Direct Primary care is an innovative alternative path to insurance-driven healthcare.

Typically, a patient pays their doctor a low monthly membership and in return builds a lasting relationship with their doctor and has their doctor available at their fingertip.

Welcome to the My DPC Story podcast, where each week you will hear the ever so relatable stories shared by physicians who have chosen to practice medicine in their individual communities through the direct primary care model.

I'm your host, Marielle Conception.

Family, physician, DPC, owner, and former fee for service.

Doctor, I hope you enjoy today's episode and come away feeling inspired about the future of patient care direct primary care.

Starting a DPC practice has been so influential and important to me as a physician.

It's allowed me to hang my virtual shingle and practice medicine on my own terms.

I'm Dr.

PDay of Flourish Gynecology, and this is my DPC story.

Welcome to the podcast, Dr.

Leeza Day.

Thank you so much for having me.

I am really, really excited about.

I, I say that at the beginning of every podcast, but legit, I get excited about every single physician I get, the honor to talk to, and in your case.

The reason I'm so excited is because we have just all come together in, on the national front of things, at the DPC summit in New Orleans, and there are people who are specialists, there are people who are primary care, there are residents, medical students, and I was so excited to have your episode air on this state in particular because I really feel that you, of all of my physician friends have just really represented what it is like to be.

An employed physician, what it is like to be a person who then chooses to do her own thing, and then also learned and executed on a direct primary care business plan.

So again, I'm super excited as I legitimately am with every single guest including you.

I am so excited for you to be here today.

I'm so excited to be on here today.

I don't know if you remember, but when I first met you at the flexed staff Summit last year, I was actually listening to my DPC story on the flight there.

And then when I met you, I was like, oh my God, I'm meeting a celebrity.

I and you were like even better in person, so

you're so sweet and Absolutely.

I do remember that.

It's so funny because I, I'm very, I think this is why I get excited is literally just the people connection.

It's very visual.

I mean, it's very it's very vivid for me.

And so I absolutely remember you.

You're wearing your black and white dress and you were like, oh my God.

And I'm like.

It's so exciting to meet people who listen to the podcast.

'cause I'm like, my kids listen to my voice all the time.

But it's very different to hear, from a physician who's oh no this episode meant a lot because of X, Y, or Z.

And definitely heard a lot about that thankfully at talking to people in New Orleans also.

So

All of that said, I wanna get started with your journey into medicine because you are still one of those amazing physicians who, takes any delivery that is coming their way you still use those skills when you do your locums work as well as now you've added direct primary care, like I mentioned.

So bring us to Dr.

Ade choosing to become an ob gyn.

To start, because I think that it, it's very much going to help paint how you had the the acumen and the execution skills to do what you're doing today.

Yeah.

So when I went to medical school, I wasn't sure, what I wanted to do.

I had shadowed a few emergency medicine physicians and thought that might be, something fun to do.

And then as I went through medical school, I really loved physiology.

I really loved hormones.

I loved when I did my OB GYN rotation that we were able to do a little bit of everything.

So as an ob, GYN, you do a little clinic, you do a little preventative care, you do specialty care, you can do surgeries, and then of course the whole world of obstetrics, which is incredible in and of itself.

I still have a picture on my phone from my first delivery as a medical student, and I had these big goofy glasses that were riding down on my nose.

And my attending took masking tape and taped them, taped my glasses to my face.

And I still have this photo, and I cried because the grandma cried.

And, and anyway, so that was a moment that I was like, I love obstetrics.

This is something that I want to do.

And I continue to love it.

And as you've noticed, I do, I still do a little bit of everything.

So I think what brought me to the field has those, those same the same and what motivates me has continued to motivate me throughout my career and career, how I revamped my career.

And I just think that's amazing though because I think that that.

When you said, especially the tape part, that when other people are hearing that they're thinking about their own, situation or whatever happened in medical school or residency that really impacted them similarly to how you were impacted by the tape.

And I think that's so awesome, especially also you are your interview is airing after Dr.

Lawrence Reed shared about her diaper chair story.

So I think that, we all have our stories and these are the stories that I think are what make my DBC story so relatable.

When you knew that you were going to do ob gyn, did you ever have a time after residency where you were, in a place thinking about, do I continue obstetrics and gynecology?

Do I only focus on one or more of one than the other?

Yeah, absolutely.

When I graduated from residency, so to give a little bit of perspective to the listeners, I had stayed on with the hospital system that I had done residency with and agreed to open up a practice in a nearby hospital.

So I opened a practice as a resident and I had actually one of my attendings and two others including Holly, she, which some of your listeners might know.

So that was a whole different experience for me.

But you know, as an OB GYN residency, it's a lot different when you take, when you have a big call pool and you have hour restrictions and largely shift work.

And so from an hours perspective, switching to being on Q3 Q4 call was a huge, it was a huge change for me.

And so there were definitely times where I'm like, how is this sustainable?

I love what I do, but I am human and sleep is kind of important.

And so, but yeah, there is definitely times when I was in this kind of traditional model that I thought I just don't know if I can picture myself at 50 continuing to, to work at this rate.

Totally.

And I know that when you said, you know you need sleep one, it's ironic because the first time I met you, you did a talk about sleep during locum shifts, but also.

I remember, like I, I don't know.

I'm dating myself.

I am 43.

I like unabashedly watched an maniacs and if anybody understands, Katie, kaboom, that is a hundred percent me post-call OB in the hospital.

And I knew when I left residency, Marielle was done with deliveries.

And so I totally get that.

And you and I are also very much similar in that we are moms of two young kids.

And so I think that that adds a completely different layer to when you are awake, that's different than how capable are you of being present for your patients, for your family especially for little kids.

So talk to us about.

How you went forward because you did have little kids in the mix along your journey to, especially because you were able to see what was sustainable or you had a feeling for that.

Whereas I, I don't, I, I don't think that that's something necessarily that we sort of pimp each other with when we're thinking about what are we gonna do after residency.

We don't necessarily always think about what's sustainable beyond what's financially sustainable.

Nipple.

Yeah.

So my kiddos, let's see.

I had a kiddo in residency and then I had a kiddo was pregnant my fourth year.

So I started my practice with.

Pregnant actually, and and delivered the first year of practice.

And I mean, honestly, who remembers those first two, like two, two kids under two and a half?

It's all just a little bit of a blur.

But over time as I was settling in into attending life and being a mother of two, and I also have a stepdaughter who is now a teenager, so we had a full house.

I really realized that there was gonna be kind of a fork in the road of like how I wanted to show up as a parent and how I wanted to balance that with my career.

And and I'm just gonna put a disclaimer as this is anybody's.

Own choice to what they choose to do here.

This was just, this is just how I felt about it.

So I knew that either I was gonna get a nanny plus daycare, I was gonna get an au pair.

I was going to kind of.

Delegate all the things that I didn't need to de that maybe I didn't need to do.

Maybe I didn't need to shuttle kids to and from practice and, but I'd be there for the games.

Right.

You kind of decide what's important for your family, what's important to you, and then how does that balance with what fills your cup at work?

For me, I really just wanted to be there for everything.

I wanted to drive my kids to practice.

I liked I think we've talked about like mundane conversations though with other parents at, at sporting events and sometimes it's less than fun.

But for me, I kind of, I kind of liked that and so I knew I wanted to be kind of part of the community for my kids.

And so that was a little bit of a roadblock for me in terms of staying in the position that I was in and how I would continue to not only be present but be mentally there.

Right.

Not be tired, not be checking.

Messages on my phone not putting out emergencies, kind of like left and right.

And that said, how did you take those next steps to then make that sustainability, make that plan a reality?

Mm-hmm.

Yeah.

So in, so what happened career-wise was I ended up taking a leadership role in the clinic.

A few of my partners had left and I was still very motivated to improve the clinic.

And again, we started it from scratch.

It was really a wonderful clinic.

It was thriving and I wanted to elevate it.

And so I had actually reached out to a coach to see more of like executive leadership training as a physician.

Like how do I one overcome the fact that I was a resident in this health system and now I'm a leader?

And yes, I was their resident, but I have good ideas and I can connect with my staff and with my patients, and how do I gain the respect of, of administrators?

So in doing that, there was just a lot.

It was the first time where somebody had asked me like, what are the four things that you value?

Put them in order by the time you're 50.

35 things that you want to do this or that, like it, what, what are, give me answers to these questions.

And maybe we did this in medical school, but like the context was like totally not there.

And so now so I did that and I, I realized what was important to me.

And I actually had no intentions of leaving my practice.

I had got up the strength really to, to ask for something that I wanted, right.

So I felt like I was giving I was bringing a lot to the table.

I have pleasant personality.

Patients like me as a good physician.

I am motivated.

I like all the techie stuff.

I'd help everybody with their epic.

And so I went and asked for just a little bit of time to.

To accomplish these things.

'cause it's hard to do it when you don't have any time.

And I really, this idea of time became very finite for me.

And so I knew that I couldn't continue to operate with this much on the plate, so something had to give.

And so when I asked for it, I was told, well, yeah, you're great.

You're probably better than most, but it wouldn't be equitable to give you more time than somebody else.

And, and, and I don't know what it was, but then I was like, I don't know what came over me, but it was a very fine line in the sand.

And then I was like, I put my notice in 10 days later, no idea what I was going to do.

it's just so kick ass mm-hmm.

You are very much similar to me in that it's I don't necessarily have a plan, but I can't do this anymore.

Mm-hmm.

Mm-hmm.

And

you, we've figured it out, so.

Mm-hmm.

As scary as that is, I, I, again, am really intentional about the audience hearing your story right after DPC Summit, on the heels of days of people, drinking the DPC Kool-Aid, having their come to whoever they pray to moment and mm-hmm.

Just saying my gosh, there is something out there called Direct primary care.

It is real.

It is happening and this is a possibility for me.

So I'm wondering, especially if you can hear, talk about the conversation you had with your, with your husband, with your partner, because that is also something that it's like as we are very capable female physicians to say like, I ain't doing that anymore.

It's another thing to be like, also, I have a family and I gotta make this work for my family too.

So tell us about the conversation that you had in this moment of well, if treating your physicians.

Equitably doesn't mean taking care of them.

Then this is not for me and this is not an equitable position for me to stay in.

What did you and your husband then talk about?

Because again, there's lots of people going to their partners or their family members who are dropping things like, I'm gonna leave my position pretty soon.

Very interesting because I was very nervous to tell those around me that I cared about what my plans were because again, I trained in the system.

I started practice in the system, grew the practice, grew into a leadership position.

I think I was like on that.

Track, ladder, what, whatever you wanna call it.

And I also happened to be primary income for my family, so I was a little bit nervous on how that would all shake out.

But I, I can't, I think I told my husband first and I said, I think I'm going to quit my job.

And he goes, oh yeah, about time.

I was like, wait, what?

I thought I was holding it together really good.

What do you mean about time?

And then I told my mom and she said the same thing.

And then I told my brother and he said the same thing.

And then I told my mother-in-law who lives across the country, and she said the same thing.

So that actually blew me away.

And what it actually really taught me is that we are affecting those around us.

And we.

Our loved ones don't necessarily wanna give us that feedback because they know our career is so important to us.

My husband has been with me from the start, and he wants me to do what makes me happy.

And I think you all were a respectable career, we're physicians and sometimes they're afraid to say things.

And so that, that was a, a little bit of an eye-opening moment for me.

I think it, I think it's awesome and I, I think it just makes me think about how sometimes we can't see past the ends of our noses and we, we sometimes get into our own head space so much so that it's here's a great example.

You didn't even have to say anything and everyone else was already confirming your thoughts, even though you hadn't said them out loud.

So that's, that's amazing.

And I, I hope that it is also giving some people some.

Courage or, just just another story to hear in their head when it comes to that as a conversation I have yet to have with my loved ones.

So after you decided to quit definitely in the world of ob gyn there's always going to be the need for a very well-trained physician, especially in acute care and acute deliveries, to have a job.

And you very much leaned into locums, and I'm just wondering if you can tell us about that, because.

It's very different when, especially on ob, like anyone who's done a rotation in OB knows that the people who run the OB floor are the OB nurses.

And so when you're going from, I know my OB team and residency, I stayed on as an attending and then I have to go to different OB teams all over the country.

I would, I would never make that decision myself personally because I stopped doing deliveries after residency.

'cause I, that terrifies me.

But for you, what was your, what was your thought about doing locums versus looking for a different employed position that was quote unquote more equitable?

I'm just saying that so snarly'cause it's ridiculous.

Mm-hmm.

Yeah,

I wanted to make one comment on quitting your job before I answer that question.

And one thing I just wanna point out to those that are listening is that you don't have to wait till the point that you are burnt out to a crisp to draw the line and change your job.

And so I don't think that I was necessarily burnt out.

I just knew that this was not sustainable and I didn't want to know what would happen to myself or my family or those around me if I continued at this pace.

And so, again, for those that are listening, you don't, you don't have to push yourself to the ultimate end before you make a change.

It is people in other specialties and other jobs careers, they make changes all the time.

Change is okay and I think.

We're not used to that mindset.

So again um, to answer your question about why I decided to do locums, I was not ready to commit to another permanent position.

I, I also was leaving in June and wanted a little bit of a summer selfishly forth my family.

And Dr.

Chen had, she had left I think eight months prior to my final.

My final shift.

And she had dabbled a little bit into locums before, and I was like, okay, great.

I'll just see what's out there.

And for me, it actually worked out really organically.

And I shared this a little bit when I talk about direct contracting, but I was on LinkedIn and I got a message from a hospital that, for a permanent position, and I had said was not interested in a permanent position, but I am actually free to help your hospital until they find one.

And they were like, great.

And there you go.

That was the start of it.

And I went there a week, a month for, and I still go there two over two years later.

And so yeah, when you're thinking about doing locums.

In general outside of even being an ob, GYN is that you have to be pretty malleable and you have to be pretty flexible.

This is not the time where it's like we do things my way and only my way.

You have to integrate yourself the hospital system, and there are protocols.

You have to trust the nurses.

And honestly, there is only like one place maybe that I got a little bit hazed.

But since then, really every, they're very appreciative.

I go to smaller communities, so they're just really happy one to have hope for their physicians.

What I've really noticed in these small communities is that especially these nurses look out for their physicians and they are really worried about their wellbeing.

And so they have really accepted me and.

Like I said before, in general, I'm like pretty pleasant.

Like my med school evaluations, every single one, she's so pleasant.

So for me it was, it, it was nice to also feel appreciative.

So all the, all the things that my other, my former employer was like, yeah, you're all these things, but it doesn't really matter.

I'm now, I'm in a position where people appreciated my personality and they appreciated my work ethic and the way I took care of patients.

I can absolutely testify that Dr.

Lee today is not just like pulling your leg.

She is a very pleasant person to be around.

But I think that's so funny because it's, I think that it just, it makes me think about that pleasant does not mean that someone can just walk over you.

And I think that that is something that especially in the employed.

Positions that, people who have zero medical training and yet they make gazillions of dollars off of the backs of the physicians who actually see the patients.

They have the audacity, to perceive that being malleable, pleasant, flexible hardworking is that you are an indentured servant and you get to be told what is okay and what is not okay.

So, I just I'm, I'm very proud of both of us for making it very apparent that those two are not equal pleasant and pushover.

I am really grateful that you mentioned you don't have to let yourself burn to a crisp before saying these are my boundaries.

I think especially in the mindset of a physician entrepreneur that that is what happens all the time.

If your patient is calling for Tylenol at two o'clock in the morning when they can go to the 24 hour Walmart, or, if somebody is, is stepping on boundaries, it's so important to not wait until it gets so bad.

And yes, like I've definitely been there where I'm like, oh my gosh, how did it get this bad?

I'm never gonna have that happen again.

I've spoken to my regret of taking patients acutely to my practice.

But it's, I think it's a really good point for people to listen to because it also.

It's part of that honoring like you said, who are, who am I and what do I need to be sustainable?

That that spirit of us right.

When it comes to the, these small communities, I'm wondering because there's probably a lot of people in the audience who have not, probably until before Dr.

Lawrence Reed talked about locums, have thought about locums before.

And you were also one of my go-to people when it comes to the world of direct contracting, the world of locums.

Because I think that what many of us are familiar with is the recruitment emails.

I mean, yesterday I got, okay, I, I love this'cause it says Sheboygan, so I'm gonna read it just because it says Sheboygan.

What was it?

Hi Doc fm Green Bay slash Sheboygan.

Epic.

EMR, 18 to 20 patients a day, 36, patient contact, hours for profit, interested, reply, stop to opt out.

Those are like our dating messages that we get and we are very familiar with those.

But for you you have, you have your own crib sheet when it comes to addressing what jobs you will and will not take.

So I would love if you could talk to us about as you started working in these smaller communities, as you started getting used to being nimble and being able to, work with different teams, how did you then hone in on that craft so that you were taking things that you wanted to do and not what was just left out there?

the idea.

Of the scarcity mindset comes up a lot and I think physicians unfortunately tend to have that.

And, and I don't think it's of any fault of our own.

It is just that we have been on the wheel to get here, right?

Like we were in high school, we need to get into college.

When we're in college, we need to take the MCATs, get into med school, med school residency get a re be a research fellow, do X, Y, or Z.

And and a particularly the residency match, right?

You took what you can get.

And so that has really translated, I think into life after residency for a lot of physicians.

And, and so I think it's really.

Important to shift from that to more of an abundance, a mindset of abundance.

And it was pretty quick.

I, I would say initially when I started, I was, I maybe overcommitted because I was a little bit nervous that there weren't gonna be available positions.

But then once I started doing it for a couple of months I got to be a little bit more free in, in saying no really.

And then that, that's another important thing that I think physicians need to learn to say and may be just humans in general is no.

And just, and, being part of Flex Med staff and going to their conferences, there's a lot of good CME there about really how you navigate these conversations.

And it's hard to dilute it down to one or two sentences, but what you, I think if your listeners take something away from this is that you have the skills, okay?

You are taking care of the patient, they need you.

And so if you view yourself as the business, as the, as the service, and you conduct yourself in that way, it works really well.

And you just have to be able to say, if it's not.

The terms that you agreed to, that you walk away and knowing that there are gonna be plenty of more opportunities to come.

It might not be in the exact time that you want.

Right.

But there's a lot of different ways as you're thinking about, setting up your, your, your business in providing like safeguards and layering stability in, in this type of work.

so true.

The, the, the, the, the way that we are put into the, the cold water of our boiling pot of a, a career in healthcare, it's like you literally are so trained to you don't think about, anything other than.

You are supposed to get your 16 patients seen in the ICU by rounds at 2:00 PM you are supposed to do this.

And it, we, we very much don't think about is there a different way we could do this?

Is there a more effective way that we could do this?

Is there there a more personable way that we could do this?

Instead it's well, I, I can get everyone's A1C to 7.1 who has diabetes.

Absolutely.

I I can do that.

Yes, sir.

Thank you.

Have a good day.

Can I have some more girls?

Like it's really, it's really frustrating that, when we are out of that system, we can see.

The, the personality the, I wouldn't say personality, but the the tendencies that we, we have in training in a very, and I will say patriarchal society, because that's absolutely what, your, yours and my generation experience.

Mm-hmm.

You have the attending and you have the third year, the second year, the first year.

Or God forbid if you're in seventh year training for neurosurgery.

I'm, I wish you well, I could never do it that long, but I do think that it, it is, it is so interesting and it is so sad that it is so relatable when it comes to just the the, the way that we just did.

We didn't, we didn't have a lot of autonomy.

Yeah, yeah.

That's

so true.

I think when I had initially left my job and I was working one week a month and I didn't really do much else, the.

Remainder of the three weeks which is when I learned sleep is really important.

'cause that was the first time in a very long time where I slept every night like eight, at eight to nine hours a night for three weeks straight.

And I felt like a whole new human.

So it's very interesting that you say that, that we just kind of did what we were told and that really became apparent to me after I was in this new work schedule where I had three weeks off.

I was able, it's very interesting.

I was able to make, make more decisions for myself because I had more freedom of time, whether it was in my personal life or in my work life.

And what I did find out about myself is I do enjoy, I do enjoy working, like medicine is stimulating for me.

And so that's how the birth of my direct specialty care came in was really from that downtime where I was away from the like ultra robotic productivity that I was so used to achieving that now I had the space to be creative and really find like what I enjoyed doing.

But I don't get, you don't get that when you just don't have the time or freedom or energy really.

To tap into,

tap into those thoughts.

Totally.

And it makes me think about how people have said on this podcast that, DPC is not a walk in the park.

DPC is, it can be one of the hardest jobs, but it's so much more rewarding as you're doing the job versus what we were used to in fee for service.

And so here, I wanna ask, again, thinking about you as a doctor, you as a mom, you as a business owner, you as an entrepreneur I, I totally get you, when it comes to your brain comes alive, like you realize what you like and what you don't like.

For you, it ended up being doing locums, along with opening up a direct specialty care practice.

Tell us about that, because none of those roles that I mentioned are easy.

But you have decided to, to add a different way of how you deliver yourself in the form of patients, in the form of being an expert.

In your field you could have chosen not to.

And so I'm just wondering if you could tell us about that decision to add a layer of direct specialty care onto your locums.

Yeah, I think I easily could have done locums a week, a month and then had the remainder of the time off.

But for me, I started to miss like longitudinal care and continuity of care and.

I missed having a little bit of a home base.

When you do locums, you, you don't really have a hospital system.

You don't have an EMR.

You don't, you don't have, you're not part of any community.

So, for the most part, I will say I've been doing, I've been going to some sites for a very long time, and now I feel like a part of their community.

But for, but in general it, you don't have that same continuity of care or even recognition, right?

Sometimes it's nice to be the doctor in your community or build your own community.

So, I was doing in that time also some telemedicine, perimenopause, menopause care.

I, I am menopause Society certified practitioner.

And so, I was running into some people that I knew kind of personally had worked with, and they're like, I would love to see you.

Had patients reaching out to me on LinkedIn and again, I was like, I don't really have anywhere to send.

I can't see you.

So at, at some point I felt like I was a physician, but I didn't really have a place to just practice medicine.

So when I opened flourish Gynecology, it was like really handling my virtual shingle.

And I was able to see patients old patients that had come to me, colleagues, nurses that I've run into.

I was able to be like, yeah, sure, I can see you here.

So yeah, for me it was really just feeling a little bit more connected to the community that I was living in and just being able to practice as a physician in my own way without.

Ivory tower.

I love that.

And I'm just wondering if you could talk about the, the money aspect, the finances aspect there, because you have to manage your, your money differently when it's not just oh, did my paycheck come in today?

I mean, yes, you're gonna get paid at doing locums, but at the same time, like you are very much a part of how you get paid in that much more so than we just show up to work and somehow we get a magical check.

Mm-hmm.

And then adding a direct primary care business model layer to it.

I'm just wondering, did that help in terms of knowing what to do financially, how to prepare financially?

How did you, how did you experience the addition on when it came to the finances?

And then I'm gonna ask about how that addition happened when it came to, when it comes to time.

Yeah, so I think when you branch out and you're more of a independent contractor, entrepreneurial physician finances are a, a big thing.

I think fortunately doing locums is, can be financially lucrative.

It can be unstable if you don't create some stability in it.

And so for me, since I had done that about a year before I launched my kinda DPCI had a few different sites on rotation.

I had.

I had a little bit of an emergency fund.

I kind of had all my ducks in the row.

The reason I decided to do telemedicine also was to keep my overhead low as I kind of dip my feet in the water.

And I think a quote I always is perfection is an enemy of progress, right?

So I just wanted to start somewhere and it seemed like pretty safe to start overhead was quite low for kind of an office only GYN malpractice with with, your EMR and a few, a few other things, a Google voice, a a a fact line.

And it's not, it's not terrible.

And so, for me, locums is still my primary income.

And I've intentionally grown my DPC slowly.

I don't have any employees.

It's just me.

And like I said, it's more of a passion project for me in terms of, I just really connecting with women and providing just kind of a different type of care that I don't, I feel like I can't provide a traditional system.

And, and so again, the locums allows me to primarily do that.

I do see a time where that can shift but that'll acquire a little bit more

time and effort on my end.

Totally.

And so that perfectly dovetailed into the time aspect because as you said, there's only so much time in the day and being intentional about your future so that it is sustainable.

How did you.

Add your DPC business services to, how did you add your membership services to your locums?

Because I think about your locums is a defined from this day to this day, Dr.

Lee Day will be on call at this hospital.

Mm-hmm.

How, how do you work with your patients on the mm-hmm.

Outpatient side of things?

Mm-hmm.

Yeah.

So right now I do primarily telemedicine, GYN and I do pay fee for service, essentially pay by the appointment as opposed to a membership model.

That might change in the future.

Again, as I think about how I'm gonna grow I also have the interest in metabolic health and I'm sitting for the obesity med boards later this year.

And so, that might change a little bit, but anyway, when I am I usually travel for locums.

I was going a week up at a time.

Now I'm going more than four to five days.

I don't schedule appointments during that time.

But I am readily available to my patients via the portal.

And again, because I know these patients really well, for me, it's really easy to quickly answer a question.

It doesn't bother me at all.

And then when I come home or when I know that I'm not on call and I have time, that's not gonna be disrupted, then I schedule my visits there.

That's awesome.

And I will say that especially if you did pick up your physical copy of the toolkit our magazines specifically for the DPC community, or if you haven't yet, go to my dpc story.com/magazine and download your copy today.

But when you mentioned portal, I think that this is speaking very much to what we addressed in the battle of the EHRs that we just had, but also like from my perspective, when I looked at what was sustainable for me, I knew that I did not want to, in our practice, give more time and space for texting than I already have in my regular life.

And so for me, the patient portal was huge.

And I, I say that especially for people to think about their own, like what do they prefer if texting more?

Is oh my God, I would love that.

Versus me texting more is like making me feel so anxious.

Mm-hmm.

Listen to those feelings as you, go forward when it comes to time.

I wanna ask about the time with your family, but then you also wear hats of being a mom and spending time with family, and then also being medical director for a startup called Frame Health.

So tell us about how.

You continue to be intentional about your time, especially like we're recording this after you guys just got back from a family vacation.

I noticed that I will fill my time regardless of what it is.

And my husband's now understood that.

And so, so yeah, I think.

I would be lying if I say every time I get it right.

I mean, I have to do checks every couple of months, every quarter, check in with my husband, check in with myself, what feel, what, what, is it too much that I overdo?

Do I need to downsize my commitments?

And I've done that.

And I think that's something that I've really learned in this journey is that there is times where there's opportunities and you expand and you take'em.

And then it's okay to say, okay, well that opportunity served me during that time.

It's no longer serving me, and then I move on.

So I take inventory pretty regularly.

I did, get to a point earlier this year when I probably overcommitted and then I, downsized a little bit.

And so, and earlier when I talked about change, like change is welcomed.

It's, it's okay.

You don't need to get to the point where you're.

To a Chris to just reorganize.

And so I would say I reorganize fairly often.

I love digital health and AI and technology.

So, this opportunity to be part of frame fertility has been really awesome for me.

Actually had talked to them a long time ago and the timing wasn't right and so this is another ode to networking, talk to people, keep in contact opportunities may arise in the future.

I love that.

And just going back into the DPC side of things, I'm wondering how did you set your business model up in terms of is your DPC separate a separate entity than your locums versus frame?

Because I think that that also something that people aren't necessarily like thinking about, but it is good to plan for.

Mm-hmm.

Yeah.

So I have A-P-L-L-C that's kind of owns everything.

And then I have a doing business as for Flourish GYN and then the any of the consulting I do medical director at Frame, those are all just subcontracted work under my PLLC.

Awesome.

And I, I'm very mindful that there are people listening probably for the first time.

And so check with people, the, the network that you just made at DBC Summit.

Talk with your friends and family.

Go to go to the map@mydbcstory.com, but look for what is appropriate in your state.

For example, in California, we cannot be anything but an S Corp for A-A-A-D-P-C.

So I think make sure that your legal cards are all in order as you go forward.

so I'm wondering if you Could talk to us about how you manage your DPC, because it is, you, you don't have any other staff right now.

And yes, like you, you mentioned, it's not like you started with a thousand patients, 500 patients, 300 patients, but at the same time, you still have people who are your patients.

Earlier I get a text about can I get a rabies vaccine with this a additional diagnosis that I have?

And I'm like, my God, I did not think that today someone was going to ask me about a rabies vaccine with other diagnoses on board.

So it's like we, we never know what the patients are going to say to us.

So I'm just wondering if you have any things that you've taken from your.

DPC is a business model journey that have either really helped you maintain being a micro practice and what you think could help others who are also thinking of doing something similar to what you've done.

Mm-hmm.

Yeah.

I think I'm lucky in the sense that my practice is a little bit of a niche practice and kind of narrow.

But what I also love about my practice is that when my patient reaches out and they say, I just went to Mexico and I have a GI virus and they put me on antibiotics, now I have a yeast infection or X, Y or z.

I don't have to say contact your primary care, right?

I can handle some of some of these other, questions that they have.

I think it's important as you're growing your practice again to take like inventory.

What's my patient load look like now?

And is this sustainable for how I want my life to be?

So right now, I, I have enough downtime that it's not a big deal when I get messaged.

But there have been times in the last two years where I haven't, where I scheduled myself.

All of a sudden now I'm working four and a half days a week again.

And I really wanna be working more like two to three when I'm not working my locum shift.

So you, you do have to again, take inventory and, and see what it feels like now and what it's gonna continue to feel like.

And again, you don't have to wait till it's a problem to address it.

But for me, I, I have always been one of those people that have been on like MyChart messaging patients back for me.

I just don't, I don't mind it.

I don't mind sitting on a beach and responding to messages, which is what I did last week on vacation with my family.

Love that.

Oh my gosh.

And that's, that's the thing, it's like somebody just asked me if I could speak to their residents about DPC, and it's this is the type of stuff I think about.

I'm like, in what world could you have worked, a, a fee for service, corporate job, like most of us experienced in residency on the beach.

You would be so terrified to be like, I don't know if I can get the time off.

All this stuff that like, you just get to be free and practice medicine.

I mean, yes, digitally, safely, but also like you get to practice on a beach because, especially if you're.

Because you get to call the shots, especially when you're doing telemedicine, so that's awesome.

Mm-hmm.

Yeah.

That's awesome.

Yeah.

And

yeah, and I've thought about, as I expand on having hybrid model and brick and mortar, and so, again, like DBD if that, that occurs, but again, like depending on where you are in your life and your career, you can start small and kind of add on and expand as you need.

you've given a lot of people a lot of amazing pieces of advice, especially the part about taking inventory on their own lives because there is no one else like you out there, and the, everybody has to tailor today for them and tomorrow is gonna be potentially very different.

And so, I'm wondering here if you give the audience any resources or recommendations that you would have for people who want to learn more about locums, want to know, because there is an entire that is an entire world that like, is very, very foreign.

I'm getting like toes wet in it, understanding it, but it's like that is something I'd love if you could mention resources for as well as where can people, connect with you going forward.

Yeah, it definitely is a whole mindset transition as you leave an employed position.

I'll say it's a hundred percent worth it.

So everybody out there who's like considering is surround yourself with people that do this because you will find a lot of naysayers, a lot of, I mean, there's been multiple times that physicians have told me, oh, that's only gonna last so long.

Or You're gonna need X, Y, or Z, you're gonna need the benefits.

But really you can take care of yourself.

You can be a business owner, you can give your own benefits.

There is a lot to learn.

You don't have to learn it all at once.

And I really recommend talking to a ton of different people because they're all gonna have different experiences.

And if you take, one thing away from each person, that's amazing.

For me, flex Med Staff is a group that Dr.

Aaron Morganstein runs and a few other of our physicians and Dr.

Shen.

And so.

When I went to the first summit two years ago now, it was an incredible feeling to be in a room surrounded by physicians who are like-minded.

And I just cannot emphasize this.

More is what I hear so much from physicians is that they're afraid.

But if you are around people that do it, you'll, you'll feel inspired.

You'll be encouraged.

And then coming back the second year and seeing those people.

Do what we said or, change their careers and just say thank you so much for changing my life.

Again, I think networking and community is so important.

We've a rise up summit in October and that is gonna be a, a kind of a collab between DPC and Locums.

And again I'll be giving a few lectures there.

And again, just surrounding yourself with the people who have done it is, is invaluable.

I love that.

And I will say that when I saw you for the second flexed summit, that's when you said, I opened my DPC and I was like, oh my gosh, tell me more.

And so absolutely this is, this is why I, I'm really glad you mentioned those resources Flexed staff.

Absolutely.

Look them up.

And also the rise Up summit, I think it's gonna be a great CoLab it's totally virtual, but.

It's a, it's another foothold in the, the rock climbing wall to physician entrepreneurship.

So, amazing.

Well, we're gonna continue our conversation over the Patreon community.

Definitely.

If you are not aware, we have a my DPC story, Patreon.

It helps support the work we're doing, but Dr.

eDay and I are gonna continue talking about this, point at which you decide to leave versus waiting until you're burn to a crisp.

And also talking about menopause care and how menopause can be addressed differently in the direct primary care and direct specialty care space.

So, so thank you so much Dr.

eDay for joining us today.

Thank

you so much for having me.

This has been so fun.

And if anybody wants to chat with me afterwards, you can find me on Instagram.

It's Dr.

Aliza Day, OB GYN.

Thank you.

Thank you for listening to another episode of my DBC story.

If you enjoyed it, please leave a five star review on your favorite podcast platform.

It helps others find the show, have a question about direct primary care.

Leave me a voicemail.

You might hear it answered in a future episode.

Follow us on socials at the handle at my D DPC story and join DPC didactics our monthly deep dive into your questions and challenges.

Links are@mydpcstory.com for exclusive content you won't hear anywhere else.

Join our Patreon.

Find the link in the show notes or search for my DPC story on patreon.com for DPC news on the daily.

Check out DPC news.com.

Until next week, this is Marielle conception.