Latest / DPC Life: Direct Primary Care Podcast / When Doctors Break Quietly: What Corporate Medicine Takes and DPC Restores

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When Doctors Break Quietly: What Corporate Medicine Takes and DPC Restores · DPC Life: Direct Primary Care Podcast

0:00
So I'm not going to sit here and say DPC is perfect and that
0:03
there's no problems, but they're my problems and I have the
0:06
control to fix them. They are.
0:09
I am the system. I hated the person that I had
0:12
become in corporate medicine. It was a very frightening
0:15
condition to be in. No control over my schedule, no
0:18
control over where to refer my patients or how much time I got
0:22
to spend with my patients. Welcome to DPC Life, the podcast
0:26
where independent doctors share real stories.
0:29
Bold ideas and the freedom of doing medicine on your own
0:33
terms. I'm your host, Doctor Anne
0:36
Gonzalez, and together we'll explore the winds, the
0:39
struggles, and everything in between.
0:42
Let's dive in. Welcome back to DPC Life, the
0:46
podcast where we talk about all things DPC and everything beyond
0:51
the office. Today I'm talking with Doctor
0:54
Noemi Adame. She's a pediatrician and founder
0:57
of Culver Pediatric Center. She previously worked in
1:00
corporate pediatric world but decided to leave when she felt
1:06
she couldn't practice medicine the way that she felt it should
1:09
be practiced. And so now she has built her
1:12
practice around her values, and she left her corporate job when
1:17
she felt that she could not care for complex children in a system
1:22
that only gave you 10 to 15 minutes with each patient.
1:25
So if you're a physician who has felt like you are slowly
1:28
breaking down within the system, this conversation will show you
1:33
how. One Doctor Who felt the same way
1:36
has rebuilt her practice and enjoys practicing medicine
1:40
again. So let's get into the episode
1:43
with Doctor Noemi Adame. Today my guest is Doctor Noemi
1:47
Adame. She is a pediatrician in Culver,
1:50
IN and her practice is called Culver Pediatric Center and
1:55
she's also called the Veggies over pills doctor, so she'll get
1:58
into that later, I'm sure. But welcome to the show I'm.
2:02
Glad to be here. Absolutely.
2:04
So glad to have you. So let's start out.
2:06
You are a pediatrician obviously, and tell us how you
2:10
found DPC I. Started off my first job
2:12
straight out of residency. I was a hospitalist in San
2:16
Antonio for about 10 years, and I thrived in that environment.
2:20
And then we lived out of the country for two years just
2:23
simply because my husband and I wanted to show our kids a
2:26
different life than living in a gated community in the San
2:30
Antonio suburbs. And when it was time to come
2:32
back, we decided to live in a small town 'cause we had lived
2:34
in a small town in Costa Rica. And so we wanted to come back to
2:37
the States, live in a small town.
2:38
That's how we ended up in Culver.
2:40
And obviously there was number hospitalist jobs here.
2:43
So I went into the corporate medicine world and I just did
2:47
not thrive in that environment. And it was just that.
2:51
And it was the hurry up, hurry up, we've got 10 minutes to see
2:53
a patient. And it didn't matter if it was a
2:55
suicidal 15 year old or a breastfeeding mom that was
2:58
crying because she was struggling to get her baby to
3:00
latch or a sore throat. And I was so morally injured and
3:06
distressed, I don't even know how I lasted five years, quite
3:08
honestly. And I think it was just part of
3:10
that. In medicine, you just, you plug
3:12
along, you're resilient, you're tough, you make you do it for
3:15
the patients, right. And somewhere around there,
3:18
there was a doctor, a local doctor, Joel Schumacher, who had
3:21
opened up his own DPC practice. So I had reached out to him.
3:24
I didn't really know what DPC was, but honestly, it was to see
3:26
if he would hire me. It is why I had reached out.
3:28
And he, I feel like he was like my Yoda.
3:31
He showed me the way of DPC and I realized that I didn't just
3:37
hate the doctor I had become in corporate medicine.
3:40
I hated the person that I had become in corporate medicine.
3:44
It was a very frightening condition to be in.
3:48
So I knew I either had to do this, do DPC and open up my own
3:52
practice so I could practice medicine the way I wanted to, or
3:54
leave medicine all together because I just, I could not
3:57
continue with a moral injury in the corporate world.
4:02
And so that was how long ago? That was like that was around
4:07
2018 when I 2019 when I sat down with him and learned all this.
4:13
And then I opened up my practice in August of 2020.
4:17
Yeah. Wow, great times.
4:20
Wow, so you are really one of the early Peeds DPCS?
4:25
Yeah, when we first, I think there were 12 people in the
4:28
Peeds DPC group, the Facebook group when I joined and now
4:32
there's 500 or. Something.
4:34
Wow. Thing that growth has been.
4:36
Amazing. That is great.
4:37
Yeah. My husband's a pediatrician.
4:39
And so when we opened one time, I was reading him a note from
4:42
one of our patients, and it was so sweet.
4:45
We spent so much time, and this is the best place I've ever
4:48
been. It just tip things that DPC
4:51
patients say. And he was like, I've never
4:54
gotten anything like that from my patient.
4:59
And I've asked him if he wants to join and he's just set in his
5:02
ways. He's no way.
5:07
And that's great when it can work.
5:09
Yes, yeah, yeah. But it's, I hear so many women
5:14
talking about just like you said, you know, the moral injury
5:18
and either it's DPC or I'm out, which is terrible right now.
5:25
Because, you know, it's so funny because people keep saying, oh,
5:28
the system is broken. The system needs to change.
5:32
As physicians, we have lost control of the system.
5:35
We don't have control over the system.
5:39
We can't tell it to change. So I'm not going to sit here and
5:43
say the PC is perfect and that there's no problems.
5:46
But they're my problems and I have the control to fix them,
5:49
right? They are.
5:51
I am the system, yes. So I have autonomy and I have
5:56
the freedom to make those changes.
5:58
And so so yeah, it just, I felt very powerless and had and felt
6:03
like I had no autonomy. Again, when you are the most
6:06
educated person in the room, but somebody else with less training
6:08
and education is telling you what to do, it is just mind
6:10
boggling. So no control over my schedule,
6:13
no control over where to refer my patients or how much time I
6:19
got to spend with my patients. That was just so distressing for
6:22
me when I was a hospitalist. You're in this academic bubble
6:25
and I could round all day with my residents, right?
6:28
You know, I mean, we and we took care of sick complex kids and
6:32
we're a tertiary care center and we're an academic center.
6:35
So but I could round all day if I need, if I had one patient
6:39
that I needed to sit down and spend an hour with and dive
6:42
through the chart and generate A differential, I could do that.
6:45
You can't do that in the corporate world.
6:46
Like click the billable, encounter the CPT code and move
6:50
on. Yeah, I couldn't do that.
6:51
That that just distressed me to know.
6:53
Yeah. Back to about the system being
6:56
broken, you see people talking about kind of the DPC naysayers
7:00
talking about, well, this is hurting the system, But it
7:03
bothers me when people try to put all of the problems of the
7:07
system on DPC doctors. Like DPC is supposed to fix
7:10
everything. Well, we know it's not going to,
7:12
and that's a ridiculous thing to say to people who are trying to
7:17
make a change. So that's yeah, that's my gripe
7:20
today. So anyway, you are the veggies
7:26
over pills doctor. So tell us how you got that
7:29
name. So when I was growing up to a
7:33
little bit, my parents were from Mexico, they were immigrants.
7:36
I grew up predominantly in the Spanish speaking household and
7:39
we didn't have access to healthcare.
7:41
So my mother treated us with home remedies at home.
7:46
And so I entered medical school, I think with more of an open
7:52
mind with regards to complementary and alternative.
7:55
We call it alternative Even so it's been around like much
7:57
longer right than allopathic medicine.
8:00
And like I took, I went to school at UTMB in Galveston,
8:03
which I was actually even back then, I kind of like a crunchy,
8:07
a little more progressive type of school.
8:10
And so I took courses on holistic or at that time they
8:14
called it complementary and alternative medicine.
8:16
And so I was always very interested in that.
8:19
But then of course you start residency and then you go into
8:21
the academic world where it's like it's evidence based or
8:24
nothing, right? And then the corporate world
8:26
where maybe it's not as rigid with that regard, but there's no
8:30
time, right? There's no time to learn or
8:33
explore all these other things. So when I finally reclaimed my
8:38
time and my joy and my peace, when I started out my own
8:42
practice, I, I started taking all these courses that I could
8:45
finally take that I had always been interested in.
8:48
So I started taking nutrition classes or nutrition training
8:51
through the American College of Lifestyle Medicine.
8:53
I started, I took, I did training on the integrative
8:56
management of ADHD and autism through the Andrew Well
8:59
Institute of Integrative Medicine.
9:01
And, and then all this time like that was in my professional
9:04
life, in my personal life, I had become a vegan.
9:06
I've been vegetarian since, since I was in residency like in
9:08
2004 and then became a vegan around 2018.
9:12
And so then so learning about lifestyle medicine very much, I
9:16
incorporated that not just into my professional life, but in my
9:19
personal life also. And I realized that the data was
9:23
just so robust that as a doctor, I would be irresponsible not to
9:29
share all this information with my patients about the impact of
9:32
not just nourishment, but social connection, avoiding toxic
9:37
substances, restorative sleep, mindfulness based stress
9:41
reduction, all those at pillars of lifestyle medicine and all
9:45
these integrative medicine principles that I had learned, I
9:48
could finally integrate them. And ultimately with a lot of my
9:51
patients, I take care of very complex kids, PANS, PANDAS,
9:54
autism, very complex kids. And ultimately my goal is
9:57
actually to unmedicate. And so when I was trying to come
10:00
up with, OK, how do I attract that type of family that yes,
10:06
absolutely. And I do prescribe medications
10:08
and I always tell families I do prescribe medications.
10:11
But ultimately my goal is to give you the tools that we can
10:17
unmedicate your child safely and with very close follow up.
10:21
And with the absolute, the absolute, we will pivot if we
10:25
need to, But if we cannot medicate, I want to.
10:28
And so when I was trying to come up with a little slogan of how
10:31
do I attract families who ultimately want to unmedicate, I
10:34
came up with Veggies over Pills, which is which was kind of a
10:37
play on Forks Overnight, which is a magazine that that promotes
10:42
Whole Foods, plant based recipes and nourish.
10:44
So that's how Veggies over Pills was born.
10:46
That's genius. So how did that work?
10:49
Really Well, I actually, we do attract a very niche.
10:53
I'm in Indiana, right? And I mean, I'm looking out the
10:57
window at a cornfield that was just harvested.
11:01
There's there's hail hay field over on this side, There's cows
11:05
over on this side. The clinic's at my house.
11:09
And and yet I have families that travel from Chicago.
11:16
They drive past Larry Children's, University of
11:19
Chicago, Brush, Loyola to come to us.
11:22
I have families from Ohio that drive past Nationwide and Dayton
11:27
Children's and they come to us. We had a family that flew in
11:31
from California. My gosh.
11:33
To see me, and I think it's in part is a reputation, right?
11:37
But I do think it's that the my ultimate goal is to unmedicate.
11:43
And I think a lot of families are looking for that.
11:46
They don't just want pills. They want skills and other
11:52
resources and other tools and ultimately a Doctor Who listens.
11:58
And I could not do this in the corporate world.
12:01
The only way I can do this is because I am in the DPC world.
12:05
And when I do meet and greets, I tell families I don't have
12:08
access to secret medicines or secret treatments that other
12:13
doctors don't have access to. In fact, I would not trust the
12:17
Doctor Who says, oh, only I can do this test.
12:20
Only I can do this treatment, right?
12:23
I don't have. I don't have access.
12:25
What I have that other doctors don't is time.
12:28
Yeah, is the time, and that's what DPC has allowed me to do
12:31
right, Is I have the time to sit down and review your child's
12:35
records and review their case and review all the labs and then
12:39
order more labs and review. We do a very detailed intake
12:42
also, it's not just review of records.
12:44
I have them fill out a lot of forms so that by the time I see
12:46
them, I'm not trying to gather history.
12:48
You know, again, the corporate world is so inefficient.
12:52
Like the first time I meet the patient, I don't know anything
12:54
about that. I'm just trying to like piece
12:56
things together and the way I've, I've my protocols is by
13:00
the time I do my first intake, I already know a lot about the
13:03
family. So it really is more about
13:05
clarifying, OK, well, the chart said, the chart review said
13:08
this, but your intake said this. And just trying to piece some
13:11
things together, create an accurate timeline and really go
13:14
over treatment goals. What does recovery look like for
13:16
you? And and so I do think that it
13:19
has worked in the sense that it has it that name the veggies
13:23
over pills calls to a certain type of patient and it's a type
13:27
of patient that I want to work, right.
13:29
It's very direct. It's a direct call to the people
13:32
that you want. There's no ambiguity about that
13:35
ambiguity, right? So that's great.
13:37
And again, then I have had people like, do you prescribe?
13:40
I'm like, yes, of course I'm a licensed pediatrician.
13:43
I'm an evidence based doctor. But ultimately those a lot of
13:47
those medications are band aids and and so ultimately I do want
13:52
to get to and I know a lot of physicians get triggered with
13:54
the term root cause, but yes, but the root cause and find out,
13:58
OK, so OK, what is causing the inflammation?
14:01
Is it the gut? Is it the immune system?
14:03
Is it allergies? Is it Celia like the sure
14:05
Things? Yeah.
14:07
Well, that's fascinating. So when you opened Culver
14:10
Pediatrics, did you already know that he wanted to work with
14:14
Pans, Pandas, all those kind of complicated things?
14:18
Not at all. It's funny because I, I set out
14:24
to be like the small town country Dr. right?
14:30
Like I wanted to be like all creatures great and small, but
14:33
for Pediatrics instead of animals, instead of a veterinary
14:37
medicine. I was doing house calls you.
14:40
Like I said, the clinics at my house initially, all my patients
14:44
were patients who followed me 'cause I've been in the
14:46
community for five years at that point.
14:47
So they followed me and then slowly we started getting some
14:50
word to mouth patients. And so no, I set out to be like
14:54
the hometown country, small town country Dr. that clinics at the
14:58
house and does house calls and sees kids in the parking lot of
15:01
the grocery store, like that kind of thing.
15:03
And, and what happened was in late 20, about two, almost three
15:09
years after opening is we had our first Google family, what I
15:14
call my, our first Google family.
15:16
And they found us through Google.
15:17
They googled holistic pediatrician near me.
15:20
I was actually an hour away from them, but that just tells you
15:23
when what of a medicine desert we live in.
15:26
And we were doing one-on-one meet and greets at the time.
15:28
I talked to the dad. I actually had no idea that the
15:31
child had been sick for about a year.
15:33
And I said, I, I don't know what's going on, but all I can
15:36
tell you is my background. I'm a digger.
15:39
I'm a diagnostician and I will do a deep dive and figure out
15:43
and if I don't figure it out, I will help make sure I find
15:47
someone who does. And so they joined the practice
15:49
in January 2023. February 2023, I go to the first
15:54
pediatric DPC mastermind and Dr. Courtney W Get out of
16:00
Pennsylvania gave a talk on mental health and behavioral
16:02
health for the DPC pediatrician and she talked about PANDAS and
16:07
I was like, Oh my goodness. Now at that point I was seeing a
16:13
lot of ADHD and depression and mental health because that's
16:16
usually who gravitates towards Pediatrics DPC.
16:18
But I hadn't I that at that point.
16:22
I, it triggered a memory from when I was in medical school
16:25
because I went to medical school in 98.
16:27
I was my first year of medical school.
16:28
That's when the first studies came out and I remember my
16:31
professor talking about strep pyogenes and the complications
16:34
that included rheumatic fever post streptococcal
16:37
glomerulonephritis and PANDAS. That was my training PANDAS.
16:40
And so I'm sitting here in this conference and I hear about
16:45
PANDAS again after 20 something years.
16:48
I literally, I'm at the conference, I open up my
16:50
computer, I emailed the family and I say I know what your child
16:54
has. And we started the treatment
16:56
algorithm from the PANDAS physician network.
16:59
Dr. West very kindly guided me through my first patient and and
17:03
she went into remission after her first dose of IVIG.
17:05
Amazing. I just got chills.
17:07
Hearing that story, amazing. And and the pandas community is
17:11
very tight knit. They have Facebook groups, they
17:16
have parent support groups. And from there they my name
17:21
started spreading and now we have a little over I and you
17:26
know, you can take the girl out of academics, but you cannot
17:28
take the academics out of the girl.
17:29
So I read a lot. I read a lot and I learned from
17:35
my patients. Also, I learned something new
17:37
every day from my patients and kept an open mind and also
17:40
realized there's a lot of money grabs and predatory certain test
17:44
panels that are thousands of dollars that ultimately don't
17:47
really change anything that we do.
17:49
And so I do feel I'm able to at least guide families.
17:53
OK, we don't need to spend $2000 on the Cunningham panel.
17:56
It's not going to tell us anything other than their.
18:00
Your child has inflammation. And I can tell you that, yeah,
18:04
right now that there's inflammation, right.
18:06
So do we really need this very fancy and very impressive report
18:10
that says yes, cytokine, blah, blah, blah is elevated?
18:13
We really don't. So.
18:14
But yeah, that's how it happened.
18:16
It was serendipitous and. And for me, it's been great
18:19
because as an academic, I do like that the challenging cases
18:24
and the diagnostic dilemmas. And so it's filled that void
18:28
that I was worried about intellectual stagnation.
18:30
Yes. And, and so it has filled a void
18:34
just intellectually for me, in addition to how it just, it's a
18:38
humbling, it is a humbling experience.
18:40
Well, you can tell that you enjoy it.
18:42
I mean, your face just lights up when you talk about it, so it's
18:45
wonderful. I'm so glad for your patience
18:46
that they find you. So how many kind of pans pandas
18:51
patients do you have now like percentage wise of your
18:54
practice? We have about 120 patients and
18:59
at our last count about 30, although we that, that was a
19:03
couple months ago when we did a count.
19:05
So it was probably at this point we probably have like 35 S Most
19:08
of my, my patients don't have PANDAS, but most of our new
19:14
patients definitely it's for our PANDAS clinic.
19:18
So yeah, is your practice. It's not closed.
19:22
You're still open to new patients.
19:24
Yes, we are still taking new patients.
19:26
Yes, we still take new patients. Yeah.
19:28
And are you advertising or are you just kind of word of mouth?
19:31
You know, it's interesting and marketing is always something we
19:34
have these discussions in the DPC world about marketing.
19:37
None of our paid marketing has ever given us any return on
19:42
investments. If there's DPC docs listening, I
19:45
have spent disastrously expensive radio ads, print ads,
19:52
Google ads, $9000 worth of Google ads we have and no pay.
20:00
Oh there's a lifestyle magazine that local for our county that
20:03
people pay like $10,000 to be on the cover.
20:06
We did not pay that much, but yeah, it was like 3 grand for an
20:09
article and. Nothing zero.
20:12
I did a radio show for a while. It just the paid marketing here
20:17
has left has 00 investment. So the way we market 1st is we
20:26
provide amazing care absolutely. And so word of mouth is one of
20:29
our main is our main marketing is the other is we do have a
20:32
very active social media and web presence because because
20:37
especially since people from the Facebook groups talk about us
20:40
and I still consider that word of mouth because even though the
20:43
word is happening in social media, it is still one person
20:46
telling another person. About it's organic.
20:49
But then they go to our website and our social media for the
20:51
vibe check. And then from there they can
20:53
we're very digital and very automated.
20:56
And so they can schedule a meet and greet directly from our
21:01
website. And then all that process is
21:02
automated. And so we market in that sense.
21:06
We still do social media. We're very active.
21:08
My daughter actually does our social media.
21:10
And, and so, yeah, it's a post every day on Facebook and
21:13
Instagram. And then our website is very
21:15
active. I keep A blog for SEO mainly.
21:18
I mean, nobody reads it, but but we use it #1 for SEO because
21:22
Google detects that like how active is the website?
21:27
When was it last updated? And so, so yeah, those are the
21:31
kinds of things you have to think of as a DPC doc.
21:33
Either you have to think about it or somebody else has to be
21:35
think about it. Because your website isn't
21:37
active, it's not going to pop up on the search engine reviews.
21:42
We ask for reviews. So all of our reviews are five
21:45
star right now. So that's also a marketing in
21:47
the sense that it's Google, right?
21:49
It's playing the Google game. But yeah, the reviews have led
21:53
us to more patience than the disastrously expensive Google
21:59
Ads. But then I hear dogs from other
22:02
markets that say that Google Ads have yielded them a lot of our
22:05
apps. I just, it's it just every
22:07
market's. Different.
22:08
I think it is very area specific.
22:10
Very area specific here in with me with being rural and being
22:14
such a niche demographic. It's word of mouth.
22:18
Yeah, yeah, yeah, definitely. Well, I wanted to talk about
22:23
things that you do outside of your regular practice because
22:27
that's what we talk about on the podcast, DPC stuff in the office
22:30
and also outside. So whether it's things like non
22:33
medical or whatever your passions are.
22:36
So tell me about your women's retreat.
22:40
Yeah, So that, wow, that was a passion project.
22:45
Yeah, that was a passion project.
22:47
So I'm gonna get a little personal here in 2023, so I had
22:51
already been open for three years at that point.
22:54
I got a phone call that that from my sister or one of my
22:57
sisters that my mom had a stroke and it was a shock because she
23:03
was 79. She was months from turning 80,
23:05
but she was healthy. Like she walked three miles
23:08
every day. She lived independently.
23:11
She cooked, she baked that the day that she had her stroke, she
23:14
actually, she went on a walk, power walk for three miles.
23:17
She LED a Bible study. She had lunch with her friends,
23:20
She baked cookies and she worked in the backyard.
23:23
We were able to piece all of that from the Ring camera.
23:27
And so she'd had a stroke. And so I flew down to Texas.
23:30
And six days later, she succumbed.
23:33
And during that time, while I was literally in the ICU
23:37
watching her die, I was sending refills, answering texts, doing
23:42
telehealth from the bathroom in the hospital.
23:46
And in the aftermath of processing all that trauma, I
23:51
realized that what had led me to that point was some internal
23:57
pressures, right? The people pleasing.
24:00
I'm the first born daughter of immigrants.
24:01
People pleasing is my drug of choice.
24:04
So saying no is really hard for me.
24:07
I've gotten better about saying no, and I actually can say no,
24:10
but I still feel really bad about it and still working with
24:13
a mindset coach about that. But I realized that I had to
24:18
overhaul both my personal and my professional life.
24:22
Around that time. I came across 2 studies, 1 from
24:26
2022, that showed that patients and staff send female doctors
24:31
more messages through the portals, 25% each.
24:34
So depending on the size of the panel, that can be 60 messages
24:38
or more. A 2025 study that patients are
24:41
more likely to send female doctors demeaning or negative
24:44
messages. And then another study that was
24:48
very eye opening, while in the general population women outlive
24:52
men and not for female physicians, we don't have that
24:57
longevity benefit with our male doctors.
24:59
And so learning all of that, learning what I'd learned from
25:07
being in practice at that point for about 3 years and trying to
25:12
heal from the trauma of not just losing my mother, but what had
25:16
led to me being in the ICU. And instead of being fully
25:19
present during the last, her last days, doing these things,
25:23
right? Like answering, like still
25:24
working even though I was the boss.
25:26
Like literally it was, this was me, right?
25:29
This was me. I came up with the idea of a
25:31
retreat. Actually I was in the
25:33
mastermind, in the second DPC mastermind, and I mentioned
25:36
something about how we would do retreats for moms of children.
25:40
And one of my colleagues, Deanna Berry, who she was one of the
25:43
participants and she coordinated the DPC mastermind.
25:46
She said you should do this for us.
25:48
And I went, girl, we'll do it. So we had our first retweet
25:52
September of this, last of this year, September 2025.
25:56
It was such a powerful experience to have a group of
26:01
all DPC women talk about things that nobody else in the world
26:07
understands and not even our male colleagues, right?
26:11
Because again, patients treat us differently than they treat male
26:16
DPC doctors, right? They have different
26:19
expectations. And, and so it is more important
26:23
for us as female doctors to establish boundaries, to
26:28
establish processes and protocols that protect us.
26:32
That one of the things that I talked about in the retreat was
26:35
dare to Click to click less and care more, which is delegate,
26:38
automate, renovate or eliminate so that you're protecting your
26:43
energy and your bandwidth as a female DPC dog.
26:46
And the retreat had all the fingerprints of a noemi thing,
26:49
right? So all the food was whole, was
26:51
plant based. We did yoga every morning.
26:54
We had meditations at night. So it was just really fun for me
26:59
to do something that was non medical, healing, empowering and
27:07
just brought together this community of women that really
27:11
there's no one else in the world that understands what it's like
27:14
to be a female DPC dog than other female DPC dogs.
27:18
Yeah, yeah, I hear what you're saying.
27:20
I think that's it's wonderful and I think a lot of people are
27:24
feeling that. And that's one reason why I love
27:27
the DPC women's Facebook group. It is a safe space and everyone
27:32
understands what each other is going through, even if you have
27:35
a different kind of practice, a different style, different size,
27:38
all of that. But there are still some things
27:39
that are very universal for women DPC doctors.
27:44
Right. And I do think that there's some
27:46
things that I would not feel comfortable discussing in the
27:51
general group, for example, pricing, right?
27:53
You know, as female doctors, we do have to think about pricing
27:59
differently because the we do have to keep smaller practice
28:04
sizes I think than our male doctors.
28:06
There's just a different expectation.
28:09
There's just a different we, I think we attract a different
28:12
population. I do think patients that make
28:14
more demands of us and, and so we, and then so those are the
28:18
external pressures, but the internal pressures female.
28:20
And this is studies, studies show female doctors have better
28:24
outcomes and this is across multiple specialties, surgical,
28:29
inpatient and primary care. Female doctors have better
28:32
outcomes for patients that are treated by female doctors
28:35
amongst all these specialties or all these fields have better
28:38
outcomes. And but what it takes to have
28:42
those better outcomes is we spend more time with patients,
28:45
we interrupt less, we are more likely to adhere to evidence
28:49
based guidelines. We spend less time, we don't
28:52
interrupt as much. So, but all those things take
28:55
time. And the system, I mean talk
28:57
about why a lot of us are burning out in the system.
28:59
The system does not reward that type of practice, right?
29:03
The system rewards the way males doctors practice, which is
29:07
quick, right quick, quick, quick and And please no disrespect, I
29:12
have. Great general relations please.
29:14
Yes. Right.
29:16
But you know, this is what the studies show.
29:18
I just felt as female doctors, specifically female DPC doctors.
29:22
And yeah, I love the Facebook group to be able to have these
29:25
discussions without fearing judgement or from other people
29:30
who feel the same way or have experienced that same have that
29:34
level of experience is just such a powerful thing.
29:37
So we are going to have the another retreat, same thing.
29:40
This is going to be September 24th through the 27th in Culver,
29:43
IN. So if you're a female
29:46
identifying DPC doc, I hope you can.
29:48
Join 2026, so a little less than 8.
29:50
No, no, yes, yeah, 30. Less 2020.
29:52
Yeah, I know. What year is it anymore?
29:55
Yep. So yes, we actually, and I don't
29:58
know if other states have this, but in North Carolina, actually,
30:02
the woman I interviewed for my episode last week, Doctor
30:04
Catherine Locke, she's in Asheville.
30:06
She started a women's monthly DPC group on Zoom and it's been
30:13
really good. Really good.
30:14
I'd be interested in that. It's yeah, you can do this too.
30:17
Community is so important. So yes, she start, it's just
30:21
very simple. It's a Zoom call, you send out
30:24
the invitation, it's the first Friday of every month you drop
30:27
in if you can, if you can't next time.
30:29
And she will have a topic every month moderates and kind of
30:35
facilitates the topic, facilitates the talk.
30:38
And it's just really nice because it's a great mix.
30:39
It's established a new practices, people who are
30:42
thinking of joining or opening ADPC.
30:45
It's so it's a great experience for everyone.
30:47
So yeah, if anyone else is listening and thinking about it,
30:50
it's really easy. You just need a Zoom account and
30:53
just reach out to your, you know, kind of statewide doctors
30:57
and it's very easy to start. I think most states have some
31:00
sort of Facebook group for the state.
31:03
Yeah, I am part of like the Indiana State Medical
31:06
Association, so and we actually just got approved for CME
31:11
through them for the retreat. Fantastic.
31:13
Yeah. So we will be offering CME for
31:15
the retreat and, and I had actually been thinking about
31:18
having like a DPC women's Cafe basically like getting together
31:23
and talking about and yes, I think doing it state specific is
31:26
a great idea. Yeah, I think it's also good
31:29
there. Are a lot of state specific
31:30
issues when you're opening up a business.
31:31
Yes, true, Very true. And I know some people, I think
31:35
Doctor Adriana Rouse tried, I don't know if she's still doing
31:38
it, but she was having kind of coffee chats, except it was,
31:41
she's in Michigan and it was kind of a nationwide thing.
31:45
And so the time difference makes a difference too.
31:47
A lot of people couldn't make certain times because of course
31:50
the differences. Yes, No, that's a great idea.
31:53
Yeah, Indiana, we're either eastern or central.
31:55
But you know, I mean, there's not that much of a difference
31:57
between you could make it early in the morning, for example.
32:00
And yeah, that's a good. Idea.
32:02
Yeah, no, that's a great idea. Well, I appreciate you coming
32:06
on. Is there anything that you would
32:07
like to tell the listeners in particular that you haven't
32:10
already? Let's see if you are interested
32:16
in opening up your own DPC practice.
32:19
I will say the one thing I wish I had known before is I wish I
32:25
had set up my practice when I had five patients and the same
32:29
systems and set the same expectations for my patients as
32:33
if I had 100, yes, 205 hundred patients.
32:39
So once again, though, that internalization of wanting to
32:42
please first, I was answering text messages within seconds and
32:46
sending refills within minutes. And that is not sustainable.
32:49
So as you get busier, you're not able to do that.
32:52
So your patients can be disappointed, right?
32:55
Dismayed that well, wait a minute, you used to answer right
32:58
away and now you're now I'm talking like I used to answer
33:02
within minutes and now it takes me like a few hours right.
33:04
I still it's still beating any metric any other doctor in the
33:08
area. But when your patients did have
33:10
a certain expectation, we have had to retrain.
33:13
We have had to retrain our patients and fortunately most of
33:16
them love us. They they are absolutely
33:19
understanding and it's not a problem at all right.
33:21
But it was hard to have to retrain our patients, right?
33:24
No. So I tell all new doctors is OK,
33:29
get an EMR that you can pre schedule responses for later.
33:33
Even if it's just a few hours later, but you're not answering
33:36
right away. That way you're still addressing
33:37
it, right? And so it's out of your
33:39
headspace, but the patient doesn't actually get it until a
33:42
few hours. Sure.
33:43
Or set expectations that even though yes, you can send that
33:46
refill at that moment, don't send it for another 244872
33:50
hours. Set the expectations and the
33:52
processes early on, not just for when you have 10 patients, but
33:56
when you have a full panel. I think I do wish I had done
33:59
that. Yeah, that's wonderful advice
34:01
because that does protect your time, protects your boundaries,
34:04
protects your time with your family.
34:07
And so I do the same thing. I tell people to think about if
34:10
you only have 5 now, what about when you have 100 or 200 and
34:12
it's winter and and a sick and they want to see you?
34:15
What do you do then? So you have to start the way you
34:19
want to finish. So yeah, it's really important.
34:21
And you have a lot of automations and things in place
34:24
now, yeah. Yeah, and I wish I had, but you
34:27
know what, honestly, when I first started five years ago,
34:30
like a lot of these. Things didn't exist.
34:32
They didn't. Exist.
34:33
So you kind of hodgepodge Calendly and MailChimp, and then
34:37
you realize, OK, this isn't doing what I need it to do and
34:40
Oh my goodness, now they're like all these options, but they're
34:44
beasts. They're beasts trying to manage.
34:46
But yeah, the other thing I'm a big fan of besides automation is
34:50
group meet and greets. We do group meet and greets.
34:53
We don't do one on ones. That's something I had not
34:56
heard. Yeah, yeah.
34:58
Oh my goodness. I encourage people to do that
35:01
because meet and greets, first of all, it does create this
35:06
opportunity that a lot of people will just want to and tell you
35:09
everything, right, their entire medical history.
35:11
So it does prevent that, but it also prevents you from repeating
35:14
the same thing over and over. We don't take insurance and this
35:17
is my background or whatever, and it doesn't take your time
35:20
away from your patients. So, but yeah, we've been doing
35:23
group meet and greets for my goodness over a year now and
35:27
it's worked very well. How often do you do?
35:28
That once a week, once a week, Monday's at 5.
35:31
And that's the other thing. It also sets the expectation
35:33
from the beginning of if you want to talk to me, if you want
35:37
to meet with me, you need to adjust your schedule or so yeah,
35:41
Monday's at 5:00 and the link is on our website.
35:45
And we tell people this is Doctor Alan's availability.
35:48
And so I do think that also sets a an expectation from the
35:52
beginning. So they schedule for that time.
35:54
Is that how it works? OK.
35:56
Yeah, we up to 10 people can schedule for one meet and greet
35:59
and the link is all over our website.
36:01
And if they they go to our website.
36:04
And so that's the other is we're Pediatrics.
36:06
So our families do tend to be younger.
36:08
But yeah, we our families need to be pretty digitally savvy.
36:12
And the way we filter that is you want to schedule your first
36:17
meet and greet or consult, go to our website and schedule it
36:20
there. So that kind of helps weed out
36:23
the people that are. Right, right.
36:26
Well, that's great. That's a wonderful idea.
36:28
I appreciate you coming on. It's been so nice talking to you
36:33
and hearing about your practice. Thank you for listening to my
36:37
episode with Doctor Noemi Adame. I hope that if you are a
36:41
physician who's been feeling rushed and morally injured by
36:46
corporate medicine, you realize that other people have felt the
36:50
same way and that you are not stuck.
36:53
O if you are a woman physician who is thinking about moving
36:58
into the DPC world and you want to talk about this with other
37:03
physicians who've done the same thing and discuss boundaries,
37:07
systems, money, and your identity as a physician and an
37:11
entrepreneur, that is exactly what the DPC Women Connect event
37:16
is for. It is happening this February in
37:19
North Carolina. If you want details DM me.
37:22
Connect on Instagram and I will send you the link.
37:25
If this episode helped you, please follow the show and send
37:28
it to 1 colleague who needs to hear it.
37:30
Thank you for being here and I will see you on the next
37:33
episode. Thank you for listening to DPC
37:37
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37:40
you, hit follow. Leave a review and share it with
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a friend who's ready for change. Remember, wherever you are in
37:49
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