Direct Primary Care Doctor
Dr. Brian Ostick is a board certified Emergency Medicine physician. He practices in the San Fernando Valley of Los Angeles. He is the ER Medical Director of Valley Presbyterian ER in Van Nuys, CA and just finished a 2 year term as the Chief of Staff at that hospital. He recently joined Health and Healing Direct Primary Care owned and run by his wife Dr. Aimee Ostick. He is taking a small panel of patients to “diversify his practice” while still doing a full slate of ER shifts and keeping his ER administrative duties.
He plays competitive basketball weekly in a men’s league and took up golf during the pandemic (currently a 16 handicap) to keep himself in shape. Dr. Brian Ostick and his wife Dr. Aimee Ostick live in Los Angeles with their 3 children Siena (12), Madelaine (10), and Luke (8).
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MY DPC STORY EPISODE 12: Dr. Aimee Ostick
MY DPC STORY EPISODE 23: Dr. Katriny Ikbal and Neer Patel
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Transcript*
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 fingertips. Welcome to the My DP C story podcast, where.
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, D P C, 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.
My wife, Dr. Aimee Ostick, who is the owner of Health and Healing DPC, and I feel that Direct Primary Care is the future of medicine.
I have seen burnout in the medical profession and putting the patient doctor relationship back at the forefront does a lot to heal that burnout. We went into medicine as doctors to help people not fight with insurance companies and become documentation robots trying to maximize revenue. I feel that if more doctors could see the benefits of DPC then more would go into primary care.
Thanks for having me on your podcast. Let's get the word out there, how great DPC can be. I'm Dr. Brian Ostick of Health and Healing Direct Primary Care, and this is my DPC story.
Dr. Brian Ost is a board certified emergency medicine physician. He practices in the San Fernando Valley of Los Angeles. He is the ER medical Director of Valley Presbyterian ER in Van Nuys, California, and just finished a two-year term as the chief of staff at that hospital. He recently joined Health and Healing Direct Primary Care owned and run by his wife, Dr.
Amy Sik. He is taking a small panel of patients to diversify his practice while still doing a full slate of ER shifts and keeping his ER administrative duties. He plays competitive basketball weekly in a men's league and took up golf during the pandemic. Currently a 16 handicapped to keep himself in shape.
Dr. Brian Osec and his wife, Dr. Amy Ost, live in Los Angeles with their three children, Sienna 12, Madeline 10, and Luke eight.
Welcome to the podcast, Dr.
Oic. Hey, thanks for having me, Mary. I really appreciate you having me. Absolutely, this is such a treat because, for the listeners who might not know Dr. Brian and Dr. Amy have been very instrumental in trying to pull all the California DPCs together. They facilitate our meetings on a regular basis and we just started that up again and, you guys doing that, it really embodies your excitement about DPC as a couple now functioning at Health and Healing dpc.
So, I wanted to get started with the fact that you are an ER trained physician. I am. And. Yeah. And so it's so interesting that we are seeing people like yourself who are not necessarily internal medicine, family medicine, pediatrics, choosing to do dpc. So can you share a little bit about what your life looked like before you joined on at Health and Healing?
Yeah, sure. So, you know, my wife, Dr. Amy Oik and I met in medical school at Jefferson Medical College in Philadelphia and fell in love and ended up graduating, getting married, and then starting residency. And, and she did her residency in family medicine and I did mine in er and we've just been a family doc and an ER doc since then since we started our first jobs in 2011.
So, It's been 10 years, 11 years now, of me just doing emergency medicine. I love it. And I, and I, I'm the ER medical director at my site and I still do a full slate of ER shifts, about 14 shifts per month. But my wife started this practice three years ago in September of 2019, and it's been really a great success and I've seen how happy she's been in her practice and, and how good it's been for her and how amazing the DPC community has been and just that model itself.
And so, Doing emergency medicine can be difficult. There's a lot of you know, it's shift work. You know, you don't schedule emergencies. So people show up and there's a lot of stuff that we do in the emergency department to help people with emergencies and to help people do a lot of primary care as well, because unfortunately there's not a lot of access to, to healthcare.
So when Amy and I were talking recently, Probably about a year ago, we said, well, what if we could make some sort of transition, not a full jump from ER to, to dpc, you know, right away, but, but could, could I come and, and in some aspect start working in the practice? And we did. We were able to carve out Mondays where I'm in the practice and I'm gonna take a small panel of patients, probably about 50.
And it, it's, it's been pretty amazing actually. I've been very happy with it. I started doing it in September of 2022, so just a few months ago. And I, I, I've. That's incredible and I, I will say, You have such a unique perspective, not only because you are an ER trained physician watching Amy do her thing and make health and healing successful, but also you were wearing quite a few hats with regards to supporting her practice before, before you joined.
Yeah. So, In those first three years as you were watching Health and Healing Grow, what types of roles did you play and what did you see from your vantage point as an er? Position and how DPC looked like to you from, you know, a financial survivability perspective as well as, being able to help offload those non emergencies from your emergency room.
Right? So, I mean, to take the first question, you know, I think when Amy started the practice in September of 2019, it was right before the pandemic. And I, I was, I have no ownership in the, in the model. I'll tell you that right now. Amy is 100%, you know, female owned. And, and that's the way it will be. And she'll be the sole owner, I think, forever.
So I had no financial, I mean, we're married obviously, but, and I, and I joke a little bit, but I didn't get paid anything. From her until I just started working in the practice as a, as a doctor. But I, I called, you know, I was the cmo, I was the chief marketing officer. I did all of our social media stuff.
I was the cfo, I, I say the Chief Furniture Officer cause I was building furniture and making sure that her, you know, everything was set up. And I didn't get paid for any of it. But it was a lot of, a lot of sweat a lot of sweat equity and a lot of doing what needed to be done just to open the practice and then to get things started.
And you know, like I said, it started in September, 2019. So to take your second question, the pandemic hit not soon after that. And it was kind of interesting to open the practice at that point and say, oh my gosh, like now we have this pandemic hitting. Like, is this practice gonna work out because what, you know, are people gonna even go to the doctor anymore?
And, and, and are they be too scared? Know, what we saw was is that Amy stayed open during the pandemic, her practice did. And so she was open and figured out how to do COVID testing for people. So all of a sudden we became a Covid testing site just by default because she was one of the only doctor's offices that were, was open.
In my practice, in the er, we were seeing a lot of doctor's offices that were closed and patients were coming to us saying, listen, I, I think I have covid. I just can't get in to see my doctor cause they're closed. And I'll tell you today, there are still doctors in the community that are not seeing patients with cough and fever because they think it could be C and we're three years past the start of the pandemic.
I mean, you gotta figure it out at this point. And Amy's been open. From day one, never closed for Covid, has stayed open and, and continues to stay open and continues to test for covid and uses appropriate PPE and all that sort of thing. And actually has seen, I think, growth during Covid because she was open and the patient said, wow, you're open, you're available, you're testing.
I can come to you. Well, yeah, I'm gonna sign up for your practice. Definitely. That comment is echoed in multiple practices in the direct primary care model because of having the ability to be accessible to your community, the way your community needs you to be accessed. And so the fact that you guys, and at Amy at the time was able to.
\ practice the way that your community needed to in Woodland Hills and be a point of access. I think that's, that's awesome. And it, it is a testament to how she determined what needed to happen. Not, oh, the admins say that we have to cl close the clinic this day until further notice because she doesn't have any admins looking over her.
So, Thinking about you, you said about a year ago you were talking about, could you come on, what was it that really made it a reality for you to say, okay, I'm gonna go from chief furniture officer and and chief marketing officer, to actually making the transition happen where you could wear the hat of an ER physician as well as an H and h p.
Sure. So, you know, in the emergency department, like I said, it, it can be tough work and there is a lot of burnout. You don't see a lot of old ER doctors unfortunately, because I think it's a tough business, right? Shift work. Weekends, holidays, we're open 24 7, 365 days a year, and. And that can get difficult for people, especially as you get older, right?
Doing night shifts is hard when you're young and just fresh outta residency. But doing night shifts when you're in your fifties, sixties, seventies, eighties becomes very difficult like that, the circadian rhythms being thrown off and all that sort of thing. So I'm looking to the future and saying, How do I just, same the same way we would diversify a financial portfolio.
We were saying, how would you diversify a medical career? And so am I just gonna do this ER thing for the next 30 years until I burn out? Or hopefully I don't burn out before then. Or is there some way that I can join your practice at Health and Healing Direct Primary Care and, and diversify my practice a little bit, which is very different from what I do in the er.
So, you know, in the E. I do my best work when people are unconscious and don't know that I'm even there, right? They, they, they don't remember their ER visit at all because they're in extremist or sick or whatever, and in. Other situations where we're doing urgent care, primary care type stuff. My job is to really see them do a medical screening exam, make sure they don't have something emergent, and then get them out of the ER so that I can have room for the next patient that may truly be emergent.
So I don't get a lot of time to spend with those sorts of patients who are the urgent care, primary care type patient that's in the emergency department. Well, then you take the doctor out of that er setting and put them in the drug primary care setting. And now you have an hour to spend with a patient.
And it's actually pretty fulfilling to say, gosh, I could sit with you for an hour and talk to you about all these different things. And I'll tell you one, like, you know, one of my patients that I have now that's new to me has a, you know, high blood pressure, high cholesterol, hasn't seen a doctor in forever, but he's in his, you know, late forties, has a family and is like, gosh, I, I know I haven't taken care of myself the last decade.
I need. Start taking care of myself. And we have him now with, you know, blood pressure controlled, his cholesterol's improving and those sorts of things. And, and to be able to sit with him and, and go through that and say, man, you're having these thoughts of, I wanna make sure that I'm healthy for my family and my, my wife and my kids.
And now we can do that is, was really fulfilling to me. You know, and to, to be able to have those sorts of interactions in a direct primary care practice is awesome. Very cool. And like I mentioned, there are other ER trained physicians out there. Dr. Mitch Lee's been on the podcast Dr. Megan Gaylor in Georgia.
Dr. Jim Lim is in Florida. if you were to, you know, speak to a room of ER residents or medical students or people who are dreaming of being an ER physician who are also hearing about the direct primary care model, in addition to, the idea of longevity in the er?
What else would you share with. Now now as a DPC plus ER doctor. Yeah, so I, I think having some sort of other, like, like just doing, just doing ER shifts, just being a pit doc for the whole career, I don't think it's sustainable.
I think you need to have some sort of outlet. In your career other than just the ER shifts, and that could be a number of different things, right? It could be administration, it could be sports medicine, it could be wound care stuff that some ER docs do with hyperbarics and that sort of thing. Or you know, now it could be direct primary care.
Now I'm an ER doctor and I did my ER residency and I'm board certified, but I don't pretend. That I'm a family doctor or I'm an internal medicine doctor, and that I know everything that you did because you guys did three year, four year residencies for your internal medicine family medicine residencies.
And so there's a lot that I have to learn. And one of my I would say one of the things that I was nervous about with joining Amy's practice was, gosh, I really know emergency medicine. I've been doing it for over a decade. I do not know primary care as well as I want to know it. I know urgent care pretty good because we do a lot of it at at at Valley Press, my er, but.
But what's an A S C V D score? How do I know who needs a statin? Like, that's not decisions that I am doing in the er. I've never calculated an A S C V D score before two months ago. So, it's, it's really helpful to have a wife who's a very good family medicine doctor that I can curbside consult a lot but I'm doing a lot of learning on my own as well.
In addition to Amy having her there, have you found any other resources that were helpful to you that could be helpful to others who might be feeling that same, you know, uneasiness going into primary care from an ER perspective? Yeah, so you know, there's. Up to date. We use a lot.
I mean, I have access to it, so I'm using up to date an awful lot. I use a lot of MD Calc to, to make sure that I'm trying to be evidence based as best as possible when making decisions and so forth. Em Wrap is a um, er. Podcast that we've, that I've listened to since I was a resident and is, is fantastic and really well done.
And there is a primary care wrap that they've also done in conjunction with that. So there's some great stuff there that you, that you can use to, to learn. I mean, the, the information's out there, you just gotta go looking for it. And one of the things I wanted to ask you about was just how you highlighted, you know, making sure that a person is thinking about diversification is important from your, from your recommendations.
And you, you and Amy have diversified in terms of you physicians in different training roles. You've created this This, you know, you've created a situation where you're now able to help out at health and healing. But in terms of looking at life from a financial perspective, you highlighted during the pandemic, that was a little bit scary at first to say like, what, what's actually gonna happen financially with this clinic just having opened and now we have the pandemic among, amongst us.
Financially, how did you guys plan to open health and healing, and how did you continue to strategically plan financially going into the future, given that you guys have achieved financial freedom during your journey to open D P C? Yeah, so. That's a great question, and the financial piece of medicine I, we love talking about and I think we should be more open and honest and talk about financial, both personal finances and business finances.
I think we would all be better off if we would share ideas. But so for our story, we did come out of medical school with $550,000 of student loan debt combined. And Amy and I got on the Dave Ramsey. Let's pay it off as fast as possible. Plan. Dave Ramsey's Baby Steps is kind of what we followed, and we paid all of.
All of our debt accept our mortgage off by December of 2017, and we had graduated in 2011, so six years. Had a few kids along the way. We have three now, and we were debt free by by then. So that was what really gave us the freedom to say, okay, maybe we can start to start primary care practice because now we no longer have our student loan debt that we have to make.
$4,000 a month minimum payments, that's gone. It's zero now, and I'm still doing my ER thing. So how about we just live off your ER income and save up money to start this practice? So we saved up about 30, $40,000, something like that, to do some renovations for our office to get things started, to buy the initial things that you need to start a dpc.
And then and then opened in September, 2019, and we opened with, I would say probably 20 to 40 patients, something like that. Not a lot, but, but something. And we, and we built that up to, I think as of today we have 561 patients combined. Amy has most of those. And it's been a very financially successful model for us.
We did go to the nuts and bolts, dpc nuts and bolts a few years ago before we started the practice. And Amy and I sat down and we had a business meeting in, it was in Disney at the time in Orlando, and we went to Disney Springs and we said, with our laptop, sat down and said, all right, let's put out this business plan.
And on the back of the napkin, I was like, gosh, if you had just throw out there, $65 for an average patient per month cost, right? Or charge. And you had, you know, 200 patients, we could probably meet our, our, our minimums of what we would need to kind of keep the lights on. If you had 400 patients, you could probably.
You know, get close to what you were making when you were working with Kaiser and UCLA and those sorts of things. But you had 2000 and 3000 patients on a panel, and if you had 600 plus patients, like you'd probably be making more money than you ever did with, with, with those companies, which is crazy. And when we looked at that, I was like, do we do that wrong?
Like, are those numbers actually accurate? And we double checked it. I mean, and it was, yeah, it was, Hey, this is the kind of revenue that you would see with a 600 panel patient or a 600 patient panel. At $65 average patient charge and, and you don't have a ton of overhead. That's, that was kind of the beauty and that was, I think, the light bulb for us to say, yeah, I think we can do this.
And we had the benefit of, of me still being able to work in my job and, and being able to make our personal financial budget with just my income. And then as she's built her business, you know, we've gotten back to that, to that point where we were before she had started her. Amazing. Yeah, and I, I definitely would say, you know, it, I appreciate you sharing that because some people still who are new to Direct Primary Care as a business model that that transparency of.
We we're transparent with pricing for our patients, but we're also transparent in terms of this amount of patients equals this amount of money. And that is how you can calculate your overhead and project your PNLs and whatnot. So let me ask you this. Very commonly I hear residents say, oh, but, but I have that debt that the $550,000 in debt and, you know, might be single, no.
Really intimidated and really fearful of opening DPC because of the financial portion. Mm-hmm. you, you shared that you guys followed Dave Ramsey's baby steps. What other pieces of advice would you give to those people in particular? So that DPC could be reframed or the jump to DPC financially could be reframed for those fears that they might.
Yeah, I mean, I think the disclaimer would be that everybody's situation is, is individual and, and, and personal finance is personal because everybody's life is different and everybody has different you know, there's, there's different needs and there's different wants and those sorts of things. So, but you know, what would I say to like the new residents starting off graduating from a financial or from a, from a family medicine residency who is looking to start a dpc?
I would say that probably number one, it can be done. And there are ways to do it. Like, it's not like you have to go all into to this or all into that. You could sometimes do a hybrid type model of, listen, I'm gonna, I'm gonna, I'm gonna start this practice, I'm gonna work for this urgent care, and then I'm also gonna do this DPC thing and I'm gonna, I'm make that happen.
I'm gonna look for some sort of if there was some sort of payback model that I could do to, to pay off the loans and I could get the loans paid off, that would be one thing. Or you know, maybe you say like, gosh, I. We, we made this decision to take out student loans in the past, and I have to clean up my mess and then I'll be able to start my direct primary care practice after that.
So I take the job with Kaiser or UCLA or whoever it is, and I work for a number of years, and I, and I really try to crush it and knock out these student loans as fast as possible and live like a resident, live like a medical student. Don't buy a big house, don't buy a fancy expensive car. Like, you know, if you're, especially if you're young and single when you're making money as a doctor post residency, you know, it's, it's, it's a good amount of money that if you can, if you can manage it right, you could throw pretty hefty debt payments at student loans.
So, Maybe it's a, maybe it's a plan. Maybe that's your five year plan. You say, I'm gonna, I'm gonna sign up with this company. And I know it's not my long term goal. My learn term goal is to have a DPC practice and I'm gonna build this DPC practice in the background, but this is the bridge that I'm gonna use to get to that point where I can say, I'm not gonna work in that fee for service model anymore.
I'm, I'm, I'm making the jump over to my DBC practice full time. But everybody's different, right? Like if you come out of, if you came out of family medicine residency, By some, you know, reason you had no debt, like your parents were able to fund it or you did the military service or whatever it was that you were debt free.
Maybe you are able to start the practice right out of, out of residency and say, I don't really have any financial burdens or obligations that I need to, that I need to make sure that I'm, I'm paying, that I can just kind of get out and start, and start making some money and start small and build it up and you can build quickly.
And one more question about finances in regards to big purchases, Dr. Matthew Minz had shared about buying a very expensive piece of equipment to add value to his value proposition of his dpc. In terms of if you were to look at, you know, a big purchase for health and healing, like, you know, a vaccine fridge and freezer or something big like an ultrasound machine.
Mm-hmm. , do you have any advice? How to project your finances when you might be building your panel. You don't necessarily know how many patients are gonna come in, but you would like to buy a big piece of equipment to incorporate as part of your value proposition for your clinic. Yeah, that's a great question.
There's gonna be different thoughts here. I'm gonna give it to you from what we would do and what we did do because we were that Dave Ramsey, get outta debt, baby steps, followers. We, we don't borrow money, right? So like we, we were not going to borrow a hundred thousand dollars to buy a machine or what, whatever it is, or a fridge, but we were not gonna go into debt to do that.
So, that was just a non-starter for us. If you were going to borrow money to buy whatever, whether it's in your own business or in your own personal life, like you better have a way that you can pay it back. Because if you can't pay it back, like that becomes a real big issue. And so for us, we try to live our life debt free.
Like we are still, I don't use, we don't use credit cards. We still don't have any student loans. They're gone. We don't have car loans. We, our, our, our, we own our cars. There's no debt on the business at all. And, and that, that feels very freeing and clean to us. And so, I, I couldn't say that we would, we would ever go out there and borrow, but I listen, I, I understand that, that, that people are going to, and they're, and they do just have a plan for it.
great advice. And I think that people can take those words and adapt it to their own situation, which is super helpful. Yeah. Now you mentioned you were the chief marketing officer before you joined on, so when you were unpaid, by the way, unpaid. Unpaid, when you were in this volunteer position, , and you were.
Helping the practice. visibility in the community and also grow and make people aware of the value proposition. What did you find was most helpful and what strategies did you try and find were not as helpful?
Yeah, the great question. And you know, I think we had, we always had a Facebook presence. We then started pretty quickly with an Instagram presence. Don't really use Twitter or TikTok at this point, although we probably should. And so it was very much posting and sharing and doing those sorts of things, but also making sure that you're getting your when, when people Google the name Health and Healing Direct Primary Care, or people Google Dr.
Amy Os, like, make sure that those things that are showing up on your Google search are accurate. So what I would see in the beginning when we first started off is I would Google. Dr. Amy Oik and it was showing up as her Kaiser phone number and Kaiser address and those sorts of things. And I'm like, she hasn't been at Kaiser for two years, three years.
Like why is that still showing up? I need health and healing direct primary care to be the phone number and I need health and healing direct primary care to be the address so that when people see that they're not confused. And so I was very diligent with, especially in the beginning of saying, I own this page, right?
Like this is me. We're going like, and, and putting in requests to, to change the information. And it was frustrating cuz there's a lot of different sites out there that have a lot of wrong information, especially if you've been at a couple different, you know, practices in the past. And so it was a matter of like, Every couple days, like going on and Googling again, helping in under our primary care and seeing what was there and what was accurate and what wasn't, and then just trying to go and make those changes.
We used Google, like making sure that our Google Maps was updated and that that was ours, and that we can manage that. We used Yelp. We have a Yelp. You know, make sure you go to the Yelp page, not to pay for Yelp because we did do that and I don't recommend it. I didn't like paying for Yelp. I thought it was not helpful and I thought they were pretty pushy.
But making sure that you have said, this is my Yelp business page, that you can monitor it, look at it, respond to people who email you through it, as well as post pictures. And that would be, that's another thing is I think visibility with, with pictures is, is pretty underrated. I see a lot of practices that don't have any pictures of the doc there.
Like when people sign up for. DPC practice. They wanna see the doctor, they're coming to see you, the doctor. So make sure your pictures are showing you the doctor. And they should also show, you know, what the, what the place looks like, what the exam rooms look like, what the lobby looks like, if you have a lobby what the waiting room is, what, whatever it is.
And, and people that work there, right? So, Anna, Maria and Paula are our two MAs that work with us and they're prominently displayed on all of our social media, right? People know Anna, Maria and Paula, and they love Anna, Maria and Paula. So when they see 'em, they respond to that. So make sure you post your people, make sure you post your place.
Make sure you have more pictures than all the other doctor's offices out there. And early on during the pandemic, you guys started really, really awesome videos in terms of just sending updates, whether it was about covid or about, you know, just general primary care type things. What was your guys' time investment in terms of preparing for those videos and posting those videos?
And did you find that having , a video presence out there was effective for your c. Yeah, the, the time investment was not much. I mean, we would, we would say, okay, on Friday morning I'll come over cause I'm not working and we'll just do a video from your office. And so we would kind of just wax poetic on the phone with a little ring light and, and we'd have some sort of rough outline that we would put together right before we went on.
But it wasn't. There wasn't a lot of time that was invested in there and I think people liked it. I mean, I hear from people still saying, oh you guys stopped doing those weekly videos. I was watching all of 'em. And it's funny cuz you see how many views you get and it wasn't like it was getting a ton of views.
But I think we had some people that that really liked seeing it and maybe it was a bit of a common presence during a scary time. And I hope it was. And I hope we did get some, some good information out there cuz there was a lot of misinformation out there. For sure. Definitely. And I think. just going back to the, you know, showing who's there at the office.
That was a very, very, you know, detailed version, so to speak. Like arguably to show who the doctors were now and the, you know, the doctor was at the time, just Amy at the time, in terms of who you would be seeing and does this person talk like, They're treating you like a normal person rather than speaking in just medicalese or whatnot.
And it can, it can show your guys' value proposition just through how you're sharing information, which I thought was awesome and you guys did a great job with those videos. You can do so much, so much free marketing. You don't need to spend a lot of money on a marketing budget, if any. I would and, and I don't think you need to pay for a big marketing company to come in and do all that for you.
I think you can do a lot of it. You know, via grassroots and, and in the end, I'll be honest with you, I think the best marketing is not social media marketing at all. I think it's word of mouth. I think it's a family of five that signs up with you and has the best experience they've ever had with a doctor and they're like, oh my gosh, I can come in on the same day I call you and I can have you see my kid who I think is sick and have them and have you tell me that.
The kid's gonna be okay, or the kid's gonna get antibiotics and that's amazing. And then they go back and tell their friends like, I just had the most ridiculous, amazing experience with this doctor's office. You need to sign up and that's the best, that's the best marketing you could ever have. I, I definitely agree with that.
So I, I, I encourage people to, no matter where they are, especially if they're in their starting out days, to, you know, continue to treat your patients as you wanted to treat them when you opened your dpc, because the word will spread. So, I, I absolutely agree with you on that. Yeah. Now, going back to your guys' business plan on that napkin, sitting at Disney Springs, when you.
Who joined your practice and do you have a fi you know, a, a financial strategy, but also a patient onboarding strategy in terms of how many patients you want to reach? Or are you just feeling that out based on how it is balancing the ER plus health and healing? Yeah, so we didn't go into it saying like, this is gonna be your niche, although we did think.
That the male audience that was around my age would probably be more interested to see me. That was kind of our hypothesis of like, Hey, maybe we'll get more men to show up and you'll do more, you know, men's health type things, and low and behold, it actually. Kind of worked out the way we thought it would, right?
So most of my panel right now are the dads of the families who had never signed up before. And so we would have a mom and three kids, but the dad wasn't a member. And then I joined and all of a sudden, okay, dad is gonna sign up now because he wants to see you as opposed to Amy. And that's just like some people feel more comfortable seeing, you know, somebody that, you know, a guy wants to, wants to have a doctor who's a guy or female wants to have the doctor who's a female, or vice versa, whatever.
And whatever you like is. But for us in this practice that seemed to be, you know, who was gravitating towards seeing me. And, and that's been kind of cool. And so I think we're kind of pushing that is to say, Hey, if you want, you could sign up the whole family. Dr. Amy will see the mom and the kids and Dr.
Brian can see the dad. And that works out for us. Cuz Amy's got a bigger panel than I do obviously. So, I, I, I think, I think people. And then with you joining the practice how did you start accepting and then onboarding patients? Was it modeled after how Amy was accepting and onboarding patients?
Or did you have your own separate workflows because of your brain working differently than your wife's? When you came on and started taking. Yeah, so you know, the girls are pretty good. I think when people are calling in now to sign up patients to say like, oh, are you calling? Would you rather see Dr.
Ham? Would you rather see Dr. Brian? And then kind of funneling them that way and then getting them on our schedules. And so when I see a patient for the first time, I'm going through a full history and physical, obviously we have that hour long, you know, that we need. But I am trying to follow along some sort.
Initial history and physical exams so I can get all the information at first. And for me it's helpful cuz we use Atlas MD so you know, we have the initial, you know, I, you know, it's a little dot phrase if you would call it or hashtag whatever it is. And it kind of pulls up the, the history and physical exam and I can kind of fall through that in more of an algorithmic process.
I think that helps with my ER brain cuz we do a. ABC's, airway, breathing, circulation. And this is kind of like, let's follow along and we, I can get through this and we'll get all the, all the health information we need, and then we'll kind of go from there. And then because you guys are practicing as a husband and wife, co physician team with three kids how are you guys, you know, people will say balance.
People will say different words for the ability to live your life as mom and dad, as husband and wife, as doctors, as all the hats. So how are you guys managing your time when it comes to doing all the. No, I think that's a great question. So on a day to day basis, if, if I'm in the office on Mondays, that's kind of Amy's day during the week to not be in the office.
Now she does take, you know, phone call or text if she needs to during the day, but that's kinda like her mental health day, if you will. Where the kids are at school and she can do what she needs to do without anybody else around. And then she's in the office Tuesday through Friday doing her regular clinic.
And then on Saturdays and Sundays, you know, it's. If I, I, we don't go into the office on Saturdays and Sundays, but we're available by text or phone if need it. When you talk about, you know, vacation, like I'm going back with the whole family to Philadelphia next week cuz my sister's getting married, so that's gonna be awesome.
Right. But well we do have a doctor that has helped us to cover while we were gone, so that's been really, really nice. She's an amazing time medicine doctor. We're actually trying to get her to join the practice. We'll see if that ends up happening, but she's been really willing to help out when we've needed.
And to cover. When it comes down to it though, I think a lot of our patients are pretty understanding. And a lot of patients are still able to get in touch, you know, with the doctor if, if needed, but it doesn't, having a direct primary care practice has not kept us from going on vacation. I'll say that.
So reassuring for, I'm sure many of the listeners to hear because it's a common thing that comes up in terms of another fear, financial fears being won. But another set of fears is how am I going to. Be able to not burn out when I'm the solo doctor, or in your case, like a husband and wife might be both doctors and both practicing in the practice and there's no coverage potentially.
So, I think that that's, it's great to hear your experience and to have people you know, from your experience be able to brainstorm and envision their own lives. Taking things like vacation cuz it's super necessary for us to be able to take care of ourselves, to take care of other people. So I love that.
I would, I would put a plug in for you guys though. I mean, all the work that you've done with Amy and with James about getting that, you know, the DPC California syndicate and, and the website up and running. And I know you guys are trying to do a kind of a, Hey, can we cross cover for each other when people need it?
Mm. That sort of thing is available and, and with the way the DPC community is, how helpful I think DPC docs are with helping other DPC docs. It really is pretty refreshing cause you don't see that in a lot of different specialties. Definitely. And just a little backstory there in terms of the meetings that Dr.
Amy and Dr. Brian have helped set up for all of the California DPCs Dr. Frankie Feedler in the Bay Area had mentioned this idea of, Hey, could we help cover each other so we could have coverage When somebody wants to go to, I think Jordan, When one place somebody's going and for us it was Lego land, like I needed coverage the other, the other month. But but yeah, you know, brainstorming amongst each other, within your area, your state, because you're licensed in your state you don't necessarily have to physically be In the same location as another DPC doctor to be able to cover patients.
I'm glad you brought that up because it is definitely a way that we've helped just identify who's willing to cover. Is it coverage for trade of other coverage? Is it, is it coverage for a certain price per day? But having, having more opportunities, I think is, I agree. Easier in the DPC space because DPC physicians are very supportive of helping each other Be not only successful, but also to maintain our, our sanity and our autonomy. So I think that it, it's a really great place to, to start if you, if you are in a micropractice and you might not have a local doctor to be able to cover. And then in terms of what you mentioned with regards to Dr.
James Gore and Amy and myself the website. People can go to it easily enough. It's cali dpc.com, c a l i dpc.com. And what we've tried to do is just like people have done in Houston area and other places, but we've tried to create a central page. So if, if there's a resident in California or a resident who's looking to move to California that we have a networking place for if, if somebody wants to find.
And, and recently it was a broker needing to find somebody to work with in California. The, the website was very helpful as a centralized place to find DPC practices no matter where in the state you were looking for. So definitely that's another recess to check out cali dpc.com, especially if your state might not have something like that and you're looking for a model to create one.
That, that's just what we created. But yeah. Now looking back, is there anything that you guys would've done differently or changed? Fin whether that be financially or whether that be, you know, onboarding patients as quickly as you did, or any services you may have offered or not offered, anything you would've done differently and why?
Yeah, I think we just went to, again, the DPC nuts and bolts. That was, that was in Dallas just a couple weeks ago. And it was a great conference to see everybody and see some of the DPC docs around the country. And a lot of the talk there was bringing on employers, and I think that was something that we didn't.
Push when we first opened. I mean, and, and I think for us it was because a lot of our patients were coming from our school and our church and our local community, and that was what we were really focusing on. But I do see the value, I think, in bringing on small businesses especially and combining that with the DPC practice.
So there's a lot of talk, you know, near Patel with virtuous benefits was there, and we were, we were talking about, gosh, do you have. This small business that's 10, 20, 50 employees and they're spending a ton of money on health insurance because they use one of the BCA plans, blue Cross United, Cigna, Anthem, or Humana.
And they're spending all this money and they don't need to. If, if they could get with one of these, you know, if they could get with near another company that would do similar things where you could cut your insurance costs in half, combine that with a DPC practice that would give those employees better care than they've ever had before, and save yourself the bottom line for that, for that business.
It's like a win-win. So, I'm really kind of excited about pushing that now and saying like, are the next 50 patients that sign up with health and healing to our primary care coming from a small business as opposed to coming from our community? And how does, how does that work? So, you know, if you're starting off, consider that.
Think about reaching out to small businesses in your neighborhood and say, gosh, we might be able to save you money and sign you up for our practice and get you better care than you've ever had before. Definitely, and I would say for a very, very entry level, but awesome primer on, you know, even the, the different types of plans, the BCA plans versus a self-funded plan.
I'll highlight Dr. Katrina Ibal and near Patel's my DPC story podcast episode in the blog accompanying your podcast so that people can take a listen to. But it, it, it's a great. It's a great explanation that he shares so people can understand. Like when, when we talk about employers, With 50 or fewer employees it, it, it might be small compared to, you know, like a, a Google employer, but at the same time, 50 people generating a ton of debt for a company because of unnecessary costs that can come out of primary care cost.
Being inflated by an insurance plan really makes an impact. And especially during the pandemic, we saw a lot of businesses, you know, look for different ways that. Able to still give their employees excellent healthcare without putting them in into bankruptcy. So I definitely would say, you know, check that episode out and, and do I, I do, I do agree.
I encourage people to, to think about or envision could I work with employers and how could that work for me? Because I will say, like I've said on the podcast before, I remember sitting and listening to Dr. Shane ll talk about it at the 2019 Hint Summit. And I was like, oh heck no. I will never work with employers because.
50 people join and then 50 people leave. I'm down 50 people. But there's definitely other ways to look at it. So I would say, you know, if you are in a place where you are a micro practitioner and you are, or you are not near other DPCs who may or may not be taking employers, start talking to people about like, Hey, what, what could that look like?
Because you might not have the perspective that somebody else does, and you might learn something from them and think about things differently. So I just, you know, I say, Summary of, with a summary of just keep an open mind. So I thank you so much for mentioning that. Yeah, absolutely. In terms of going back to your intro statement this idea of if more physicians, or physicians in training knew about direct primary care as a model that more people would go into primary care, speaking from an ER physician trained background, you know, I, I wonder.
What was it that made you choose emergency medicine? And what would you say from those shoes you would've chosen primary care? Had you seen something different in your training? And what would you envision being a, a big impactor for people to get exposure to DPC as a model going into the future to possibly increase the amount of primary care physicians in the nation?
Yeah, I mean, first off, let's say that I'm glad you're doing this podcast cause it's getting the word out there, right? And we didn't know, Amy and I didn't know about Direct Primary Care until just a few years ago we heard about it. So, it's new. I mean, it's fairly new, right? I, I think Dr. Josh Umber has probably been doing DPC for 10 years, 11 years, something like that.
And he's like one of the oldest guys doing it. Not old in age, but oldest DPC practice. That that has probably been around. So it's, it's very new and, and what's interesting is that emergency medicine is one of the newer specialties. If you talk about, you know, internal medicine started hundreds of years ago, and surgery has been around obviously for a long time.
Like, er medicine really only came around as a specialty in the 1970s and got popularized by some of the TV shows, like, you know, Ambulance and er, and those sorts of things. And so, we're fairly new as that. Why did I go into er? Because I love the excitement. I love that you have something different every day.
You never know what's coming in. Those same things that I love about it are also the same things that may burn you out because you never know what's coming in. And, and, and there are stresses and challenges that go along with that. So, I still love it. I still am going to do emergency medicine. I am.
I tell people I'm not switching over to Amy's practice a hundred percent. I'm not quitting my job. I think I'll be in the ER for a very long time. But I, I have found this direct primary care, the, would you call it a movement? Would you call it a new specialty? Would you call it a practice model?
However you define it, Amy, I think it's the future that this is, that if more people did this, The care of people in America would be better, people's health would be better, and the mental health of the doctors themselves would be better because I think the traditional insurance model of primary care burns people out seeing 25, 30, 40 patients a day in a traditional fee for service based model.
It's, it's, it's crushing. It is, it is soul crushing. And so having the freedom to have your own business, to be able to spend time with patients again and go to spend an hour with patient if you need to is a breath of fresh air. And I think more people should learn about direct primary care and experience it and hopefully start their own.
I love it. And you know, just hearing that it, it just makes you think about how it is restoring the health and healing to both patients and physicians. So awesome that you guys encompass that in the name of your practice. And thank you so much for joining us today, Dr. Oik, and for sharing wise words of wisdom.
Thanks for having me on. I really appreciate you. Do a great job. Keep it up.
Next week look forward to hearing from Dr. Nicole Harkin of Whole Heart Cardiology in San Francisco, California. If you've enjoyed the podcast and you haven't yet done so, subscribe today and share the episode with the physician. You may know who needs to hear about D P C. Leave a five star review on Apple Podcast and on Spotify now as well as it helps others to find all these DP C stories.
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Marielle conception.
*Transcript generated by AI so please forgive errors.
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