Direct Primary Care Doctor
Dr. Michael Lovelace grew up in a small town in upstate New York along the Hudson River, and ended up trading his snow shovel for sunshine after high school. He headed to Loyola University in New Orleans for his undergraduate degree in Finance, and then later on to Arizona State University in Phoenix for his MBA.
He has worked as a Financial Analyst for a Fortune 500 company, Project Manager for a non-profit institute, and ran a family business (plant nursery) with 45 employees.
While working at a cancer research institute he made the decision to change careers and go back to school to become a physician. After graduating from the University of Louisville School of Medicine, he completed his training in Family Medicine in Columbia, South Carolina.
He chose the specialty of Family Medicine because of the wide spectrum of illnesses that he can treat. As Family Medicine physicians they are trained to treat newborns, pediatrics, women's health, adult chronic disease, and geriatrics.
During his training, he studied different practice models and chose to open a Direct Primary Care (DPC) practice because he believe that it provide the best opportunity to truly connect with patients. As a former business owner, he understands that providing quality customer service requires time. Another huge positive of being a DPC practice is that he can save patients money on medications and labs.
When he's away from the office, he enjoys playing golf, running, and gardening. He also loves spending time with his wife, Rebecca, their two young children, John Michael and Aly Claire, and their rescue dog, Roux.
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Address: 2908 Taylorsville Road, Louisville, Kentucky 40205, United States
Telephone Number: 502-324-5416
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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 D P C story podcast, where each week you will hear the ever so relatable stories shared by physicians who have chosen.
To practice medicine in their individual communities through the direct primary care model. I'm your host, Marielle conception family physician, 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.
D P C is the arena that allows me to be a physician, a business person, and a father. Hi, my name is Michael Lovelace and I own Derby City Direct Primary Care in Louisville, Kentucky. And this is my D P C story.
Dr. Michael Lovelace grew up in a small town in upstate New York, along the Hudson River, and ended up trading his snow shovel for sunshine. After high school, he headed to Loyola University in New Orleans for his undergraduate degree in finance, and then later on to a Arizona State University in Phoenix for his M B A.
He has worked as a financial analyst for a Fortune 500 company, project manager for a nonprofit institute, and ran a family business plant nursery with 45 employees. While working at a cancer research institute, he made the decision to change careers and go back to school to become a physician. After graduating from the University of Louisville School of Medicine, he completed his training in family medicine in Columbia, South Carolina.
He chose the specialty of family medicine because of the wide spectrum of illnesses that he can treat as family medicine. Physicians are trained to treat newborns, pediatrics, women's health, adult chronic disease, and geriatrics. During his training, he studied different practice models and chose to open a direct primary care practice because he believes that it provides the best opportunity to truly connect with patients.
As a former business owner, he understands that providing quality customer service requires time. Another huge positive of being a D P C practice is that he can save patients money on medications and labs when he's away from the office. He enjoys playing golf, running and gardening. He also loves spending time with his wife, Rebecca, their two young children, John Michael and Ali Claire, and the rescue dog Ru.
Welcome to the podcast, Dr. Lovelace.
Thank you. Thank you for having me.
This is such a treat. I, this we're recording probably end of summer-ish here and we've been trying to get you on the pod for quite some months, uh, since I met you at, uh, CLU Orion and Aaliyah Gupta's Mastermind last year. So I'm super excited to have this conversation, conversation.
I just wanna kick it off with the fact that your journey into med school was a little bit different than somebody who's going from high school to college, to med school. And so tell us about what was life like before you even started med school. Before med school? All right. Well, that's a story in itself.
So kind of briefly, I went to, I grew up in upstate New York, uh, bounced around, went to a ton of different public schools, and when I finished high school, I. For some, I actually, I know why I went. I went to New Orleans for Mardi Gras, so it's, this is strictly on nothing academic about this and had a great time.
Shocking, uh, 18 years old in New Orleans during Mardi Gras and Loyola University was there and I applied to go there and I got accepted and went to college down in New Orleans, got a finance degree and when I graduated, moved out to Phoenix, Arizona and started working in finance. I did that for about 15 years total.
Uh, shortly after getting moving to Phoenix, I went to Arizona State University and got my M B A in the evenings. And throughout that 15 years, I was a financial analyst, a project manager. I worked for some Fortune 500 companies, um, Lockheed Martin, Xerox, Xerox. And then I also worked for a small family business in central Louisiana running, uh, growing plants and a nursery.
So it was like a 200 acre nursery. Then in my mid thirties, I actually, well truth be told, in my mid thirties or I got divorced and I literally had like a reset moment where I had flexibility to go wherever I wanted. And medicine was in the back of my mind for, for many years. And I think like a lot of non-traditional students, we had plenty of logical reasons not to go to med school between time and cost and not sure if you're gonna get in.
And so I actually went and worked for a genetic research institute in Phoenix as a project manager to try and bridge science and business. And I did that for about two years and, and realized it was interesting, but I realized I was more interested in the clinical work that they were doing as opposed to the business stuff.
And so the University of Louisville has a post-bac program for folks who don't have a background in science. And so I applied to that program. I got into it. And that's basically how I got into med school, was through a post-back program. It was definitely a long road. I, I quit my job and started at, you know, bio 1 0 1, chem 1 0 1, physics 1 0 1, and did pre-med for two and a half years.
And so in my class, little fun fact, I was the oldest person in my class. So my first year of med school I turned 40, uh, in the fall.
And here you are. I love it. Like I am cheering over here on this side of the mic because one, I am also a Postback grad, um, between uc, Davis and I did a Creighton Postback.
So Awesome. I definitely wanna ask you more about that in a second. But also, like my lecture buddy was Dr. Steven Barbie, and he was also a non-traditional student. He was, I, I think there were two people who were non-traditional who had careers prior to medical school, I believe. And he was one of them.
And we were lecture buddies every single day. We would be like, I. Oh man, this is, oh, that's the, it's the hat dude. Or like, oh yes. It's a rollercoaster dude. Like I enjoy talking to him so much because he had so much life experience. I believe he worked for nasa, if I'm mistaken. I apologize Dr. Barbie, but he's an internal medicine doctor and it's so funny, I, and I think I've mentioned this on the podcast before, but like when we were on the Creighton Selection Committee for incoming medical students, number 10 was, what was your MCAT score?
Number one was like, would you want this person to be your doctor? Like that type of question. Mm-hmm. Like the life experience that someone has coming into medical school. Like I remember, I think Dr. Siri Carney was, uh, she had done phlebotomy before. Mm-hmm. There were people who had, you know, not necessarily careers before, but definitely different experiences coming in, like camp counselors and accountants and all this stuff.
So I just love that you brought such a rich, you know, history and background already when you started learning about. How to take care of the human being because all of what you've learned, I'm sure, has influenced you in terms of not only your medicine, but also your business decisions. Yeah, it has, you know, one of the advantages of being older and going into, like I said, I practiced business for 15 years, so I was a patient, you know, I didn't know anything about medicine.
I wasn't involved in medicine, and so I got to experience primary care in the quote traditional system. And, you know, the difficulty getting in the short appointments, um, the surprise bills, I, I mean, I got to do all that. So when I started designing my direct primary care practice, I have those thoughts in mind.
Like, how would the patient experience this? And how would I wanna experience it as a patient? So that is definitely an advantage of being an older med student.
Well, you know, it, it was the same at Creighton for me. You know, I wasn't necessarily non-traditional in terms of, I didn't have a full career before. I mean, I worked for like odd jobs between medical school and undergrad.
For me, you know, taking a test is the hardest thing ever in my life. Like I sometimes having, you know, being a mom of young kids is even easier than taking a standardized test for my brain. Mm-hmm. And my ability to sit down and in a room of, you know, other people typing on the computer for seven hours, like, oh my God.
I'm sure other people are having flashbacks to that too. But Creighton, even though I wasn't a quote unquote non-traditional student in the sense that I didn't have a career before, I absolutely felt so much more confidence. Getting into a program where as long as we maintained a certain G P A and a certain MCAT score, then we would be guaranteed admission.
The way that it worked at Crane at the time, I don't know if it's still the same, was that every year you matriculated with your class, you earned basically your postback tuition back. So every year you would or earn a quarterback of your tuition. So I basically was able to go to Postbac for free because I matriculated every year with my class at Creighton.
So I just love that and I, you know, I, I think about people like Dr. Cindy Daishi. She opened D P C right out of residency, but people who are like yourself, myself, Dr. Daishi, who are like. We're gonna go to med school, we're gonna do this. Like, how, how do we do this? I mean, even Jennifer, Dr. Jennifer Allen, like, she had a very different way of getting there, rather than like, I applied and I'm in.
Like, that's, that's how most people get in. And that's awesome, but for the rest of us who didn't get in that way, this is why you're sharing your story. This is why it's important. So when you were thinking before that medicine was always in the back of your head, why was it in the back of your head?
I was always interested in the human body.
I was interested in science. Um, you know, at that time we're all obviously naive to how medicine really works when you're thinking about going into medicine, you know, it was like, see a problem, solve a problem. Like, uh, you know, in the business world I was a problem solver. That's what project managers do.
And so you combine the science and the interest in the human body and then the opportunity to solve problems that are just straight in front of you. And it sounds like an an exciting career. Obviously once you get into it, it's a little bit different. The actual, you know, trying to help folks and insurance and working through the systems then, then the problem solving becomes more challenging.
But that's really what drew me into it initially.
Awesome. And then at what point during your medical school journey did you decide that family medicine was gonna be the career path for you? I went into third year with a pretty open mind as far as what I was thinking of going into. What I kind of noticed for me and my personality was that when I was on a specialty, you know, let's say we were on pulmonology, like, you know, it was interesting, but there was also other components of their health that were factors that I was also interested in.
And so it kind of reinforced that as a family medicine doctor, I wanted to, uh, be able to talk about any part of the body. And then at the end it came down to internal medicine versus family medicine. And I picked family medicine more because it's more outpatient based as opposed to internal medicine was at the time.
Awesome. And your, uh, desire to find problems and solve them. There's a, a lot in family medicine, so good choice. Good choice there. Now when you had finished your residency, you went to residency outside of Louisville, you went to South Carolina, and then you went back to Louisville after residency. So when you were in South Carolina and you were doing your residency, had you always planned to move back to Louisville or did you think about staying in South Carolina?
So when we were, you know, my wife at going into medical school, I was then dating my now wife. And so, so I was married in med school and so we were, when we were looking at residency options, we were both interested in living in the Carolinas. So that was part of the interview trail that we went on. And so we liked Columbia when we got there.
It was hot and, and it was just funny 'cause I lived in New Orleans and Phoenix and Miss, and Louisiana and my wife also lived in New Orleans, but we were both like, Columbia's hot and we had such a good time in Louisville. The weather's, you know, a little more temperate and, and it's a fun town and it's a great place to raise kids that while, you know, basically halfway through residency we both knew that we wanted to go back to Louisville.
And during med school we had established friends here too. So we had something to go back to. So we were pretty excited to go back to Louisville.
Awesome. I, I'm, I'm laughing because you said, you know, I, I was in Phoenix. I was like, I'm like, it's, it's uh, it's, and it's, it wasn't, you know, 2023 when you lived in Phoenix.
'cause now the weather is very, very hot now. When you were. You know, you chose family medicine, you're in residency, and you had been a patient also, like you mentioned yourself and you, you had an idea of, of what the ideal family medicine doctor would be able to do or what, you know, the ideal family medicine clinic would be for you.
Did you seek employment after residency in Louisville, or did you start planning your D P C while in residency?
I started planning my D P C in residency. It was probably early in the second year. I did, you know, just to be thorough, I did look into employment opportunities in Louisville because I think when you're making a decision, like, you know, starting your own practice, you wanna know what you're giving up.
And also because until you can evaluate all the options, you really can't make the best choice for you. So I did explore working for, you know, the traditional healthcare network here in Louisville, but I had convinced myself and, and my wife, we were both pretty sold on starting D P C straight Outta residency.
I love it. And when we talk about your experience as doing financial project management and doing the, being the person to look at all of the options financially, when you were looking at job options and you were, you know, looking at all of the, the options in Louisville for being an employed physician.
Mm-hmm. What were some of the things that, you know, to this day stick out in your mind as to like, this was, you know, a red flag or this was something that would not work with my future plans, or this is something that people should look out for if they're in that same boat, graduating residency or about to graduate residency and looking at employment positions.
Yeah. At that time, you know, the funny thing. The funny thing, the biggest factor that came into play was one, did I wanna work for somebody? You know, I was in the middle of residency and as we can all say, residency isn't fun. And so it's like, oh, I could keep doing more of this. You know, the 10, 12 patients every half out half day and stuff like that.
So there, there was definitely that factor. But I was also looking at my age and at that time we had our, our son and then our daughter was, was coming along. So we had two kids and the thought process was, was, okay, let's say I'm gonna graduate residency at like 46. Am I gonna go work for a hospital network for five years and then making some money and then go back down, dropping my pay down to nothing.
And starting a business at 51 with seven and eight year old, you know, kids under 10 years old. And talking with my wife, we both realized like right outta residency was the time to start for us. Because we were used to resident salary and it was like not a lot of things, more motivating than having your back pushed up against the wall.
You know? It was like, there's no back, there's no paycheck coming in. It's you. You gotta sell the practice. You gotta start the practice, you gotta work the practice. And if you, and so basically we were highly motivated to get it off the ground, straight outta residency. So that's, that was the thought process that I went through now three years later, and being a finance guy and kind of knowing what it is to run a business, what I would say is it is not the worst idea to go take a hospital job straight outta residency.
And here's why. Because one, let's say for example, I was in Columbia, South Carolina. And yes, it was during the pandemic, but even if it wasn't, I can't do any on the ground marketing in Louisville until I'm here. I mean, sure, I could come up for a weekend, but you're not gonna run around and say, you know, I'll be your doctor in six months.
So, so that puts you at a disadvantage when you're trying to start a business remotely. You know, from out of town. Number two, you, you get a salary day one. They also help you with moving expenses. You get a sign on bonus, majority of us have student loans. You get loan repayment. Even if you only do it for two years, you probably get $50,000 from that.
And then the next thing is, while you're practicing in that town, let's say while I'm practicing in Louisville for the hospital network, that's when you build your reputation. That's when you, your patients get to know you, their family members get to know you. Let's say after two years or three years, you've hopefully paid off some of your loans.
You built up some nest egg and some savings. You now have a name, your name that you can use to get your practice off the ground. When you go on the D P C Facebook page, a lot of the folks who were established physicians, they start day 1, 25, 50, 75, a hundred patients. If you're, let's say you're, you know, for easy math, if you're, uh, charging a hundred dollars a month, you know, there's a big difference between having zero revenue and 2,500 or $10,000 a month revenue on day one.
That increases the probability of you having a successful business tremendously being able to start day one with $10,000 a month in revenue. So for me, it was the right decision to go straight from residency into my own d p C practice. But if you've got a lot of debt and you're not comfortable with it and, and you're not, you know, backed up against the wall like I was per se, you know, partially due to my age, it's not the worst idea to go make some money, save some money, build a reputation, and then be able to hit the ground running when you start your D P C.
Love it. Bring us back to second year of residency when you're thinking like, oh my gosh, I could be doing more of this the rest of my life. How did you learn about D P C back
then? I learned a little bit about it during med school, and then I think I started, I found some couple of podcasts. There's some like old podcasts, I think they're from like 2017 or stuff.
But it was, and these were like the early folks in, in D P C who were starting their own talking about different components of starting a d uh, direct primary care practice. So yeah, during like first and second year, that's when I started researching it and really looking at the pieces on, on how to practice.
Now for me, I knew the business side, so like I understood the revenue, I could figure out how much my cost generally was gonna be. The, the hard part was figuring out the sales part because you, in, in medicine, you know, in direct primary care you're selling your practice. You're to your patient, you're convincing them to pay you when they think they already have healthcare through their health insurance, you're also convincing them to pay you today when they know they're not sick and they feel like they're not gonna be sick, but you're convincing them to pay for the membership and the subscription to.
Or when they are sick that you'll be available to them. And so that's definitely a skill that I still struggle with, but I definitely had to, to build when I, um, started my practice and was going through the startup process. And as you, you know, shared with us that for you it was right to start out a residency into your own D P C and you're back in Louisville before you opened.
As you talk about, you know, you already knew how to do the finances, what are some of the things that you, you did leading up to opening in terms of making sure that you were going to be, you know, financially set in terms of having a backup plan, having enough money to fund the first six months or the first year of your practice, and what are some things that you would suggest people do, like learn how to do a p and l, those types of things?
Yeah, so it was interesting, I was thinking back about, about this. So I opened my practice August 1st, 2020. So it was pretty much, you know, obviously right in the middle of of Covid. So the things that I would say were the key things. So there is this thing called a financial runway. You kind of alluded to it, which is how many months of of expenses do you have in cash today?
And because basically, let's say your monthly expenses are 10,000 and you've got $30,000 basic, you know, in three months you are broke, your business is shutting down, you gotta get a paycheck, you know, starting day 91. So you gotta figure out one, how can you minimize your expenses? So how can you take it from 10,000 to $5,000 per month?
And two, how do you build that nest egg from 30,000 to 50,000 or 60,000 so that you can extend that financial runway. So what we did, I just, before Covid started, I was able to do some moonlighting. We did, we were able to save some there and then my wife was working as well as I was doing residency. We didn't have a fancy house and we had same cars.
I still got the same car I had then, so we didn't have car payments and stuff. So we were able to save money and build up cash, uh, nesting. Now I mentioned the covid part, and we all, I forgot about this, but you used to get checks like every month or every six months, they'd be like, here's a thousand dollars per person.
And we had four people. So we would get these lump sum checks from the government and we got like the childcare credits, like they doubled it one year. And so we had all this extra, just like everybody else in the economy, we had all this extra money that we were able to put aside to build up, um, to extend our financial runway.
So we had, you know, six to seven months, let's say, of, um, cash saved up. So that's how we were able to do it. And that that is, Literally I, the one takeaway from this is that is the most important thing. It is hard for non-business people to believe this, but you can have the best product, you can be a doctor.
You know, it's like, who doesn't need a doctor? Like you can find a job in 48 hours, right? A bank will not lend you money if you do not have a successful business. They will not lend you money on potential. They will talk about it, but they won't give you the check. This is how crazy the banking business is.
But you need to know how it is before you go into it. So my wife worked in the hotel business. She was laid off during Covid, and then I finished residency. So we didn't have any quote documented income on day one. Luckily we had already bought our house and, but back then, you know, interest rates really low.
So I talked to 'em about, Hey, we've got some money. Can we refinance this? We already own the home. And the banks were like, no, we can't because you have no verifiable income. And I'm like, but I'm a doctor. You know, I could go get a job tomorrow. Like I said, What ended up happening was six months after I started it, I got a W two job with a, you know, as a moonlighting gig and I got two paychecks and I called up the bank and they were, you know, and I'd already spoken to them and they're like, okay, great, you've got two paychecks.
We will now refinance your half a million dollar home on two paychecks. And that's the way the banking world works, is they feel that the W two paycheck is guaranteed. And your business, regardless of how successful it is or how successful it's gonna be, it is not really guaranteed until it's already happened.
So a lot of times it's two years where you've been making good money. So like the first six months where you're not making money, they don't count. Like it's two years of steady money where they will acknowledge that as as income. And so that can really put you in a tight spot. When you're trying to like move to a new city and buy a house or finance a car or anything like that.
So that goes back to you have to have enough cash when you start your business day one to cover your fixed expenses for six months or nine months, or ideally a year because you're really the only one that's gonna help you. And once your credit card company finds out you don't have regular income, they're gonna drop your credit limit.
And so you will walk day one, you'll be like, oh, I got $25,000 on my Chase card that I can use whenever I want. And then they find out you're not working and all of a sudden you've got $2,500 in credit limit. And yeah, they, they actually, chase did call me like shortly after we moved back up to Louisville and they were like, we we're a little concerned what's going on with your credit card?
And we had just moved into a new house, so of course we were buying things and it's like we were. Buying paint and all furniture and all this stuff, but they watch it closely. If they see that you are spending abnormal, they will either just cut your credit and ask questions later, or they'll reach out to you and say, you know, what's going on?
And that can be, that can be detrimental when you're trying to run your business and you're using your credit card as your backstop, because in reality, it's not a very solid backstop.
I'm so glad you're mentioning these realities about, especially leaving residency and you're not necessarily making more than $50,000 a year as a resident and then moving and, and doing all these things that you went through.
Let me ask you there, when you talk about refinancing your home, are you talking about a line of credit because you said you owned your home, or, or did you refinance it in a different way? Like, uh, using a mortgage to refinance your home? I. Yeah, in our case we just wanted to refinance it. 'cause I think we had, you know, we were taking it from like four point a half percent down to like two point a half percent.
So we were just taking advantage of that. And so it wasn't, we weren't pulling out money for that purpose. We were just saving money. And Can you speak to good credit versus bad credit? 'cause I'm sure there's some people out there who are like, ah, I don't want any debt at, at all. I don't want any more debt to add to my student loans or whatever.
Yeah, that, that is a tricky question, but it's an important one. So yes, if you are somebody in the credit world, if you are somebody who's never bounced a check, you've never needed to take out a loan, you've never needed a credit card, you know, you paid cash for everything. You bought your car, you paid cash.
You've always, let's say you've always rented or you lived at home in the credit world, you don't exist. They have no history of you, of somebody lending you money and then you being reliable to pay it back. I'm not saying you want to go out and take out loans unnecessarily, but when you can. So let's say you're a resident and you've got a steady paycheck, and let's say you've never had a credit card and you wanna make sure you get a credit card, even if you just charge your Netflix to it and then pay it off at the end of the month.
One that shows that you paid your debts on time, so that improves your credit score. Two, it also shows that you don't rely on your credit card to fund your life. So this is a tricky thing. They give you a credit card because they want you to spend money, but then they don't want you to spend too much because if you do, you've almost maxed out your credit card and now they're worried that you can't really pay it off.
So that's where they call, it's like a percentage of usage of your credit. And so when you can, particularly, like, let's say when you're a resident and you have a W two job, that's when you wanna get your, um, credit cards established and that will establish your credit rating so that when you go to buy your home or when you, you know, need.
To borrow money, that credit score is gonna help you. So let's say, so let's give you an example. Two years into my practice, there was a building. This building came up available for sale, and so I decided to buy it. I obviously, I didn't have the money just to pay cash for it, so I needed a loan. Well, my business was successful, so that's, that's good.
That checks off one box and I was making money. That's great. Checks off the second box. But I had a good credit score. So those three things made them feel comfortable enough to loan me enough money to buy the building. If I didn't have a credit score or if I had a bad credit or a low credit score, they would say, yeah, you're making money and yes, your business is successful, but look at your history.
You don't pay your bills. And that's not, we're not comfortable taking that risk. And then the opportunity for me to buy the building would've been, would've passed or. They would say, we're gonna penalize you for having bad credit. And instead of it being, let's say 5% interest rate, we're gonna charge you 10.
And nobody else wants to lend you money. So either you want the building or you're gonna pay 10%. And that's when you get forced into really bad, uh, financial decisions. So yeah, so, so establishing credit is, is really, uh, an important part of, uh, moving into adulthood basically.
I love that. Oh my gosh. Yeah.
I remember very vividly, um, at uc, Davis in the quad there was like, open a free credit or open a, a credit card today and get three free posters. And the amount of people that I saw, just like getting all the posters and then having this, you know, like go crazy with their credit card experience, it was like, oh my goodness.
Like, don't do that, don't do that. But you know, as you talk about, like, even if it's just a Netflix subscription, like literally that is, you pay it off at the end of the month, you pay it off at the end of the month. That is like you, you're saying, super important to think about and one of the ways to build good credit.
Mm-hmm. And when you took out a loan to buy your building, did you go to somebody, some financial institution locally, or did you approach uh, a national financial institution? Yeah, so in med school, one of the local financial institutions sponsored a lot of our activities. So the basically it's, it's a, a good business plan.
So they sponsor activities in med school and then a certain chunk of folks stay in Louisville to go to residency. 'cause University of Louisville's got a lot of residency programs and so those folks now are eligible to buy homes. And so they kind of feeds into, they use that bank for, for physician approved loans.
So when I came, and I, so I knew the, the banker. When I came back to Louisville, I'm like, Hey, we're coming back to Louisville. I would, I need to open up a, a business account for, for the business. So I did set that up and so all my revenue went through that business account. And so when the building came up, I could point back to the business, to the bank account and go, here's the money that I'm making, or this is the money that I've got.
I also had to provide financials, you know, profit and loss statements, but you know, they could see the money that was sitting in the bank account. And they knew me personally 'cause I knew him from med school. And so that was going back to, let's say 2015. So this was coming up on like eight, 10 years that I, that I'd known the banker.
So he was able to advocate for me to the committee. 'cause there's always a committee that just makes the decisions on these loans. When I applied for the business loan for the building. So that is, you know, in a perfect world, if you can set up that type of relationship with a local banker, that that can be helpful when you get into those sticky situations.
And, and what I mean by sticky situations is, is let's be honest, I'm a doctor who opened up a practice a year and a half, and now I'm asking for, you know, hundreds of thousands of dollars for a building. And what are the chances that the, that my business fails? I mean, that's another reality about running a business is there are many good businesses that fail for reasons that are the owner's responsibility and reasons that the owners don't control.
And so the banks have to take those things into consideration. So having that relationship with the, with the local banker, I think really helped work through the process, uh, when I was applying for the loan. So, And can you speak to longevity of the loan a 10 year versus a 20 year versus a 30 year and paying off a loan too early?
Yeah, so this was something I didn't know about 'cause I'd never done a commercial loan before. So what I got was, uh, the way it worked, or at least the way it was proposed to me, is it's a seven year arm loan. So that means that the interest rate is fixed or will not change for the first seven years. But the payment schedule is based on a 20 year loan.
So basically it's set up that if I made the same payments over 20 years, the loan would be paid off. So that's what that means. But after seven years, The interest rate's going to adjust. So, you know, I still got five more years, but let's say it were to change, you know, adjust today, it would be significantly higher than what I got a year and a half ago or a year ago.
So, but that's the way, or that's one way that commercial loans work the far as paying it off too soon. I haven't run into that problem yet, but I am, I, I mean, but in all truthfulness, I am paying down the debt. So that's one of the things I'm like fiscally conservative. And when I can, again, keeping my financial cushion, keeping my financial runway long.
If I now have excess funds, I can look at, okay, what do I, what debt do I pay off? And so right now I'm gonna pay off the business. Building debt. And in part, and this is just my own personal decision, in part because that once I pay off that asset, that's an asset that can pass down to my wife and my kids in the event that I die, right?
If you've got the building and a huge mortgage, then basically once you die, they're, they're just trying to sell the business to pay off the mortgage and the asset really kind of dissolves. So that's part of my financial plan is to pay off this asset. So now it's available to go on to the next generation.
Love it. So you're in Louisville after residents say you're opening up your D P C in the middle of this amazing pandemic. How did you start getting people to join your practice? So you, you talked about that, you know, that this is something you're still working on, but. How did you start and what have you changed in terms of marketing and strategy to get the word out about your D P C?
Yeah, so it's kind of looking back, it's a funny story. So patient number one who is still with me, but patient number one, I was down in Columbia. She called me up and she said, I heard from my daughter from who heard from a friend that you're opening up this type of practice and this is what you're doing and I want to be a member.
And I was like, okay. And so I'm like, I'll open up in August. And she's like, that's fine. You know, here's my phone number, you call me when you're ready. And I was like, okay. And I, and so I got to like set up the E M R and I sent it to her and, and she signed right up. And I was like, well, this is gonna be pretty easy, you know, all people need, I.
Tell 'em I'm open. Right? And that's not the case. It did not grow like that from that point on. But it was limited by Covid. You know, you couldn't do group events. Um, there wasn't a lot, you know, you, it would be crazy to go door to door and talk to people and stuff. We tried a bunch of different marketing things.
We did some mailers to businesses. We did mailers to homes. Um, we signed up for one of those like mailers where there's like 10 different businesses on a postcard that goes to a zip code that really are cheap. But honestly, they didn't, it just didn't work for, for my practice and stuff. I talked to a lot of people when I had the opportunity.
Again, during Covid, you really didn't have a lot of opportunity to do that. I tried social media, like Facebook postings. It's just not something that I'm, I'm not comfortable with it and not great at it. Basically, every time I post something, you know, I get some comment about somebody talking, you know, you post like the flu shots available and the person says, you know, by the way, that flu shot causes the flu and blah, blah, blah.
And I just don't want to have like, deal with that. And then generally speaking, it didn't really, it generated clicks, but not membership or traffic at that point. You know, again, go back to the financial runway, the ca the cash cushion. I'm spending more than I'm bringing in. 'cause I got one patient, so I'm bringing in, you know, 80 bucks a month.
So it's like, okay, what are we gonna do to generate revenue? And so I had some people who walked, knocked on my door and they were like, you know, are you a doctor? And I've got, you know, this rash, which, you know, shingles, whatnot. Can you take care of it? And I'm like, well, this is what I do membership wise and da da da.
And they're like, well, I don't want a membership, I just, but I'll pay you if you can take care of this right now. And so at that time I was charging $80 a month for membership. And I was like, you know, you gotta charge more. So I was, I just pulled the number. I looked actually at the competition and the urgent care visits were going for $125.
And so I started doing some urgent care visits. Not many of them converted, but they brought in revenue. And so, you know, it wasn't crazy. I might have done five to 10 a week, so you know, 500 to a thousand bucks a week, which is $4,000 a month compared to $80. And then through the D P C Facebook groups, I found out about the veteran disability exams.
I actually knew about that before. I mean, I knew about it when I was in residency, so that was one of the things I worked on when I was starting my practice or setting it up, is I started that enrollment process and training process with the Veteran Disability Exam Company. It still took a little while.
It took a while to get it off the ground. So I opened in August. I probably didn't really see any significant volume until November, just 'cause it takes that long to get everything going. So, you know, I reached out to them and it's like, okay, we're ready to get this going. 'cause again, I needed to generate revenue and it, and it's very cliche, but every, everybody says, you know, word of mouth is the key to marketing.
And of course it's like, well, you can't get word of mouth until you have people. But it, it did pick up once I got to like 75 a hundred people, people, I. Like their spouses, interestingly, their spouses started to join, and then family members, coworkers, that kind of thing that, that started to pick up. I do want to bring up this, uh, this is another business concept that I think is important for people thinking about going into D P C.
When I first started, in my mind, and this was naive, but in my mind, I thought that I was going to basically have, you know, let's say 500 people and I was gonna provide them primary care services. They were gonna be happy, they were just gonna come to me because we were offering a better primary care service.
And the reality is we're all similar. You know, we just don't like to pay for primary care service if we're not using it unless we've had a bad experience in the traditional system. And so, going back to that urgent care thing that I brought up is that people were willing to pay me for that visit. And you know, when you're making money, you can make the choice to not accept that revenue.
When you don't have revenue coming in, you have to decide, okay, am I going to compromise and see an urgent care patient and put money in my bank account or deny it, right? And then in that case, you're just gonna work down your cash or spend down your cash. So you have to make that decision not only as you know as a physician, but also as a business owner.
The other thing is you wanna look at the market that you're in and see where the other competitors are not satisfying clients. And so I opened up during covid and one of the things that, ancient history, it feels like now, but you, if you were to traveling international, you had to have a covid test within a small window of time.
A lot of times it was 48 hours or 72 hours. And in the traditional settings, you know, the Walgreens CBSs, the hospital systems, they were having so many people being tested that they were getting the results back 3, 4, 5 days. Basically you couldn't travel without a test, less than certain timeframe. And I found out about this randomly.
I had a gentleman call me up and say he needed a test, but he needed the result in an hour, which was unusual at the time because like people just wanted a test to find out if they were sick or not. And so he came into the office, we talked about it, and come to find out, Germany had changed their policy that day and now his test that had already been done was invalid.
And so I was able to turn, you know, just regular antigen test, I was able to turn it around in 15, 20 minutes. I wrote up a general note giving him the results. And that got me started thinking about, okay, how can I fit the community's need? And you know, is this a business? Is this an idea that I can, a business idea that I can implement and turn into a business or a line of business?
And long story short, I was able to not only do the antigens in my clinic, but I also got some, um, ID now Abbott, ID now machines, which were P C R based, um, machines, which a lot of the countries required P C R only. They wouldn't accept the antigen. Not only that, I did online scheduling, so people had to make appointments.
They were spaced out appropriately so I could turn around their test, give them a report within 30 minutes. The reports looked legitimate. Uh, a lot. I, you know, you'd see some other folks, they would make a photocopy of something, then check the box that said negative. And of course, the airport wouldn't accept it.
They would get P D F copies and then basically I said, this is the product that I'm going to deliver. And then I delivered it. Then with, I end up using Calendly for all my scheduling, which is an important factor because Calendly, one of the things it does is it allows you to request Google reviews. Okay, so going back to this, I'm doing a lot of tests every week.
Well, let's say 10% of 'em respond to the Google Review. You know, I gave them a good experience. I said I was gonna do something, I did it on time, and I did it, you know, and it was a clean office and, you know, everyone was nice. They would leave a five star review. Then when folks were looking for primary care doctors, they would see this doctor's office currently that has like 245 or 250 reviews at a 4.9.
And it's like, okay, what's going on? Why there's no doctor's office that has 4.9, let alone this many, but that initial covid testing is now what's driving my primary care, uh, business growth. But the key thing there is, or there's a couple of key things there. Find out what your competitors are not providing to your patients or to the community, and ask yourself, is this something that you want to do?
And can you make, you know, can you make money at it? Then two, if you're gonna do it, do do it well so that you get a positive review. And then three, you gotta figure out a system. I happen to use Calendly, but you gotta figure out a system to get yourself Google reviews because as consumers, as you and I, as consumers, Google reviews drive our decisions.
You know, if I go to a new town and I'm looking for a tire shop because I got a flat tire, I'm gonna look at the Google reviews and see who's got, I stay away from those who have bad reviews, but go towards those that have good reviews. So even making a decision, you know, where do I get my tire fixed?
That comes into play. And so it definitely comes into play when you're picking a primary care doctor.
It totally does. And that's one thing that's important to keep in mind for those people who are, you know, planning or like currently in the opening stages of D P C is asking, how did you find my practice?
And, you know, even to this day in a small town, I literally have people who are like, oh, I found you on Google. Like, oh, you're, you're the doctor. Like, they walk in, they know it because that my picture's on big tree's, MDs, Google Business or Google my business, whatever it's called now. But yeah, I, I totally agree with you and I love that by talking about your, your financial runway and now talking about diversifying your income.
I think that it's really smart whether you're doing side gig, whether you're doing different services, one-off services, like you're, you're talking about everything at the end of the day, if it's in alignment with what you want to do, And you're still able to take care of everybody that you need to take care of, including yourself and your family, and financially, it's, it's working.
Then, you know, this is where if you've seen one D P C, you've seen one D p C. So I love that you've taken this diversification to your advantage and it's helped you, but that's an incredible amount of Google refuse. Like, that's, that's amazing. So let me ask you there, because as you're growing your practice out, your kids are little, um, at the time they were four in one when you opened, how did you balance doing all the things?
As you know, Dr. Lovely said, Derby City, D p c, and being present as a husband, and as you know, just Dr. Lovelace himself as an and as a dad.
I mean, honestly, I probably didn't do it. I didn't do it as well as I should have. I'll be honest about that. You know, in the beginning I was so hyper-focused on generating revenue because it was, you know, we had a mortgage, you know, we had utilities and daycare and all this other stuff going on, right?
So we had expenses that weren't gonna go away. And so it was like hyper-focused on generating revenue, buying more time to get the business off the ground. 'cause I really did not want to go work for a hospital system. And I thought, I think about this by this six months point, the D P C really wasn't growing that, that fast.
And I had plenty of time. And so I started looking for moonlighting gigs. And so I found one that was basically with a company that, uh, offers, it is like employer based healthcare. So they didn't bill insurance so I didn't have to be enrolled. So it matched up well and they needed doctors and they had part, uh, you know, evening shifts and stuff like that.
So it was really good fit. Well, it was a startup. They had plenty of work and I had plenty of free time. So I ended up work signing up for like 32 to 40 hours there, right? And then I would be in my clinic for 20 to 30 hours a week, you know, just available for my patients, answering the phone calls and trying to figure out marketing and stuff like that.
So I had inadvertently scheduled myself like a resident. So I had scheduled myself 80 hours a week, but I was getting paid for those hours. Now granted, the D P C wasn't making that much money, but I was getting paid for the veteran exams. I had a few members, I had a few urgent care visits, but then I was getting paid basically full-time pay from my moonlighting gig.
And I got health insurance and 4 0 1 K C M E money, like, you know, it wasn't a, it was a good deal for me, but the trade off was, I wasn't home a lot. And so, you know, if you say, oh, how were you as a dad, if you just looked at it from like, were you, you know, there No, the short answer is no, I wasn't. But the long answer was, you know, I was making money so that we could live this lifestyle, which I have, I've improved since then.
Uh, really more in the last, like three to six months as far as being present in my children's lives. Because, yeah, I worked hard for like two, two and a half years, paid off debts, saved up some money, and it was like, okay, I could keep running this same pace and keep, you know, trying to make a lot of money, but is it really worth it?
And, you know, and I, and I did talk to, I got some good, good advice from, from folks who, you know, had older kids and stuff and knew about my business and, you know, they were just, you know, just, just a heads up. They're growing fast. You're, you're not gonna get this back. Um, you know, just be careful because yeah, next thing you know, they're 15 and they don't want to see you anymore.
So in the past three months, I've cut back my moonlighting gigs. And so instead of being scheduled three nights a week, I'm sorry, two nights a week and a, and a weekend day, I'm only doing p r n shifts. And so three, I have to do three shifts a month. So I went down from 12 shifts a month to three. There's obviously financial trade off, but now I'm intentionally able to participate in my, you know, I was able to do baseball this year and soccer and, and my son's doing first tee golf.
And so like I'm able to be a lot more involved in the kids' lives. I. It is crazy. I got to do one for my son and one for my daughter. Like, uh, first grade in kindergarten and then my daughter was preschool. I got to do like, you know, go in and talk about career day as a doctor. And yeah, those, those kids can be intimidating.
They, they, they come at you with a lot of questions and, and, um, but you know, if I worked for a regular hospital network, there's no way I could take off a Wednesday at 10 o'clock in the morning and go hang out at preschool for an hour. But like, you know, my daughter loved it, you know, and, and it was a fun experience and we got, you know, hang out with her, her friends and stuff.
And the same thing for my son, you know, it was like eight o'clock or nine o'clock in the morning on a Tuesday, and we all, and it was a last minute request or like, you know, two weeks out, something like that. And we all know, like you can't just go into your regular clinic at, at x, y, Z hospital and say, oh, I need to come in three hours late that day.
You're already booked. So yeah, it's like even if you want to be intentionally involved in your kids' lives, you need to know these things six months out so you can beg to get to come in late for two hours so that you can do, you know, something at the school. And, and by me cutting back on my hours and being a D P C doc doc in the last three to six months, I've definitely been able to do a lot more activity with kids.
So, like I said, in that area, I've definitely improved since from when I started. Well, I
appreciate you, you know, sharing and being so open and honest and vulnerable about that, because I think that, you know, when we go through these D p C journeys, like there's things that we might wanna change. There's, you know, there's things that we might wanna improve on.
But the fact that, like you said, you're not in a hospital setting, so you could easily say like, I determine my schedule. I'm realizing that this is my priority now. I need to make my work things align with my priorities because, you know, these are the priorities that I'm setting first. And so I think that's so important for people to hear, um, especially if they're, you know, with young kids or with older kids who still want hugs from their parents.
Like, I aspire for that when I, when our kids are bigger. But you know, or the people who are planning to have families. I think that that's really important to hear because, you know, patients come and go, but family is family. So when you, from this place of, you know, three to six months ago, you're like, Hey, I, I need to realign my, my intentional time with my kids and my family and I need to, I need to adjust so that everything's working with my priorities.
You do offer an awesome amount of services in terms of, you're gonna be doing f a a physicals on your website. You have listed a medical cannabis. You have, uh, A D H D and mental health, Botox and Xeomin, as well as d o t physicals. So as you've shared, like you use Calendly, and I was super impressed by that.
'cause I was like, you know, trying to schedule myself into all of these appointments and I'm like, man, they're literally like, you can have all of these different services on the same like Monday, Tuesday, Wednesday. So when you were trying to figure out. Like what will will work with my plan? Did you set a certain number?
Like in Calendly you can, you can say like, I only allowed these many a day. How did you incorporate diversification with these different services for members as well as non-members into your practice while still being in alignment with where you wanna put your focus and your time? Yeah, so each one kind of came from different, like they had different, I guess, origins, so, so for example, the D O T I was at a, uh, local business chamber meeting and one of the people there was complaining that the large corporate provider of D O T exams, that his employees were there for half a day and they didn't like it, he didn't like it, it wasn't really working for his business.
And he asked me, is this something that you could do? And so I wasn't planning on doing D O T exams, but I said, well, let me look into it. And basically you had to study for a week. I studied for a weekend, took, you know, got the information on Thursday, took the test on a Monday. Pass the test test and, and it was able to do it basically like within a week or so.
Now, truth be told, I've only done two. I got a third one coming up, so I really haven't even broken even on it. But it's there now, right? And the licensing is good for an extended period of time. And so now when people, it'll start showing up on Google and I'll start generating some additional revenue and basically any revenue that I generate going forward is 95% profit because I'm not spending money on marketing for it.
And I've already paid for the testing and stuff. So that's where that came from. The medical cannabis, Kentucky's got an unusual situation. Basically they wouldn't pass anything for medical cannabis, so the governor issued an executive order saying that he would pardon folks who had one of 21 conditions and they had a note from a physician stating that they had one of those 21 conditions.
They had less than a certain amount of me of medical cannabis and they had to buy it from outta state at a legal dispensary. So there was a lot of hoop that jumped through to qualify for this. Pardon? Well, unfortunately, and this is going back to you gotta, if you look in at the landscape and see what does your local medical community not provide and what are you comfortable doing and what are you willing to do?
If you find a niche, you can actually generate a business or a line of business from it. And so this medical cannabis certificate is literally a statement that states I have met with. Ms. Smith, Ms. Smith has Huntington's disease, and the local hospitals would, and physicians or local hospital networks would not allow their physicians to write that.
And so they would take literally folks with terminal illness, Huntington's Disease, P T S D, cancers, you know, multiple forms of cancer, you know, significant illnesses. And if these folks wanted to go outta state and buy some medical cannabis, the, they, the networks would prevent their physicians from writing these statements.
And so I didn't do, you know, I probably did 20, maybe 25 letters. Certificates, but I offered it as a service. And so I would get records from the cancer center and say, yes, this oncologist says this person has cancer. And, and so they meet the qualifications and then also make sure that they understood all the rules and stuff.
So that is where that came from. And then like the other stuff, like I was kind of interested in doing some Botox. I will say this. That was one of the things where I did it prior to leaving residency. I went and got training, and then when I moved up to Louisville is when I started doing it. And it's, it's a very challenging business to grow because your materials expire pretty quickly and, and it's word of mouth because it's a very competitive market to advertising.
So that's another thing when you're setting up your business, is you want to understand who you're competing against for advertising. So if you do wanna show up on Google Ads, If you are advertising medical cannabis in a state where it's legal, it's gonna be very expensive because they have unlimited money.
If the same thing for Botox, it's gonna be very expensive. In Kentucky, if you're advertising medical cannabis, there's nobody here 'cause it's not legal. So it's cheap from a Google Ads perspective. But like guess going back to it, the, the Botox I do more is fun, but it is not really a money generator at this point.
And that's okay. That's one of the things as a business person, you have to realize is that some of your ideas are not gonna work. And some of them you just have to end. And cut your losses. But some of 'em, like in my situation, the Botox, you can just dial it back. I don't spend money on advertising, but when my patients come in or, or neighbors or you know, people I meet, or if they happen to find the website, if they say, Hey, can you do some Botox?
Can you do some Xeomin? Sure, we can do that. And, and I just limit my inventory so it doesn't expire. But as a business person, you do have to realize when an idea's not working and, and then cut your financial losses and you know, just like you were mentioning before, like you're able to do that and then decide what you're gonna do next.
Like, you don't have to. Wait for somebody to approve, like, yes, we can change this workflow, or, yes, we can, you know, reduce the number of this X, Y, Z, and then increase the number of the other X, Y, Z. So I love that when I looked at your website earlier, you have pricing and you have like, you know, for your Botox it'll say, you know, like 10 to 25 units or whatever, and it'll have the price and you'll, you like, the price for your practice now has gone up from the $80 per member per month.
But what I really liked is that. You know, it'll, on like your mental health tab, it said like it's $99 a month for membership that includes mental health. And it's like if they missed that it was $99 a month to join your mem your, your practice as a member, it was like on multiple pages. So it was like wherever they landed from the Google search or whatever, you know, they could learn about the practice, especially about the membership.
Have you found it helpful to have pricing on your website? And if so, why?
I decided to put pricing on my website pretty, like you said, pretty explicitly because as a consumer I really get frustrated going to websites and not finding, okay, yes, I'm interested in this service, but realistically how much is it?
And so like for me, it's a pet peeve of mine. So again, I look at it from the consumer's perspective, so I was definitely gonna be listing all my prices and I, I try and list everything everywhere. So yes, Google a, a Botox clinic and you'll find half of 'em don't list the price, so, but they'll take your appointment and so you, I don't know, you just show up and then they tell you that it's 20 bucks a unit, 10 bucks a unit, whatever.
I like to put it all straight up front. That way when people call or when they make appointments, there's no gray area or anything like that. The $99 a month thing, like the individual, like the A D H D, the mental health, that was, uh, actually I got that lesson from a friend who's in marketing and he was, he basically mentioned that, 'cause I, I had it in a different format and he was like, you need to just come out and say it.
And, and, and it needs to be, basically they're gonna read the first sentence. And if they're not interested, they click away. If they are interested, maybe they read a few more, but if basically they're gonna click away at some point, none of us read the whole pages, but that's okay. And so I just wanted to, on each page, I want to drill down and reemphasize that this is membership, that this includes full scope primary care, which includes mental health, which includes A D H D, which includes primary care, at least for my practice.
And so that can be helpful for folks. 'cause there's a lot of niche providers now. So there are folks who just treat A D H D or folks who just treat mental health and it's even like, just straight up, you know, they only prescribe Zoloft. So it's not like they're managing multiple psychiatric meds or anything like that.
But that's their niche. And, and a lot, and a lot of 'em are online now and they will charge 80 bucks or, or between, let's say 80 and $150. And so what I'm trying to communicate to those patients is, You're already paying blank 80 bucks for just your Zoloft prescription for $99. You get your Zoloft and your birth control and your A D H D meds.
If that's in play and your primary care, like this is actually probably gonna save you money. And that's, that's part of the message that I try and, and deliver to the patient.
Love it. And when you were going about, uh, like you said, you know, you used to have the copy different on your website. Do you manage your website or do you have someone manage it
for you?
I managed my own website. I learned a lesson. So, so here's what happened. I was doing the covid testing. It was booming for international travel. I had my own terrible website up that I created myself on the fly. It looked like I created it myself on the fly, but people were coming to it and it was working and the Google ads were working and I was busy.
You know, let's say I was 70% booked. I mean, I was. Rocking and rolling. And I said, you know what, maybe if I hire somebody professionally and pay a little bit more, I can scoop up some of this 70% or 30% that was left over and, you know, maybe it's a, a better business decision. So I went through the process.
They were great, they were very nice. The website they created was great, but they didn't understand that I already had like a working product that was very niche and very time sensitive. And whereas they were coming at it from a, a thing like, we're gonna build this website, and then through momentum, over six months, you're gonna start, people are gonna find you.
And I'm like, no, they're already finding me. I need you to make me find more people. And unfortunately what happened is overnight, literally overnight, my traffic just bottomed out. And because it was a new, new site, new page and all this stuff in Google, it likes longevity. And so it didn't see this as an, it was saw as a new page, so it was not gonna, you know, pop it up top.
And then their ad cycles were all also messed up as well. So I tolerated that for about two weeks. I mean, I could see the revenue plummeting and 'cause the bookings were plummeting. And so basically after two weeks I turned it off and I said, look, you, you know, they made it, the website that they created was great.
It looked great, it really looked professional, but it didn't generate revenue. And that's the key. If you're gonna run a business, it's gotta generate revenue. So this is a tough choice when you're starting your own practice, okay? You need to spend money to bring people into your practice.
And, and so if you hire a web designer and they create a beautiful website and they optimize your search engine optimization and they come up with great ads and boom, that's gonna cost a lot of money.
Okay, let's just call it 25,000. Just pull it outta the air. Right? But you don't have any money 'cause you don't have any patience. And the reality is, let's say again at a hundred dollars a month, you need hundreds of people or a hundred people signing up with you really quickly to generate revenue, to just pay for that.
And then the other part of it is they're gonna maintain the website, they're gonna do edits. So you're paying monthly for them to also be your vendor because they're doing a service for you, which is fair. A lot of times your, your margin and your revenue growth just is not there on the d p C market to justify it.
You know, how many new patients do you want to take on, on a day? Two, three, maybe. You know how many in a week? Five, 10? Maybe You talk to folks who do 10 new patients in a week and they're just pulling their hair out and they're exhausted. Let's say it's five. That means your revenue can grow by $500 a week.
At $2,000 a month and you've sock down 25,000 to get the website off the ground, and you're paying a thousand bucks a month for maintenance, right? You're just sinking and you're just burning up your cash. And it's frustrating because that's when you need to do the best marketing, but you don't have the money.
And when you finally do have the money, you've got 200, 300, 500 patients. You don't need to spend marketing money. But that's the reality of being a D P C owner is, even though it's, it's in your gut to spend a bunch of money in the beginning and market like crazy and really go, you know, glamor and you're just spending money, you're not gonna, you're probably not gonna get a return on.
'cause even if a thousand people wanted to sign up with you on day one, you couldn't even handle it and you'd have to turn the business away, which means you turn the revenue away. And so there's basically, you're not gonna get that revenue. So that's a long-winded story saying I tried to do the professional marketing thing and it kind of burns me.
But then also secondarily, like when you're first starting, it's really dangerous to sign up with a professional marketing crew. Well, I think you've done a fantastic job with your website. Tell me about your logo. 'cause I, I'm obsessed with your name, like Derby City Direct Primary Care, like just, it rolls off the mouth and I get it.
You're in Louisville. I, but I think it's super awesome and I love your logo. So tell me about your logo.
Well, my friend who designed, it's gonna love this, but I have a friend who's a professional designer, graphics designer, and has been doing this for many years. And so when I was getting in residency, when I was coming towards the end of it, I, I reached out to him and said, this is what I'm doing.
This is what I'm looking for. And so he came up with some concepts. And so, you know, Louisville is the home of the Kentucky Derby. One of the nicknames for the city is the Derby City. And there are tons of businesses. There's actually a Derby City Dog, pooper Picker, pooper Scooper or something like that.
But there's Derby City Gaming, there's everything, right? So I, it does roll off the tongue and, and it obvious to everyone locally that it's a local business, so you know where it's at. The other thing that I find that's funny, but I think it's it's fair, is that nobody can sue me for trademark. I can't sue anybody else for trademark because it's Derby City.
Like literally everybody's using it like crazy. So a lot of times you come up with this unique, what you think is a unique name and come to find out somebody in California is also using that name. And then you get into this, you potentially can get into a legal squabble. So, but he, uh, he came up with it.
And the thing I really liked about it was that it didn't have any medicine in it. There's only so many locusts that can have a stethoscope in it or a heart in it, or e k g sign in it. And he had a few of those. And, but that, like, yeah, it jumped out at me when I saw the horse and I just liked the circle and it was just a really cool, and also it looks okay.
It looks good on shirts. That was something you gotta think about one. How's it gonna look on a business card? How's it gonna look on your website? How's it gonna look on a shirt? Because if you're gonna throw it up on a shirt, it needs to look okay. 'cause you're gonna wear it all the
time. I love it. Um, reminds me of when Dr. Erica Young in White Marsh Island, Georgia, she was talking about how like she wanted something that looked good on a sticker and she found a sticker on someone's like Vespa or something and it was her sticker on it. So I, I think your logo is awesome. So good job there. So, in closing, I just wanna ask, are there any other financial, you know, nuggets of gold that you.
Have, you know, experienced from the D P C space and now that you know, it's 2023 and you've been open, well, like literally it's three years since you opened, because today's August 1st that we're recording. So Congrat like happy anniversary. Thank you. That's amazing. Yeah. Are there any other nuggets of gold that you would like the audience to know when it comes to being financially savvy and being a D P C physician?
So, yes. One more key financial tidbit. I have a finance degree. I've worked in finance, I've worked on budgeting. Um, I have an M B A, you know, I got all this business background and so I never claimed to be an accountant. Really didn't like accounting when I had to take the classes. But I knew enough to get around.
I could, you know, like I said, read a p and l statement of profit and loss statement and understand the, uh, the reports. So when I opened the business, I got a regular accountant really on the cheap. And really cheap. And, and for the first like couple six months, it worked out fine because I didn't have, I had limited revenue and, and this person was able to keep up and everything was fine.
Right? Go into the next year, basically the second year of operations, the reports start coming in less frequently, like my monthly p and l reports. And this person doesn't live in, they don't work live or work in, in Louisville. They're in some other part of the state. And all of a sudden, like, I'm not even getting billed for their services.
And I'm like, this is weird. So we get to like October or November. Now I know that I'm making money because I'm able to do my own budgets. You know, I can see, I know what my costs are and what my revenues, so I'm comfortable with that part of it. But I'm like, okay, we gotta like tax seasons coming up and stuff.
And I'm not an accountant for taxes and so I just get ghosted. And I called the number, the number's disconnected, and this is like November. And I'm panicking because we as a young family, we had everything up in the air. We had like moved from one state to the other. We had sold a house, we had kids and, and retirement accounts and business and all this stuff, right?
And so thankfully I went to the D P C website and looked at the accountant recommendations and I talked to a few of them and, you know, explained the situation. And I got a, my accountant, and I don't know if we should say names, but if anybody wants to call me or email me, I'm glad to, to share the name.
But anyway, yeah, so we had like a heart to heart conversation. I'm like, I just laid all the cards out and go look. I've got 30 days and the year's over and I don't, I'm flying blind here on, on my finances and I don't even know if I can get the data because I don't have access to the QuickBooks that they were using.
But this person is very skilled and very good at their job and has a, a, basically a, a straight up pricing schedule. So again, before I even talked to 'em, I knew how much it was gonna cost because that was on their website. That goes back to my argument earlier. For me, my preference is you put your prices on your website.
So when people call up, they're not thinking you're $300 a month. They're not thinking you're $25 a month. They know you are exactly X amount, um, per month because that's what you've listed. But this person was able to basically retrieve the data from QuickBooks and then worked, cleaned up the prior year.
We did our year end taxes and then helped me with like financial planning going to the next year because. As you become more successful, your tax brackets change. As you have kids, your tax, tax implications change. And then they've also, as, as we know, congress is always making changes to it for the business as well as the individual.
And so this person, again, thought I knew kind of what I was doing, but this person is like, have you thought of doing this? Have you thought about doing that? And you know, if you do this, you could deduct it. And I'm like, oh. And so basically, you know, light bulb goes off and like, like year one, I spent a lot of money on taxes.
Year two, I spent a lot less on taxes. And I'm more than paid for how much this, you know, more expensive accountant costs me. So long-winded, what I would say is if you're gonna spend money, Spend it on an accountant in the beginning because there are things that you're gonna do, whether it's depreciation, whether it's your retirement accounts, whether it's your salary that you're gonna draw from your business.
There are things that the accountant will know and they can say, okay, you know, if you do this, you can reduce your taxable income. Or your income is so low this year, it doesn't make sense to buy this expensive equipment. Just save it till next year, or we can carry it over next year. That's the questions that the accountant can really make a big difference and, and.
Truthfully save you a lot of money. The other thing I will say about my accountant that I really like is he essentially has a D P C model. It's a subscription model, not a D P C model subscription model. So, and I have no hesitation just firing off questions to him randomly saying, Hey, you know, if we do this, if we do that, or explain to me again.
So I, I, we've converted to an S corp, so I'm getting a salary and I'm like, Hey, by the way, I'm no longer doing this moon landing job. Like, when do we need to readdress my salary? Like it's from a, from a legal and a, an accounting perspective. And he'll answer back. And it didn't cost me anything more. And I think what I got trapped in or convinced myself with when I first started talking to accountants, they were per per hour kind of thing.
So, you know, a phone call or an email was 50 bucks or whatever. And so me being cheap, I was never gonna. Engage the accountant. So even if I had the question, I'd probably Google it and go with that instead of spending the 50 bucks to talk to the accountant. And that wasn't, that wouldn't be good for me.
And like I said, I went cheap and I, I got what I paid for in that circumstance. So if you're gonna run a real business and you gotta complicated, this person does our home and our business, 'cause they're, and they're both connected, it, it is definitely worth the money. Uh, so I would highly recommend spending some money on that.
And coming from you with all of your background in finance like that is so important for people to hear. So thank you so much Dr. Lovelace for sharing your story today.
Thank you. Thank you for having me.
Next week look forward to hearing from Dr. Phil Hellman of Paradox Health, D P C in Rochester Hills, Michigan. If you've enjoyed the podcast and you haven't yet done so, subscribe today and share the episode with a physician you may know who needs to hear about D P C. Leave a five star review on Apple Podcasts and on Spotify now as well as it helps others to find all these D P C stories.
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*Transcript generated by AI so please forgive errors.
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