially sound.
3:59
There's something wrong with the system and that led me down the
4:02
rabbit hole of just the interference of insurance, how
4:05
it really devalues primary care that we're a loss leader, right?
4:08
Like they don't expect us to make money.
4:10
We're not valuable to the system unless we can refer, refer,
4:13
refer. And so just help me understand,
4:15
like why the system does not work for primary care.
4:18
I had been eyeballing DPC for years and just never felt brave
4:21
enough to do it. And then when this moment came,
4:24
it just push came to shove. And I was like, look, this is
4:26
there's no more clear of a signal that I need to do
4:28
something different. The benefit of my health care
4:31
system terminating my contract is it also released me from my
4:35
restrictive covenant, which was great.
4:36
So I was able to be able to start my practice right in the
4:38
community where I wanted to be and where I was working.
4:40
So many stars aligned. And I was like, you know, if I'm
4:43
going to stay in medicine, I've got to do this.
4:45
I didn't want to go work for another hospital system or go
4:47
work for another team. I felt like it was going to be
4:49
the same, just different location.
4:51
And that's kind of how I got shoved into DPC.
4:53
So I feel fortunate in that way because I don't know how long it
4:56
would have taken me to write that resignation letter.
4:59
Change is hard. And like, to really, like,
5:00
declare that you're leaving is hard.
5:02
But like, I had a stop point that I had no control over.
5:05
And so even though I hate what happened to my community, I
5:08
don't know if we're ever going to recover from this in my
5:10
lifetime, but it was the impetus I needed to go ahead and go down
5:13
the DPC route. Wow.
5:15
So how long of notice did they give you that you know they're?
5:20
Going to absolutely. So it happened around Labor Day.
5:23
Labor Day was when they were supposed to give the
5:25
announcement and it got leaked to the press that it was going
5:28
to be shutting down. And so they like it came in this
5:31
rush fashion of like this hospital system is closing.
5:34
Employees not even informed yet. So it became this huge fiasco
5:38
that this hospital system was planning to shut down.
5:40
So they were shutting down Labor Day.
5:41
So I'm almost exactly 3 years out from that today because we
5:44
just passed Labor Day in September and then my last day
5:47
was November 18th. So it's about 2 1/2 months.
5:51
Of course, the 90 day contract required us to be paid through
5:54
90 days. I think I was paid right through
5:55
the end of the year. But yeah, after by November I
5:58
was gone from February, sorry, September to November.
6:01
OK, so you'd been eyeballing DPC but not actually planning it, so
6:06
that kind of kicked it into. Queue Yes, I'm actually met
6:10
Doctor Julie Gunther, who I consider one of like the DPC
6:13
godmothers. She came to a Georgia Academy of
6:15
Family Physicians meeting, honestly back in 2016 or 2017,
6:18
so we're talking almost 10 years ago.
6:21
And she explained this amazing model called DPC and how it was
6:24
so much better. And I was like, this is exactly
6:26
what I want to do. But Oh my gosh, I'm not a
6:28
business person. There's no way.
6:30
I've got loans. Just all the excuses.
6:32
But I remember just like never forgetting that this was out
6:35
there and that there's another practice here in Georgia with
6:38
Doctor Rob Lambert, who has an incredible YouTube video
6:41
explaining the DPC model. And I was like, they're out
6:43
there and they're doing this maybe way that day I can do.
6:46
But I just never felt brave enough.
6:48
So even though I was eyeballing DPC, I was kind of making a
6:51
plan. Like, so to be honest, even
6:54
though I was my, I was released from my system in my head, I was
6:58
like, I'm leaving this place after a year.
6:59
Like I was making plans to make plans, but like, and I got
7:02
accelerated into that much, much faster because of the shutdown.
7:06
So I was moving very slowly at a snail's pace and just kind of
7:09
needed that force. So I was starting to plan, but
7:11
really didn't, you know, wasn't ready to make that leap.
7:14
So September and then, you know, it's funny you mentioned Doctor
7:17
Gunther. My story is kind of similar
7:20
where it was actually it was around 12/20/13 and I had a 2
7:24
year old and a six year old and an 8 year old and my husband's a
7:30
partner at his practice and I was part time, you know, part
7:33
time. I heard about it at it was North
7:37
Carolina AFP meeting, like the annual meeting and I think I
7:42
think it was doctor Brian Forrest.
7:44
He has DPCS in kind of like around the Raleigh Apex area,
7:50
but he did a talk and it was the same thing.
7:52
It's like, wow, what an amazing practice model.
7:55
That sounds exactly like why I went to school, why I went to
7:59
medical school, but the same thing.
8:02
I don't think it was so much the business cuz I probably didn't
8:04
even get to that far in my head. I was just like, I can't do my
8:08
husband's a partner. I've got three young kids, I
8:11
can't do this. And so, yeah, just stuck.
8:14
Yeah, it stayed. You had stayed there because I
8:17
think you need to have that thought that you can do it a
8:19
different way. I think a lot of times we think,
8:21
well, this is what Healthcare is.
8:23
We just have to accept it. You know, it's so bad, but how
8:26
can we change it? We're just poor little doctors.
8:27
No matter what recommendations we give, nobody's listening.
8:30
So let's make it work. I remember at one point even
8:33
like almost wanting my patients to feel bad for me.
8:36
Like when I look back, like the self loathing was horrible.
8:38
Like when I was behind on schedule, like they're coming in
8:40
because they need my help, but I was drowning and I was like, I
8:42
hope they have some mercy on me and forgive me for being late.
8:46
And like, and that's not a therapeutic relationship, but
8:49
I'm already walking in the room at a deficit.
8:51
You know? So it just, it does not fit up
8:53
well for doctors. But we can't give the best care
8:55
to our patients. And so when I learned that,
8:57
gosh, there's a model that actually honors the doctor
8:59
patient relationship and insurance is out of the way and
9:02
you can spend more time. And like, I was like, how are we
9:04
not doing this? Like, why does this make that
9:06
just makes so much sense. So yeah, just once you get that,
9:08
that idea of, oh, you can tell it differently, it's hard to let
9:11
it go. So when you OK, so you left, we
9:14
were done in November, were you opening up immediately or you
9:19
still had some time? I took about six months when
9:21
that letter came in. I remember having one of my make
9:25
or break moments, and I'm not gonna go into heavy details, but
9:28
I hit this incredible clash with admin because of my schedule.
9:32
My schedule was overwhelming. They didn't honor my vacation.
9:35
Like I kept fighting back fighting back.
9:37
And I remember there's one day that I was called in to speak
9:40
with admin at lunch and they told me that I was being too
9:43
aggressive on my schedule, that staff were fearful of working
9:46
with me. I was creating a hostile work
9:48
environment. And I remember that was at the
9:49
moment I snapped in medicine. I was like, this is too because
9:52
I know that's not who I am. Like I love my team.
9:54
I like I love working with people.
9:56
This is my passion. It was making me out to be
9:57
someone who I wasn't and I snapped that day.
10:00
I'm walking out of the office and thinking I was not going
10:02
back, but I went back because my patients scheduled for the
10:05
afternoons. I can't leave them.
10:06
But I remember thinking like I'm not going back.
10:09
But my walk out, you know, made it up the chains to hire admin.
10:12
They told me to take a week to recover.
10:14
And in that week I remember starting to make plans like I've
10:16
got to get out of here. So it was my annual plan.
10:18
Like I was thinking I was going to leave in a year.
10:21
I didn't know that I was going to be leaving.
10:22
I remember like look like talking with a lawyer and
10:24
talking about my non compete and how do I exit?
10:26
I was making plans because I knew I couldn't stay in that
10:29
system any longer. So I knew I wanted to, but I was
10:32
like, I got to figure out how to do it.
10:33
And then when that closure happened, I was like, Oh my
10:35
gosh, like This is why I was preparing for it.
10:37
And also partly why things were getting so hostile because I was
10:40
on a sinking ship and didn't realize it.
10:42
So by the time I got to November, I was, I was pretty
10:46
dead set that I was going to do. DPCI also signed up to go to my
10:50
very first Nuts and Bolts conference, which was held in
10:53
Dallas. And I was like, let me just go
10:55
to a conference, meet these doctors, like see if this is
10:57
really real, see if this is something I can do, get all the
10:59
tips I can. And that meeting was much more
11:02
confirmation. This is absolutely what I needed
11:04
to do. So going to that meeting
11:06
confirmed it. I think I went the weekend
11:08
before my last, like my last week with my healthcare system.
11:12
I remember trying to finagle it so that they would pay for my
11:14
CME for my for my DPC meeting. They ends up rejecting that, so
11:19
screw them. But they end up projecting my
11:21
CME for that meeting. But I was like, I'm going to go
11:23
to DPC and they're going to pay for it.
11:25
I'm going to stick it to them and they they're like, no, this
11:27
conference didn't qualify or some nonsense like that.
11:30
But either way, whether they paid for it or not, it was so
11:32
worth it because it gave me the tips I needed.
11:35
It gave me the community I needed to know that this was
11:37
possible. And I had a full community of
11:38
doctors out there that had my back.
11:40
Yeah, and that really is one of the things that just about every
11:44
DPC doctor talks about is the community and how everyone is
11:48
helpful and willing to pay it forward.
11:52
And you know, we want everyone who does DPC to succeed because
11:59
when everyone, you know, it's just a win, win for everybody.
12:02
So it's been the most supportive system and or you know, group of
12:08
doctors. And so like when you go to the
12:10
summit, everyone's. Yeah, at the Nuts and Bolts
12:14
conference, sometimes they label it like the happiest sea of me
12:17
on earth, which I thought was kind of silly, but it really
12:19
was. I think many of us.
12:21
You talked about going to some of your medical society
12:22
meetings. I feel like when you go to those
12:24
meetings, people just go there to complain.
12:26
They talk about I'm so glad I'm out of the office.
12:28
I hate what's going on. I'm not gonna be in medicine for
12:30
much longer. Like they become these these
12:32
complaint sessions of doctors who are miserable and even while
12:36
they're there, you know, catching up on charts and like
12:39
catching up on their EMR, like they really aren't present.
12:42
And this was the first time I saw doctors, like, looking for
12:45
solutions, sharing ideas, taking leadership and actually having
12:48
the authority to make decisions. And you just can't go back.
12:52
You just can't go back. So I've actually been hesitating
12:54
to go to some of my other meetings because I'm like, I'm
12:57
not ready to get back into that conversation.
12:58
I was like, oh, I make this. I don't want to do my work
13:00
anymore. I'm so burnt out.
13:01
I'm so burnt out. Like I feel for those doctors.
13:03
So I definitely understand. But if you're taking time with
13:06
your practice to go somewhere, you want to feel enriched and
13:08
not dragged down. Right, right.
13:10
Yeah. So for anyone who is thinking
13:13
about doing DPC mean for sure the DPC summit every year a must
13:19
must go to Absolutely. I call it summer camp for DPC
13:23
dogs. It really is.
13:25
I mean, I, and it's funny because I didn't go, I went to
13:27
my first summit after what's what I actually spoke at my
13:30
first summit, but I went to my first summit after I started my
13:33
DPC. So I didn't get to go
13:35
beforehand. But everybody, you've got to go
13:37
to summit. You've got to go to summit.
13:38
And I had been to Nuts and Bolts and actually went to Nuts and
13:40
Bolts twice before I ever went to the summit.
13:42
And they both are equally valuable.
13:44
But the summit is something else.
13:46
I mean, huge meeting people of all different levels.
13:49
People have been in DPC for a long time, people who were just
13:52
new people who were just beginning.
13:53
And just that community of support, like you said, is
13:55
unmatched. It really did feel like summer
13:57
camp, you know, even like that, more social sessions.
14:01
You really see people let their hair down and have a good time,
14:04
like and really enjoy this thing That was so much, so much of our
14:06
lives too. It's wonderful to see that.
14:08
Right, yes. And actually that was was that
14:12
2024? It was, Yep, it was 2024.
14:14
So my first time it was 2024. So she won't say anything about
14:20
it. I'm sure your talk on boundaries
14:23
at that summit was amazing. Thank you.
14:26
It really, it was fantastic. And afterwards, you know,
14:30
everyone's just like that was one of the best talks of the
14:33
whole summit. So if I don't know is it is it
14:36
recorded? Like is recorded actually not
14:38
seen. It actually asked the AFP to
14:40
send me the copy and I had a glitch with getting the copy
14:42
back, but it is out there. You can access it through AFP if
14:45
you access the DPC Summit. So I think if you either went to
14:48
Summit and purchased the package, you should be able to
14:50
see it. So I do wanna go back and look
14:52
at it. So I did on boundaries for two
14:54
reasons. Number one, I do enjoy just
14:56
connecting with my DPC community.
14:58
I love speaking, it really fires me up and I love being able to
15:02
inspire others and #2 because I needed to talk myself.
15:05
And so I always say when I want to learn how to do something,
15:08
the best ways to learn how to teach it.
15:10
And so if I can teach these other doctors what the key to
15:12
boundaries are, I'm going to have to hold myself accountable
15:14
because people do look to me. It's like, are you actually
15:16
following what you're preaching? And I have to, because if I
15:19
believe in it, I'll be able to better share that.
15:21
I was really excited because I came back to the summit this
15:23
year. I was asked to give the
15:24
boundaries talk again, kind of like an elevated to talk about
15:27
boundaries. So we went over a lot of the
15:29
things that we did last year, but still kind of made it more
15:32
applicable and more inspirational.
15:34
So it's really fun to be known for boundaries cuz again, it
15:36
holds me accountable. Part of I think what makes what
15:41
made DPC so scary for me and for many docs is that I think I was
15:45
practicing DPC in a setting that wasn't DPC.
15:48
You wanna give patients a time, you're gonna respond to their
15:51
message. Like you feel that
15:52
responsibility, but you weren't in the right structure to be
15:55
able to deliver that, which is really what leads to burn.
15:58
You don't wanna just leave patients hanging.
16:01
When I worked with other docs, I kind of felt like I got a lot of
16:05
crazy feedback about oh you care too much, this is just a job.
16:08
Like don't take it so seriously, you know, learn how to cut
16:11
people off. Only one or two problems per
16:14
visit. Like all this stuff that felt so
16:15
anti patient, which just felt so yucky to me.
16:18
So I was practicing DPC before I could really practice it.
16:22
So I went into DPC and I realized that you can do it this
16:24
way and give patients what they deserve.
16:27
I was like 1 fee for service that nearly burned me out.
16:29
It's going to burn me out in DPC too, right?
16:31
Like now they're going to have more access.
16:33
And now I got to respond to text messages, like all these
16:35
different things. And I realized with appropriate
16:38
boundaries, not only is it doable, but it's also, it's
16:42
incredible, right? Patients finally respect what
16:45
those boundaries are because you respect them.
16:47
Like you show up to it, you're available.
16:49
And so I feel like when you can operate when that framework of
16:51
boundaries, it makes it sustainable on both ends.
16:54
But prior, I had no control over the boundaries and I was
16:57
pouring, pouring, pouring into a system that wouldn't allow me to
16:59
create the appropriate boundaries that would make that
17:01
acceptable. So I hope I explained that well,
17:04
because I think that's one of the fears a lot of DPC docs have
17:06
is like, I'm drowning in portal messages, now I'm drowning in
17:10
refills, now I'm drowning in requests.
17:12
Like how am I going to make this work in another setting where
17:14
patients may even have poor access?
17:16
And I think the key to that is appropriate boundaries.
17:18
And it's not about being cut off from your patients about just
17:22
establishing what the rules are. You know, these are the rules of
17:24
engagement, right? And as long as we're in the
17:26
rules of engagement, like it's a go, we can have a fun time
17:28
playing this game. But once we get out of those
17:31
rules of engagement, like that's where the burnout starts to
17:33
happen. Like we're doing stuff after
17:35
hours and you're asking for things that are outside my scope
17:38
of practice. OK, now we're out of the rules
17:40
of engagement. And this is where we're not safe
17:42
anymore. So we need to be very careful
17:44
about protecting those boundaries.
17:45
And when we do that, it's beautiful.
17:47
It's beautiful. Yes, yes, agreed.
17:51
Yes, the boundaries are about, you know, it's good for patients
17:54
as well because like you said, if if you're getting burned out
17:58
in fee for service and we we went into medicine because we
18:03
have servants hearts we want to give and.
18:06
That's how we know, right? As a physician, it's just like
18:11
constant, you know, constant giving.
18:13
And you're right, if you go into DPC and you just continue,
18:17
you're going to burn out again, which is what you want.
18:22
I mean, you left. Because you don't.
18:23
And at that point, it's your fault, right?
18:24
Like you hate to admit it, but it's like you had rain, so it
18:27
was your fault if you did that. And so not to like wag the tail
18:30
of DPC doctors that go down that road, but we never had the tools
18:33
to say, OK, you can actually implement things that will allow
18:36
you to have a sustainable practice and that's OK.
18:39
You don't have to be a doormat. I feel like in these systems,
18:42
like we're required to be doormats.
18:43
And the more you push back, the worse it gets here.
18:45
You don't have to be a doormat. You have to make appropriate
18:48
rules, right? And once you do that, it can
18:50
work wonderfully. But many of us just were never
18:52
given that skill set. And so that's why I keep coming
18:55
back to talk about boundaries, to talk about how do you handle
18:57
after hours phone calls? How do you handle doing text
19:00
messages? How do you handle if someone's
19:02
asking you to do something that's out of your scope and you
19:04
feel pressured because they're paying you directly, now you're
19:07
a slave to them. That's not how it works, right?
19:10
So I think doctors just need to know that there's a way you can
19:12
set that up appropriately and it will work just fine.
19:14
Your boundaries, Queen. I'll say it because, like I
19:17
said, it holds me accountable and I think that that works
19:19
really well. Yes.
19:22
And one thing that I don't remember where I heard this, but
19:25
it may have been at one of the summits.
19:26
Maybe it was you. If you start feeling in DPC, if
19:31
there's a patient who was asking for something and you start to
19:34
resent that, like that's a clear sign there's a boundary being
19:39
crossed and then you have to step back and say, OK, one, what
19:44
boundary it was crossed? Did I even know it?
19:45
Was a boundary exactly. It makes you.
19:47
Assess and, and then yeah, yeah, yeah, then reassess.
19:51
And those you know, sometimes there are patients that are just
19:54
crossing, crossing, crossing and the only answer is either to fix
19:59
your boundaries or sometimes those patients are going to be.
20:04
Yeah, Understand that it's there to protect you.
20:06
And I think, you know, in fee for service and there were times
20:08
and we see this come up in our Facebook groups and some of our
20:10
physicians groups saying people have had like a really horrible
20:13
experience with a patient and they may have asked their system
20:16
to try to release that patient or terminate that patient.
20:18
They don't have the power to do that.
20:19
So you're forced to keep engaging with somebody that
20:21
you're having those really bad counter transference feelings
20:24
towards. At that point, the therapeutic
20:26
relationship is broken. You can't move forward.
20:28
You just can't move forward. And I find that every time I've,
20:32
like, wiggled on my boundaries, that's always come back to bite
20:35
me. So I had a situation very
20:37
recently where I had a patient join my practice.
20:39
And generally, I do not do chronic benzo management.
20:42
But, you know, there was a sob story and she came on chronic
20:45
benzos and was ready to get off of them, but not quite yet.
20:48
Like, I just need a little bit more time.
20:49
Can you work with me? Like this huge sob story?
20:51
And I was like, you know, I am a doctor.
20:53
We try to help people who are in need.
20:55
And this patient continued to push and push and push my
20:57
boundaries up to the point where she started asking for chronic
21:00
opioid therapy. And with the chronic opioid, I'm
21:03
like, this is the line I can't cross.
21:04
As I was working with you with the benzo, this is like right at
21:06
the edge of where I'm comfortable because I don't want
21:08
to do this, but I know there's a risk of withdrawal if we just
21:10
stop this abruptly. But now we're escalating and
21:13
this is where I'm out of my boundary.
21:14
So I tried to refer to pain. She refused.
21:17
She wanted me to prescribe for this because they gave her to
21:19
the ER and just kept getting uglier and uglier.
21:22
And I had to really hold my boundary with her and say, even
21:24
you go to pain management or you're not getting opiates here.
21:27
And she was super frustrated and she left my practice.
21:30
So she kind of, you know, self selected herself out.
21:33
So in the end, it was better for both of us, right?
21:35
Because I have this boundary. I said this is the line we can't
21:38
cross. She wasn't happy, but neither
21:40
one of us were happy with where that relationship was going.
21:42
So there's no longer a therapeutic thing.
21:44
So in some ways, I think the best thing you can do is when
21:46
the therapeutic relationship is broken is to move on.
21:49
I'm not the right doctor for everybody, and that's OK, OK,
21:52
right. My job isn't to take care of
21:54
everyone. I can't take care of everyone,
21:56
but the people I can serve the best.
21:57
That's who I want to be a part of my practice, and that's who
21:59
wants to join. If you feel like I can't serve
22:02
you, then don't come here. And I think as doctors were
22:05
afraid to say that because we're taught like, care for everybody.
22:08
Don't let anybody you know, not be, you know, someone that you
22:11
can help. And you should be willing to
22:13
help as many people as possible. But also understand you're just
22:16
not the best fit for everyone, and that's OK.
22:18
That's OK. Definitely.
22:21
So we first met in person in Atlanta at the Mastermind in
22:26
2024. And I had, I think I've been
22:28
seeing your social media, so I knew who you were.
22:30
So I was very excited to meet you there.
22:32
And so that's one thing that we both have in common is we're
22:35
trying to spread. And.
22:37
Teach DPC, you know, and spread the DPC word and help people
22:42
escape paper service. And so one thing that you're
22:45
doing is you've organized the Atlanta, is it called the
22:49
Atlanta? Correct, right.
22:50
That's our working title, the Metro Atlanta DPC Mixer.
22:54
And how many DPCS are in I should know?
22:57
That number, but I don't. So I think there's over 10 of
23:00
us, maybe even upwards of 20. I can think of at least 10 off
23:04
the top of my head. So I do need to get that number.
23:06
I don't think we have a great count right now that should know
23:09
the answer to that. And of course, most of us know
23:11
each other and the numbers been growing, which is exciting.
23:15
So with the DPC mixer, again, like I'm a teacher at heart.
23:18
I love to talk. If I know something that I think
23:20
is helpful to somebody, I have to share it.
23:22
So I opened my DPC in 2023. I went to the summit.
23:26
So I was like, I've got to spread the word.
23:27
Like other doctors need to know that there's another way.
23:29
And so we did our first metro Atlanta mixer in September of
23:32
2023. I was only like 3 or 4 months
23:34
into my practice at this point, so far from an expert, right?
23:38
But I brought in the experts and I brought in Doctor Anad Mehta,
23:41
who led our DPC Sun, our mastermind, Doctor Who's coming
23:44
back this year. She was there.
23:46
Doctor John, who's had one of the oldest DPCS in the metro
23:49
Atlanta area, he was there. And Doctor Babilola, who had
23:52
just started when I did, she was there too.
23:54
So it's great to get perspectives of people who are
23:56
kind of like early, medium and long term in DPC.
24:00
So I kind of brought them in as panelists.
24:02
We had a great time, a great time.
24:04
So it really just got the word out there that DPC is growing.
24:07
And from that mixer, I can think of at least three or four
24:10
physicians who have now started their practice from that first
24:12
mixer. Wow.
24:13
We repeated it last year, you know, got a little bit bigger.
24:16
We brought more people into the room by that point.
24:17
Some people started their DPC mixer.
24:19
So it's growing and this year we're bringing it back.
24:23
And you're going to have it. You're hosting it at an.
24:25
Even correct, correct. So last year we hosted at one of
24:28
the what do you call that place? It was like a local museum.
24:30
It's owned by a municipality, like one of the county museums.
24:33
They had this nice little space. So it's a great space to be at.
24:36
Now we're gonna be at a hotel, so we have a larger conference
24:38
room. We got more sponsors and vendors
24:40
this year, which is really exciting because again, as much
24:44
as I love to help, you know, teach and help educate and help
24:48
promote the world of DPC, it takes a lot of energy and a lot
24:50
of money. Right on some of these, on the
24:52
first one, I think I broke even last year, actually lost a
24:56
little money put in the stomach that was like, but it still felt
24:58
worth it because of the value it brought to the communities.
25:00
Having people who believe in this cause and want to help
25:03
invest in it has been incredible.
25:04
So I'm so excited because it's the first time we've had a high
25:07
number of sponsors who are helping this dream come true.
25:10
OK, wow. Absolutely.
25:14
So our platinum sponsors are Resurgence.
25:17
Resurgence is an orthopedic group that's based in Atlanta.
25:19
It's one of the largest groups that's here.
25:21
So they do accept insurance, but they want to expand some of
25:24
their cash and direct pay practices.
25:25
And they've been a big supporter of my practice.
25:27
Their surgeons have been amazing to refer to.
25:29
So they're coming, Alma Lasers is a sponsor.
25:32
So people who are interested in aesthetics, who might be
25:34
thinking about doing aesthetics or laser, I do have one of their
25:37
products. I met with their Rep and he was
25:39
like, I love what's going on with DPC, how can we support?
25:42
So they came in on as a sponsor. AI Communications is a social
25:46
Media Group that helps professionals spread social
25:48
media messages, particularly in healthcare.
25:50
And so they're coming as well. So for people that are afraid of
25:53
social media, how to project their message, they will be
25:56
there. And then our final platinum
25:59
sponsor, we have 4, our final platinum sponsor is Hint Health.
26:03
You know, so Hint has also been a huge partner and they've come
26:05
to Atlanta a couple of times to do outreach and mixers.
26:09
And so I let them know that I was doing one.
26:10
I'd love if they want to partner with us.
26:12
So Hints will be there as a partner too.
26:14
They help support a lot of DPC practices, you know, so many all
26:16
in one solutions with the EHR system and now working on the
26:19
employer side. So they're one of our platinum
26:21
sponsors. And then we have three smaller
26:23
sponsors. Our gold sponsors are a
26:25
pathology network. So pathology Partners Network.
26:28
They're based out of Tennessee, but they're providing cash based
26:31
pathology services, so I'm able to provide pathology for my
26:34
patients and the specimens run about 50 to 100 bucks.
26:37
That's been wonderful. Great turn around time, access
26:40
to the pathologist. That's been great.
26:42
Georgia Healthcare Lawyers is another sponsor.
26:45
The owner of that practice is attorney Angie Edmonds and she
26:48
specializes in healthcare law, particularly for cash based
26:51
practices in Med spas. I've actually worked with her
26:54
directly to do some contracts from my office and she's been
26:56
incredible. She was the final speaker on my
26:59
DPC podcast. If you ever watched the legal
27:01
aspect of it, she was the final speaker.
27:03
So we've been building a relationship and she wanted to
27:05
support the DPC community. Her last gold sponsor is Zion.
27:08
Zion is the Health Share who also helps support DPC, so
27:11
they'll be there too. A lot of incredible, great
27:14
support this year, so I couldn't be happier with that.
27:17
Yeah, those are some big heavy hitters.
27:20
That's great. Yes.
27:21
And it's really, it's, it's great that you have an attorney
27:24
there because that's one thing that people are always.
27:28
Asking. And there's like the three
27:31
attorneys in the. US that do, right, I mean,
27:33
because again, it's like we realize that there is healthcare
27:37
vendors and then there's kind of DPC vendors and not everybody
27:40
that works in healthcare. You go to them, they're like,
27:42
OK, well let's work on your contracts with all the insurers.
27:45
It's like, well, that's not what I'm doing.
27:46
They don't get what we do and she gets it.
27:48
It's been really nice to be able to connect with attorney that
27:50
understands DPC. Like you don't have to explain
27:53
that part to her. She's ready to go.
27:55
So yes, I think we need more people in the space that can
27:57
support our practices from a legal perspective.
28:01
Well, let's talk about and usually some of the episodes are
28:05
more kind of talking about kind of lighting outside of DPC, but
28:09
you've got so much going on in your DPC, we may have to break
28:12
this into. Two, right.
28:12
I want to see a few more things about the mixer just kind of in
28:15
terms of promotion. Oh yes, go on.
28:17
Our keynote speaker is Doctor Lee Gross, and I could not be
28:21
like I it makes me shake to think that he's coming to be
28:24
with us. So Doctor Gross is truly like
28:26
one of the leaders in DPC. He is the chairperson or a
28:30
cumor, his official title, but one of the big wigs with docs
28:33
for patient care, and they're the ones that put on the nuts
28:35
and bolts conference. Lee Gross was like one of those
28:38
hands that brought me into DPC and showed me that there was a
28:40
way. And I saw all the hard effort he
28:42
put in to do the Nuts and bolts conference.
28:44
He lobbies Congress. He does so much to make sure
28:47
that DPC can move the ball forward.
28:49
And, you know, as a personal favor, I called him.
28:51
I was like, hey, Lee, you know, we're doing this in Atlanta.
28:53
Will you be able to be here? I know your son lives here now
28:55
and you want to make a little trip to see us.
28:57
And he agreed. So we talked about that DPC
29:00
community. It's right there.
29:01
And so people pay good money to see Lee.
29:04
And we're going to have him for a very reasonable price.
29:06
Like, not something you want to miss with HSA being accepted for
29:09
DPC, catastrophic insurance coming.
29:11
Like, he has all the details. And so it's such a treat that
29:14
he'll be with us. We also have two panelists that
29:17
will be there, Doctor Aaron Harris, who I totally admire.
29:21
She's one of the few Black female DPCS in Georgia.
29:23
She's the first Black female DPC in Georgia and her practice
29:26
about 10 years old. So she's got incredible secrets.
29:28
And of course, the fabulous doctor Krista Springsteen.
29:31
So they will be on our panel. We have two more speakers.
29:34
I'm not going to announce them yet, but I will give a little
29:36
little drops about that. One of them is a direct
29:38
specialty, provides their specialty position.
29:41
So we'll get that perspective. And we have an employed DPC dot.
29:45
So I'm just excited that we'll get the spectrum of DPC breadth
29:47
of what we look like. It's not always the same.
29:49
So if I couldn't plug in that October 11th here in Atlanta at
29:54
the Four Point Sheridan, we'll be doing the metro Atlanta.
29:57
It's actually Saturday. It's a Saturday, the free
29:59
Saturday. Yeah.
30:00
So it's a Saturday. It is being held in the hotel.
30:02
I just talked with my office manager today.
30:04
We're able to secure a small block of room.
30:06
So people do want to come in from out of town.
30:08
I've had a request from a doctor actually in Massachusetts who
30:11
was like, look, I couldn't make it to the summit, but I might be
30:13
able to make it to this perfect opportunity.
30:16
So if you're close to Atlanta, it's not a bad drive.
30:18
And we're also, this venue was about maybe four or five miles
30:21
from the airport, so very convenient even if you're from
30:25
around the country. So it says metro Atlanta, but
30:27
we're welcoming anybody who's interested in DPC.
30:30
Yes, wow. OK, so if they did want to sign
30:33
up and join, how do you is? There, absolutely.
30:36
So there is a website, a subpage of my website.
30:39
So I can't tell you what the name is right now, right?
30:43
Put it in the show notes. The easiest way to find it is if
30:45
you go to my LinkedIn, on my LinkedIn page, there's a lot of
30:47
links to it. So I put several posts about it
30:50
and you can get a link there. And I post it in all the DPC
30:52
Facebook groups as well. So yes.
30:56
Yeah, it's, I think it's like 4 hours.
30:59
Yeah, we're at a. Reasonable place I thought it
31:02
was on. If it's not a heavy point, you.
31:04
Can. I thought it was on a weeknight?
31:06
Yeah, I thought it was on a weeknight.
31:08
So since it's a weekend. It's a Saturday now.
31:10
The only thing is it is Columbus Day weekend or whatever we're
31:13
calling that now. Indigenous, I don't know what we
31:15
call it, but whenever that October holiday weekend is.
31:17
So some people may have plans. So that may be a plus or minus.
31:20
You know, maybe you're open that weekend, maybe you have travel
31:22
plans, but it is a holiday weekend.
31:24
So for whatever that means to people who are listening, we
31:27
have a hotel, we've got a great spot and we have some of the
31:29
best DPC speakers. So I just wouldn't miss it if
31:32
you had the opportunity. Yes, again, summer camp.
31:36
For DPC right summer camp here in.
31:37
Atlanta, yes. So let's see.
31:43
OK. So now you are in Atlanta in the
31:46
place where you had worked for several years and when you
31:51
opened your DPC, who were you? Wanting to serve, Initially
31:55
really wanted to serve the people of my community.
31:58
So Atlanta is a very diverse place, but where I live and
32:01
where I work in Atlanta is the Southwest Atlanta region.
32:04
It has a strong historically Black community, and that's one
32:07
of the biggest reasons I came to Atlanta.
32:09
So I'm not originally from Atlanta.
32:10
I'm actually from Boston. I'm very proud of that.
32:13
But Full disclosure, it was hard being a young Black woman in
32:15
Boston. I didn't have a lot of role
32:17
models for someone who was smart and academically gifted.
32:20
I felt ostracized a lot in Atlanta was a sanctuary for me
32:24
because there were smart black people here.
32:26
Spelman College was here, a black medical school was here.
32:29
Just things I never believed in. My wildest dreams were here.
32:33
And these places were made with me in mind.
32:35
When I looked at other medical schools, other colleges.
32:38
I mean, not to get too political here, but you have to in some
32:40
ways, like these schools were not made thinking about black
32:43
women. In fact, they actively
32:45
restricted them, you know, And we weren't allowed to join until
32:47
the 60s, seventies. They've been around since the
32:49
1800s. But I was not welcome there
32:51
until my grandmother where my parents were born.
32:54
And so while many of these institutions may be great
32:56
places, you feel some kind of way when you're like, you didn't
32:59
really want me to begin with. And so being in Atlanta was a
33:03
way for me to really connect with my Black heritage in a very
33:06
positive way. And I wanted to be able to give
33:08
back and contribute to that. So I had the honor of going to
33:11
Spelman College. It's which is a Black women's
33:13
College in Atlanta. We're now the number one HBU 19
33:17
years in a row. So I'm very proud of being a
33:19
graduate of Spelman College. I crossed the street, went to
33:22
Moore Health School of Medicine, which is one of only three or
33:24
four historically Black medical schools.
33:26
I got to train with some of the people who were the first Black
33:29
pediatric surgeons, the first Black cardiologist in Atlanta.
33:33
Like, these were my teachers. Like they are living right to.
33:36
The fact that, like, racism was so strong even here in the
33:39
South, that these people are still alive and still teaching
33:41
medical students is crazy. So I feel part of an incredible
33:45
legacy and I want to be able to give back to that legacy.
33:48
So this is not the at the exclusion of other groups, but
33:51
really at the celebration of what MyHeritage is.
33:54
And being here in Atlanta allows me to celebrate that.
33:56
So when I started my DPC, I'm in the Southwest Atlanta community,
34:00
which is home to a lot of these institutions.
34:03
Doctor King's house wasn't far from here.
34:05
He attended Morehouse College, which is my brother college.
34:08
So a lot of great history here. So I feel very anchored here,
34:11
even though I'm not from here. So when that hospital system
34:14
closed, it really was a thorn in my heart because truly they left
34:18
the blackest community of Atlanta.
34:19
Like I said, they're still standing there in other parts of
34:22
Atlanta that are wealthier, that are whiter, but they left this
34:24
community behind and I was called to really serve this
34:28
community. So I was so glad that I was able
34:30
to override my my non compete or my restrictive covenant because
34:34
I didn't want to have to leave this community.
34:35
So I wanted to keep tears here and do it in a new fashion.
34:39
So when I first opened my DPC, it was just kind of like I'm
34:41
here to serve the people of the South metro Atlanta area.
34:44
I'm here to serve this community and that mission still stands.
34:48
But something interesting happened.
34:49
You asked about me being in a niche or niche.
34:51
I've heard it pronounced both ways.
34:52
I think either way is right. But I did niche down and there
34:56
was a very strategic reason why I niche down.
34:58
And there's two reasons. Number one, in the back of my
35:01
head, I've always known who I really wanted to serve, but I
35:03
was always kind of afraid to say it out loud, right?
35:06
Sole direct primary care is the sacred space for Black Women's
35:09
Health. Like that was.
35:10
That's a radical statement. It's a very radical statement to
35:13
say and sometimes doesn't feel like a safe statement.
35:16
But in the back of my head, when I think about my mother's, my
35:18
sister's, my aunts, my Spellman sisters, I say that Black women
35:22
often get undertreated and underserved in medicine.
35:24
We have the data to back this up.
35:27
And if we can't move the ball forward in that, how can I help
35:30
that initiative? I'm like, OK, I'm declaring that
35:32
this practice is the safe and sacred space for Black women.
35:36
Does that mean I don't treat other people?
35:38
Absolutely not. I have people of all colors that
35:40
join this practice. I have men in my practice.
35:42
I have the most hilarious white guy who joined us, and he was
35:45
like, look, I just feel safe around Black people.
35:47
Can I be a member? It's not.
35:48
He's a member. But what I love about anyone who
35:51
joins who's not a Black woman is they also support our mission.
35:54
Like, they understand they're joining a space that's for Black
35:56
women, and they respect that. It's not hostile, right?
35:59
And DPC allowed me to do that. The second reason I did that is
36:03
because when you get into DPC, you go down these rabbit holes
36:07
about like, how do you market your practice?
36:09
How do you get more patient? And I read the one page
36:12
marketing plan, which changed everything for me.
36:14
And in that book, it's like when you're a small business, you
36:18
can't compete with the larger organizations.
36:20
I can't compete with like a Mayo Clinic or these large
36:23
institutions. You compete on being a
36:25
specialist and really offering something that these big
36:27
institutions can't, right? You're never going to be able to
36:30
compete on pipe price. You're going to lose that war
36:32
every time. You're going to be able to
36:33
compete on the fact that you serve a very specific population
36:37
or very specific niche. It's something that clicked to
36:39
me. I was like, Michelle, stop being
36:40
afraid of calling out who you want to take care of.
36:43
Like call out to that niche and they will start to come.
36:47
I remember, like going back and forth like, Oh my gosh, I say
36:49
this, Are people going to think I'm being racist or, you know,
36:51
discriminatory or. But I really knew what I wanted
36:54
to do, right? And so finally I leaned into it
36:57
and I was like, that's it. Like, yes, soul will welcome
36:59
anybody, but our mission is to serve Black women.
37:02
And what that has done for my practice has been explosive
37:05
because now when people think about Soul Direct primary care,
37:07
they think about the sacred space for Black women's
37:09
Wellness. And that message is strong.
37:12
So, and I know it's working because there was one time I was
37:15
speaking to another physician who is a specialist, and she'd
37:18
heard about my practice. And I didn't know her.
37:20
She didn't know me personally, but Black women were coming to
37:22
her practice saying, I'm so frustrated with my primary care.
37:25
I don't like what's happening. And she's like, you know, well,
37:27
there's this little practice in Eastwood that's designed for
37:29
Black women. So she heard that message.
37:31
It's stuck. And she got it to my audience,
37:33
right, because she knew what I stood for.
37:35
If I was just sold DPC. It's like there's some direct
37:38
primary care practice. Like nothing makes it special.
37:40
But now when people say, OK, here's the the population, here
37:43
is the practice that's for you. And they tear it together.
37:47
So it's helped bring a lot more referrals into my practice.
37:49
And for those women that felt unseen, they're like, this is
37:52
our home. This is where we want to be.
37:54
Like this is where I can let my hair down.
37:55
This is where I'm not going to be judged.
37:57
This is where someone knows my health conditions.
37:59
I don't have to explain why my hair is different or why my skin
38:03
looks different. Like I don't have to explain
38:04
those things here because they get it.
38:07
And so it's been one of the most powerful things for me to do.
38:10
And now that we're in this age, that's so strange, but all of a
38:13
sudden, like very anti DEI and not celebrating diversity
38:17
anymore, it seemed like a risky move.
38:19
But it's actually been more powerful than ever because I
38:21
think people want something to hold onto that feels like this
38:23
is a sacred space and it's just for us.
38:26
And so I've been holding that baton for a while, but I kind of
38:28
got there in an awkward way, but I really just had to double down
38:32
and say don't be afraid to say it.
38:34
You're going to have some enemies.
38:35
You're going to have some people that don't believe in your
38:36
mission. You may have some people who are
38:37
actively against it, right? But those are those boundaries.
38:40
If you don't want to come here, that's fine.
38:42
Just don't stand in my way, right?
38:44
Don't, don't, right? I'm not saying you can't, just
38:46
don't, you know, And I don't have to be for everybody, but
38:49
sometimes when you're speaking to everyone, you're speaking to
38:51
no one. And I just got very clear about
38:53
who I'm speaking to and in the DPC realm, when I love about it
38:57
is it really helps inform everything you do at your
39:00
practice. I think people struggle with
39:02
marketing because they don't really know who they're talking
39:03
to. They're like, I just want
39:04
patience. It's like, well, who do you
39:05
really want to serve? Who would you best at serving?
39:08
For me, I know the needs of black women that can serve that.
39:11
Maybe you're an ex athlete. You know what ex athletes go for
39:14
and that's where you serve because you are the best at
39:16
knowing how to fix those Acls and how to optimize downtime and
39:21
all that kind of stuff. Or maybe you're neurodivergent
39:23
and you know how to speak to those patients that have autism
39:26
or horror on the neuro diverse spectrum.
39:28
So I think DPC allows doctors to take what's best about them,
39:31
what's special about them, and give it to the patients that are
39:34
going to benefit from it the most.
39:35
So it was one of the best decisions I've made and it was a
39:38
scary decision that it was a risky thing to do, but it's been
39:41
one of the best decisions I've made in my DPC.
39:44
Yeah, that, yes, I mean, that's how you brand, that's how you
39:48
build a brand. Yeah, that's the definition of
39:51
it. And the scary part of it, I
39:54
think is maybe deep down you were like trying to see, do I
39:59
have permission? To do this.
40:02
Right. You know, what are people going
40:05
to say? And so that yeah, that's why
40:08
it's scary, because all. These things, right?
40:10
And it's all just the mind matter that's there, and you
40:12
just have to clear that out of the way.
40:14
It's like, yeah, somebody's not going to like you, but who
40:16
cares? You only need 300 patients
40:17
anyway. You know, like you're going to
40:19
have to keep typing yourself up. It's like you don't have to be
40:21
that doctor for everybody. You don't have to be everybody's
40:24
friends, but the people who you were there for are willing to
40:27
ride with you. You know, we all DPCS deal with
40:31
churn. They deal with people leaving
40:32
their practice. And it happens here too, right?
40:35
But most of my patients who leave are leaving kicking and
40:37
screaming. They're like, look, I have to
40:39
move or, you know, and you know, I lost my job.
40:42
I just don't have this in the budget input that this is where
40:44
I want to be. Like, this is my home.
40:45
I'm so sorry to go. Because they value this care.
40:48
And that also allows you just to be a better doctor because now
40:51
you're caring for people who really value your opinion, who
40:54
want to know what you want to say.
40:55
Like, they don't come in hostile, They're coming in
40:57
hungry for what you're able to deliver to them.
41:00
And that has really restored my love of medicine again, because
41:03
people who come here really value what we deliver.
41:07
Right, they value you and not just.
41:11
Their right, so I was like you take this and it's like there's
41:13
no connection, but now it's like no, I'm here because this doctor
41:16
is a serving a problem I've had for a long time and she sees me
41:20
and so yeah, that it's been. Incredible.
41:22
That's that's amazing. And I totally get it because
41:26
when we first opened, my partner and I, we thought, OK, well, we
41:30
are coming from a multi specialty like OB kind primary
41:34
care office. So of course, I mean, I've been
41:37
seeing women for almost 13 years, just women.
41:41
And we thought, OK, well, if we really, if we really want to
41:44
help people make a change, right?
41:47
If they're smoking, if they're not eating properly, if, you
41:49
know, you need to kind of you need to help the family, right?
41:53
We're family medicine doctors, right?
41:54
So you need to help the family. That's the whole biopsychosocial
41:56
model. So we did start seeing men,
42:00
which is fine. Yeah, it's fine.
42:06
But we've realized we don't love it.
42:09
I mean, not to say that our male patients are, you know, bad or
42:13
anything. It's just we really do prefer
42:15
seeing women. And so this past like 6 months,
42:20
you know, we've kind of leaned into the midlife care, hormone
42:25
therapy. And this summer we like change
42:28
the website and it's like midlife in his care.
42:31
I mean, we still take male patients.
42:33
Like you said, you're welcome to see people, but that's really
42:36
that's who we're focused on now. Exactly.
42:40
And there was a little bit of that.
42:41
Can I do this? Can I put that on the website?
42:45
And it's like. Right.
42:48
Right, we're just. That can happen, you know, But
42:50
yeah, I feel like we're always looking for that permission of
42:52
who's going to sign off on this and doesn't have to go to a
42:54
comedian. To be able to have the
42:56
flexibility to make those changes is both a huge benefit
43:00
and value of DPC. But it's also kind of scary.
43:02
It's unfamiliar. Like it.
43:03
It's weird to have that power back in our corner again.
43:06
I make, I have a funny memory about when I was setting my
43:09
schedule for DPC. It was like, Oh my God, I can
43:12
make my appointments as long as I, well, I don't have to ask
43:14
any. But like in here I am like a
43:15
grown woman, like, oh, I can make my, you know, like we're
43:19
not used to having that authority, you know, over even
43:22
some of these simple things. The DPC brings that back into.
43:24
Our life. Yeah, I told my partner.
43:28
I said, I'm not seeing anyone before 9:00 AM because I have to
43:32
drop my kids off. And I'm always, the office is
43:35
half an hour from our house, so I am rolling in like at 8:50 or,
43:38
you know, 755. And she was like, you can't do
43:42
that. And I said, why not?
43:44
I'm going to do that. And so sometimes I don't start
43:47
till 10 actually, you know, definitely 9 is the earliest.
43:51
But yeah, she's like. And then she said, Oh yeah, I'm
43:56
not either. And that's.
43:56
Your boundary like this is what works for me.
43:58
It may not work for every patient.
44:00
So that early bird patient, you're just not the right doctor
44:02
because it doesn't fit, you know?
44:03
And so I feel like the more you can get that congruence between
44:06
your patients, those patients that don't mind or they're late
44:08
starters of the morning, like it works, it works.
44:11
But I feel like sometimes in those studies where you don't
44:12
have the authority, they're like, no, we want to capture as
44:16
much as the market as possible. We're starting clinic at 7:00 AM
44:18
because people want early appointments.
44:20
And now it's totally conflicting with your life and you can't
44:23
take your kids to school. And that joy that you wanted to
44:26
be a mom is gone. And it's violence.
44:29
And so it's like, it's OK, you don't need that permission.
44:32
Like, if it works for you, that's enough.
44:33
Yeah, that's enough. That's a great place to end, I
44:36
think. I know we get deep.
44:38
I know you talk about DPC and it's so like soul wrenching,
44:41
right? So we get to those levels.
44:43
I know. When people talk to me about
44:44
DPC, I'm like. Well, I know, right?
44:46
What do you? Have because I can do this all
44:47
day, like literally all day. I could do this.
44:52
So OK, well let's wrap up. How do people find you on the?
44:57
Inner web certainly, so I make myself very findable on my
45:00
website, of course, for the practice is sole dpsol-dpc.org.
45:05
If I give any tips to DPC doctors about your name, try not
45:08
to put hyphens in there. It confuses everybody.
45:10
But I missed that book, but sol-dpc.org.
45:13
But finding me personally, I'm on Facebook, I'm on Instagram,
45:16
I'm on Tiktok at Doctor Michelle Cook.
45:19
So if you've just yeah, Doctor Michelle Cook and Michelle is
45:21
2L's and cook at the end of the cook is an E at the end of the
45:25
word. Just remember that Part 2 L's
45:27
cook with an E. Yeah, and your website is?
45:29
Itis.org, That's correct. OK.
45:32
Just to be clear, because. That's available there's.
45:34
Actually another sole DPC and I'm going to forget the doctor's
45:38
name. It just I she's in, I want to
45:39
say either Arizona or one of those like Southwestern states.
45:43
And we met for the first time at the DPC summit.
45:45
She's like, I'm your sister sole pick.
45:48
So that's another one. So the domain was taken.
45:51
I didn't know why, but there's another sole DPC.
45:53
So there are two of us, but I'm the East Coast, you know,
45:55
Atlanta baseball or southern, if you will.
45:58
So ours is emerald health. There's an Emerald DPC in Ohio
46:02
and I haven't met that doctor yet, but I I don't know why it
46:06
didn't come up when I was searched when we were searching,
46:08
you know, like someone else have this name and literally the day
46:12
after I saw it. Right.
46:14
I think as long as you're out. Of maybe like a week after we.
46:17
Don't have started, you're out of state.
46:18
It's OK. I mean, it's nice to kind of
46:19
have that domain, but if it's not like somebody that's like
46:22
your neighbor or something like that, I think it's OK.
46:25
Yes, yeah, yeah, yeah. OK.
46:27
So we will. Let's see.
46:30
We'll put the website, all of your information in the show
46:33
notes and then also for the mixer, which will be today.
46:36
So right, we're about 2 1/2 weeks out, October 11th here in
46:41
Atlanta, 11 to 3:30 at the Four Point Sheridan near the airport.
46:45
So I'll definitely send you the the landing page where you can
46:47
buy your ticket. And where's the after?
46:49
Party so we'll have to ask me to let our our sponsors about that.
46:52
I'm usually pooped after those things.
46:54
I don't know I'll be a good for an after party, but if you like
46:56
to plan it in, you know, we will have the hotel space just let
47:00
you know. And they do have a rooftop area.
47:03
You know, October in Atlanta is usually still pretty nice.
47:04
So maybe. Maybe so.
47:08
We'll think about. Get on on it.
47:12
All right. Thank you so much.
47:13
This was so much fun. And yeah, we'll have to talk DPC
47:17
all day long and. Absolutely.
47:18
Thank you and thank you for making this podcast.
47:20
I love that we're reaching more DPC docs and showing it.
47:23
So thank you for your bravery in this.
47:25
Yes, absolutely. Well, thank you.
47:27
I appreciate you and we forgot you also have a podcast I'll
47:31
put. That one on the show, yeah,
47:32
building DPC, it chronicles my first year in DPC, so like how I
47:35
got there. So you'll hear more in depth
47:37
stories about my exit and then just all the things that I
47:39
tackled from choosing my EHR, choosing my location, how do you
47:43
build a website, all that stuff. It's all in there.
47:46
So if you're getting started, it's definitely worth the
47:47
listen. Yes, so definitely for starters
47:50
or DPC dreamers as I call them. Thank you so much.
47:52
I appreciate your time and hopefully I'll see you.
47:55
Thank you, Anne, thanks for listening to DPC Life.
48:00
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48:04
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48:08
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48:11
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