Latest / Banter At The Bedside / Building a Mobile Healthcare Practice in Rural North Carolina | Consult & Calling with Dr. Ivy DNP

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Building a Mobile Healthcare Practice in Rural North Carolina | Consult & Calling with Dr. Ivy DNP · Banter At The Bedside

• 0:06
  SPEAKER_02: Hi everyone, and welcome back to Banter at the Bedside.
• 0:10
  SPEAKER_02: We are here today for our third consult and calling.
• 0:13
  SPEAKER_02: So these are our episodes or segments where we're really diving into the personal stories of different healthcare workers to show you the many paths that we have out here and maybe help guide you.
• 0:25
  SPEAKER_02: As always, this is for entertainment purposes only.
• 0:28
  SPEAKER_02: Our thoughts and opinions are our own.
• 0:30
  SPEAKER_02: We don't represent any entity.
• 0:32
  SPEAKER_02: This is not medical advice.
• 0:34
  SPEAKER_02: You should always seek the care of your medical professional.
• 0:37
  SPEAKER_02: I'm Abby.
• 0:38
  SPEAKER_02: I'm the one of the nurse practitioners here.
• 0:40
  SPEAKER_02: We're joined, as always, by our other co-host, Nurse Kaylee.
• 0:43
  SPEAKER_02: Hey everybody, welcome back.
• 0:45
  SPEAKER_02: And our special guest today is Miss Ivy.
• 0:48
  SPEAKER_02: Is it Dr.
• 0:49
  SPEAKER_02: Ivy?
• 0:50
  SPEAKER_02: And do you have your doctorate?
• 0:51
  SPEAKER_02: I do have my daughterate.
• 0:52
  SPEAKER_03: But Ivy is not one.
• 0:54
  SPEAKER_02: Sorry.
• 0:55
  SPEAKER_02: We have Dr.
• 0:56
  SPEAKER_02: Ivy, a nurse practitioner, and she's going to be here to tell us all about her journey in medicine and starting her own business, which is really exciting.
• 1:06
  SPEAKER_02: And it seems like a really creative healthcare business.
• 1:08
  SPEAKER_02: So I'm so excited.
• 1:10
  SPEAKER_02: So well, tell us about yourself, Ivy.
• 1:13
  SPEAKER_04: So my name is Ivy Bagley, and I have been in healthcare for over 20 years.
• 1:18
  SPEAKER_04: Um I used to tell the exact number, but now I'm getting older.
• 1:21
  SPEAKER_04: So I'm like, eh, maybe I won't give that number yet.
• 1:24
  SPEAKER_04: But I was um I've been a nurse practitioner for 18 years and I actually um have my lactation.
• 1:30
  SPEAKER_04: So I'm an IBCLC.
• 1:32
  SPEAKER_04: And then I went back for my psychiatric NP as well because I saw there's such a need in um for that, but especially where I work, which is in eastern North Carolina.
• 1:42
  SPEAKER_02: So wow, that's it's a lot.
• 1:45
  SPEAKER_02: It's a lot of specialty.
• 1:47
  SPEAKER_02: What made you?
• 1:49
  SPEAKER_02: I guess take us a little deeper.
• 1:51
  SPEAKER_02: Lactation, psych.
• 1:53
  SPEAKER_02: You kind of touched on it, but how did those journeys come about?
• 1:56
  SPEAKER_02: Were there specific incidences or were was it just your passion took you?
• 2:01
  SPEAKER_04: So I think a lot of it was the passion.
• 2:03
  SPEAKER_04: I do think that nursing is a calling.
• 2:04
  SPEAKER_04: I'm a big believer in that.
• 2:06
  SPEAKER_04: But for me, uh, my mom was in a serious car accident.
• 2:10
  SPEAKER_04: I was actually in the car with her when I was 13 years old.
• 2:13
  SPEAKER_04: And I started saying I wanted to be a surgeon because the trauma surgeons had saved her life.
• 2:18
  SPEAKER_04: And then when I really reflected on things, I realized that it was actually the nurses who did so much of the care.
• 2:25
  SPEAKER_04: And totally, not only were they there for her, but they were there for our family as well.
• 2:30
  SPEAKER_04: So that sort of changed my trajectory.
• 2:32
  SPEAKER_04: And I ended up uh applying and being accepted to nursing school.
• 2:36
  SPEAKER_04: And I started feeling like maybe I should be a little bit more, do a little bit more, be a provider.
• 2:42
  SPEAKER_04: So I went back to FP school and I did that for 16 years.
• 2:48
  SPEAKER_04: And then started realizing during the pandemic we could not get kids in to be seen for psychiatric problems.
• 2:55
  SPEAKER_04: And they would wait eight to nine months if you were lucky, or they would have to travel, and it was a huge problem.
• 3:02
  SPEAKER_04: And so I decided I was gonna jump into the psychiatric NP uh program.
• 3:09
  SPEAKER_04: And I applied and was accepted at one program and didn't feel that it was the right program for me, so I actually declined that and um waited a little bit and was accepted at ECU.
• 3:21
  SPEAKER_04: And so I went to their program and sort of to back up just a little bit, um I've always had a passion for breastfeeding, and I worked for a while in uh it's called convalescent nursery, but it's actually and then it was special care, and now it's sort of integrated into the NICU at um the local hospital.
• 3:38
  SPEAKER_04: But I worked there and I loved helping the moms uh with breastfeeding, and that was a big issue um was the lack of IBCLCs in East North Carolina, and so I decided to pursue that.
• 3:49
  SPEAKER_04: So people always say, How in the heck does all that relate?
• 3:53
  SPEAKER_04: And so my favorite story is the mom that I went in to visit the baby.
• 3:59
  SPEAKER_04: So we had the newborn visit.
• 4:01
  SPEAKER_04: Um, we were doing that visit with her.
• 4:03
  SPEAKER_04: She asked for lactation help.
• 4:04
  SPEAKER_04: So then I was able to jump into that role and help give her lactation help.
• 4:08
  SPEAKER_04: And then over the next few days, she reached out and said, I'm really struggling with some postpartum um anxiety and depression.
• 4:15
  SPEAKER_04: And I was able to actually help her with that.
• 4:18
  SPEAKER_04: So it's really neat to see how it all comes full circle.
• 4:21
  SPEAKER_02: Yeah.
• 4:22
  SPEAKER_02: I mean, that all makes sense.
• 4:23
  SPEAKER_02: I guess there is a lot of postpartum.
• 4:27
  SPEAKER_02: Um that I am nowhere near OB OB stuff, but my understanding is that there is a lot of that that's missed diagnosed.
• 4:37
  SPEAKER_02: It is not always caught.
• 4:39
  SPEAKER_02: Um so I think that's great.
• 4:42
  SPEAKER_02: I did love that you said I applied to a psych NP program.
• 4:48
  SPEAKER_02: I got in, but I didn't feel like it was the right fit.
• 4:50
  SPEAKER_02: And I really want our listeners to like know that that's okay.
• 4:55
  SPEAKER_02: So you might have this calling to pursue a higher degree or even pursue a nursing degree or any degree of some type.
• 5:03
  SPEAKER_02: But if the school is not a good fit for you, if you don't think you're going to get what you want out of it, then don't do it.
• 5:09
  SPEAKER_02: It's okay.
• 5:10
  SPEAKER_02: There's so many options, and you're a perfect example of how waiting for the right choice can really put you on the right path.
• 5:17
  SPEAKER_04: And it's so important to be in the right school and in the on the right path, honestly.
• 5:23
  SPEAKER_04: And I think some people jump in and and they realize, wait, this isn't quite for me.
• 5:27
  SPEAKER_04: Or, you know, maybe they realize that not that not that F and P or Psych isn't for them, but that like you said, the school and they they push through.
• 5:35
  SPEAKER_04: And I think that's a a mistake that yeah we we tend to make sometimes.
• 5:40
  SPEAKER_02: Yeah, and I think there's there's a lot of outside pressure once you say I'm going to do this, then it's like, well, I gotta do it.
• 5:46
  SPEAKER_02: And it's like I just really love that you're so honest about that.
• 5:50
  SPEAKER_02: Um, I think that's great.
• 5:52
  SPEAKER_02: So you currently run and own your own practice or business, is that correct?
• 5:59
  SPEAKER_02: Yeah.
• 5:59
  SPEAKER_02: Tell us Tell us about it.
• 6:02
  SPEAKER_04: So I'd worked at my current job for almost 17 years, and I was finished up my Psych MP, and they just said we're not renewing your contract.
• 6:12
  SPEAKER_04: I was like, I'm sorry, what?
• 6:13
  SPEAKER_04: So kind of a shock.
• 6:15
  SPEAKER_04: Yeah.
• 6:15
  SPEAKER_04: And oh my God.
• 6:17
  SPEAKER_04: I just sort of took a step back and said, okay, where where are we gonna go with this?
• 6:22
  SPEAKER_04: And it was interesting because in one of my certifications that I obtained, I wrote a paper about how mobile health care could change the face of healthcare in East North Carolina.
• 6:34
  SPEAKER_04: And I remember thinking about that paper.
• 6:36
  SPEAKER_04: And we started talking about it.
• 6:38
  SPEAKER_04: And my boyfriend, who's one of my biggest supporters, said, Why don't you do it?
• 6:42
  SPEAKER_04: I said, I don't know.
• 6:43
  SPEAKER_04: I I've sort of already looked into it because I wrote the paper and I, you know, could possibly do it, but it's a little bit harder in North Carolina because we have to have a collaborating physician.
• 6:52
  SPEAKER_04: There's certain things that have to be in place, and everything literally just seemed to fall into place within a matter of a few weeks.
• 6:59
  SPEAKER_04: And just to watch that happen, you know that is exactly what you're meant to do.
• 7:04
  SPEAKER_01: Mm-hmm.
• 7:04
  SPEAKER_02: Uh-huh.
• 7:05
  SPEAKER_02: Yeah.
• 7:06
  SPEAKER_02: I I just I do have a side story that I think you'll appreciate because we work rural as well.
• 7:13
  SPEAKER_02: Um, when I was doing my doctorate in leadership, they made us set up a clinic and we had to come up with something creative.
• 7:22
  SPEAKER_02: And the hypothetical was rural Mississippi.
• 7:26
  SPEAKER_02: And there is some new everyone else in my group lived in major cities, New York, Philly, Atlanta.
• 7:33
  SPEAKER_02: And they're like, I think we should have a mobile aspect to this.
• 7:37
  SPEAKER_02: And I was like, Okay, yeah, like I think that's great.
• 7:40
  SPEAKER_02: And then one of the New York City people was like, I just see, I just have this image of like you drive into these towns and everyone's coming to your mobile clinic and the lines at the door on the van.
• 7:53
  SPEAKER_02: And I was like, Well, yeah, that's not that's not how that's going to happen, though.
• 7:59
  SPEAKER_02: No, I was like, that's not how that works.
• 8:03
  SPEAKER_02: And they're like, What?
• 8:04
  SPEAKER_02: I was like, Yeah, like the houses are miles apart.
• 8:08
  SPEAKER_02: We live mile 20 miles from the nearest town sometimes, even more than that.
• 8:13
  SPEAKER_02: I was like, that's not how that works.
• 8:16
  SPEAKER_02: And they were like, What do you mean?
• 8:18
  SPEAKER_02: It's not festival.
• 8:19
  SPEAKER_02: You're not parking a food truck.
• 8:20
  SPEAKER_02: Like they were like, their minds were like, wait, what do you mean?
• 8:25
  SPEAKER_04: They're not going to just they have no concept of what it's like.
• 8:29
  SPEAKER_04: No, I think a lot of it's in a rural area.
• 8:31
  SPEAKER_04: And um I I think a lot of people still with me are like, you go where and how far do you go?
• 8:37
  SPEAKER_04: And so I um any given day, like this morning, I drove an hour more towards the Outer Banks.
• 8:46
  SPEAKER_04: Um, um after we finish this, um, and I have a little bit of lunch.
• 8:50
  SPEAKER_04: I'm gonna drive an hour more towards uh it's actually Kinston.
• 8:55
  SPEAKER_04: So I'll be on the other side of Kenston in a area called Deep Run.
• 8:59
  SPEAKER_04: So I go sort of all over.
• 9:01
  SPEAKER_04: Um, and if you ever look at a map of North Carolina, you'll think, what in the world?
• 9:05
  SPEAKER_04: So it's it's sort of hard to sometimes find that territory because I had a lot of patients that I had seen for many years and they wanted to continue to see me.
• 9:15
  SPEAKER_04: So we were like, okay, where is our our boundary line?
• 9:19
  SPEAKER_04: And sometimes we do go a little bit past it for families who I've had that connection with.
• 9:24
  SPEAKER_04: But for the most part, I I sort of stay in one area and I go an hour kind of around.
• 9:31
  SPEAKER_04: But but you're right.
• 9:32
  SPEAKER_04: I mean, I just because I'm seeing, you know, three families in one area, they still could be, you know, 10, 15 minutes apart.
• 9:40
  SPEAKER_04: A lot of people don't quite understand that.
• 9:42
  SPEAKER_04: And it's a learning curve for me too.
• 9:44
  SPEAKER_04: We started out with 30-minute appointments, and then I would sort of watch the schedule as um I would say, well, wait a minute, they're not 30 minutes apart, or you know, we need to tweak this a little bit.
• 9:55
  SPEAKER_04: So we've we've since made some changes to the template where all appointments are going to be an hour, and it's simply to give a little bit more driving time.
• 10:03
  SPEAKER_04: Um is something we need to incorporate.
• 10:06
  SPEAKER_03: So are you is this go ahead, sorry.
• 10:08
  SPEAKER_03: Is this a psychiatric service or is this primary care?
• 10:12
  SPEAKER_03: I do both.
• 10:12
  SPEAKER_03: So that's okay.
• 10:14
  SPEAKER_04: That's what makes it really unique.
• 10:16
  SPEAKER_04: Um, is I offer both services.
• 10:19
  SPEAKER_04: Now, some people obviously don't need the psych and they're just doing primary care.
• 10:22
  SPEAKER_04: Okay.
• 10:23
  SPEAKER_04: But a lot of my families who have children with uh, you know, special needs, autism, ADHD, they love it because they're getting to encompass all of that.
• 10:32
  SPEAKER_04: And I come to the home and you know, several of my patients with autism, we do their well visit, I'm in the floor and we're able to do it while they're playing, they're comfortable.
• 10:43
  SPEAKER_04: Um, and even even children that don't have special needs are just way more comfortable in the home, which has been a unique thing to see.
• 10:52
  SPEAKER_02: The yeah.
• 10:53
  SPEAKER_02: I I could imagine that the how they feel with you in the home is probably very different than when they're in this kind of sterile clinic environment.
• 11:04
  SPEAKER_02: So that's gotta be rewarding.
• 11:06
  SPEAKER_02: How it it doesn't sound like it to me, but I could be wrong.
• 11:11
  SPEAKER_02: You know, there's all these concierge medicines.
• 11:13
  SPEAKER_02: How do you think you're different from that?
• 11:16
  SPEAKER_02: Or are you kind of a concierge medicine?
• 11:19
  SPEAKER_04: So it's similar to concierge, and a lot of people get that confused.
• 11:22
  SPEAKER_04: A lot of people think that I charge extra.
• 11:24
  SPEAKER_04: Um, and there's people that have told me you should should charge extra, but right now I take what your insurance, so it's the same as your copay if you go to office, but you do have more access to me.
• 11:36
  SPEAKER_04: And that's more of the concierge type approach.
• 11:40
  SPEAKER_04: And I practice that way anyway, typically.
• 11:43
  SPEAKER_04: So I still wanted to carry that into my own practice.
• 11:48
  SPEAKER_04: Yeah.
• 11:49
  SPEAKER_02: But there's not uh you're you're not charging a convenience fee.
• 11:53
  SPEAKER_02: I don't know if that's what yeah.
• 11:55
  SPEAKER_02: So that's what I think really makes you different.
• 11:58
  SPEAKER_02: You are really taking the clinic to them, and it's yes, it's more convenient, there's maybe there's better access, but I think it's really just addressing some of these barriers that people and I think it's some of the barriers we've talked about.
• 12:13
  SPEAKER_04: You know, if you live 20 minutes from a town, well, just because you live 20 minutes from that town, that town may or may not even have a health care provider.
• 12:21
  SPEAKER_04: And for a lot of families, I see we're already driving one to two hours um for care.
• 12:28
  SPEAKER_04: And so we're able to kind of bridge that for them.
• 12:32
  SPEAKER_02: Yeah, that's awesome.
• 12:34
  SPEAKER_02: Do you have like a mobile van or do you just have like like how do you go from place to place?
• 12:42
  SPEAKER_04: My boyfriend's really smart.
• 12:44
  SPEAKER_04: And when we were trying to figure out what to do, we looked at all the different options.
• 12:48
  SPEAKER_04: And eventually we might add a van, but they were very, very expensive.
• 12:51
  SPEAKER_04: And I knew startup cost, uh, I didn't really know if I wanted to do that.
• 12:56
  SPEAKER_04: So actually, um, we do pack out boxes and I take everything with me, and I kind of know where everything is at in the car.
• 13:05
  SPEAKER_04: And so I load everything up in the mornings um and take, you know, the scale, the everything, you know, I've got coolers to take certain things in, um, test for strep, flu, all that stuff comes with us.
• 13:18
  SPEAKER_04: Wow.
• 13:18
  SPEAKER_04: That's great.
• 13:19
  SPEAKER_02: Walk us through a very typical day or a very typical week for you.
• 13:23
  SPEAKER_02: You kind of touched on it a little bit, but outside of sitting down with us for an hour.
• 13:29
  SPEAKER_02: What what is a normal day like and your team too?
• 13:32
  SPEAKER_02: Because they know you have a team with you.
• 13:34
  SPEAKER_04: I do.
• 13:35
  SPEAKER_04: I'm very fortunate.
• 13:35
  SPEAKER_04: I have they're all very part-time.
• 13:38
  SPEAKER_04: So um it's sort of a a working process, work in work in progress.
• 13:43
  SPEAKER_04: I can't talk.
• 13:44
  SPEAKER_04: Um, I have a girl that I love to death, working with her for years, and it's such a neat way.
• 13:50
  SPEAKER_04: She's a stay-at-home mom, and she's able to help me with entering patient data, doing, you know, sort of the the clerical type things.
• 13:59
  SPEAKER_04: And she can do that if it's after her little one goes to bed.
• 14:03
  SPEAKER_04: She can do that while he's taking a nap.
• 14:05
  SPEAKER_04: You know, we have that flexibility for her.
• 14:08
  SPEAKER_04: And, you know, some weeks she says, I've got, you know, appointments on this day and this day, and I won't be able to help you those days.
• 14:14
  SPEAKER_04: And we we make it work.
• 14:16
  SPEAKER_04: And then I have some other staff that work um as well helping me do prioritizations.
• 14:21
  SPEAKER_04: And um, I recently added a biller because that was an area that I need help with.
• 14:26
  SPEAKER_04: And yeah.
• 14:28
  SPEAKER_02: Don't we all?
• 14:29
  SPEAKER_04: I mean, it's just it's a struggle.
• 14:31
  SPEAKER_04: It's really a struggle.
• 14:32
  SPEAKER_04: That side of the business I would tell people is probably even though I knew going into it, it was gonna be one of my bigger challenges, I still to this day um am like, I don't think I knew like how big of a challenge it was gonna be as far as the the billing.
• 14:47
  SPEAKER_04: So I'm very grateful that I have um staff that I can call on and um communicate with.
• 14:54
  SPEAKER_04: And so, for example, this morning I left about um eight o'clock.
• 14:59
  SPEAKER_04: It was actually a little bit later day for me.
• 15:00
  SPEAKER_04: A lot of mornings I leave the house by about seven, seven thirty.
• 15:04
  SPEAKER_04: And usually I'm traveling somewhere.
• 15:06
  SPEAKER_04: So I traveled about an hour to see um a couple kids, sweet little kids.
• 15:12
  SPEAKER_04: And then I um came back and saw another little one.
• 15:17
  SPEAKER_04: And um actually, like I said, after we finish, I'll go out and head to Kinston and see a few um families there.
• 15:24
  SPEAKER_04: So every day's a little bit different, which is something I do like.
• 15:28
  SPEAKER_04: Um Tuesdays and Wednesdays tend to be my busier days, although Fridays gotten to be pretty busy.
• 15:35
  SPEAKER_04: I try to take Friday afternoon, quote unquote, off and it's more for I need some time to do paperwork, I need administrative time.
• 15:42
  SPEAKER_04: But a typical Tuesday, because I do a lot of telehealth on Tuesday nights, that usually starts about 7, 7:30 in the morning, and I go until about 10 or 10 30 seeing patients.
• 15:52
  SPEAKER_04: So that's a busy day for me.
• 15:54
  SPEAKER_04: Wow.
• 15:55
  SPEAKER_04: That's that's a long day.
• 15:56
  SPEAKER_04: That's a long day.
• 15:58
  SPEAKER_04: Dang.
• 15:59
  unknown: Wow.
• 16:00
  SPEAKER_04: And I do offer um appointments on Saturdays and Sundays I do try to only do sick visits, but Saturday mornings I will do well visits.
• 16:11
  SPEAKER_04: And a lot of my families like that because obviously you know you're not having to miss work.
• 16:15
  SPEAKER_02: Yeah.
• 16:15
  SPEAKER_04: And again, I think that take touches on the socioeconomic stuff we were sort of alluding to earlier and and the barriers.
• 16:23
  SPEAKER_04: Because if you have a family that has to miss work and I mean, they're hourly, that could make the difference between groceries for them.
• 16:32
  SPEAKER_04: I mean, that's the reality.
• 16:33
  SPEAKER_02: I would love us to dive into this a little bit more because I don't think people that live in cities really can understand sometimes the socioeconomic barriers, the geographical barriers that we have in these rural areas.
• 16:50
  SPEAKER_02: It just reminds me I was actually talking to a nurse friend who just went from hospital to clinic work.
• 16:58
  SPEAKER_02: And so now they're Monday through Friday, 9 to 5, and they were talking and they're like, How do I go to a doctor's appointment?
• 17:05
  SPEAKER_02: Like, how does anyone they ask their manager or their clinic manager, like, how do well, what about if I have a doctor's appointment?
• 17:14
  SPEAKER_02: They're like, Yeah, you take a day off and you schedule all your appointments in one day and you have to take a day off.
• 17:19
  SPEAKER_02: You have to use a PTO day.
• 17:21
  SPEAKER_02: They're like, Well, I only get so much PTO, and they're like, Yeah.
• 17:24
  SPEAKER_02: So I'm just it I mean it it's ridiculous.
• 17:28
  SPEAKER_02: It is ridiculous, and it's so amazing because I we're talking and I'm like, I'm like, it is a little crazy to me that in this day and age that our clinics like I get people providers that we want nine to five, we want those hours.
• 17:43
  SPEAKER_02: I don't, I work in an ICU, so I'm just I'm there all the time.
• 17:47
  SPEAKER_02: But we want nine to five, but the barriers that it creates for our patients, and then they were talking in the same conversation, they were like, There's so many no-shows.
• 17:57
  SPEAKER_02: And I was like, You were just complaining to me about how do you get to the doctor?
• 18:02
  SPEAKER_02: Some of these people, like you said, they're hourly pay.
• 18:04
  SPEAKER_02: If they don't go in, they don't make money.
• 18:07
  SPEAKER_02: They, you know, taking a whole day off just to go to an appointment.
• 18:10
  SPEAKER_02: So I think it's so amazing that you do telehealth at night, that you have these Saturday appointments, that you're really, really kind of like living a mission of, or what it seems, is living a mission to help serve people.
• 18:23
  SPEAKER_02: Am I reading that right?
• 18:24
  SPEAKER_02: Do you have a mission?
• 18:26
  SPEAKER_04: Yes.
• 18:27
  SPEAKER_04: So I I'm um a Christian and I love the Lord and I believe that it is a calling.
• 18:32
  SPEAKER_04: And I believe I was called to serve.
• 18:35
  SPEAKER_04: And I think that offering families, meeting them where they are.
• 18:40
  SPEAKER_04: Um, do I have some families that yes, it's not an inconvenience for them to be seen, you know, on a Tuesday at 10 a.m.
• 18:47
  SPEAKER_04: And and most of the time that's when they schedule.
• 18:50
  SPEAKER_04: But a lot of my families, they need, you know, after five or they need Saturday morning.
• 18:56
  SPEAKER_04: Um and I'm not gonna say I haven't done some wells on Sunday.
• 18:58
  SPEAKER_04: I have.
• 18:59
  SPEAKER_04: I have a a sweet, sweet mama that um her her children were gonna get kicked out of daycare.
• 19:04
  SPEAKER_04: And I was like, you know what, we're gonna do it Sunday afternoon.
• 19:06
  SPEAKER_04: And um because it was kind of last minute add-on.
• 19:10
  SPEAKER_04: But obviously, you still I always tell people you still need time for yourself.
• 19:14
  SPEAKER_04: And so Sunday's the day I try to to do that.
• 19:16
  SPEAKER_04: Um many reasons.
• 19:18
  SPEAKER_04: But it is, it is a passion and a mission.
• 19:21
  SPEAKER_04: And I think that for too long we have sort of got this mindset of I want to work my, you know, eight to five, nine to five, have my half day, um, and take my three weeks and go, you know, here and travel.
• 19:34
  SPEAKER_04: And and those are great things.
• 19:36
  SPEAKER_04: And I'm not knocking people that choose to do that when I say that.
• 19:40
  SPEAKER_04: But I think that we need more providers who are willing to say, how can we do it differently?
• 19:47
  SPEAKER_04: Because at the end of the day, a child that doesn't get visits is one that we may miss something that we could prevent long-term problems with.
• 19:56
  SPEAKER_04: Um there's a lot of reasons that we want to make sure everybody has access to care.
• 20:00
  SPEAKER_02: What's also yeah, I think it's amazing.
• 20:04
  SPEAKER_02: Are there other barriers?
• 20:05
  SPEAKER_02: You know, we've touched on the socioeconomic, the geographical.
• 20:08
  SPEAKER_02: I mean, when you live that far and just the socioeconomic too, of like the gas to get there, the car.
• 20:17
  SPEAKER_02: Um are there other barriers that you're seeing that your mobile health clinic, your mobile care clinic, um has really begun to address?
• 20:27
  SPEAKER_04: I think it is the access to care.
• 20:30
  SPEAKER_04: Um, so I do work two days a week at a psychiatric practice.
• 20:33
  SPEAKER_04: I love it.
• 20:34
  SPEAKER_04: Um, I enjoy that.
• 20:35
  SPEAKER_04: It is um sort of what's keeping me fed right now as I build this.
• 20:40
  SPEAKER_04: I mean, that's just a reality.
• 20:42
  SPEAKER_04: And I had patients that were traveling almost three hours, like two and a half, three hours to see me there.
• 20:48
  SPEAKER_04: That's insane.
• 20:50
  SPEAKER_04: It is insane.
• 20:51
  SPEAKER_04: But but that's the reality of what some of the so a lot of the clinics don't take Medicaid.
• 20:57
  SPEAKER_04: Um, and we do at both the practices.
• 20:58
  SPEAKER_04: That's something I'm I'm passionate about.
• 21:01
  SPEAKER_04: And then if they don't, the option that they may have the other option that they may have may have an eight to nine month wait list still.
• 21:09
  SPEAKER_04: And and so there's not access.
• 21:12
  SPEAKER_04: And a lot of people don't realize, I know we keep talking about the rural part of North Carolina.
• 21:16
  SPEAKER_04: So North Carolina is the second largest rural state in our nation.
• 21:21
  SPEAKER_04: And a lot of people don't don't really understand that because they think about, oh, we have Charlotte, we have Riley, we have all, you know, Greensboro, all those bigger areas.
• 21:29
  SPEAKER_04: And so I tell people it's kind of like a sandwich.
• 21:32
  SPEAKER_04: You know, we have the rural part of North Carolina, which we saw in Hurricane Helene.
• 21:36
  SPEAKER_04: I mean, I went up there and worked during that.
• 21:38
  SPEAKER_04: We saw the devastation that was there, but then also, you know, the needs that were already there before Helene.
• 21:45
  SPEAKER_04: So we've got the western part, we've got the eastern part, and then we kind of have this area in the middle that is, you know, more populated.
• 21:52
  SPEAKER_04: Yeah.
• 21:53
  SPEAKER_04: Number one is Texas, by the way.
• 21:55
  SPEAKER_04: Always find that interesting.
• 21:56
  SPEAKER_02: Well it's a giant city.
• 21:59
  SPEAKER_04: Yeah.
• 22:01
  SPEAKER_04: But it does put it in perspective.
• 22:03
  SPEAKER_04: If you think about Texas, you know, it is a giant state.
• 22:06
  SPEAKER_03: And now there's always eight to nine months as a as a waitlist is crazy for psychiatric help.
• 22:13
  SPEAKER_03: I mean I y that stuff I just can't wait.
• 22:19
  SPEAKER_03: I mean, I don't know.
• 22:20
  SPEAKER_03: That just seems insane to me.
• 22:21
  SPEAKER_04: Well, that's one of the reasons I like the ECU program is they are working to address that in North Carolina because in their program, you actually have to be a North Carolina resident um to be accepted.
• 22:33
  SPEAKER_04: And so their whole goal is we're gonna try to keep nurse practitioners in North Carolina who are psychiatric.
• 22:40
  SPEAKER_02: So that's interesting.
• 22:42
  SPEAKER_02: Just to kind of take a bit of a dive into the business side.
• 22:48
  SPEAKER_02: So you kind of told us you met this crossroads and that's how you started it.
• 22:55
  SPEAKER_02: What do you think has been the most challenging for you in starting this?
• 23:01
  SPEAKER_04: I think um the credentialing piece, the credentialing side is pretty easy if you're a provider, but if you're credentialing a business, that's a little bit trickier and it takes a little bit longer.
• 23:13
  SPEAKER_04: And so there's frustrating things that have happened definitely with that.
• 23:16
  SPEAKER_04: Quite often it's it's always amazes me that I will literally think, okay, I'm gonna quit today.
• 23:23
  SPEAKER_04: And we all have thoughts like that when you you have your own business.
• 23:26
  SPEAKER_04: I'll say, I'm gonna quit because I just, you know, this is the part that's driving me crazy.
• 23:30
  SPEAKER_04: And um, then it all whatever the problem is, just seems to work itself out.
• 23:34
  SPEAKER_04: So I think I always tell people if you're you're thinking about this, and I've had a lot of NPs call me and say, Can I do this?
• 23:43
  SPEAKER_04: Well, you can do it, but I think you need to go in there um with a very realistic expectation.
• 23:50
  SPEAKER_04: I I would have loved to have had a little more income and savings before I did it, a straight up honest, but I had been in school and so my savings had gone towards, you know, that.
• 24:03
  SPEAKER_04: I was not in a position to do that.
• 24:05
  SPEAKER_04: So I would definitely tell people think about that.
• 24:08
  SPEAKER_04: And there's definitely a lot of trust.
• 24:10
  SPEAKER_04: You have to trust yourself and trust the people that you work with.
• 24:14
  SPEAKER_04: And I'm really grateful I've had a lot of people who've helped me with the business side.
• 24:19
  SPEAKER_04: Um I I think waiting for payers to come through and that whole piece of a clinic, and you submit claims, and you know, it's it's um not necessarily rejected, but you submit a claim and you're waiting for it just to be paid out to you.
• 24:36
  SPEAKER_04: Um so the billing side is definitely of uh concern that I still struggle with sometimes.
• 24:43
  SPEAKER_02: Um I just recently saw a statistic.
• 24:48
  SPEAKER_02: Don't quote me exactly on it, but it they were comparing like previous pay in like the 90s for clinics, um like time to pay out versus now, and it was like two or three weeks before from come from insurance companies, and now it's like an average of like three to six months or something crazy.
• 25:09
  SPEAKER_02: So it's like they were comparing like how long these practices like yours wait to get their money, and it's months where it used to be weeks, and that's why it was talking about where are all the private practices, and they were talking about well, this is part of it, because waiting that long, especially when you're first starting, starting fresh like you, that's a long time to wait before those first payouts come.
• 25:40
  SPEAKER_04: Yeah, and a lot do close or or allow themselves to be bought out by bare entities.
• 25:46
  SPEAKER_04: And and it's for that reason.
• 25:48
  SPEAKER_04: I knew going into it, I probably better have another job that's gonna help pay, you know, my personal bills for a while.
• 25:56
  SPEAKER_04: And I think that's normal whenever you have something that you're you're starting to out to.
• 26:00
  SPEAKER_02: Mm-hmm.
• 26:01
  SPEAKER_02: Yeah.
• 26:02
  SPEAKER_02: We we know that.
• 26:04
  SPEAKER_02: Yeah.
• 26:06
  SPEAKER_02: We know that over here.
• 26:07
  SPEAKER_02: There's actually there was another I read a lot, so I always have like these tidbits.
• 26:12
  SPEAKER_02: I'm sorry, I'm weird.
• 26:14
  SPEAKER_02: Um, but there was one and it looked at like startups in like um uh Silicon Valley and the ones that make it and the ones that don't, and the ones that they found consistently made it were actually the owners that maintained another job that had that extra income that could feed them while they built the business.
• 26:34
  SPEAKER_02: The ones that were like, I'm all in, I'm not, I'm I got focused 100% on the business, which is what I think most people think when you're starting something, is you have to go all in.
• 26:45
  SPEAKER_02: And if you don't go all in, then it's going to fail.
• 26:48
  SPEAKER_02: But they actually found that when you have that side, that side money and it keeps you living, you can keep going and fighting until it takes off.
• 26:58
  SPEAKER_04: And you know, you're talking about kind of side hustles.
• 27:00
  SPEAKER_04: I mean, I've taught CPR, I've done other things for years, and I I remember thinking to myself after everything happened, I'm really glad I still have those businesses because there were times, especially early on, when I was just starting to work as a psych MP, that honestly, you know, teaching CP a few CPR classes is what paid some of my bills that month.
• 27:23
  SPEAKER_04: And that's an you know, and I enjoy teaching.
• 27:27
  SPEAKER_04: I've continued to teach mainly because I enjoy it, but look at how I was able to utilize, you know, funds from that to help pay a light bill or yeah, different things.
• 27:36
  SPEAKER_02: Yeah.
• 27:37
  SPEAKER_02: Just meet and give you a little extra cushion.
• 27:39
  SPEAKER_02: I know I I teach, um, and that extra little cushion each month is it's nice.
• 27:46
  SPEAKER_02: That side, but healthcare workers are we I feel I don't know if it's our type A or lower pay or whatever, but we do love a side hustle.
• 27:56
  SPEAKER_02: Maybe a combination of both.
• 27:58
  SPEAKER_02: Probably a combination.
• 27:59
  SPEAKER_02: I'd say a combination.
• 28:00
  SPEAKER_02: Combination of both.
• 28:02
  SPEAKER_02: But what do you feel in building this has been your biggest support system?
• 28:08
  SPEAKER_02: Wouldn't family, friends, your patients, the ones that followed you.
• 28:13
  SPEAKER_02: Who what is it?
• 28:14
  SPEAKER_02: I would say the community.
• 28:17
  SPEAKER_04: Um, and I I say community because I think it encompasses a lot of the people that you you named.
• 28:22
  SPEAKER_04: You know, um, I wouldn't be here except that my my boyfriend literally was like, you can do this, let's go for this.
• 28:27
  SPEAKER_04: And he still is my encourager, even though sometimes he'll ask me a question.
• 28:31
  SPEAKER_04: I'm like, You asked me about that two days ago, don't ask me right now.
• 28:34
  SPEAKER_04: It's trusting me out.
• 28:36
  SPEAKER_04: And he's like, Okay, can I ask tomorrow?
• 28:38
  SPEAKER_04: You know, because he's interested.
• 28:40
  SPEAKER_04: He wants to see that I'm I'm successful.
• 28:43
  SPEAKER_04: And um, just the people that have showed up.
• 28:46
  SPEAKER_04: And so some of the some of them are patients that have transferred to me.
• 28:49
  SPEAKER_04: You know, I have always strived to build relationships with patients, and that's um something, you know, I love that I'm taking care of second generations now.
• 29:00
  SPEAKER_04: Now, full disclosure, they were a little bit older when I started.
• 29:03
  SPEAKER_04: Um, but you know, having that second generation that I'm now taking care of is just that full circle, and I love that aspect.
• 29:12
  SPEAKER_04: The people who showed up and literally moved everything for me, um, and just said, We got this, you know.
• 29:20
  SPEAKER_04: And granted, it all ended up in my house, and I was like, I don't know where this is all gonna go, you know.
• 29:25
  SPEAKER_04: People who have told me, Hey, you're coming to see my sick kid.
• 29:29
  SPEAKER_04: Um, are you okay if I fix you dinner?
• 29:31
  SPEAKER_04: I don't mind fixing it to go if you don't have time to eat.
• 29:33
  SPEAKER_04: So just the people who have poured into me.
• 29:37
  SPEAKER_04: Um and I'm gonna start crying on the days when I really say, I'm done, God just sends somebody, like the mom who says, I know you've had a busy week.
• 29:48
  SPEAKER_04: Um, and she doesn't really know that, but I really had had a really, really busy week.
• 29:52
  SPEAKER_04: She said, I'm gonna make you dinner and you take it home with you.
• 29:56
  SPEAKER_04: Just the people who have even just a word of encouragement, sending me a text.
• 30:01
  SPEAKER_04: Hey, how's it going?
• 30:02
  SPEAKER_04: Or I was driving through one of the small towns I go to and the mom sent me a text and she said, Where are you off to today?
• 30:10
  SPEAKER_04: And I'm like, Oh, I must have passed you.
• 30:12
  SPEAKER_04: I didn't, you know, I didn't see you.
• 30:14
  SPEAKER_04: Just that connection.
• 30:16
  SPEAKER_04: I think that is what truly drives me.
• 30:19
  SPEAKER_04: And I think when you have a passion like that and God gives you that passion, you you're going to continue because you know that it's all gonna work out.
• 30:29
  unknown: Yeah.
• 30:30
  SPEAKER_02: That's beautiful.
• 30:32
  SPEAKER_02: It reminds it reminds me of those stories you used to hear of you know, the local doctor in the town that would see you for like a chicken.
• 30:41
  SPEAKER_02: Like you bring them a chicken.
• 30:44
  SPEAKER_02: It sounds like you're going back to that, which medicine's always cyclical.
• 30:48
  SPEAKER_02: We always end up back where we started.
• 30:50
  SPEAKER_02: So I think that's beautiful.
• 30:52
  SPEAKER_04: It's funny you say that because I do have one family that they're so sweet.
• 30:56
  SPEAKER_04: They're like, look, next time you come, maybe our chickens will be laying their eggs and we can send you home with eggs.
• 31:01
  SPEAKER_04: And I love it.
• 31:02
  SPEAKER_04: I love, you know, um, I have a family that I was able to see their goats, like their 4-H goats, and you know, spend some time.
• 31:10
  SPEAKER_04: I mean, it's just that full circle connection.
• 31:15
  SPEAKER_02: Yep.
• 31:16
  SPEAKER_02: What advice would you give to anyone that is trying to build a similar model?
• 31:21
  SPEAKER_02: I mean, this is a care model that is really, I think, going to be, I think you're ahead of the curve.
• 31:27
  SPEAKER_00: Yeah.
• 31:28
  SPEAKER_02: Um, I think this is where medicine's going to start moving towards.
• 31:32
  SPEAKER_02: So, what would your advice be to someone wanting to build a similar model as you?
• 31:39
  SPEAKER_04: So I'm going to give the advice that someone actually shared with me.
• 31:43
  SPEAKER_04: They don't do what I do, but they own their own business.
• 31:46
  SPEAKER_04: And I met with them pretty early on and I was like, what are your thoughts on this?
• 31:49
  SPEAKER_04: You know, this is what I'm doing.
• 31:50
  SPEAKER_04: I mean, I'd already set it up, but he said, the number one piece of advice I'm going to give you is get help sooner than you realize it.
• 32:00
  SPEAKER_04: And it honestly was a few days after that that I reached out to the second person that I hired and said, Hey, I'm kind of at this point.
• 32:10
  SPEAKER_04: Um would you be interested in joining me?
• 32:13
  SPEAKER_04: It's very part-time.
• 32:14
  SPEAKER_04: This is what I can offer.
• 32:15
  SPEAKER_04: It's not a lot.
• 32:17
  SPEAKER_04: And I don't ever regret that.
• 32:19
  SPEAKER_04: Um because you you need time for yourself and you need to be able to delegate certain things.
• 32:26
  SPEAKER_04: Yeah.
• 32:26
  SPEAKER_04: With that said, I still have learned, you know, how do you do prioritizations, how do you order these things.
• 32:33
  SPEAKER_04: Things that I never really had to do because I always delegated that in the clinic that I was at.
• 32:38
  SPEAKER_04: But I learned how to do all those things so that if my person is busy and can't help, it still gets done.
• 32:45
  SPEAKER_04: Yeah.
• 32:45
  SPEAKER_04: And so I think having that person that you can reach out to and use um as a team member and having that team connection.
• 32:54
  SPEAKER_04: And I feel like we have a really strong team.
• 32:58
  SPEAKER_04: I started out from the get-go thinking, what do I want to do as I ad people?
• 33:03
  SPEAKER_04: How do I want to um celebrate them?
• 33:06
  SPEAKER_04: Because they help me do the things that I do.
• 33:10
  SPEAKER_04: So we have a we had a retreat um in January, which was kind of early for a practice to have a retreat, but I knew from the get-go I wanted us to to start off with doing those things.
• 33:20
  SPEAKER_04: So once a year we um are committed to going somewhere and spending a few days just number one, have a little bit of downtime.
• 33:28
  SPEAKER_04: And number two, you know, reconnecting, talking about the practice, what works for you, what's not working for you, and your role.
• 33:35
  SPEAKER_04: I do a lot of things, such as um send them a like it on Valentine's Day, I sent them a Starbucks gift card and it's not a lot, but I think it's important to do those to do those things and to celebrate celebrate people.
• 33:49
  SPEAKER_04: Because the you know, so I think definitely having that per the person or person you add um and and developing a team approach.
• 33:59
  SPEAKER_03: Yeah.
• 34:00
  SPEAKER_03: I love that.
• 34:01
  SPEAKER_03: It's like you're just actually trying to take care of your folks and I think that's probably one of the big advantages of having a smaller practice.
• 34:10
  SPEAKER_04: Correct.
• 34:11
  SPEAKER_04: And I think we are missing that in healthcare.
• 34:14
  SPEAKER_04: I think we are not taking care of each other.
• 34:17
  SPEAKER_04: Um and I I think I was like, I want to do this different.
• 34:21
  SPEAKER_04: I know I want to do it different.
• 34:23
  SPEAKER_04: Yeah.
• 34:23
  SPEAKER_02: Mm-hmm.
• 34:24
  SPEAKER_02: Yeah.
• 34:25
  SPEAKER_02: We agree, and that's kind of how we ended up making this podcast and this group is we we felt like there's so much like fighting in healthcare or miscommunications and people bashing each other online.
• 34:39
  SPEAKER_02: So that's why we, you know, wanted to bring everyone to the table together, explore how medicine can work really well, um, and serve and be mission-based like you.
• 34:52
  SPEAKER_02: You're a perfect example of you know what we want to highlight in medicine.
• 34:56
  SPEAKER_02: And I think it's so amazing that you you're not just serving your personal mission for your patients, you're serving it for your team.
• 35:04
  SPEAKER_02: That's what it sounds like to me is you're doing it for your team.
• 35:08
  SPEAKER_02: And I think that's amazing.
• 35:10
  SPEAKER_02: Yeah.
• 35:12
  SPEAKER_02: I do have one question that I've I've been curious about as I was prepping for this.
• 35:21
  SPEAKER_02: Working for big systems, yes, you have the safety net of money and all of that.
• 35:27
  SPEAKER_02: But I mean, I think as you experienced when they were like, Yeah, we're not renewing your contract, there's kind of bad sides.
• 35:33
  SPEAKER_02: I just want to know personally, what does it feel like to be able to be your own boss in that sense?
• 35:41
  SPEAKER_02: In that you don't have to worry about some of these policies in your day-to-day life because you make the policy.
• 35:50
  SPEAKER_02: What is that feeling?
• 35:51
  SPEAKER_02: Is it free?
• 35:52
  SPEAKER_04: It is freedom, and it is the best feeling.
• 35:55
  SPEAKER_04: And I wish I had probably done it years ago.
• 35:58
  SPEAKER_04: Maybe when I wrote that paper.
• 36:00
  SPEAKER_04: I don't know.
• 36:01
  SPEAKER_04: And I also think God's timing is perfect, and so I'm gonna, you know, say this is when he meant for this to happen.
• 36:07
  SPEAKER_04: Um, my mom got breast or got diagnosed with breast cancer literally, I think it was about three weeks after I opened, and I immediately was like, Okay, how am I gonna do all this?
• 36:18
  SPEAKER_04: I don't know.
• 36:19
  SPEAKER_04: And I was able to be there for her surgery and schedule myself off and um still saw patients.
• 36:27
  SPEAKER_04: You know, I did telehealth from their house and was able to just work that out and having that freedom to look at my schedule and say, Hey, um I need to regroup a little bit.
• 36:40
  SPEAKER_04: And you have to have patients that are willing to do that too.
• 36:42
  SPEAKER_04: And I think most of my patients, if I call them and say, I have this going on, I need to reschedule you, they also don't wait.
• 36:50
  SPEAKER_04: So I might work a Friday afternoon or I might say, Let me work in Saturday morning.
• 36:54
  SPEAKER_04: You know, there's a give and take.
• 36:57
  SPEAKER_04: But yeah, um, it is so nice to just be able to look at the schedule and say, you know what, I am gonna take a little bit of time here.
• 37:05
  SPEAKER_04: I don't do it as often as I should.
• 37:07
  SPEAKER_04: But I think having that flexibility and not having to go to someone and beg to be off to do something, or um I think we can do better about some of those things in healthcare for people because again, it comes down to taking care of your team.
• 37:26
  SPEAKER_04: Now, that doesn't mean that obviously you got to go to work and we got to take care of patients, and those things have to happen.
• 37:31
  SPEAKER_04: But how can we add that flexibility?
• 37:34
  SPEAKER_04: And some of it for me does come from the fact that I set my own schedule.
• 37:39
  SPEAKER_04: Um and it is more I set my own schedule.
• 37:44
  SPEAKER_04: So if I walk into a home and I feel like I need to spend a little more time there, I can juggle things a little bit and juggle my day and make that happen.
• 37:54
  SPEAKER_04: Or if I'm really packed, like a lot of Tuesdays, sometimes I'll say, Hey, let me um let me add you to tomorrow.
• 38:03
  SPEAKER_04: Um, or let's just start the process and we'll finish out tomorrow.
• 38:08
  SPEAKER_04: Last night I was on a telehealth and the mom's like, oh, by the way, you know, I really feel like, you know, I need you to look this rash over.
• 38:15
  SPEAKER_04: And I was able to add the other child and and take care of that.
• 38:18
  SPEAKER_04: And so there's a lot of flexibility with that.
• 38:22
  SPEAKER_04: And there is a I always I have always said for years the schedule's a suggestion, and I do think that.
• 38:27
  SPEAKER_04: I mean, obviously we have to have times to meet people and and but we also have to have that flexibility.
• 38:33
  SPEAKER_04: And so I love that aspect.
• 38:35
  SPEAKER_04: Yeah, that's real life, you know?
• 38:38
  SPEAKER_02: Things come up.
• 38:39
  SPEAKER_02: That's amazing.
• 38:40
  SPEAKER_02: I yeah, I think that's great.
• 38:42
  SPEAKER_02: And I just gotta imagine there's some freedom too, and just it like I just think about like they tell us, you know, where we can wear our badge and what we can wear and your hair and your nails, and yeah, like I understand the reasoning for it, but sometimes it's just like man, I just I just could could I have a little bit of freedom?
• 39:08
  SPEAKER_02: Could I have a little?
• 39:09
  SPEAKER_02: No.
• 39:11
  SPEAKER_04: So sometimes I mean to some more like this morning.
• 39:14
  SPEAKER_04: I woke up and I was like, oh, I kind of want to put on jeans today.
• 39:17
  SPEAKER_04: I'm just gonna wear jeans.
• 39:19
  SPEAKER_04: You know, my family who live on a farm, they don't really care if I have on uh jeans shirt, you know?
• 39:24
  SPEAKER_04: So I I do see that as far as what you know, what you wear, badges, things like that.
• 39:30
  SPEAKER_03: Uh-huh.
• 39:31
  SPEAKER_03: It's like the freedom, but then I'm sure on the flip side it's like the responsibility, and there's no one, it's like it's who I can't pass it off to anybody else now.
• 39:40
  SPEAKER_03: That's true.
• 39:41
  SPEAKER_03: Right?
• 39:43
  SPEAKER_04: The buck stops here, and it is it is true.
• 39:47
  SPEAKER_04: And then there's been, you know, I mean, I've had a few people that, you know, I'm like, okay, but the reality is you're not gonna please everybody.
• 39:54
  SPEAKER_04: I mean, you have to accept that, and and not everybody's a good fit for everybody.
• 39:57
  SPEAKER_04: I mean, some people, this is not a good model for them.
• 40:01
  SPEAKER_04: They want to come in a clinic, they want to, you know, come in, have a set schedule, time, you know, walk back out.
• 40:07
  SPEAKER_04: And the reality is is I might get stuck in traffic.
• 40:10
  SPEAKER_04: And if I'm an hour traveling and an hour in between, I mean, you know, that can add 10 or 15 minutes.
• 40:16
  SPEAKER_04: Now, for the most part, I've ran um, because I'm tracking it, and that's part of the reason we're gonna add a little more time to the schedule.
• 40:23
  SPEAKER_04: But most of the time I'm only about 10 or 15 minutes, but every so often, I mean, life happens.
• 40:29
  SPEAKER_04: Um, but I also would say, well, if you were on the flip side, if you were that late to a clinic, they probably wouldn't see you.
• 40:36
  SPEAKER_04: So, you know, at least you're able to wait in your home, you're not having to drive.
• 40:42
  SPEAKER_04: I mean, so there's there's benefits to that.
• 40:44
  SPEAKER_04: Um and I'm I have a great supervising physician, you know, Carolina requires us to have a supervising physician.
• 40:51
  SPEAKER_04: Um, always joke with him because I'm the one going up there um advocating for us not to have a supervising physician.
• 40:58
  SPEAKER_04: And the main reason is the financial impact.
• 41:01
  SPEAKER_04: And so I always lead with, I have a really great one.
• 41:05
  SPEAKER_04: And I have a it's no disrespect to him, but this is what an imp this impact is on my clinic.
• 41:11
  SPEAKER_04: And it's an experience that, you know, but it is nice.
• 41:15
  SPEAKER_04: I have colleagues sometimes.
• 41:16
  SPEAKER_04: I'll reach out and say, Hey, can I just run this by you?
• 41:19
  SPEAKER_04: You know, let's talk about uh yeah, but yeah, it does ultimately the final decisions.
• 41:25
  SPEAKER_04: I mean, that is a lot of responsibility.
• 41:27
  SPEAKER_02: Yes.
• 41:28
  SPEAKER_02: But it you have a lot of experience though, too.
• 41:31
  SPEAKER_02: So I'm sure that you seem like you'd be a good boss.
• 41:34
  SPEAKER_03: Thank you.
• 41:35
  SPEAKER_02: Yeah.
• 41:35
  SPEAKER_04: I I do think the experience side makes a difference.
• 41:38
  SPEAKER_04: I mean, obviously, I don't think someone who's, you know, one or two years in that this is probably the best model for them.
• 41:46
  SPEAKER_03: No.
• 41:47
  SPEAKER_03: The questions I probably need.
• 41:49
  SPEAKER_03: You know, you need people to check with and support.
• 41:52
  SPEAKER_03: Yeah.
• 41:52
  SPEAKER_03: You don't want to be learning a new business while doing a new skill that is really a big, big deal, especially when you're seeing people's children.
• 42:01
  SPEAKER_03: So I think that sounds the experience that you've got really, really, really helps.
• 42:06
  SPEAKER_03: Yeah.
• 42:06
  SPEAKER_03: I agree.
• 42:07
  SPEAKER_02: Any final thoughts for us as we kind of come to a close?
• 42:12
  SPEAKER_02: Anything you want to talk about?
• 42:14
  SPEAKER_04: If you're thinking about doing it, um meaning opening something up, um don't don't let the naysayers tell you you can't.
• 42:26
  SPEAKER_04: I still have people that I I just try to ignore.
• 42:30
  SPEAKER_04: Um, and some of that comes with age and experience.
• 42:32
  SPEAKER_04: You're you're like, okay.
• 42:34
  SPEAKER_04: Um really, you know, there are people who still will say um in some of the like online there was a post and someone said, Well, she's a great provider if you want to pay more money.
• 42:45
  SPEAKER_04: And I'm like, Well, you don't actually pay more money to see to see me, you know.
• 42:49
  SPEAKER_04: So there's always gonna be um people who, especially when you're doing something different, are gonna try to to knock you down.
• 42:57
  SPEAKER_04: And you just have the mindset that, you know what, I'm gonna be all right because this model is working.
• 43:03
  SPEAKER_04: I mean, I've been open a year and a half, and wow.
• 43:08
  SPEAKER_04: Yep.
• 43:09
  SPEAKER_02: And it's growing.
• 43:10
  SPEAKER_02: Is it still growing?
• 43:11
  SPEAKER_02: You're growing.
• 43:12
  SPEAKER_04: I am.
• 43:13
  SPEAKER_02: I am schedules full.
• 43:14
  SPEAKER_04: It is.
• 43:15
  SPEAKER_04: It's getting it's getting busier.
• 43:17
  SPEAKER_02: Yeah.
• 43:18
  SPEAKER_02: So tell us what the future looks like for you.
• 43:22
  SPEAKER_02: What do you have coming?
• 43:24
  SPEAKER_02: What do you hope to come?
• 43:26
  SPEAKER_02: How do you want to build this?
• 43:27
  SPEAKER_04: So I I already know I have a another nurse practitioner who's gonna be joining me um just very, very part-time.
• 43:34
  SPEAKER_04: So that's kind of our big news.
• 43:36
  SPEAKER_04: We haven't even announced that yet.
• 43:37
  SPEAKER_04: Um, I don't know, the podcast might come out before we announce it, but that's okay.
• 43:41
  SPEAKER_04: We're getting ready to announce it soon.
• 43:43
  SPEAKER_04: And um I'm excited.
• 43:44
  SPEAKER_04: She's a great person.
• 43:46
  SPEAKER_04: She's bringing a few patients with her and she'll be um, you know, working just a little part time.
• 43:53
  SPEAKER_04: We'll kind of see how it goes.
• 43:54
  SPEAKER_04: We may add some more hours in at some point, and we're excited about that.
• 44:00
  SPEAKER_04: Um, we have a small office space that we're gonna start to use for some I do have some families that have asked for an office space just for various reasons.
• 44:08
  SPEAKER_04: And so that's opening up in the next uh few months.
• 44:12
  SPEAKER_04: So exciting times for that.
• 44:14
  SPEAKER_04: It's just it's part of an uh another office, so it's not an independent office.
• 44:18
  SPEAKER_04: Um I continue to see this growing.
• 44:20
  SPEAKER_04: I mean, I think so far families have loved it.
• 44:23
  SPEAKER_04: It's been a good win-win for a lot of folks.
• 44:27
  SPEAKER_04: I would love to see another at some point another full-time person that's involved.
• 44:33
  SPEAKER_04: Um and I would really love to be able to expand the psychiatric side a little bit more just because it's such a need.
• 44:41
  SPEAKER_04: And it's important that I have um to be able to do that.
• 44:45
  SPEAKER_03: So yeah, absolutely.
• 44:47
  SPEAKER_03: That sounds so exciting.
• 44:49
  SPEAKER_03: It's so amazing.
• 44:50
  SPEAKER_04: Exciting times, it is.
• 44:52
  SPEAKER_03: Kaylee, any final questions, thoughts?
• 44:55
  SPEAKER_03: Oh, um, does your page have like an Instagram or anything?
• 44:59
  SPEAKER_04: I do.
• 44:59
  SPEAKER_04: I have Instagram, I have um Facebook, um, and I have a website.
• 45:04
  SPEAKER_03: For your practice as well.
• 45:05
  SPEAKER_04: Yeah.
• 45:05
  SPEAKER_03: Yeah.
• 45:05
  SPEAKER_03: Okay.
• 45:06
  SPEAKER_03: Um well, we'll try to link those if you want us to.
• 45:10
  SPEAKER_03: I would like to follow along with y'all's progress and keep an eye out.
• 45:14
  SPEAKER_02: We're excited.
• 45:16
  SPEAKER_02: Excited to watch this grow.
• 45:18
  SPEAKER_02: Thank you so much for reaching out and sharing this wonderful care model.
• 45:23
  SPEAKER_02: That again, I really think having recently studied it, this is kind of where medicine's heading.
• 45:29
  SPEAKER_02: And I think it's so amazing.
• 45:30
  SPEAKER_02: The integration of psych and family practice, going to the people and really serving these underserved communities is just so beautiful.
• 45:41
  SPEAKER_02: So thank you so much for sharing and for your honesty on the business side.
• 45:45
  SPEAKER_02: I know sometimes that can be a little not fun, but I I love it.
• 45:51
  SPEAKER_02: So thank you so much for joining us today.
• 45:54
  SPEAKER_04: Well, thank you guys for having me.
• 45:56
  SPEAKER_04: I mean, I've enjoyed this and I love listening to your podcast.
• 46:00
  SPEAKER_04: Well, good.
• 46:01
  SPEAKER_02: We're glad that you were listening to it because we love making it.
• 46:08
  SPEAKER_02: So if you're still here, make sure you go and follow Dr.
• 46:12
  SPEAKER_02: Ivy.
• 46:12
  SPEAKER_02: If you're in eastern North Carolina, maybe you can be her next patient.
• 46:16
  SPEAKER_02: Doesn't that sound amazing?
• 46:18
  SPEAKER_02: From all of us shift talkers here at Banter at the Bedside.
• 46:22
  SPEAKER_02: We'll talk to you soon.
• 46:23
  SPEAKER_02: Thanks.
• 46:24
  SPEAKER_02: Bye.
• 46:25
  SPEAKER_02: Bye.
• 46:26
  SPEAKER_02: Bye.
• 46:34
  SPEAKER_00: Step into the light where the stories come.