Latest / DPC Life: Direct Primary Care Podcast / Starting DPC With One Patient: How Dr. Marissa Fusella Is Finding Patients For Fusella Family Medicine

Transcript

Starting DPC With One Patient: How Dr. Marissa Fusella Is Finding Patients For Fusella Family Medicine · DPC Life: Direct Primary Care Podcast

• 0:00
  And at the end of the day, I'm worrying about the paperwork in
• 0:03
  the click boxing instead of the actual patient.
• 0:06
  I mean, people that are doing these mini greets are those ones
• 0:10
  that are frustrated with the system, don't feel heard, they
• 0:14
  don't feel like they can get into their doctor.
• 0:16
  And my whole goal is being that family position that's trained
• 0:19
  from being born till later on in life, knowing that patient and
• 0:24
  guiding them preventatively lifelong and being there for
• 0:28
  them and from being from the area.
• 0:31
  My goal is to be here for a long term.
• 0:34
  Welcome to DPC Life, the podcast where independent doctors share
• 0:38
  real stories, bold ideas, and the freedom of doing medicine on
• 0:42
  your own terms. I'm your host, Doctor Ann
• 0:46
  Gonzalez, and together we'll explore the winds, the struggles
• 0:50
  and everything in between. Let's start in today.
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  My guest is Doctor Marissa Fusella.
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  She is a family medicine doctor in Latham, NY and is just
• 1:01
  opening her direct primary care practice.
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  Welcome to the podcast. Thank you everybody.
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  I am. Hello, thank you for being here
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  and thank you for sharing your story.
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  So let's talk about how you got into direct primary care.
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  Your why? What's your purpose in doing
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  this? So I've been networking at my
• 1:22
  current job for about 8 years and I love what I do.
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  I love seeing my patients, I love getting to know them and
• 1:28
  their families. But I have realized that visits
• 1:32
  are becoming shorter with patients.
• 1:34
  People are waiting a long time to see me and at the end of the
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  day, I'm worrying about the paperwork in the click boxing
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  instead of the actual patient. And I just don't feel like for
• 1:45
  the long run that is good for my patients as well as myself and
• 1:49
  my family. And I, once I found DPCI, knew
• 1:53
  that this was the way to do things, to be a full, rounded
• 1:57
  family physician, just the way I was trained and bring me back to
• 2:01
  my old school roots. So you were in employed practice
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  until just a couple weeks ago, correct?
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  Correct. Yep.
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  And as a family physician, were you doing full scope with OB and
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  PEDs? I didn't do any Obi did see
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  Pediatrics so I saw newborns all the way to.
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  Cradle to grave. You got it.
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  Yeah, you have other DPCS in the area.
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  How many other offices are there near you?
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  So there is a, there's a maybe like a handful, There's one, one
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  just started out in September, there's another one that's
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  starting out soon and there's been a few that have been around
• 2:45
  for the last couple of years. But everybody's very open and
• 2:48
  welcoming. And like I said, that's the best
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  part of the CBC community. Yeah, with having other local
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  DPCS, you have coverage if you need to.
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  If you want to take a break, you have people who are nearby that
• 3:00
  can help you. Have you met everyone that's DPC
• 3:03
  in your area? I am very familiar with a lot of
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  them. I'm sure I'm learning new people
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  constantly that have been out and I just didn't even know
• 3:13
  about. And I think that is the
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  difference. Obviously being out in a
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  business world, you meet a lot of different people, a lot of
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  services that could actually help your practice and be good
• 3:23
  referrals. When you're in the system,
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  you're very focused on just those offices, just that
• 3:30
  immediate medical system and this.
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  It just is refreshing to meet other businesses and therapists,
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  occupational therapists, various where people could benefit from.
• 3:41
  Yeah. So your practice is officially
• 3:44
  open or and you're opening in a couple of weeks?
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  Yep. So I'm currently in that
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  transition. I've done some meet and greets.
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  I have a list of people that want to enroll and I have had a
• 3:55
  patient enroll already. So yeah, yeah, yeah.
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  So very exciting, Very exciting, Yeah, yeah.
• 4:01
  How did those first meet and greets go?
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  They went well. I mean people that are doing
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  these meet and greets are those ones that are frustrated with
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  the system, don't feel heard, they don't feel like they can
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  get into their doctor. They, they just feel like
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  they're being referred to all different specialists and they
• 4:21
  realize direct primary care is the way that can help with this.
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  And my whole goal is being that family physician that's trained
• 4:28
  from being born till later on in life, knowing that patient and
• 4:33
  guiding them preventatively lifelong and being there for
• 4:36
  them and from being from the area.
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  My goal is to be here for a long term, so yeah.
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  So it's like very exciting. It makes me feel good at the end
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  of the day that you know there is this direction to go.
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  Right now, your previous practice, are you close enough
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  that patients can follow you? So I couldn't do, I had a non
• 4:59
  solicitation clause in my contract.
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  So people can definitely find me on social media and I think
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  that's probably what they will do.
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  But that's kind of how I left things with them.
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  But I am, I do miss my former patients.
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  Every day I wake up saying I really, I was just used to that,
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  going to the office, seeing my patients and I really love it
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  and I really miss it. So I can't wait to open these
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  doors and start seeing new patients and meeting other
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  people and hopefully education about DPC.
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  Yeah. So how do you find your
• 5:33
  patients? What's been the best way to
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  attract patients for you so far? So I will let you know I'm very
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  new on this whole social media. I'm not very good with
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  technology. So this has been a learning what
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  I've done so far as I've used Facebook as a big one just to
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  kind of start advertising my practice.
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  I've also used the BNI group. I had friends from college that
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  got me involved with BNI and that has been eye opening.
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  And I think it eye opening to the point where I didn't even
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  know there was that like other side of business or other people
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  to talk to. And they've been very good with
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  helping me out. Just referrals or how to do this
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  marketing wise. Because when you're in medicine,
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  you're just focused on going to see that patient.
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  You don't really go into that whole marketing or social media
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  part, but in DPC obviously this is very new.
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  So this you have to kind of be out there and educate and I
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  think that's the biggest thing. And so far I think it is working
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  and I think it will take some time to come across, but I hope
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  I'm doing it the right way and I hope people will guide me along
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  too. Always just putting yourself out
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  there. Number one, that is the first
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  thing because that is that is the hardest thing, right?
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  To actually say this is what I'm doing.
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  Hello. Right, right.
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  Yep. And for myself, that's just
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  never been me. I just, I take care of my
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  patients. I have 3 little boys.
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  I just focus on, you know, them. And it's very hard for me to be
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  like me, me, me, this is what I'm doing.
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  But I think I think it's for the better good now.
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  And I'm realizing this is good. This is a different form of
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  education that's different than people's health.
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  It's how to get better healthcare, how to get better
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  access to your doctor. And there's a different model
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  that can do this for you. Right, right now, not everyone
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  is familiar with BNI, so can you tell us more about that?
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  How does that work? So it's a business organization
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  that's nationwide in this area. There is many different chapters
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  and in these chapters there's all these different business
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  people that run their own businesses and they talk to you
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  about them and they and get your input on how they could help you
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  in your business and how you could help them.
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  And the goal is to get referrals to your businesses and the other
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  people in different industries. And I think that in itself is
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  just refreshing as a sole business owner that you have a
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  different kind of community that's outside of your actual
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  industry, but also realize you all can help each other out.
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  And in medicine, I see all different people, patients, they
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  come in with all different jobs. And I think that's a huge part
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  of their health cares, knowing the actual jobs that they're
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  undergoing. And this is a different way that
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  you can do this. And I think for ADBC, just
• 8:28
  starting out, it's a way to get this, your whole educational
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  spiel about what DBC is. And I think for a lot of us,
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  it's kind of hard, especially if you're not used to that public
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  speaking component. It's a good place to start and
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  practice because they're just there to guide you along in that
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  and it's local. So I think it's, it's been a
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  great start for me. I'm just in the starting stages
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  of it, but it's been very great. Good for me to start.
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  And the referral issue, so you can get referrals from the other
• 9:00
  people in your B and I group. So if they know friends or
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  family that could benefit. But the other thing is they are
• 9:06
  also business owners and so their employers and they can
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  work with you. Absolutely.
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  Yep. And I've talked to people about
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  that too. So yes, that's a whole different
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  side of the DPC that I'm just starting to learn.
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  But that definitely has already come up and for that cost saving
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  aspect of their healthcare and their own employees, how this
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  could help their business. So the conversation has already
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  started with a few people on that.
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  So yes, that has been very good. Yeah.
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  And then also the fact that HSAS and are are now OK, really
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  officially approved to be able to.
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  Use your. Membership, so that's even more
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  helpful. Absolutely.
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  And the interesting thing about B and I is these groups only
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  allow one person from each industry.
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  So you don't have 5 plumbers or five roofers in the same group,
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  which makes it very. Very helpful.
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  Absolutely. Yep.
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  And that's what they said. They haven't had a doctor in a
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  while there so. So they were definitely really
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  wanting that. Yeah, Now some BN is can be
• 10:10
  expensive. I'm curious how much is the BNI
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  up there? So that I don't know yet 'cause
• 10:16
  I'm not. Oh.
• 10:16
  You're still a. Member I'm still a guest and I
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  just am learning this because there's so many different
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  chapters and times and some people are video or hybrid.
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  And so I'm just still in the starting stages of being like,
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  OK, is there one that's closer to me or I want to see what if
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  other ones have difference avenues where it might be more
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  beneficial with the healthcare system?
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  But once I do decide I want to be in one, don't kind of give me
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  that membership information. But I can I guess you can see
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  you can go and visit twice per chapter.
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  That's a lot of. That's yeah, yeah, it is a lot
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  of visit and that allows you I think to see if the other
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  members or something that could be helpful to you and that you
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  mesh with. But I think it's a great thing
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  because like I said, I think there's over 10 around this area
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  that you could actually go to. Everyone it looks like is
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  different and you can actually look up on the BNI, all the
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  different names of people and to the different industries that
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  they're in. And I think that's pretty neat
• 11:18
  thing you could do. OK, so that you can kind of pre
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  screen and then say OK these I know these people like I think I
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  would fit in this group. I didn't realize that.
• 11:27
  Yeah, that's. Cool.
• 11:28
  Yeah, Yeah. It's really neat.
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  Yeah. And then with, if you have 10
• 11:33
  two visits a year, like that's half a year, you could just,
• 11:36
  yeah, just coast surf. Along.
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  There you go. There you go.
• 11:41
  Yeah. No, I think, I think my goal is
• 11:43
  to sign up very soon. Yep, that would be great.
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  I've learned with this whole market and there is just so many
• 11:50
  things that you can incorporate yourself with it.
• 11:52
  And I think sometimes that is the hardest thing.
• 11:54
  We're in this position because you're trying to get your word
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  out there, but there's so many different ways and you also
• 12:00
  don't want to get overwhelmed with these things.
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  So I've been invited to the a woman's business group in the
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  area, which is great. I'm going to be doing a talk
• 12:07
  next month about what the health prevention month and then I'm
• 12:11
  going to be starting going to dinners there and then I have
• 12:13
  the business meetings. But you also want to make sure
• 12:16
  that you are focusing on starting your practice and
• 12:19
  making sure all the pieces of that are being taken.
• 12:23
  Yep, it can get overwhelming, yeah, because there are so many
• 12:28
  ways, like you said, that you can spread the word.
• 12:30
  So you kind of have to focus on what's going to be the most
• 12:33
  useful for you. Yep.
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  And that's one thing about DPC is learning how to protect your
• 12:39
  time because. Correct you.
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  I think DPC owners, because being entrepreneurs, like
• 12:47
  there's a lot of this kind of shiny object syndrome where you
• 12:51
  sure squirrel out and yeah, what can I try next?
• 12:55
  So yeah, sometimes you have to. Rein in.
• 12:58
  Yeah, exactly. Yeah.
• 13:01
  Yeah, now you are practicing and living in the same place where
• 13:05
  you grew up. How?
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  How is that going? What do?
• 13:09
  You how I love it. Oh, they love it.
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  So I guess I never really thought I was going to come back
• 13:14
  home in high school. I always envisioned I'd be going
• 13:18
  to California or some other place.
• 13:19
  But and then I went down South. I was away from my now husband
• 13:24
  at the time and did the long distance relationship.
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  And that was very hard being in Virginia, being so far home from
• 13:30
  New York. And when I decided to come back
• 13:33
  N we both went to Ellis residency and Schenectady and
• 13:37
  then got married, had three little boys soon after.
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  And it's been so rewarding. I think it's very difficult
• 13:44
  being in the medical field, especially when you know your
• 13:46
  significant others in the medical field without any family
• 13:50
  support. We're very fortunate that we
• 13:52
  have our family around us and our kids and they kind of had
• 13:57
  guided us to take good care of our patients, be there for our
• 14:02
  families and just be a well-rounded family physician.
• 14:06
  This way we can. Yeah.
• 14:09
  So your husband is also a physician?
• 14:11
  He is, yeah. He is what kind of physician?
• 14:14
  He's a family physician. Oh.
• 14:15
  OK, so is he going to join you? So he's currently he's going to
• 14:22
  stay with his job right now. He he's going to make me let
• 14:25
  make this jump. He's very supportive.
• 14:27
  He's he's the backbone of myself and our family.
• 14:31
  So he's just he's definitely for it.
• 14:34
  He loves his patients, he loves what he does.
• 14:35
  So right now, he's letting me make that leap.
• 14:39
  Yeah, well, that's, it's always, it's a really nice situation
• 14:44
  when you do have someone who is super supportive and, you know,
• 14:47
  able to let you do this your way because it is it's it's really
• 14:52
  hard, especially, I'd say especially for women because we
• 14:56
  carry a lot of responsibility in the home and not only caring for
• 15:04
  the family, caring for the kids and then having an additional,
• 15:08
  having a practice on top. It's a lot.
• 15:11
  Oh, absolutely. So again, it's that you have to
• 15:14
  be careful and make sure about the boundaries of time and
• 15:18
  trying to. I wouldn't say there's a balance
• 15:22
  really. I mean it, it's kind of a flow,
• 15:25
  no harmony. Oh, absolutely, Yeah, yeah.
• 15:28
  But I think the one thing he said is the other day, he's just
• 15:31
  getting so excited to come home now because I have so many
• 15:34
  different things that are going on.
• 15:36
  My big is obviously I'm still looking for patients and I think
• 15:38
  that's always going to be an up and down thing.
• 15:40
  But it's different than the day-to-day going, seeing the
• 15:43
  patients, doing your tasks. Do you know, doing your
• 15:46
  callbacks. It's more exciting.
• 15:49
  You're make, you're building this kind of dream.
• 15:52
  And I'm very thankful for that. Yeah, I think it is.
• 15:55
  It is very exciting. You know, I mean, employee
• 15:58
  practice, at least for a family physician, is different every
• 16:03
  single day, right? So at least that part is the
• 16:07
  same. Everything is different.
• 16:08
  Except as a practice owner, your days are more broken up in
• 16:13
  seeing patients. But then there's also admin,
• 16:16
  there's the outreach. Yeah.
• 16:18
  So it's, it's even, there's just a lot more variety, which I
• 16:22
  guess that's why we went into family practice, right?
• 16:25
  Yep. Yep.
• 16:25
  That's right. That's right.
• 16:27
  Yep. So now that you're opening up
• 16:30
  and you are starting, are you doing everything yourself or do
• 16:35
  you have any? Help.
• 16:36
  So I am, Yep. So I'm going to start out all by
• 16:39
  myself. I'm going to be acting like a
• 16:40
  secretary, a nurse. And I think the why I want to do
• 16:44
  that is just to see how everything is done.
• 16:46
  I don't know how long I can do this for, what I can actually
• 16:48
  maintain. But I think when you're starting
• 16:51
  a business, you really want to know how things are done.
• 16:54
  And then that way you can pass that on to somebody.
• 16:57
  So we can make sure that I'm aware of everything that's going
• 17:00
  on. Because again, going back to the
• 17:02
  system, when you have so many different pieces and so many
• 17:06
  people kind of in the same pot, it gets very confusing.
• 17:10
  And I want to try and prevent that for my business.
• 17:12
  And I want to know. I want to be in the know.
• 17:15
  Yes. And that's, that's it's
• 17:17
  essential. I mean, yeah, ultimately,
• 17:19
  because you're the person who's responsible for everything.
• 17:21
  So you need to know where everything is and how everything
• 17:25
  works. And eventually, yes, you can
• 17:27
  hand that off. But yeah, you want to.
• 17:30
  You want to know how everything fits and how everything got
• 17:33
  started too. Absolutely.
• 17:36
  Yep. I'm doing a lot of learning, but
• 17:37
  it's it's all good. It feels good.
• 17:40
  Now, how long did you take planning your DPC?
• 17:44
  When did you start thinking about this?
• 17:47
  So I've been looking into this for the last couple of years.
• 17:50
  It wasn't until in the past year to six months that we really
• 17:54
  pushed myself to make this jump. I went to the summit in New
• 17:59
  Orleans this past July and it wasn't until that conference
• 18:02
  that I said, OK, it's go time, let's start really getting
• 18:06
  everything together. And that's when we finally said,
• 18:09
  OK, why don't you make a goal of putting your notice in October,
• 18:13
  goal of trying to start up after the new year.
• 18:16
  So that's kind of the timeline. And for the, for the most part,
• 18:19
  it has worked out and it's a it's a learning, learning
• 18:23
  process. It really is.
• 18:25
  Are you opting out of Medicare? I am opted out of Medicare.
• 18:30
  You already did so this last January cycle.
• 18:33
  Great. Yep.
• 18:35
  Yeah. So that opens things up for you.
• 18:37
  Yeah. Yep.
• 18:39
  And when you started planning this, how did you do that?
• 18:42
  Did you use the books? Were there certain resources
• 18:45
  online that you used? Yeah, so I signed up for the
• 18:49
  Facebook group just to kind of see what the community was
• 18:52
  saying. I did the hints camp just to
• 18:55
  kind of put me on the computer and with education with other
• 18:58
  people that are going through the same process.
• 19:01
  I read different blogs. I had the books.
• 19:05
  There's just so many different resources.
• 19:07
  And I think like anything, until you're actually in starting up
• 19:11
  your practice, it's hard to apply those things sometimes.
• 19:14
  So now in the past two weeks since I've been officially done,
• 19:17
  now I'm realizing, OK, now I have those resources, I can go
• 19:21
  back to them. And that's kind of what I'm
• 19:22
  doing at this point. I think it's coming together.
• 19:25
  Yeah. What would you say is the best?
• 19:27
  Was the best resource building the practice for you?
• 19:30
  So there's been so many. Or top three.
• 19:34
  Top three, I know it's hard because there is so many.
• 19:37
  And in the meantime, I've also reached out to a bunch of DBCS
• 19:40
  in the area and kind of done phone conversations.
• 19:43
  And honestly, I've started that out last year intermittently to
• 19:47
  kind of, and I think that has been good because at least you
• 19:49
  pick up contacts with people that are in the area or within
• 19:52
  your state. And I've reached out to them and
• 19:54
  they've kind of guided me through just simple questions
• 19:57
  right now. Honestly, probably the Facebook
• 20:00
  blogs have been really good because that put you in contact
• 20:02
  right away with people that are going through the same thing.
• 20:05
  So you're not feeling so alone. I've done the, you know, DPC
• 20:10
  podcast like yourselves and like the ones that are online.
• 20:13
  I think those are fast things to listen to, especially when
• 20:16
  you're working out. For myself, I mean, I have the
• 20:20
  books, I've read like few chapters, but unfortunately with
• 20:23
  life trying to balance working kids and starting a new
• 20:27
  business, it's been a little challenge.
• 20:29
  But I have them and I think they are very beneficial as well.
• 20:32
  And I probably will have some more time as I'm starting out to
• 20:35
  get back to those. Yeah, but now that you are open,
• 20:40
  what kinds of things are you planning to do with all the time
• 20:44
  you have? I mean, cuz you're still getting
• 20:46
  patience so you have some time downtime, what are you gonna do?
• 20:50
  Yeah, yeah. So I think there's a lot of
• 20:53
  different thoughts in my mind. I mean, my goal is obviously to
• 20:58
  try and balance my work life as well as my family because I have
• 21:02
  3 little boys, 35 and 9, so they're very busy.
• 21:06
  So I definitely want to be a part of their lives as well.
• 21:08
  And I think right now for them, it's very exciting that mom has
• 21:12
  a new job and they're trying to be part of this as much as they
• 21:16
  understand at this point. So I think a lot of this at this
• 21:20
  point will be going out in the community.
• 21:22
  I've been even simple things like people that did my signs,
• 21:26
  people that put my embroidery on my scrubs, meeting those small
• 21:29
  businesses, helping each other out and being part of things
• 21:34
  like the Chamber of Commerce. I've been going to events the
• 21:36
  last couple of months, you know, educating through those and just
• 21:40
  trying to get the word out to educate people that there is a
• 21:43
  different healthcare system model that they could consider.
• 21:47
  So I think that's going to be the next couple of steps here.
• 21:50
  I've met so many different people along the way that we're
• 21:53
  thinking about joining forces and doing educational podcasts
• 21:57
  in the area. Meet and greets over here are my
• 22:00
  office, my new office where we can do Wellness workshops.
• 22:03
  This is the thing about the DBC. You can kind of do do exciting
• 22:07
  things, walk with a doctor. I see people doing nutrition
• 22:10
  programs. I'd love to do just have you
• 22:14
  been like a yoga class at my office and those kind of things
• 22:16
  just to incorporate the community and build a good
• 22:19
  community team approach for better care in the area.
• 22:23
  Yeah. So obviously you're very
• 22:25
  community minded, which is wonderful.
• 22:27
  I mean that that's, that's a family position for you.
• 22:30
  Yeah, yeah, yeah. I yeah, I did see pictures of
• 22:34
  your office online. It looks beautiful.
• 22:37
  Thank you. Thank you.
• 22:39
  Yeah, that's just the start. So I was so fortunate they left
• 22:42
  a lot of their office equipment here.
• 22:46
  So that is from what it was on day one.
• 22:49
  And I'm going to be changing it a little bit as we go.
• 22:52
  But I just wanted to have some kind of pictures out there so
• 22:55
  they can see how it is when it started and they can follow this
• 22:59
  journey with me as I transition it.
• 23:02
  So was your office a doctor's office previously?
• 23:05
  So it was a former plastic surgery office.
• 23:08
  Yeah. And I guess they never really
• 23:10
  practiced in this suite. They had it, I guess, all
• 23:13
  redone. And they never were here for
• 23:16
  long. And and then they moved so and
• 23:20
  they let and then they left other exam chairs and you know,
• 23:24
  they had redone all the floors. Oh my gosh, yeah, the front.
• 23:28
  Desk. So yeah, yeah.
• 23:30
  So when I, when this came up, I said, you know what, it is?
• 23:33
  My it's a beautiful office. It has a lot of opportunities.
• 23:36
  It's way too big right now. So it's definitely to a point
• 23:40
  where I could definitely sublease to people that may be
• 23:44
  beneficial with referrals and everything.
• 23:46
  So that's something to look into starting a business.
• 23:49
  I didn't know if I was going to be looking for my own place to
• 23:51
  sublease from. But when this came up, I said
• 23:54
  everything happens for a reason. I think we have a lot of
• 23:57
  opportunities here. It's very close to my house.
• 24:01
  So I think hopefully this is, it feels good.
• 24:03
  Every time I come in here, it's like it doesn't feel like a
• 24:06
  typical family physician. It's a very calming feel, very
• 24:09
  quiet. And I think that's how your
• 24:12
  medical office should be. Not, you know, not a happy
• 24:15
  place. I want I want my place to be
• 24:17
  happy and calming. Yeah, you don't want it to be
• 24:20
  chaotic and frustrated, full of frustrated people.
• 24:24
  No, no, no, no, no. Well, that sounds amazing.
• 24:27
  I mean, if they left all their equipment, I can just it's those
• 24:31
  chairs. I'm just thinking about the
• 24:32
  chairs. They must be like $5000 each.
• 24:35
  It's a plastic surgery office. I'm I, I'm sure, yes, they
• 24:39
  definitely have controls that I don't even know how to use yet.
• 24:42
  So we're going to be working with that.
• 24:44
  Wow. But yeah, they're, they are
• 24:46
  beautiful. Yeah.
• 24:48
  Yeah, it sounds like a lovely place, and it does.
• 24:50
  I mean, if that's where you started, those pictures look
• 24:52
  great. Yeah.
• 24:54
  Thank you. Thank you.
• 24:55
  Absolutely. So we as we come to a close, I
• 24:59
  want to ask you, since you're just starting out, have you
• 25:03
  thought about where you want to be like in five years?
• 25:06
  How do you Where do you envision yourself?
• 25:09
  So I plan on being bright here and that's the biggest thing is
• 25:13
  from the area, having little kids, getting to know all my
• 25:17
  patients, my community. I'm planning on being here
• 25:19
  lifelong as people's family doctor, as people's friend, and
• 25:25
  that's my vision for in the future.
• 25:27
  And I have some great ideas, like I had previously stated
• 25:31
  about do a community reach outs, Wellness events, just to kind of
• 25:35
  get out with the community and spread awareness, preventative
• 25:39
  medicine as well as just quality of life.
• 25:43
  And I think that's a huge thing. My goal is to hopefully if
• 25:48
  things would increase with patients and the word gets out,
• 25:52
  I would love to have other providers with me that that
• 25:55
  would be my goal and just expand the practice.
• 25:58
  My goal is never to have too many patients because I think
• 26:01
  that is part of the DPC. So I, I think as a provider, I
• 26:05
  definitely only want to see a couple 100 patients and you
• 26:08
  know, as the patients expand over a couple 100 start maybe
• 26:12
  adding some providers. I think it's really, it's really
• 26:16
  useful to think ahead, like where, where will you be in five
• 26:19
  years? Like how many patients are you
• 26:20
  going to have? You can have another office.
• 26:23
  What kind of services are you providing?
• 26:26
  Because then it helps with it, helps with guiding you as far as
• 26:31
  the decisions that you make. So if you know your kids were
• 26:35
  going to, they'll be how old at that point?
• 26:38
  Yeah, I, I can't, it's hard for me even to think about that.
• 26:40
  But they're going to be in their teens, so they'll be in high
• 26:42
  school. So, yeah, they'll be watching
• 26:45
  the practice grow and, and maybe they'll be, you know, never
• 26:48
  know. That might be helping out the
• 26:50
  reception desk. So why not, right?
• 26:53
  Yeah. Why?
• 26:54
  They can shred papers. They can.
• 26:56
  There you go. Floors.
• 26:57
  They can clean bathroom. There you go.
• 26:59
  Yep, there you go. They.
• 27:00
  Can earn a little to. Work.
• 27:02
  Yeah, they can earn a little pocket money.
• 27:05
  Yeah, Yep. Well, they're so cute.
• 27:07
  I mean, right now when I first showed them the office, they're
• 27:10
  like, mom, can we live here? They said well.
• 27:14
  That's so sweet. Yeah, and it was very sweet.
• 27:19
  Very so cute. So cute.
• 27:21
  Yeah. It's really neat to be able to
• 27:24
  grow up in a situation and watching your mom build
• 27:27
  something from nothing and make it succeed, which it's going to.
• 27:32
  I mean, it's direct primary care practice.
• 27:34
  You've got you've got the right mindset and the heart for it.
• 27:38
  Your community minded you. You want to serve your
• 27:40
  community. So yeah, I think your kids are
• 27:44
  going to have a great experience watching this grow, and it's
• 27:49
  such a great lesson for them. Absolutely you.
• 27:53
  Know about and that's a huge part of this.
• 27:56
  I want to show them that you can do anything.
• 27:59
  You might have a little bit of bumps in the road, but you can
• 28:03
  make things what you want with practice.
• 28:06
  And I think another thing in this journey is as I transition,
• 28:09
  I as a physician, I think most of us are very, you have to do
• 28:12
  things perfect. And it's very hard for me to let
• 28:15
  things go. And I've realized even in the
• 28:17
  last couple of weeks, it's like you better just post on social
• 28:19
  media, even if it's not perfect, just start going because that's
• 28:23
  the only way to get the word out there.
• 28:25
  And I think for me, it's been a little bit hard to do that, but
• 28:28
  I think that's the best thing to get out there and go.
• 28:32
  Yeah, it's interesting. I think, of course, being a lot
• 28:35
  of us are type A's and we're perfectionists, right?
• 28:39
  I just read something today. It's a perfect is poison, and
• 28:43
  that's that's that's a great that's a great saying because it
• 28:47
  really is true. You know done is better than
• 28:50
  perfect. Absolutely.
• 28:52
  Yep. And I think that's a huge thing
• 28:54
  for a lot of us starting out. It's just, you know, do your
• 28:57
  best, do it with your heart and keep on going because if you
• 29:01
  wait for it to perfect, it's you're going to miss out on a
• 29:03
  lot of opportunities. Yeah, that's a great place to
• 29:06
  end. I love that.
• 29:08
  Yeah, I love that. So I just wanted to, to
• 29:11
  highlight some things that you did say especially that helped
• 29:13
  you is reaching out to the DPCS around you and getting support
• 29:18
  and then getting active on the Facebook groups, learning from
• 29:23
  the people who have already done it.
• 29:25
  And yeah, the Facebook groups are wonderful.
• 29:27
  They are people are so, so sharing and it's ready to share
• 29:32
  and and talk about their experiences, even if they're not
• 29:35
  great. Right, right, absolutely.
• 29:38
  Because everything and I think just this struggles.
• 29:41
  Well, that's it. Like just hearing the struggles.
• 29:43
  I mean, even telling my experience right now, I only
• 29:46
  have one patient enrolled. Really folksy.
• 29:48
  Hopefully check in with me in a couple months, maybe things will
• 29:51
  improve. Hopefully they will.
• 29:52
  And how did I do that? So yeah, yeah, I know.
• 29:54
  I'm sure they will. But you know, just for other
• 29:57
  people to realize it's a lot of times we just hear oh, so and so
• 30:01
  has 100 plus patients. Well, how long did it take them
• 30:05
  to get? So I just want to make sure that
• 30:07
  we're all feel like able to communicate and guide each other
• 30:11
  and help each other out. Some people will say that
• 30:14
  they've got 100 patients when they opened.
• 30:17
  Right. And that's not everyone.
• 30:20
  No, no, no, no. And it takes some time, I think,
• 30:24
  in the transition, you know, out from your prior job to kind of
• 30:28
  get your word out in the community that you've even left
• 30:31
  that current job and you're doing something, you know,
• 30:34
  different. Yeah, yeah.
• 30:36
  And and your previous practice is not.
• 30:39
  You're not going to tell your patient.
• 30:40
  Oh, no, no. Unfortunately, no.
• 30:43
  Yeah, just definitely got to get the word out on your own.
• 30:46
  It's it's on you. I saw that you're doing that.
• 30:49
  I think in the Carolinas, you're getting people together.
• 30:51
  I think that's great. I mean, I don't know if you've
• 30:54
  ever thought about doing like kind of like a bunch of people
• 30:57
  that are starting out and kind of being mentors even online,
• 31:01
  just because I would love to go to something like that, but from
• 31:04
  New York. It's a little difficult, but I
• 31:07
  think what you're doing is great.
• 31:09
  Thanks. I did, yeah.
• 31:12
  I did actually think about like virtual, but one of the things
• 31:17
  and you went to the summit. So you know, one of the things
• 31:19
  that's really, really good about the summit is the in person.
• 31:23
  Yeah, just meeting people and I think online is wonderful.
• 31:28
  I mean, obviously we went through it in COVID and, you
• 31:30
  know, everyone did Zoom stuff and, and so there is benefit to
• 31:34
  it. It's just not the same.
• 31:36
  And I'm yeah, I was trying to think of how, you know, how can
• 31:40
  you do that? And it would be kind of like,
• 31:42
  you know, you'd have like a big Zoom room and then do breakout
• 31:46
  sessions. But even still, like it's hard.
• 31:48
  It's hard to do just yeah sessions.
• 31:51
  I've done them before and it's a little awkward sometimes.
• 31:54
  That is true. And I don't know how big your
• 31:56
  network is, but even, you know, if you did something like that
• 31:59
  and then brought people to these events together.
• 32:01
  So you kind of like in all these different states doing BBC and
• 32:04
  then you kind of came into a, you know, a small group where
• 32:08
  you met each other. So many good.
• 32:10
  All kinds of good ideas. Right, you know, but I think
• 32:12
  you're doing great. Maybe doing like like I get to
• 32:15
  go to different places. There you go.
• 32:18
  Yeah. That too have things, you know,
• 32:20
  organize things in different places.
• 32:22
  So, and then that's a great thing to do too.
• 32:25
  You could do something like that and go to people's different
• 32:27
  offices all around the States and you know, everyone could
• 32:30
  show off what they do, what their DPC is like.
• 32:33
  So there's so many different things you can do.
• 32:35
  That's, that's wonderful though. I love this what you're doing.
• 32:38
  And I think it's great when, especially when you're starting
• 32:40
  out and you kind of feel you're a little alone doing this kind
• 32:43
  of new thing. And but I think it's great.
• 32:47
  That's one thing about DPC is it can be very, it can be very
• 32:50
  isolating, yeah. Period.
• 32:52
  Yeah, yeah. And I think, you know,
• 32:54
  especially if you're in a place where there's no one there, and
• 32:58
  I think there really is like, are you?
• 33:00
  You're in the DPC women group, aren't you?
• 33:03
  That I don't know. I don't know if I am actually.
• 33:06
  I didn't know there was a separate one, but I'll have to
• 33:09
  look at that one then too. There's so many different groups
• 33:12
  there are. But yeah, no, I'll definitely
• 33:14
  look into that. That would be wonderful.
• 33:16
  Yeah. I'll look and see and then I'll
• 33:18
  invite you if you're not. But I really do.
• 33:20
  I really do like that one because I really think, I mean,
• 33:26
  DPC is DPC, but there are differences between just like we
• 33:29
  were saying, a woman doctor starting ADPC practice versus a
• 33:33
  male doctor. And I mean, that's just it is
• 33:36
  what it is. I'm not disparaging anyone.
• 33:39
  That's just that's, yes. Yeah, Yep.
• 33:42
  Well, it's just sometimes whoever is bouncing that house,
• 33:45
  my husband was joking me with this morning, he's like, focus
• 33:47
  on getting patients, don't focus on the home, doing the dishes,
• 33:51
  doing the laundry. But unfortunately, as part of
• 33:53
  what I've always done, I have to run the whole household too.
• 33:57
  So there's certain things. And I think it's good for me
• 33:59
  mentally to take that break, you know, take care of our house to
• 34:02
  make sure our kids are properly going.
• 34:04
  But sometimes that mindset you have to kind of realized.
• 34:09
  I love that he's he's saying that because what an enlightened
• 34:13
  husband. Yeah, I know.
• 34:15
  Yes, He wants me just to focus on getting the business up and
• 34:20
  running and supporting me through this kind of going from
• 34:23
  an income to no income. And, you know, and that in
• 34:26
  itself is sometimes a little tricky.
• 34:29
  Yeah, well, are you familiar with Doctor Una?
• 34:32
  It sounds really familiar. So she is a business coach for
• 34:36
  physicians. Oh, I I know business.
• 34:39
  School yeah Entree, MD Business School and she always talks
• 34:43
  about having a home team. OK.
• 34:47
  And, and other business coaches talk about this.
• 34:49
  Alex Hormozi is 1. You're talking about the value
• 34:53
  of your time, right? And some people love doing
• 34:57
  dishes. I mean, great, you love it.
• 34:59
  Fantastic. Do it.
• 35:00
  I hate it. I hate cooking.
• 35:02
  Now I'm like, I've cooked for 25 years for my I am done.
• 35:06
  I don't want to anymore. Yep, I don't like it either, but
• 35:09
  I know if it doesn't get done it's going to be there tomorrow.
• 35:11
  So it just builds up. Especially with three little
• 35:13
  kids. Right.
• 35:14
  Yeah, but that was one thing she said.
• 35:17
  Really trying to get a home team, and because that's still
• 35:21
  part of your business per SE, you know.
• 35:24
  So yeah, your husband's got that that mentality too, it sounds
• 35:27
  like. That's great.
• 35:30
  Having someone supporting you is so important.
• 35:32
  Absolutely. So sad that you do some
• 35:35
  coaching. So what I'd done was coaching
• 35:38
  calls for people who are new working on their elevator
• 35:42
  pitches, and I was trying to pull out some of what you've
• 35:45
  done already. So the B and I are just
• 35:47
  wonderful talking about what have you done, what's worked,
• 35:51
  what's not worked, trying to help people think about other
• 35:54
  options. Although you're doing fantastic.
• 35:56
  You're already doing a lot of the things that some people just
• 36:00
  hadn't hadn't thought about. But you're you're thinking about
• 36:03
  your referral sources, you know, you're thinking about using the
• 36:07
  B and I to hone your elevator pitch.
• 36:09
  Yeah, so and that's The thing is a lot of people just don't have
• 36:13
  that down. And the only thing I would say
• 36:15
  probably is, and this is a problem for family physicians in
• 36:20
  general when you go into DPC is you went into family medicine
• 36:25
  because you like the variety, you like the relationships, they
• 36:27
  become like your family and friends, right?
• 36:29
  Yeah. But when you send that message
• 36:33
  out, you are basically speaking to everybody.
• 36:37
  And it dilutes your message because, yeah, when you talk to
• 36:43
  people, like if you're on social media and you want to talk to
• 36:45
  people, you want to have a message that will directly
• 36:48
  address your ideal patient so that when they hear it, they're
• 36:53
  like, Oh my gosh, she's talking about me.
• 36:56
  You. Know that's me and then that way
• 37:00
  that gets their attention. So if you're just like I can see
• 37:03
  anyone from the cradle to grave, which is true.
• 37:05
  I mean, you can right, But then no one really feels like you're
• 37:09
  talking directly to them. So that's probably what I would
• 37:14
  say is in your messaging is trying to pick like your ideal
• 37:20
  patient, not that she would only see that person because most
• 37:24
  people, like I said, they don't want to narrow it down, although
• 37:28
  there is some value to that. But you want to send out your
• 37:31
  message to somebody in particular.
• 37:33
  And honestly, if it is like women, moms, thirties, 40's, the
• 37:39
  decision makers for healthcare in their family anyway.
• 37:42
  So when you reach them, you're going to get the whole family,
• 37:46
  you know what I mean? So that's kind of who people I
• 37:50
  talked to because we're all kind of, we're women in the same kind
• 37:53
  of age range, similar situations, moms, we like to
• 37:57
  treat patients that are like us. So if you start calling them out
• 38:03
  specifically, then you know all the rest will come too.
• 38:09
  That's true. Yeah, that's a good point.
• 38:10
  Yeah, I think for me, it's been very hard to get that Avatar
• 38:13
  patient because as a family physician, you see everyone like
• 38:17
  you're saying. And I think from this is just
• 38:19
  those people that are really just frustrated with the system,
• 38:22
  not feeling her, not being able to see their doctor and that
• 38:25
  busy professional that needs to get in.
• 38:28
  And they want their physician actually to know them and be,
• 38:32
  you know, have that trust with their physician again and just
• 38:36
  promote preventative care and quality of life.
• 38:40
  Yeah, So if. You think about who your
• 38:42
  favorite patient is, like, right now.
• 38:44
  Yeah, yeah. Or your.
• 38:46
  Favorite couple of patients? Yeah, that's probably your your
• 38:50
  ideal patient and that's a great thing to, yeah.
• 38:54
  And you can think. Who you know who?
• 38:56
  Is it? I could totally pick them like
• 38:59
  you're, they're probably somebody you're like, oh, I
• 39:01
  could totally hang out with them.
• 39:02
  We can go grab a cup of coffee and it would be nice to see
• 39:05
  them. So that's, I love that.
• 39:09
  I love that. I think I've never heard
• 39:11
  somebody say that to me because like I said, it has been such a
• 39:13
  hard thing. So I really love seeing all
• 39:15
  patients have different struggles in their life, but I
• 39:18
  think that that's a great thing to do.
• 39:19
  Yeah. And really, again, it just.
• 39:21
  Comes back down to like to see people who are kind of like you.
• 39:25
  And then and then that way if you can find whoever that person
• 39:28
  is and narrow it down and think about why do you like them?
• 39:32
  What is it that draws you to you know, why?
• 39:35
  Why do you like seeing them? You know, is it because of their
• 39:38
  personality or is it because of things that they do or that they
• 39:40
  care about and then trying to find other people like them.
• 39:43
  So if it's like their moms, they've got three boys like you.
• 39:48
  You know then. OK.
• 39:49
  How do I find more of these people?
• 39:51
  Like you can ask if you have a couple patients that you end up
• 39:55
  enrolling that are your favorites.
• 39:57
  And then you can ask them just like what?
• 39:59
  What do you do? What do you, where do you hang
• 40:00
  out? Where can I find more people
• 40:02
  like you? Yeah, that's absolutely it.
• 40:05
  Yeah. And go there.
• 40:06
  Yeah. So then, yeah, you just got to
• 40:09
  go. To the places where your people,
• 40:10
  your people, your kind of people are hanging out because if they
• 40:13
  like you, you know, then their friends are probably going to
• 40:16
  like you too and want to do go to your practice as well.
• 40:21
  So that's one thing. So you think about who your
• 40:23
  favorite people are. Yeah.
• 40:24
  In your practice, previous practice.
• 40:26
  I love that. I love that.
• 40:28
  It makes me excited to do what I'm doing.
• 40:31
  Yeah. You're excited to go to work.
• 40:33
  Monday's not terrible, you know. Nope.
• 40:36
  Coming. Back from vacation?
• 40:37
  You won't. Believe it.
• 40:38
  It's so nice. Yeah.
• 40:40
  Oh, I'm sure. I'm sure.
• 40:41
  Yeah, instead of a full. Inbox it's like 5 things no,
• 40:47
  Nope and you and you know. What's going on?
• 40:49
  So yeah, it's it's just that I can feel it's just a better way
• 40:52
  to do things. Yeah, definitely.
• 40:54
  Well, tell us. How we can find you Doctor
• 40:57
  Fusella so you can find me on Fusella family.
• 40:59
  Medicine.com, the way that can look at my website, find out
• 41:03
  exactly what I'm doing and set up, meet and greets, a meet and
• 41:08
  greet, you know, then that's when we talk about how to enroll
• 41:10
  from there also on the Facebook group, my business through
• 41:14
  through Family Medicine, also on Instagram.
• 41:19
  Perfect. So we'll have all of those links
• 41:22
  in the show notes and hopefully you are going to just take off.
• 41:27
  Your practice is going to grow very quickly and I'd love to
• 41:31
  check in with you maybe in six months or a year and see where
• 41:34
  you are. I would love.
• 41:35
  That I will be safe and thank you.
• 41:38
  So much. Thank you so much.
• 41:39
  It was so. Nice talking to you.
• 41:41
  Thank you. Have a good weekend.
• 41:43
  Take care. Bye, bye.
• 41:45
  Thank you for listening. To DPC Life, if today's
• 41:49
  conversation inspired you, hit follow, Leave a review and share
• 41:54
  it with a friend who's ready for change.
• 41:57
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• 42:01
  your back. Until next time, keep building a
• 42:05
  practice and a life that truly fits you.