Direct Primary Care Doctor
From Dr. Brown:
Hello! My name is Brad Brown of Strive Direct Health in Erie, Colorado and I've been in practice since March 2021. I opened Strive with a little over a year left in residency and haven't looked back. It's been a fun journey to be a small part of the DPC world from the get-go. I learned about DPC early in med school and knew it was the way of the future. Along the way, my wife and brother created AeroDPC, a all-in-one practice management EMR for DPC practices that was recently acquired by Hint Health. That has been a wild ride to say the least. We have 3 young kids and love anything in the mountains here in Colorado.
In today's episode, Dr. Brown is the latest doctor to join the podcast and his journey is unique in that he opened his DPC, Strive Direct Health, WHILE he was still in residency. He shares about how his clinic started from a dirt floored building and how he, along with his co-Resident Dr. Schuster, had 100 patients with 100 days left to go in residency. Dr. Brown also talks workflows and how a desire to have an EMR that worked for him was the nidus for starting AeroDPC, recently acquired by Hint Health, and how being a Nextera Affiliate is a perfect fit for the clinic!
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Transcript*
Welcome to the podcast, Dr. Brown
Thank you. Thanks for having me. It's been a long time coming. I'm happy to be here.
It definitely has.
And you know, I'm not gonna, I'm not gonna spoil too many surprises, but especially for those residents out there, those medical students, people who are early on in their medical careers considering dpc took a close listen to today's story. So, Dr. Brown, with that, I wanted to start with your journey into family medicine.
On your website you share in your bio how when you were at medical school in Arizona, it was very quick that you came to the decision that you wanted to practice full scope medicine. So can you tell us a little bit about that journey to choosing family practice as a, as a specialty?
Yeah, of course.
So yeah, in med school then I joined all the clubs. First year, you know, I have no family or extended family in medicine, so I didn't have any people pushing me one way or the other or telling me to do something or not in terms of family members.
And so I just joined all the clubs. I mean surgical, non-surgical, everything. I went all to the, all the lunch meetings and after hours events and met everybody and. Within a few weeks, I gravitated towards the primary care side of things. And then quickly onto family medicine as well. Um, I have an entrepreneurial itch that I can't quite scratch and family medicine seem to fit the ability to have my own practice.
But also to treat all ages. Cause that's one of the things that I really love too, is, wound to tomb as they say, or whatever fancy saying the AFP has nowadays. But that really struck a chord with me to be able to open a clinic treat patients of all ages and pretty much.
Kind of form my own path in terms of what I, what I really liked. If that was ob, great, If not, or women's health, or men's health or you name it, whatever, integrated medicine, whatever, there's pretty much we all know how great family medicine is. So that's what really turned me onto it initially.
And I haven't looked back, haven't second guessed at once.
Awesome. And my alluding in the earlier statement about how if you're a resident or someone early on in your medical career, take a close, Listen, you recently graduated residency. what Gave you the idea that opening a private practice was still going to be a thing even though you graduated recently yourself.
Mm-hmm. . Yeah. I mean, you nailed it. Uh, It's uh, this is a long answer.
I'm gonna keep it really short. And people who know me will understand it better than the people who are just listening. But I, The American healthcare system is exactly what health insurance wants it to be. Very vague, very no one really knows what's going on. And so, as I learned more about it and as I went through the various specialties in medical school and then through rotations and, and residency as well, I just finished this past summer a few months ago.
I just, I, I . We all complain about , the healthcare system, and I'm guilty of that as well. Usually when I'm really exhausted. But uh, I, I've, I felt like direct primary care and the people, the mentors friend that I have. They turn me on to the fact that like, this is actually doing something to change the American healthcare system.
And that's one of the reasons why I love it so much and why I knew early on that direct primary care was where I wanted to go because I was tired of complaining and I was tired of hearing everyone complain is including myself. And so I was like, You know what? Look, this is my small way of doing something to change.
It's really hard to change the whole world. Elon Musk or Steve Jobs or whatever, but I can, I can do my part and lift where I stand. And so it really uh, again, it just kept, it was one, one more click. Everything kept clicking. You know, We always say, Oh, it just clicked. I had a lot of clicks to get to where, in my illustrious career where I am now, if I can say that.
And that was one of them where, where I was like, Hey, I can A, have my own clinic B, feel like I'm really making a difference in the system as a whole, as well as in my patient's lives. So it was too good to.
Awesome. And I, I love that term. I, that's a new one for me, friend tour. I, think that's great.
many of us have those, those mentors as attendings and even. Residents older than us who definitely fit that, that bill of friend tour. So when you were talking with your friend tours where along that journey did you hear about dpc? Was it because you were having those conversations about the concern for the, the lack of transparency and the crazy cost of American healthcare?
That is a fantastic question. I don't know if I have a specific point in time where I knew like, this is, this is it. I think it was just a accumulation of Thoughts that I was having that I didn't know I was having and feelings of, of, you know, know, there's something, there's gotta be something better out there that we got.
It's a, consumer driven country pretty much. Why can't we e even and making money off patients' health just feels slimy as it is, and so the whole hospital administrator thing, and all I just. Once you start learning about it, then once you start talking with other people and bouncing ideas off people that you can trust of various backgrounds and everything it ones with in the DPC space and one's not.
It just kind of, again, just slowly clicked and started that snowball effect of, This is gonna work for me and it's gonna work for the country. , it's, it's happening. It's not just a movement anymore. It's we're here to stay type of thing. And then during residency, I was very thankful to have a, a program that allowed me the bandwidth to explore that.
And kind. See if that could be a possibility. And then it was very fortuitous that it kind of happened during residency , which was almost a ask forgiveness rather than permission when it came out to it. But in the end it was, it was fantastic. And it, I mean, it's just, it is just exploding from here.
Love that and can't agree more that this is not in our grassroots movement that is gonna go away anytime soon. So when you, you know, drop that amazing part of your history that you opened Strive Direct Health during residency mm-hmm. , your practice is with Dr. Sarah Schuster. And I'm assuming she's a co-resident of yours as well.
She was, yeah. Yep. So can you share, how on earth did you go from this? You know, This is definitely what I'm going to do. I'm gonna be a DPC physician to actively putting the steps in place. And then, like you said, asking for forgiveness rather than permission. . But how did that all culminate in you guys opening and you guys working together to open Strive Direct Health?
. This is a fantastic story. So about, I don't know, halfway through residency, 18 months in or so, then I was driving home post call.
I think I delivered eight or 10 babies that night. I was exhausted and there just happened to be an office space, the one I'm in right now. That was brand new. It was a dirt floor. And I, I literally like, looked in the window and , the real estate agent was here. And so he let me in and we just started talking.
I was in a, in a dissociative state. I didn't know what was going on. And I told him a little bit about what I was thinking about doing. He was like, Oh, that's and this is, that was like the first thing. I was like, Yeah, that that'd be a perfect space. It's one mile from my house. It's only a couple miles from where I'm doing residency.
It was, it was almost the, the right place at the wrong time. And so I was like, Oh, well it's 18 months away. I'm not, I'm just gonna have to let that one go. There's gonna be other office spaces. It's no big deal. And then as I got to thinking about it more after, a nice nap then.
You know what, that is the right place at the wrong time. And all of my colleagues are signing these six figure contracts months before they're, and they have, they're financially secure. That's debatable. But they're, 2, 3, 4, $500,000 contracts. And after residency, I'm starting from scratch, at zero, pretty much.
So maybe I could start getting a little bit of the momentum before patients sign up. July of 2022. And actually. Have the groundwork laid to where I can just hit the gas, and just say, Okay, everything. I don't have to worry about anything. Let's just start seeing patients, and as I was bouncing those ideas off, Sarah, she was like, Oh man, this is awesome.
And she started drinking the DBC Kool-Aid and I was like, Hey, we should just do it toge, like, why don't you just, let's just do it, and she was all in from day one as well. And so it actually made it easier with both of us because during residency, if, it was easier to have two instead of one in case a patient needed anything.
And anyway, we built, my wife designed this office, we built it. And then they put a big sign up, the landlord did that. Hey, coming soon, a new doctor to the town. And I was like, Oh crap, I didn't like, this is not supposed to be working like this. And then people started asking and signing up like crazy.
And, it was, I went to my res, my program director. He was like, just log them as moonlighting hours, I guess . So, it started, it was actually pretty cool. We had a very. Fortunate, we had a hundred patients with a hundred days left in residency. And so it was kind of a cool stat that it hit right at that mark.
And then once residency was over, we kind of, we took a couple weeks, both of us took a couple weeks off just to recharge, and then now we've just been going at it. It's, it's an absolute blast. it's really, really fun.
Awesome. And when I've talked to residents in the past, one of their biggest concerns is financially, how to go from residency to dpc.
Like you shared, your, your classmates were getting in the, into the six figure potential golden handcuff type of situations, and you chose to open, what advice would you give to people who are very much considering doing DPC right out of residency as well?
Yeah. That is a really good question, and I wish, I mean, I'm not quite in the mentor level yet. I feel like that's a question for a mentor, you know? but I, I would say, One of my friend Taurus, he always says, You do you, he says, Just block out what all the haters say and just you do what you do and you be you as well.
And it's like, Okay, I, I'm gonna do it anyway. I'm gonna be 50 when I'm 50 anyway. Might as well be doing something I love and something I want to do. Why wait, why get in those golden handcuffs? I mean, I found I was lucky enough to find a couple decent moonlighting gigs that help pay the bills while we're growing.
And it's obviously that's common. I've been part of the DP DPC Docs Facebook group since second year of med school. I kind of snuck in. But Just pouring over all the advice, just being a stalker on there and pouring over the advice. Now, what is other people doing? And you've seen one DPC clinic, you've seen me one, which gave me hope.
Like, oh, I can kind of do it my own way with the, with the, I guess the blueprint of what other people kind of do. And um, it's been, obviously there's. It's been hard. I'm not gonna say that it hasn't been, but it's been more than rewarding. And it's, you feel like you're truly working for something, And it's and not just, you're not just going to work.
Like, I love coming here. I walk in every now, not every day. I wish I should every day, but it's, I get up in the morning, it's like, this is what, this is what I want to. It's, it's awesome and I love it. And I would I could be offered billion, maybe billions. I'd take it millions of dollars.
I wouldn't sell strive, a billion. I probably would, but millions. No. But uh, the advice I would give is just, just go for it. I mean, there's, it's easier as a resident because you're already making pennies, so it's, it's easier to lose pennies than lose hundreds of thousands of dollars.
So,
And that that is definitely sage advice. So, and especially, these days when, especially after the pandemic, people are really thinking about career choice differently than we previously did as a culture, I feel. So when you.
Had, taken particular jobs to fund your practice how did you and Sarah go into it together? In terms of legally, Does, does she work for you? Do you work, work for her? Are you guys both partners legally? How have you guys set up the partnership on the legal
end? end? Yeah, that's a great, that's.
That definitely goes back to the, once you've seen one, you've seen one phrase. And so, I mean, she's like my sister. We're like brother, sister, and so we have had great conversations and we have an awesome relationship. I mean, I hope we do. I mean, hopefully after this episode, if she listens to it, she's like, Oh, we're actually, No, I'm just kidding.
uh, she early on said, Hey, you run the business. I, I, she said, I would love to just be an employee. I would love to. Have that be cuz she recently, I mean she, she, she teaches at the residency, she does some moonlighting too. She wanted the flexibility to kind of wear a bunch of different hats.
And being a mother is one of them and that, you know, this kind of lets her wear those four or five different hats. So I said sure. So we structured it to where I own Strive and I, she's actually a double W2 employee. And And then there was the question, which has been the, the logical next question.
What about patients when they sign up, who, cause everyone is always asking, Oh, is it how do you patients blah, blah, blah. How do you split 'em? And we decided we don't want his and hers patients. She's, she doesn't get a piece of the income of whatever. I said, I'll pay you a salary and your salary grows based on how many patients we have.
And then, Whoever signs up there strives patients, and we, our, our value prop to them is you have two doctors in your pocket. It's Dr. Brown, Dr. Schuster, Dr. B and Dr. S male and female doctor, we have, she's an md I'm a do, it's, she's I'm really tall. She's less tall. And so it's like we're, we're really good balance and patients love that.
Hey, I have a question for Dr as they'll shoot us a text, Hey, I have a question for Dr. B. Shoot me a text. So it's. We've seen that all of our patients love the abil, that they're like, Oh, I have two primary care docs, in my pocket. I can text at all times instead of having to choose, you know, they're seeing one or the other.
And it's been pretty seamless. And so we set it up that way and it's working really well. So far, we haven't had any issues with it. So when people ask on the DVC Docs Facebook page, I always like, Well, this is how we do it. And people are like, What? How is that even possible? It's like, well, once you've seen one, you've seen one.
It's working for us for now. So whatever.
And just going back a little bit to the financial question, when you were deciding that this is how you know it was going to be set up between the two of you and you, you had this space with a dirt floor and you were opening and you were doing these moonlighting gigs to help fund the dpc.
How did you targetedly put your. Towards certain pockets, whether it be to pay her salary or to pay the build out so that you had everything in place after you graduated residency and after you took those two weeks off.
Yeah. That's a gr I should show you my spreadsheet. . yeah, it was a lot of conversations.
They actually moved in, her and her husband moved in right around the corner from us, so we're basically neighbors as well. And we had lots of, had them over for dinner. They had us go over for dinner. And we, even during residency when we were on the inpatient service together, it's all we talked about.
People just rolled their eyes whenever we were around cause they knew it was, it was so ridiculous. But the moonlighting gigs I had were, they paid pretty decently well, and so I just, I would just 10 99 myself and had everything run. I still do everything run through the Strive account and so it's uh, all income for my Strive, llc.
And then that money gets divvied up between the build out loan, I guess the, her salary and then business expenses as well. And so it was just pretty much everything I made outside of my residency salary went into the Strive account and then it just got divvied up as it needed. As it needed.
That's the short answer without pulling up the, the spreadsheet . Yeah. It's not so complex spreadsheet in my mind, but. Yeah.
Love it. Love it. And then in terms of, again, going back to how you talked to your residency director about, you know, classifying this as, as. moonlighting When you had your very first patient how did you manage that in terms of your patient's care while still being a resident?
Yeah, I still remember my first patient's name and date of birth. Obviously, I'm not gonna say it here, but it's, it was very humbling when someone signed up and paid and put in their, payment information. And it, like, I still remember that feeling. I still get that feeling, but that you never, that first one was, very humbling.
And so, I made sure that all the patients knew, hey, we're available. We, you have the unrestricted access shoot us a text or a call. And then, they don't get a phone tree to a triage, I can triage it. And so, I told him that I, I, you I still do.
I have other responsibilities as well, and so if I'm not immediately available, that's okay. And there's very few things that you immediately need to be seen for, and if that is the case, you probably need to go to the ER anyway. That was kind of my, my two second pitch to patients. But it was a lot of, running up here on my lunch break into the clinic to see a patient real quick or on my way home or after hours, weekends, type of things.
I wouldn't say a lot, but , you know, I just did it. You just have to do it when, when you're, running your own clinic. So, um, but once residency ended, it was it almost felt like I was losing one full-time job, so I could just continue my other full-time job and another one. , I think there was only one time where a patient was a little cranky about not being able to be seen within the hour for a stubbed toe or something. But other than that patients, are very respectful of your time when they're paying you their own money.
When it's not, third party payer, they're very respectful for the vast majority. And yeah, it was, we've never had an issue.
And how did you guys market in addition to, you know this, the realtor putting out a sign that a new doctor was gonna be in town?
Yeah,
yeah, that, Well, a hundred patients with a hundred days left in residency. That was the shocking part. We were like, That was like a realization like, Oh my gosh, this is actually growing some legs. And the momentum has started, a long time before we were even done. But it was all word of mouth.
I mean, we have a couple Google ads and Facebook ads, but those have been. Zero roi. I'm still curious about, you hear it's the volume game and I mean, it's all about FaceTime. So the local market, the local networking groups we go to we do, you know, BNI meetings, chamber meetings and things like that.
We, like, I, I was just at a, a local. Girl Scout brownies meeting, taught 'em some first aid. They taught me a lot of first aid too. But things like that. Just getting your name and face out in the community cause. Sure we're, we're selling primary care, but we're really selling trust, And that's what it is, is having patients have someone that they can truly trust to come to when they're vulnerable, when they're sick.
And that's a very vulnerable time. So, have, instead of just my face and Sarah's face on a Facebook ad, getting out there. Shaking their hand and seeing like, Hey, this is, I'm a human. I have a family. I live a mile down the road. Sarah lives a mile that way. And so we're local residents as well, and we're here for the community.
That's been the, biggest roi. And it's not about that. It's, we genuinely love doing that. I love meeting with people. I'm an extrovert. And I, I could do that stuff all day. So, paid marketing has been, Not very fruitful. It's all about just putting the time and the consistent effort into it.
Gotcha. And in terms of, Colorado compared to other states, Colorado definitely is a, is a DPC hotbed, which is awesome. And, more states are achieving that. But in terms of the value proposition that you guys had experienced from what your patients were telling you, what your patients were telling you they needed, and you were developing your copy for your website and, these, these ads that you did put out, what was it that helped you narrow down your message for when you were talking quickly with, a BNI group or just meeting someone at the market?
Yeah,
I mean, as and a lot of your listeners know, it just takes repetition to get that elevator pitch down, to get that back of the envelope pitch down. I was, lucky enough to find DBC early on, and I've heard a lot of DBC docs give theirs, and so I kind of just copied and pasted theirs that fit and then kind of fit my.
Style, my vibe, if you will. And , I looked at like every single possible DPC website, , I love Paul Thomas's website. I used his, i, the first website I had, I kind of formed out off of his and I looked at everyone else's too. Not to give him a shout out, but and then just kind of, Pick and chose what I liked and then kind of put it on the website.
And then my wife was like, Yeah, no, that doesn't make any sense. I'm like, Okay, then I have to change that. She was kind of the, the editor in chief, but. It's, it just takes practice. It takes, you have to get out there and actually say the words and hear yourself say them and realize that doesn't make any sense, or that makes perfect sense in my mind cause I'm a doctor, but I'm not talking to doctors.
I'm talking to local small business owners, or I'm talking to my family or something. And so, it just takes again, consistent practice to get that pitch down. My family, they all just walk outta the room. We, there's five siblings and they all just leave. Whenever I start talking about dpc, they're like, Alright, we've heard it enough likes, whatever.
But getting as many sounding boards as possible and, and practicing is, is pretty much just what, what I did.
Awesome. And as you've shared, you developed your website, you adjusted your website as needed. Yeah. Did you also develop your logo?
Yeah, well, funny story. So I paid a few different people on like fiber and all the little, little sites and everything and I think I spent like a hundred or 200 bucks, not that much at all to try to get a cool website.
know, They always ask for what do you want? I don't know what I want. You should tell me what I want, and my sister, she's the creative sibling she's my oldest sister in St. Louis. She's a very well known wedding photographer, and so, I texted her, I said, Hey, help me out with a logo, and it was while she was cooking dinner on her phone that she, for, she has four kids, four young kids, and she was, she did it on can.
Quick and was like, All right. She was like, Just stop texting me, and I was like, Well, that's the one I knew right away when she sent it to me. That's the one. And so, that's, it's, it's a la story. It's not very reproducible for anyone else who's out there, but it, it worked for us. And in Colorado, our logo is a Ponderosa Pine or for Strive.
And so when you go up in the Colorado Mountains, they're everywhere and they smell fantastic. And so we kind of, built the whole brand
around. And can you give the audience a little bit of the history as to strive itself? How did you choose the
name? So when it, Yeah, it took like two or three years.
Honestly. We had the luxury of time cuz I knew I wanted to open my own clinic when I was in med school. So I wasn't pressed for time. I didn't put in my 90 days notice or anything. Like a lot of docs do, you know. and so I had a, my wife and I, we had a list on a Google doc that we shared on our phones and we just, every, anytime we thought of something, we just put it on there and then, I swear I was like every night we were, going over it.
And then I like had all the definitions and I made sure I Googled and made sure there wasn't other clinics with that name. And then I love just the definition of strive. I love the idea of striving for something because. You know we're always climbing a mountain, but what is the, what is the summit?
We don't know. You don't know? Okay, Now I'm healthy. It's like, that doesn't make any sense. There's always something we can work on, whether that's with our health or or not. There's always something that we can be better at. We can always be better people. We always be better husband, father, whatever friend.
I don't know who actually came up with Strive. It's on our list. We should look at the edits of that Google Doc and see who actually wrote it first. But It just, again, it clicked and it worked with the logo.
It was like the principle behind it. It just was too good to pass up. And so we got the LLC formed and then within like a week we found out that another, there's a Strive Health here in Denver that's actually a nephrology clinic. And so we're Strive Direct Health and we literally form did our LLCs like at the same time.
They're not a direct care model, they're just like a normal fee for service nephrology clinic. And so I've called them a couple times and we chuckle that it happen at the same time. But strive direct health, you gotta have the directing
perfect. And you're, directly caring for your patients.
Yeah. So that's awesome. And did anybody take that to the federal trademark level?
Uh, No, not yet. Knock on wood . I'm just kidding. No, we, we, we should we should definitely get there, but we just haven't.
Gotcha. And I, I am going back to just your guys's ability to create copy and pull from the verbiage that you've heard from the community and your everyday experience of patients as well as you, you mentioned your, your sisters four kids.
You have three yourself. And when, One of the things that I noticed on your website that there is a lot of chatter about is the, the usage of the access 24 7. So how do you, cuz I know you shared how you balanced having patient care while being a resident, how do you offer access 24 7 and balance time with your family and your kids?
Yeah, that's the never ending question, right? , my main view on balance is I really don't love that word because it inherently implies that you have to give up something else to have something. And so whether this is, doesn't ma, I don't know if this is gonna make sense, but I, I think of it more as harm.
So if you play a six string guitar, sometimes a chord, sometimes a different chord, it just sounds different. And so if you have, let's just say. Things in your life, family, religion, job, whatever it is, And sometimes it, you just have to play a different chord.
And so residency was obviously heavy on, on my career, if you will, and, and med school. And so we had to play that chord. And then once Strive got up and running and then arrow as well we just, you just have to adjust your, your harmony. But in terms of the kids, I mean, I identify as a father first, a husband second, a doctor third, and I tell everyone who, again, people roll their eyes at that.
And so, my patients know that I have pictures of my kids all over the office. And Sarah just had her first as well. And so, it's a lot When new patients sign up, it is definitely some training. People sign up for a reason. They don't just sign up because it's a good idea. They sign up, Hey, I need to be seen or something.
So that first month is usually a, a fair amount of visits or communications or patient touches, if you will. And so, I always tell them my, my two second pitch is, Hey, if it's urgent, give us a call. We always call back as soon as we can, if it's, can wait a few hours, shoot us a. And then we respond as soon as we can.
If it can wait a couple business days, throw it in an email, a young mom who emailed me a picture of her son's arm. He had just fallen off his bike and it was clearly, it was like at a right angle and it was clearly broken, and I didn't see it for a day and I was like, Okay, I need to do a little bit of patient training here.
It sounds common sense to us as physicians, but you know, as a first time, Like, I was a first time parent at some point, and I was in med school and I, I still didn't know anything, so, it is just patient training to get them to for that unrestricted access. I really, I, fall in the line of, I don't say unlimited I say unrestricted just because unlimited.
I feel like there can be definitely some interpretation there, but with the two of us, with Sarah and I. one of us holds the phone after hours, if you will. Our system can forward the number to wherever we want. So, they know that, Hey, I'm not gonna call you at 8:00 PM if my kid has stubbed their toe or something.
But we tell them, Hey, if you're, if you think your child is getting sick or you think you're eating sick, call us at 8:00 PM as opposed to two in the morning, But we have have yet to get a call between the hours of probably 6:00 PM and 7:00 AM So, and it's been 18 months. So it's just patient training.
And, and with your time since graduating residency in practice, , when the whole family is going on vacation, do you take your calls still while on vacation or do you sign out completely to.
Uh, Depends either or. I mean, , we haven't gone like on an international trip or anything, but my wife and I, we went on the anniversary trip to, Mexico this summer. And usually, I mean, Sarah is much more intelligent and brighter than I am, and so I have no problem saying, Hey, Sarah, here's the phone.
It's just two clicks in our system to have it forward to her. And so usually we just take weeks. Like I, I answer all the calls and the texts one week and then she does the next week and we just bounce back and forth and so, Vacations are just on one of our off weeks, if you will. Whoever's not holding the phone.
So she goes as well. And if there's anything that a patient's like, Hey, I have a question specific for Dr. S, and then usually I'll just text her and be like, Hey, do you want to answer this, or are you like off the grid? It's a good working relationship and again, it's a moving target. We, she and I talk, we like talk every once a week like, Hey, is this workflow working?
Do we need to adjust this? Do we need to like sign out completely? But I did answer one text from a beach in Cancun this summer just to say that I did. But I got quickly got my phone taken away from me by my wife. She was like, No, we're not. We're on vacation. You're not doing that. I was like, All right, fine.
I'm fine with that. So, yeah, we, it's, really nice having both of us because we can take a vacation. I know that's pretty unique. A lot of docs starting off or just by themselves, and that's the number one question. How do you, you're on call with twenty four seven, how do you do that? So we're pretty spoiled in that way, but.
I sign everything out to her. She signs it all off to me, and it's just a, it's a really easy way to do it.
And now you mentioned workflows, so I want to bring in here, and you mentioned it earlier, that one of the hats that you've worn during your journey is also being one of the co-founders of a dpc.
And so this baby a dpc. Can you share with people who might not be aware what is a DPC and Sure. In terms of the, the workflows, I definitely wanna get into, How your clinic has been able to adjust because you, you're creating your EMR as you were, running your clinic and the everyday experience there.
So please share though tell us a little bit about Arrow.
Sure. Yeah. So back in med school I was rotating once I knew I wanted to do dpc, I found a doc in Phoenix and he's one of my friend tours now, Kirby Farnsworth. But he he had a well established practice, know, 700 patients. He was only a few years out of residency, so we were similar in age and phase of life.
So we're, we're still pretty good friends and he was using a well known system, which I will, will remain nameless on this podcast. And as a med student, I wanted to impress and get a good grade and make my notes look pretty, and I found I was struggling through that, those workflows.
And my brother at that time was a software engineer at Amazon, and that did, later that day, I called him and I was like, Hey. Can we just build one for me and my practice? Cause I don't wanna struggle through all the other ones. You know, it'd be something professionally we could work on together because we're, he's in software engineering.
I'm in medicine for crying out loud. And so he started tinkering around in his free time and it goes, Oh, that's fun. And then residency started and I didn't have much time intern year and then, Halfway through intern year, he actually quit Amazon to go full time on Arrow because we felt like this could actually go somewhere.
And my wife started working full-time on it. Danny, she has her mba and Kyle did all the development. I did all the demos and then she did everything else on top of everything else she did too. And so, it was pretty much why we were building this office. Then Arrow really started taking off like a rocket.
I think. I mean, we did a demo early on with you, mean, it was very early on and I remember thinking. Those early demos, I'm like, Man, this is cool that we're getting demos, but I don't know if we're quite ready to actually onboard real life practices yet. And our, and our user one, I guess technically I'm user zero, user one was Kirby and his practice.
And he wanted in, he wanted on it. And then from that point on in the last year, year plus it's taken off like a rocket and we're like barely hanging onto the fins, trying to steer this thing and build it as it flies. And so the workflows in our in strive are pretty easy because. I know the, the inner workings of Arrow and like I know what is being worked on.
And so I know I, I've seen it in every single iteration so I know how to use it. I told my brother, I said, Here's what an EMR needs. This is at the very beginning. I'm not gonna show you any EMRs cuz he's never seen one. I want you to build it as if someone in the tech world would build with these requirements.
I don't want a paper chart put on a screen cuz that's in my mind. That's how they all are. I know it's whatever, debatable, but I don't want a paper chart with a bunch of tabs and all these things that, and all these words and busyness. I want it to be built for what we have, the technology we have today and the technology for 20 30, 20 40, 20 50.
And he said, okay. Yeah. And there's been some times when. I've had to say, Hey, doctors don't think that way. They need it this way. , like how labs are viewed. The first iteration of that, I was like, This is awesome. I can see why you did it this way, but this is not how we think at all. So we need to like actually do it the old fashioned way.
And so workflows, I mean, it, we've come a long way since our demo Muriel. But uh, it's really, really fun to. Hop on a call, hop on a, on a phone with someone who said, Hey, can we do this? And then we, we roll it out, and it's like, really, really fun. Kyle's gonna hate me for saying that on the air, but cuz it, it's a lot of work for him.
But to be a living, breathing tech organism, if you will, to where. Doctors feel like they have some, some say and some ownership in it is really, really cool to where they can, help build it. Because I'm only one physician, and I'm a tall white male physician who thinks in one way, in Excel spreadsheets.
Cause that's what all of us men think in. And so having. Other stakeholders to where they can, help build this airplane while we fly. It has been an unexpected joy of Arrow to be able to talk to so many different people. It's been a lot of fun. I
just love it. And it goes back to, you called yourself a, an entrepreneur at heart who is always, thinking and dreaming of how to serve your community.
And so this is serving not only your patients, but also the greater DPC community. And recently a, a very exciting change has happened at Arrow. So can you share with the audience that might not know what has happened recently with regards to a and its ability to impact direct primary cares all over
the nation?
Yeah, of course. So, um, In two days from the day of recording today I guess it's a couple weeks ago for people listening now Arrow has officially been acquired by Hint Health and they have been looking at either developing or purchasing an emr. Piece for their product line. And there we are very mission aligned.
We wanted everything a DBC doctor needs in one innovative platform is our kind of tagline as well as, being a part of changing the healthcare system and obviously Zach and the whole hint team they are, have a very similar vein of thought. And so Zach actually cold called. This summer wanting just to meet and we, I'd never spoken with him before.
He, he was like, Oh, you guys are new kids on the block. This is right when things were absolutely exploding with Arrow. And then we just started chatting and, push comes to shove, which there was none of that. But here today. It's been fantastic. It has been a match made in heaven so far.
And we feel that this can really be. Something that really changes. A paradigm for a lot of people toward, it's a one stop, end-to-end solution to where the people who are considering switching, it makes it as easy as possible. The people who are already in Arrow or, and Arrow in de in the direct primary care world they can have a whole line of products.
Everything from Hint connect to Hint, emr, whatever it ends up being called to, Hint os and have it. Truly end to end everything you need in one without having to open a bunch of windows and a bunch of different logins it's going to springboard the whole movement, but also have a one stop shop.
So it's, it's already been awesome. I, it is also been extremely professionally rewarding the few weeks that we've been officially working with them. But uh, it's, it really is a match me.
I love it. And I, I get so tickled with this story because you were really just doing what you loved and that that wasn't even on, Like you said, Zach Cold called you, but it wasn't even on the radar, and it's just, it makes me think about when a patient randomly will cold call your practice and be like, I wanna join.
And it's just like, you're just doing what you love every day, and then all of a sudden it means something to somebody. So I think that's so awesome. And going forward into the future, and because, Danny yourself, your brother have created this product from the ground up.
What is your involvement as a team working with Arrow DPC as it goes into the future, as it's been acquired by?
Before I even answer that question, , I have to say that it's been a full family thing for Arrow. Even my dad, who's been a CEO of massive companies, his, my whole life he's been like our elder statesman and at times definitely angel investor to help us get through, you know, which now, I mean, it seems like pennies, like we're bootstrapping it for crying out loud.
We didn't, we didn't go raise VC funds or anything for ERA and having him being. Okay. I have 40 years of experience. You guys should not do this. And we're like, Okay, well it seemed like a good idea. Um, So it's, it's been the four of us and then we hired another guy as well. And so it's been a lot of fun to professionally be able to work with my wife, my brother, and my dad.
So I mean, I haven't done much of the development. I do all the demos. I'm a demo guy for Arrow, you know, just a doctor for crying out loud. And, and, but being able to have these, like see my, my own father, how he works professionally, but also my wife, who's an absolute boss, And then my brother, who, he's my younger brother.
I never call him my younger brother anymore, but . Just being able to work professionally with all of them is like, Okay, I could retire now and be like, Perfectly content. Because how, how rare is it that there's no crazy family arguments? I mean, we definitely had our arguments about Arrow, but we still all love each other.
So anyway, going forward with Hint. we, one of the stipulations was, Hey, , we're still the Arrow OGs. Can we still work for Hint? And they said, Absolutely. That's what we were hoping for. And so, Kyle's one of their head engineers, Danny is, the chief of, she doesn't have a title, but the whole, everything within the EMR realm within Hint.
And then they asked me to be their, their medical director. And so, our Arrow family, they're not getting rid of us. , we're still gonna be around, We're still gonna be pushing for, to, to push that rocket to go even higher and even faster.
Amazing. And I definitely, myself as well as many of the listeners will be excited to see what happens next month, next year, in the next 10 years.
So I love it. Now when you talk about family, another thing that I wanna highlight is that you are part of the , Next Tara affiliate family. And I believe, if I'm not , mistaken, you were the 100th practice to join. So it's like this, magic number of 100 is just a, is good juju all around for you guys.
So, so how, because again, Colorado's a different place in terms of DPC in Colorado versus another state. How did you find NextEra's value proposition to be helpful and how has that manifested in your practice at Strive
Direct? Yeah, that's a great question. I mean, Clint reached out to me the head honcho of, of NextEra.
For those who dunno he reached out to me right when the sign went up on the door that a new practice is coming. He was like on it, and I didn't have the mental bandwidth at that time. I literally took a call with him while I was on the l and d floor cause that's the only time I had you.
There were like seven people laboring. I was like, I guess I'll just call, pick up the phone real quick. So goes residency sometimes and I was like, this is a great, next hair is awesome. I just, first of all, we're not even open yet. It was so early. Second of all, like, I don't, I don't have the, the mental.
Capacity to, do my thing and like see if it would be something that would be worth it. And so when time went by, we saw each other at conferences, we chat, he's, anyone who knows him or, I mean, I could listen to him talk forever. I love that man. But then we, we reconnected about NextEra specifically a few months ago.
He reached out and said, Hey, there's a need in your area cuz he has a few affiliates that kind of are on a perimeter from where we are in Erie. And so I said, Hey, I still want strive to be strive. I don't wanna put a pig NextEra sticker on my door. And he said, Oh, no, absolutely we're not gonna do that.
So it's been great. It's the whole reason I pulled the trigger on it was I wanted to, you know, the DPC thought is, How can you provide as much value as you can for these consumers, these patients? And how do you, In my mind, I wanna be able to offer as much or broaden the, the net of who can come to strive.
And so, he has a few employers in the area that have a lot of employees that live in, in Erie. And so when he showed me that, I was like, Oh, well, I wanna be able to at least see those people, those humans, when they need to be seen. So, yeah, there was a no brainer. I mean there were no finances talked at all.
I just said, Yeah, I'll be an affiliate. Absolutely. These people need doctors and we're in an area that has a, a few doctors, but definitely is overpopulated with people and needs more doctors. And so I said, value proposition, let's do it. Why not? I didn't know we were the hundredth. I should have. He should gimme a plaque or something.
Maybe I'll text him and ask him for a plaque. But
awesome. And Dr. Kyle Hampton had mentioned this and he's in Fort Collins, Colorado, but for those people who've not listened to Dr. Hampton's episode when you eventually did get to the pricing point working with these employees of, of employers locally, Did you can, Can you tell us a little bit about how that works?
Do you set your price, Does next Terrace at the price? How does that work when patients sign onto your practice? And is there a certain quota that you have to have to become a next terra affiliate in terms of number of patients who join your practice per employer?
Yeah, so no quota. And pretty much NextEra sets the price.
Depends I don't wanna say any numbers out loud in case anything is, whatever. But they set the price per head for adults and kids. It's pretty simple. And then if a company contracts with NextEra, Then NextEra gives that company a list of all the physicians around where their employees live, and the employees can pick which physician they wanna list as their pcp.
And so in our area, a bunch of it was like right when I signed up with NextEra, we had a dozen or so that were like the next day, said, Oh, I won't, They're right, right next to us. We wanna sign up with them. And then next Tara, just basical. Writes us, writes strive a check every month for however many heads times the price.
And then obviously, they have their administrative side of things that it makes it super easy for me as a practice cuz I don't have to manage the company and voices all that stuff. We just see patients, which I love running a business, but it sometimes I just wanna see patients too.
So, .
And in terms of onboarding a Dexter affiliate patient versus a patient who comes, from off the street, how do you manage the onboarding of each of those patients in terms of your clinic, when they show up to sign up at your practice to their first visit? How does it work and is it different between those two?
Popul?
Yeah, so a patient off the street, if you will we just give them the signup link. It's on our website. And that just builds them a chart in Arrow and we just confirm them. And they're part of our normal age based tiers and everything. And then a NextEra patient. That person tells their boss, or they tell NextEra, they'll have a NextEra account, say, Hey, I wanna go see Dr.
Brown or Dr. Schuster in Erie. And then we get a notification from NextEra and it's actually through Hint that they have the whole, So we have a hint account as well to where. That's where all the NextEra patients live. And then we just build them a chart in two seconds within a, and we can have their medical record, all of the finances go through the Hint NextEra account.
So it's a little bit different, but it's not hard to wrap your head around at all. .
Well, especially when integrations are, they're being thought of before a patient signs on. And so, the integrations definitely help make the administrative work less of a burden. I feel, so That's awesome.
And if your patients were to go to another state where an EXTER affiliate is, is there the reciprocity in other clinics under the NextEra affiliate agreement?
I believe so. Yeah. I think they can I don't know if going to any doctor they want is, what is pitched to them, but if they move to another state, they can absolutely just say, Hey, I wanna go see, Dr.
Mario. But if they're visiting I'm pretty sure they can just go to, to a NextEra clinic and be like, Hey, we're visiting. And then it's all worked out on the back end.
Because you've been in this amazing community from such a young age and medical school even I wanna ask in terms of words of wisdom.
For other people going into the future in terms of, pitfalls or things to make sure that they protect, whether that be family time and how to protect that family time or how to strategically avoid certain pitfalls that you might have experienced. What would you say to those
people? Yeah that's a fantastic question.
I, first thing that comes to mind is you make time for what you love. Oh, someone told me that, I don't know who, probably some famous person said that or something, but that, that was eye opening to me that, work will take the time that you give it. Family will take the time that you give it, you get out what you put in.
There's a great book. How Will Measure Your Life By it's a Harvard business professor who's retired now, and he said he goes to all these Harvard business reviews and everything and cases about how, You can't harvest relationships when you're retiring at 62 when you haven't, farmed them for the last 30 years, and so, I'm a, I'm a people person, I'm a relationship person. Personal connection means a lot to me. And so, making sure that you focus on what actually matters and You made time for what you love. I love Strive. I love dpc. I love Arrow. I love Hint. We're the all part of the Hint family now.
But if it ever came down to it, it's my kids first. You know? I mean, that's, there's no question about it. And so, the advice I would have is I would be, is, go for it. You do you first of all, but. Find that harmony and be willing to adjust that harmony. Sometimes, you're in a minor chord, sometimes you're in a major chord.
Sometimes you have the capo on. I don't wanna pretend like I, I know music, I don't even play the guitar, but it's a fantastic analogy anyway, and so it's uh,
making sure you stay in that harmony. Cause then everything else is easy. Like sometimes you're working 15 hour days and that's fine, but don't make that for 30 years, sometimes your 15 hour days at home. But that would throw everything outta whack. It's like you have to find that harmony of where it, where everything fits.
So, long, convoluted answer, but. Take it for what it's worth. .
Absolutely. And what I love about that answer in particular is it will mean different things to different people at different times in their lives. So I think that's awesome. Now, in terms of finding your harmony, what is in the future for Strive Direct Health going into next year?
Oh,
who knows. Really? Right. I still do a lot of the moonlighting and ER work. I'm hoping to back off of that while Strive grows. Obviously I, I mean this is, this is one of my babies. I have a lot of babies I guess. But I really want to see Strive I mean, it already is self sufficient and it's already growing at a nice, linear, sustainable pace.
I don't think a hockey stick type growth would really be sustainable for us, especially cuz Sarah and I both wear so many hats. But I would like to see it continue doing that. Just that, that cadence every, every week, every month of changing people's lives, and sitting here, I'm sitting in my office right.
Sitting here talking to people and them seeing the light of dpc, if you will. You know, that's again, that's why I love coming in here every day, i, I love it. And I can't wait to do that more and more.
Well, thank you so much Dr. Brown, for joining us today.
Absolutely.
Thanks for having me. This is awesome.
Next week look forward to hearing from Dr. Katie Flu of Olive Branch DPC in Maryland Heights, Missouri. If you've enjoyed the podcast, tell someone about it. There are still lots of physicians out there who have not heard about DPC, and you can help change that. It also helps others to find the podcast.
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Until next week, this is Marielle conception.
*Transcript generated by AI so please forgive errors.