How to practice medicine on YOUR own terms with Dr. Gay Purcell

Do you struggle with this frenetic pace of clinical medicine?

Feeling like your day is just rushing from exam room to exam room every 15 minutes?

Do you dream of practicing medicine at a slower pace?

Of having time to address lifestyle and wellness topics instead of just prescribing medications?

Of developing deep and meaningful relationships with your patients?

In today's episode, our guest, Dr. Gay Purcell, shares her inspiring journey of converting her bustling private practice to a serene concierge wellness model.

She reveals how she went from cramming in patients every 15 minutes to spending a luxurious 30 to 60 minutes with each individual.

Join us as Dr. Purcell paints a vivid picture of practicing medicine on her own terms.

This episode will open your eyes to what is possible within the doctor-patient relationship with the gift of more time.

Guest Links:
Instagram: kc_wellnessdoc
Linkedin: Gay Purcell
Facebook: Enhanced Health & Wellness
Website: www.enhancedhealthandwellness.net

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Transcript

0:22

​what is the most amount of patients you've had to see in one day? For most people I talk to, it's pushing 40 and maybe even more. And that's not okay. Do you struggle with this frenetic pace of clinical medicine? Feeling like your day essentially is just rushing from exam room to exam room, trying to see patients every 15 minutes, and always feeling behind I think we can all agree that the 15 minute patient visit is a total scam. Like, who actually came up with that? how can we slow it all down? How can we spend more time with patients and actually practice medicine on our own terms? This is exactly what we're going to talk about in today's episode. Three years ago, my guest, Dr. Gay Purcell, converted her private practice into a concierge wellness practice. She went from seeing 40 patients a day in a hurried fashion to having 10 to 15 patients per day at a luxurious speed. And she now spends 30 to 60 minutes with each patient. In her experience. Having this gift of time has changed literally everything. Gay shares her story of opening up her own wellness practice. And she paints this Barbie land, picture perfect vision of what it's like to practice medicine on your own terms. It almost seems too good to be true. So is it? You're going to have to listen in to find out, and after this episode, you're also probably going to have a billion questions for Dr. Purcell. So if you want an opportunity to get your burning questions answered at the end of the show, I will let you know how you can do that, but for now, let's dive into the good stuff. You're listening to Life After Medicine, the podcast for health professionals who want to make a difference, make a living, and still have the freedom to enjoy their lives. My name is Chelsea Turgeon, and my mission is to help you, the lost health professional, find your authentic path to helping others and generating stable income without having to sacrifice your own health and happiness in the process.

Chelsea: 2:38

Hello, my loves and welcome back to another episode of Life After Medicine. Thanks so much for pressing play today. We are here with Dr. Gay Purcell of Enhanced Health and Wellness to discuss opening your own wellness practice. Can you take us back to the moment where you decided you were going to open Enhanced Health and Wellness?

Gay Purcell: 2:58

I had actually been in private practice for over 20 years and I could see that the direction in which medicine was headed was looking like they were going to be cutting back on reimbursement. We were going to have to see more and more people to make ends meet. And it really felt like I wasn't able to spend as much time with my patients that I really wanted to. So I, brainstormed and I decided that there was a better way to practice medicine. And that's when came up with the idea to have a wellness practice and it was January 29th of 2021. So we just completed our third year and are starting our fourth year of the practice. And I'm happy to say that it's been really successful.

Chelsea: 3:42

For anyone listening? What's the difference between your average private practice and then a wellness practice? What is the difference between those two?

Gay Purcell: 3:48

That's a really good question. You know, we still serve as people's primary care physicians, but at the same time, we are able to provide that next level of service. And so my patients all have my cell phone number. Instead of seeing 40 patients a day, we may, see 10 or 15. The minimum number of minutes that an appointment is, actually 30 minutes. And we are able to make house calls with some planning. Every patient in my practice actually gets a big annual wellness Physical, which includes E. K. G. Lung function testing. A. B. I. S. they get cardiovascular markers, audiology, vision, grip strength training, walking speed. They get all these different things every year, and that they spend over an hour with, um. The nurse. And then about two or three weeks later, they come in with me and we sit down and we go over the results and we have a nice, really comfortable room for the patients to sit. It has a couch, it doesn't feel very clinical, and we go through all these results in a folder. And I spend at least 20, 30 minutes with them too on nutrition. So we're actually breaking down macros. Each person has a biometric screening at every visit. So I know how their muscle mass is doing and we break down breakfast, lunch, dinner, snacks, and I help them achieve their goals and some for some patients that goal is to lose weight, but other people are training for a race or they're trying to build muscle, maintain weight, or maybe even gain weight. So it's really a fun way to practice and I feel very lucky that I'm able to practice this way.

Chelsea: 5:17

That is so incredible. I feel like as people are listening to you just describe your day and describe the fact that you get to spend 30 minutes minimum with patients, there's a couch, like all of the, and that you get to talk about nutrition and wellness I feel like everyone's drooling listening to this right now. Cause it's like, that's what people want. That's how they want to practice medicine.

Gay Purcell: 5:37

It's so much fun. And in fact, in 2021, we were only open a couple months and I realized that I didn't really have this need for all these extra exam rooms anymore. And we actually knocked three of those exam rooms out and created a yoga studio. So our patients have the ability to come to yoga at least four times a month. every second Thursday of the month, the patients actually are able to join with walk with the doc and we actually meet our patients out at the park and we go walking with them. And it's a beautiful trail. We walk a mile out and a mile back, and that is open to the public because we wanted something to encourage people in our. County to become a little bit more active and then we actually have a speaker series. So the last Wednesday or Thursday of every month, we bring in a speaker

Chelsea: 6:21

Literally what you've created is incredible. It's really like the way many of us have dreamed about practicing medicine. So one, congratulations on creating that. But then I want to get into sort of the behind the scenes process. So like when you made this decision back in 2021 to transition it into a wellness practice, what did that look like behind the scenes? what sort of changes did you need to make in your operations in order to turn it into what you have today?

Gay Purcell: 6:50

Well, I think the most difficult thing sometimes is telling your patients that you're changing your practice. And I think knowing that you're not going to take everyone with you. There were some tears for patients that decided not to stay or join or decided that it just wasn't for them. When you go from seeing 40 patients a day and and you kind of downsize your practice, just realizing that not everyone can stay and not everyone wants to. To be in a practice like that. But we spent time talking to all the patients and telling them about what the new program would look like. We are able to still take insurance for the patients that stay the amount that they pay actually goes towards their annual big annual wellness exam, which is nice. But I feel like there's so many benefits and the people that are in the program really love it. We've been on a waiting list since, the first year. the first year we filled and we've been on a waiting list ever since.

Chelsea: 7:43

So it sounds like you have a bit of a hybrid model, for reimbursement perspective that there's, some insurance that you're still taking, but then there's cash pay options as well. Is that right?

Gay Purcell: 7:52

really, the amount that the patients pay every year goes towards that big annual wellness exam, and that does allow me to be able to see fewer patients. It also allows us to still take insurance, for all the normal things. Their mammograms, their pap smears, even low dose CAT scans of the lungs for people that smoke. all those normal things that insurance pays for. They're still able to use their insurance for follow up visits, etc. The patients that don't have insurance do tend to stay because we actually dropped their office visits if they want to pay cash to just 35. if they're part of the program. So we're able to really focus on trying to provide high quality health care and make it affordable. So if patients are part of the program, but don't have insurance for their every day, then we are able to offer cash prices on, office visits, as well as their blood work and other tests.

Chelsea: 8:41

So they could pay like their annual wellness fee. Like if you don't have insurance, and then they have just like 35 for a drop in office visit. There you go. Right. That sounds awesome. That sounds like because I've been traveling for the past five years. And so I have like catastrophic health insurance, basically. And when I go to places abroad, I just pay out of pocket and the costs are out of pocket. Like I went to a doctor's exam. I'm in Argentina right now. And it was. nine dollars.

Gay Purcell: 9:07

insane the amount that people are charged for basic Things here in the United States we've gotten to a point where I think that the patient is being lost in their own health care, that it's being dictated by a lot of things that are so out of the patient's control.

Chelsea: 9:22

And then I think that also just impacts providers as well. So for you, how has this changed sort of your daily experience? Because I'm sure there's a huge difference between going from seeing 40 patients a day to having a more spacious, expansive way that you can spend time with patients? how has that changed your experience of practicing?

Gay Purcell: 9:42

it changes everything. It makes you a more successful physician. It makes you feel more fulfilled. You feel like you're really making a difference in patients lives. Our office visits are 30 minutes a piece and you can do so much more with 30 minutes than you can with 5 minutes. I always used to say that I'm not past even the introductions at five minutes and then they expect me to be done, but you can do so much with 30 minutes. So our patients get an in body biometric scale every visit. Now, I can look at that and tell them how they're doing with muscle mass with body fat percentage if they are interested in that. But the changes that you are able to make and the way that you are able to impact patients lives is just so greatly improved with just the gift of time. There's just nothing that really replaces that time that we can spend with patients. The office closes for a full hour for lunch every day, which means that the girls that work here get to run home, let their dogs out, check on their parents, whatever they need to do. And then we all come back refreshed at one o'clock and we're done seeing patients. Our last patient is usually at 4 but sometimes I stay late, but it, and it'll be working, but it's not really, sometimes it'll be because I'm teaching a yoga class sometimes I'll actually stay and take the class with the patients. But the times that I'm spending after hours don't typically tend to be, grinding over filling out charts. I'm usually done with all my charts when I leave I call back patients on all my lab work. Personally. So even if it's all normal, I used to just send that to a nurse and a nurse would call them and give them the results. And I would just type my notes. But now I call each person individually. And when there's good news, I get to be the one that delivers it. Like your cholesterol is so much better. Your triglycerides have dropped 100 points. I get to be the person that tells them that now. And that's so much fun.

Chelsea: 11:31

As I'm listening to you and as I'm seeing you just like glowing, like we're, we're on a video right now, this is going to be airing over podcast, but she's just like glowing talking about the patient. like we're on like Barbie land.

Gay Purcell: 11:42

You know, I love talking about the practice because I feel like other people can do this or something I said the other day in a meeting is, not every physician loves yoga or loves to paint or do these things. But I feel that every physician has this ability to give something more to their patients, or surely we all have different interests that we can share with our patients. And with the gift of time, we're able to do that.

Chelsea: 12:05

Does that sound like one of the most significant changes for you when you switched over models? Is that you just have more time with patients?

Gay Purcell: 12:12

Absolutely. Yes. There's a huge difference in the amount of time that we can actually spend with people and be able to make that impact. When you're able to spend more time, you're not burnt out. So you don't mind staying late and doing the yoga with people because you're enjoying what you're doing.

Chelsea: 12:27

Oh, I love that because you're just developing such meaningful relationships with the patients and it's not from a sense of like obligation or guilt. It's just a natural output of having a less rushed experience because it's like there's something about being in a clinic and every five minutes you're going, going, going, and it just creates this like frenetic pace to the entire day. And when that's gone. It's just slow and spacious and wonderful.

Gay Purcell: 12:53

very luscious and you're able to really enjoy each moment and you'd be surprised how many patients just love popping in here, even when they don't have an appointment. They'll drop off gifts or come by and say hello. other thing that I've done, you know, basically I built this practice around things that I love and I love to read. So, we actually created a little library out in our waiting room and our patients all exchange books. So, we have patients that actually stop by even when they don't have an appointment to donate some books and pick up some new ones. When you create a medical home that feels like a home that is not a place that's stressful to come to, and you come to this place, even when you're healthy, And you're there to get healthy you're there to socialize or see other people. I feel like that was really needed after the pandemic we had so many older people that were isolated, had not left their house or seen people for three years to be able to bring them into an environment where they're learning. They're having fun. They're getting exercise. They're learning skills. It's been wonderful just to see how many of those friendships are made with people that never knew each other before. But hey, I saw you at the walk. I saw you at yoga. I remember you. And then all of a sudden they've gone from people that have been very isolated for three years during a pandemic to people that actually are creating new friendships and new bonds. was just recently a study that compared To a pack of cigarettes a day. I don't know if You've seen this, but the cardiovascular risk with loneliness is akin to that of smoking one pack per day. So, when we don't recognize those people that are really struggling with loneliness or being alone, and we're not, we're really doing them a disservice. And my goal is to bring all those people that feel like they don't have friends or a place to go. I want them to be able to come here and feel like they have a place.

Chelsea: 14:40

Yeah, I love that. And it's like you've created this community, this sense of belonging. And it might be too soon to know this and to have any real like evidence or data around this, but in your experience are you noticing like improved health outcomes in the patients as well?

Gay Purcell: 14:56

We see a huge difference. Uh, we actually have, I think, 14 people now that have lost over 100 pounds, with just the, the nutrition counseling, sometimes with meds, sometimes without meds. But just seeing all those people that have been struggling with their weight for so long, having the time to sit down with them and hold their hand a little bit and talk about the foods that they like and dislike and being able to find something that works for them, we're seeing their lab work improve, we're seeing really their cardiovascular, endurance improved. But the other thing is I personally I see their confidence improves. You know, those little things that you just really can't measure. I always call them NSVs, non scale victories, but these little things where they're buying a new wrap dress. They're just coming in with makeup. They're, they've got a big confident smile. They're really happy with where they are in life and they weren't happy before. There's so many things that we've seen in just the first three years that I can't wait to see what the next few years bring.

Chelsea: 15:53

I'm sure so many people listening are like, well, this sounds perfect. Like how do I do this for myself? what do you recommend? How would a physician get started in setting up a micro practice, a wellness practice like this for themselves?

Gay Purcell: 16:06

I think one of the important things is to kind of know your audience. You have to really look at your demographics. and you do have to spend time looking at that financial component of maybe which patients you think would be interested or could afford to be in a program like this. I will say that I have scholarships for 25 of my patients that I wanted to keep that I didn't know if they would be able to afford being part of a wellness practice. but you just really start by some deep searching and looking at what your demographics are, how many of those people seem really invested in health

Chelsea: 16:40

Yeah. And how many would you need as like a minimum, do you think, to have sort of a profitable practice?

Gay Purcell: 16:46

I feel like you need at least 300. We cap off at 500 here. We always tend to run a little higher because we take in a family member here or there, but we really try to keep it somewhere around 500. With that number of patients, we're able to know every single patient. We're able to recognize them by name face. We're actually able to get them in same day or next day if they need anything. So, our patients are never waiting 3 weeks to get in because they're sick. They're actually getting in that same day or the next day

Chelsea: 17:17

I think your story is unique because you took an existing private practice and converted it into a wellness practice, which is pretty So cool. And I'm sure there's so many people interested in kind of going that route as well. but then do you have any thoughts or recommendations for someone who maybe is like currently working in an employed situation and wanting to just venture out and start something on their own? Do you have any thoughts about how to get started with that?

Gay Purcell: 17:40

Yeah, yeah, that's interesting because I have a friend that is looking at that right now trying to figure out how to get out from being owned by a being employed by a hospital. There are so many different rules and nuances with that that I think are difficult, she's not going to have that ability, probably to speak to her patients about this new practice, because of a non compete clause. I think it's probably really. worth it to have some I. T. Help to have somebody that can, help in a Google search, have somebody's name pop up right away. And in case you're not able to talk to your patients about this, but the patients want to search, you would find out where you are. those are the things that you have to think about. I think if you're employed by a hospital and you're not able to Speak to the patients one-on-one about the new practice you're building. So you're going to need to make yourself findable to these patients because more than likely that hospital group is not going to work with you in setting up this new program.

Chelsea: 18:39

Yeah, no, that's such a good tip. that's a really good point, is to just make yourself really findable

Gay Purcell: 18:43

so that if they're looking for you or they search you once, that your name and your picture just keeps popping up every time they turn on the computer.

Chelsea: 18:51

Any other thoughts or like words of wisdom, like anything maybe you wish you would have known before starting this wellness practice?

Gay Purcell: 18:58

I think the financial component, you know, this, that part of it was new to me. My dad started this practice as an urgent care and he had a master's administration. So for me things and he taught me, that's so foreign to most not get nearly enough fin File appeals. even the day to day operations of checking on deposits, closing the month, closing the year, how to optimize for tax returns, but these are all things that I never really thought about. I was just happy seeing patients and spending time with them. And when I was faced with doing this all by myself and my dad retired, I mean, luckily he held my hand for a lot of it, but I think, be overwhelming. That part of it is very intimidating for physicians. We get none of that in medical school.

Chelsea: 19:50

I can see it. Cause especially me, like I, as a business owner myself, it's like really looking into the financial piece of it. It is, it's a whole different territory and it's, it's something very new and we can get really intimidated. But it sounds like. Like, it's learnable. Yes, it's scary. Yes, it's new. And it's learnable.

Gay Purcell: 20:09

Yeah, it's very learnable. Sometimes it feels like a steep learning curve lot of private practices fail is they don't have good education about how to file claims. I couldn't tell you that for the patients that have insurance, when even before in the private practice, we had such a higher percentage of collected claims, much higher than the general average nationwide. I know that our office manager, even before we became this wellness practice, she was in the top 5 percent in the country as far as having claims that were processed and paid on and there are metrics that we used to use to follow these things. But you have to be able to make even a basic. Private practice penable before you can think about, I think, moving to something like this, just having those basics down so that you're comfortable with the day to day operations.

Chelsea: 21:00

Yeah, it sounds like your office manager, the person filing those claims, like she, it sounds like she has some skills to share and some things to teach. A lot of the things we've talked about are, lovely, like, things are wonderful. There's just so many things going well. have there ever been moments where, you weren't sure it was going to work out or something that made you question if you should keep doing this? Like, what have been some of the hard parts of this?

Gay Purcell: 21:22

Oh, I think, you know, kind of what I talked about before is, in the beginning, you're just waiting for people to sign up. And that is so nerve wracking. And there's really no way to predict, I really thought there would be people that would sign up and didn't. And I knew that they could afford it. And, and I was just shocked. And then other people who really surprised me in staying and saying, I want to be part of this. But there is that nerve wracking moment when you're just waiting for people to sign up. You're just kind of piddling around for a little bit, just thinking, Oh gosh, we've just got to get some more numbers to make this work. And then it worked out fine, but that can be nerve wracking when you're just waiting for people to sign up. And there were tears and, and you know, am I doing the right thing? And you do question yourself because it is sort of a leap of faith that you're going to find people that actually want to do this and we're lucky that we are able to do it.

Chelsea: 22:12

yeah, it sounds like it was the exact right leap of faith.

Gay Purcell: 22:15

Yeah. So the month that we were supposed to open, um, we hit the peak of COVID in America. It was January of 2021. we thought we had it licked, and then we had this huge spike nationwide. And all of a sudden, we're trying to build a wellness practice in the middle of the worst part of the pandemic. No one has masks, no one has tests, everybody is sick. it was kind of crazy when I look back at it that, what I have really found is that A pandemic may be the best time to open a wellness practice. when I look back at it and I think about the people that were not willing to lose a relationship with a physician that they trusted, especially in the middle of a pandemic, that was powerful. Even though it sounds crazy, it it may turn out that the best time to open a practice is during a pandemic because in the end, I think helped a lot of people decide to stay. And once they were in it, they loved it.

Chelsea: 23:13

Yeah. That's such an interesting point. I think also as a general lesson, like. Even when it feels like maybe this is the worst time to start something, it actually could be the best time to do it.

Gay Purcell: 23:24

Well, in the end it kind of worked to my advantage, but during it, I thought, is this crazy?

Chelsea: 23:29

Yeah. And I think that happens so often, when we're about to do something big and we're about to take a leap of faith, we can feel like we're crazy. We can feel like, oh gosh, like what are we doing? We're losing our minds. But then just. taking those next steps and really moving in that direction, can lead to something incredible, like what you've created. So for anyone listening, what advice would you give somebody who is in the current healthcare system and it's feeling maybe a little disillusioned, a little hopeless? Like what advice would you give someone in that kind of situation?

Gay Purcell: 24:00

I'm a big list person. So I would make a list of the things that you love about your current job and then make a list of the things that you hope to have in a new position. Maybe not a new position or maybe things that you hope to see in your future and ask yourself whether those two things can align. Can you find the things that you want in your current job? also thinking about what things are most important to you. the order in which that should go for so many people, their family is the most important, but their work becomes their priority. And if they're feeling that way, and they're really in misalignment that way, then something's wrong. And it's time to really think about how can I work to live and not live to work? You need to enjoy your job, but you also need to have that balance. And do you have that work life balance? And what are the patients that you feel would benefit from practicing medicine in a new way? And who would be supportive? things that you think would need to happen in order to make your dreams come true. True. I'm big on having an action plan. So just thinking about what are the goals? What are the steps I need to take to get there? what is the timeline once people put pen to paper? I really feel like things start to become realer. We can all talk about these things in our head, but when we write things down, it creates this indelible imprint on our brains that makes it a little bit more real and a little bit more serious. Where maybe writing it down is that first step. step to really putting other thoughts in process and getting other things moving so that you're creating an intention. that intention can leave, lead to so many wonderful things, but you've got to have that thought and that ability to believe in yourself and just have a game plan.

Chelsea: 25:48

Yeah, I think those are all such powerful things, just like having the thought, like identifying where you want to go, believing that it's possible to go at least somewhere in that direction, and then really just writing it all out so that then you can take action and get started.

Gay Purcell: 26:02

Yeah, everything starts with a plan, right?

Chelsea: 26:05

Yes, absolutely. I'm huge in planning. I feel like your story has given people this new model and this new idea and this new inspiration for what could be possible within the world of healthcare. And so, yeah, thanks so much for just going after this, creating this and showing other people that's possible.

Gay Purcell: 26:21

You're so welcome. It's such an honor to be on here. You just provide such a light when the camera is on you. And I feel like I can really sense that you care deeply about this. And I love that you're sharing different ways to practice medicine and different ways to live and be happy with so many of your viewers. So it's been an honor.

26:41

So is there a way to practice medicine on your own terms? To care for patients without feeling mentally and physically depleted at the end of the day? It definitely seems like Gay has found a way to do that, but what I want you to take from this episode is not that you need to open up a wellness practice, teach yoga, and give patients your cell phone number to feel fulfilled practicing medicine, because that's not quite it. Yes, Gay has shown us one possible way to design a medical home, and she has created something to do that. truly special by questioning the status quo, by moving outside the traditional private practice model, and just doing things her way. She's taken her unique interests of reading and yoga and nutrition, and is sharing those with her patients. So maybe practicing medicine on your own terms means doing something similar to gay. Or maybe it means something totally different. The point is, there absolutely is a way for you to make a difference. Make a living and still have the freedom to enjoy your life. All you need to do is poach Gay's office manager and have her file all your claims for you. No, I'm just kidding. But she sounds awesome though, for real. What you really have to do is connect to what you want. Make your own Barbie land dream vision, and then write it down. start coming up with a plan to get moving and just start taking one small step at a time. If you want to personally ask Dr. Purcell questions about opening up your own wellness practice, we will be hosting a Q& A thread inside the Life After Medicine Facebook group. So you can click the link in the show notes to join the Facebook group and then drop your question in the Q& A thread pinned to the top. I'm so excited to explore how each of you can practice medicine on your own terms.