Lighthouse Foot & Ankle Center with Dr. Michele Kurlanski

Podiatrist Dr. Michele Kurlanski made the leap into direct care after turning 50 as a gift to herself! She proves that it's never too late to do it all over again and shares the legacy she intends to leave behind for future generations.

You too can have a totally different experience in medicine.

Find her at
Website: Lighthouse Foot & Ankle Center
Instagram: @lighthousefootandankle
Facebook: Lighthouse Foot and Ankle Center
LinkedIn: Michele Kurlanski DPM

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Transcript

Dr. Tea  0:00  

Owners of a direct care practice are more likely to experience higher job satisfaction than the insurance based practice, and it's no wonder why direct care is independent of insurance. Patients pay the doctor directly for their expertise. The doctor gets full autonomy in how they care for patients and how they get paid. We've chosen this path for the love of medicine, this is the direct care way. 

Dr. Tea  0:24  

By listening to this podcast, you may even start to believe that you too can have a successful direct care practice. Come listen with an open mind as I share my personal journey on how I pivoted from an insurance based practice to direct care right in the middle of the pandemic and the valuable lessons along the way. This podcast may be the very thing you need to revitalize your medical practice. I'm your host, owner of a direct care podiatry practice, Dr. Tea Nguyen.

Dr. Tea  0:52  

I have a very special guest today. I have Dr. Michele Kurlanski. Why is she special? Because she is a fellow podiatrist, and we have been walking on the same path, leaving insurance and really embracing direct care, and not just having a cash practice, but really the movement, the intention that we're setting for future generations. So yes, it's nice to walk away from insurance, but it's also fun to get people on the bandwagon, to show them a different way of practicing medicine. And Michelle has a lot more years of experience. I'm really excited to have this conversation with you. Michelle, welcome to the podcast. 

Dr. Kurlanski  1:30  

Oh, I'm so grateful to be here. So thank you for inviting me. Give us

Dr. Tea  1:33  

Oh, a little bit of a background about where you were in your clinical practice and how you decided to make the shift. 

Dr. Kurlanski  1:39  

Well, I'm, I've been practicing for a long time. So I'm, I've been, I'm, like, in my 27th year, 28th year practice. So I've done the whole thing. So I've worked for people and I've gone out on my own. So like, just, I guess, more recent, I just, it just became a big engine, a big, big animal. And so I hired all the people. I got a big office space, and then at one point I realized I was making just the same, if not less, money with having more people and more processes. And so I I just said, One day I was sitting talking to like a financial advisor, and I'm like, why don't I just take cash. And I think you just thought, like, cash money, like, here's here, no dollar bills kind of thing. And it maybe sounded a little crass when I said it, like, why don't I just take cash? But I just realized, like, it would be so simple if I didn't bill insurance. Like, it would be so simple if I didn't have that part of the equation, and so I said it out loud to myself and then. But it took from that time of seeing it another probably about two or three years for it to actually come to fruition. So that's where I was. But I also hit 50, so I just realized that, you know, things, I didn't want to keep going the same way I was going. And for another, you know, 1015, more years, I'm like, you know, day to day stuff, you can keep doing over and over and over, but it gets to a point where, like, where is this going? Like, what am I doing? You know, I can't, I can't sustain this anymore. I'm exhausted. So that's what made me flip the switch.

Dr. Tea  3:22  

What were your challenges when you had your traditional insurance based practice, 

Dr. Kurlanski  3:27  

There were numerous challenges when I had my traditional insurance based practice, staffing was an issue. There's, like, staff turnover. There's, you know, somewhat of a return with, you know, keeping people on and people leaving, and then having to train, you know, finding dependable people, um, having EMRs that weren't clunky or that worked well. Um, I did. I had billers. I did in house billing. I outsourced it. I did it through my EMR. Like, I tried all of the all of the things, and I just realized I just kept spinning my wheels trying to solve the same problem, but different tactics, you know, just trying to throw things at it, like more people, more money, more more resources. And I realized that, you know, this is better by, you know, addition by subtraction. So, you know, when I actually subtracted all of these things, like, I got space to think, I got space to, like, actually approach a problem and, like, simplify, rather than making magnifying the problem, I actually simplified the problems

Dr. Tea  4:35  

when you were starting your practice. You said, 27 years ago or so. Yeah, was it commonplace for podiatrists to open their own clinical practice, or was it more common to be employed? Because I know when I graduated, everybody was moving towards employment, so it got even less popular to open your own practice, and I wonder what that was like for your generation.

Dr. Kurlanski  5:01  

Yeah, so I did, like, an externship, like, when we were at school, we all did these externships. So I did this, like an externship at like a podiatrist office, and then, you know, we clicked, and then, and so I joined their practice, like it, did it one year residency, and then went into the practice, and then managed care kind of worked, you know, came in and I had a baby, and so it was, you know, had to be board certified to, like, stay in that practice. So I went back into the residency. So I went back into two more years of residency with two kids. They were small, and with the thought of moving here, I'm in Mae now. So then the plan to move to Mae, and then I joined another practice, and I don't know it's I didn't have a great time being an associate with someone, you know, working for somebody else. It just didn't work out for a lot of reasons, but, and then I decided to go out on my own, and so I just started really small. So I sublet space, and I built insurance and things like that, and I went to assisted living and nursing homes and things like that. So, I mean, I had a nice little practice, but then I got into an office and then, and then, kind of slowly, slowly built from there until it became like a big engine animal, like a cash eating machine.

Dr. Tea  6:18  

Yeah, a cash consuming machine. What was your day to day like with insurance? What was your patient volume and what did your staff do? 

Dr. Kurlanski  6:33  

So pre-covid, I think once I moved into the I'm in a really big space now, which I haven't been able to downsize. I mean, I love the space that I'm in, it's huge. It's just huge. But I moved into the space, and I had like six treatment rooms and like two medical assistants and a front office person, and, uh, and an office manager, and so like, four or five other people, like working for me, and then, and then me, and then so I would see, you know, 3040, patients a day. You know, most of it was like, you know, diabetic foot care. And you know, my medical systems in the room, the patients and I would just bounce from room to room to room to room, and they would help me with the notes. But, you know, at the end of the day, I'm the one responsible for the notes. And you know, I was taking notes home on nights and weekends. And I was doing, you know, after hours, after the kids went to bed, and I get up early in the morning on Saturdays. And it was just never done, you know, never done with my notes. Never done with work. You know, I'm always turning the billing to like, you know, try to catch up on the claims, like, what, what didn't go out, or what, you know, what got rejected. So, yeah,

Dr. Tea  7:45  

so then you moved into direct care as a birthday present to you, I remember you talking about this. Really just was like it was a turning point for you, mostly because you were turning 50. So how long ago was that now? When did you finally transition out of insurance? 

Dr. Kurlanski  8:03  

So, yeah, I turned 50, so I was in July of, you know, three years ago. And, like, it was really kind of surreal, because it was, I think my husband and my kids were, like, somewhere else. I think they've gone to camp or something like that, and, and I remember just filling out the application alone in my kitchen, which is kind of great, because I'm going to be talking me out of it or anything like that, and so and so I I just remember going to the mailbox and just putting it in there. And just felt so surreal putting it in there. And just thought someone was going to jump out from behind the mailbox and just say, no, no, no, don't do it like but once it's in the mailbox, I think it's a federal fence to go reach in there and take it out. Once it's in there, it's in there. And and then I just got in my car and drove away, and I was like, this is kind of surreal, like just dropping it in the mailbox. So I made sure to take a picture and, like, kind of stamp the moment. But you know, because time goes by and you don't realize, like, you know, your day to day stuff, like, it's kind of a nice back, nice to look back at these things, like these moments when you actually, like, these pivotal moments that happen. Yeah,

Dr. Tea  9:13  

I totally remember that photo that you took, and you're like, I dropped it off, and I knew, like, the feeling that maybe your heart sank a little bit, but also you're guided by a little bit of hope at the same time. 

Dr. Kurlanski  9:25  

Yeah, it was, it was weird. And I posted on, we're in that Facebook group on the moms group on pod moms group on Facebook, and someone said, like, did you send that certified mail? I'm like, Oh my God, no, I did. Like, so anxious to just put it in the mailbox. I put a stamp on it, like, drove over then dropped it in the mailbox. So I would recommend to anyone doing this that they would send it certified mail, so that they know that Medicare received the letter. But they did get it. 

Dr. Tea  9:56  

So that's what I wanted to know, did they get it? Because I did the. Same thing. And then in my area, they preferred facts, so, oh, I sent the letter with a future date, so you're not supposed to do that, and then I got confirmation by email that it was received, but it was it didn't count, so I had to even delay my opt out date even more. And I was like, why are they so painful? They really don't want to break up. You know, it's just so one sided. Yeah, okay, so, so tell us what your life looks like now it's been three years. You have your direct care practice. You talk a lot about the things that you enjoy on LinkedIn, which is really fun to see, because it's just, it's stuff that nobody tells us, until we experience it ourselves. And I'm really grateful that you're there to share your experience. So you moved away from a volume based practice to now. What does your practice look like today? How many employees do you have? How many patients do you see, and what services are you really enjoying?

Dr. Kurlanski  10:59  

So now I have an in person medical assistant who's, actually, she's been great, but actually, she just had covid. So like last week, I did, like run the practice and in person by myself, you know, but if I'd had seen like 30-40 patients, I would have been having to reschedule people. There's no way it was hard, but I may have still got through it. And so I'll probably see about, you know, if I see 15 patients in a day, I'm like, How did I ever see 30 patients in a day? I'm tired at the end, um, and then I have a virtual assistant, who's been fantastic. I've had her for three and a half. It'll be four years in November that I've had her the same virtual assistant, and she's my call center. She like does prescription refills. She like sources, the faxes. I don't, I don't hear the phone ring in the office, because she's just answering and fielding calls and scheduling like new patient appointments and all that. And then my in person, like, you know, helps him with the day to day stuff, which has been, she's been fabulous.

Dr. Tea  12:00  

How are you directing your marketing efforts? How are patients finding you, and are you paying for ads or anything like

Dr. Kurlanski  12:10  

that? Uh, yeah. So, I mean, I have our website, and then I have, I try to do some internal marketing with Square. You can get the emails, and then it will go to MailChimp. And then, if I'm good about it, I'm not consistent, which is a problem. But like, if I send out, like, emails just even about services that we're offering, or a blog post that I wrote, it'll, you know, go to my list. And then I did some Google, paid Google ads. And then, but the new patients I even had today, I asked them how they found me, and they're all like, I Googled a podiatrist near me or podiatrist in my area, and they all read the reviews. So the reviews are really, really important, but they and they do read the reviews, yeah, 

Dr. Tea  12:53  

What has been your biggest return on investment as far as filling your schedule up with the right type of patient?

Dr. Kurlanski  13:00  

I don't know, like, I really feel like, for me here in Maine, I don't know if it's like this for everybody else, but there is a seasonality to tip a dietary so, like, what I see in the summer is different than what I see in the fall versus what I see in the winter. So, you know, sometimes certain ads will land, like for fungal toenails, and I'll get an influx of that. We have a lot of summer camps in the area, and so I'll see kids with ingrown toenails, like, over the summer, that are at a summer camp. I'll see people that are just summering here in Maine, and just like, you know, here for maybe an extended period of time. And they'll come in, sometimes it's word of mouth like that, that people come in like, Oh, my friend said, you know, that I needed to see you, or this is great moms group in Scarborough, like, on Facebook that, you know, someone will reach out and say, like, Who do you see? And then my name will come up. So it's kind of like, I don't know, like, some, I mean, there's good work. And then I've also been around for a while, I mean, so there's some of that where I'm starting to, you know, just, you know, see families and people know, like grandparents sending in their grandkids and things like that. So, the biggest return on the investment may be my email list. Like having that list and then sending out, sending out emails to my internal marketing.

Dr. Tea  14:15  

You mentioned their seasonality in your practice, and that's true for me, too. And actually, I just ran across a PubMed article stating that if you treat toenail fungus, you'll tend to see that around summertime, when people are wearing sandals and they're, you know, bothered by it, but I don't know if people know, but it takes, like a whole year to get full treatment. They are already a year behind. But there is a seasonality to what we treat, and I see it too as well here in California. So you mentioned the email was probably your best investment. Word of mouth, you have been in the community for a long while, and I was just looking at your website and the lighthouse that you have on your home page, which is appropriate for your business name, lighthouse, foot and ankle. It looks very similar to some of the lighthouses I have. Here in Santa Cruz, I never thought to go to the East Coast. You had mentioned that you get some word of mouth through a mom's group. Was that something you just fell upon or was this strategic?

Dr. Kurlanski  15:13  

I didn't even know that it existed. Like people would come in and they're like, oh yeah. Like, I heard about you in this group. I'm like, What is this group? Like? I have no idea. So I'm not, I'm not in the group because I just, I don't want to, like, control myself, but like, uh, or just like, I don't know. I don't want to know. What about it? But, yeah, um, but it's nice to know what's out there, that people are like, my that my name is coming up in these, like the go to person and and there's a lot DPC here in Maine is really big, so there are a lot more and more direct primary care doctors in the area. So doctors that used to refer me to patients have now, like, left the big medical groups, and they're now, like, going out on their own, and then they're referring to you patients. So that's really great to see. So people are starting to get used to this whole direct care, like opting out of that system.

Dr. Tea  16:07  

I can't imagine the transition for you was very easy. You said it took you two to three years to finally just hear about it and then do something about it. Did you opt out of all insurances, or was it one at a time? 

Dr. Kurlanski  16:20  

Well, it was, No, I kind of went all, all in at the same time, which I don't know that I would necessarily recommend for everybody, but so as part of what's called a PO, or, I'm not sure if it's an IPO, but it was one of those like, and whatever those things are, the organizations like. So in the review that I don't really remember the name of it or an ACO. It was an ACO. So part of being in this ACO was that, like, in order to get better rates from these insurances, you were on a panel of like, five or 10 insurances. And the thing is, if you opt out of one, you had to opt out of all of them. And I was like, so there's a couple of really low payers. And I'm like, Well, I want to opt out of this one. Like, well, if you want to opt out of that one, you got to opt out of all of them. So it was kind of like, well, I guess you kind of made my decision for me. So I'm just going to, like, opt out of all of them, because I really, really did not want to participate with, you know, some of these insurances that we're not paying well and and then Medicare, I was, I was really done with just fighting and paying, like, you know, people coming in and not getting paid much or well for Medicare, and just, you know, every year it's like, oh, there's a 3% cut. There's a 3% or they're looming, they're 3% cut. And I was really, just, I was really tired of that. And then I don't know what exactly is there. I don't think there was one. It was like death by 1000 paper cuts, because it wasn't like one thing that's put me over the edge. It was all the things that put me over the edge.

Dr. Tea  17:54  

I totally agree. It's like death by 1000 clicks. You have these EMRs that are overly complex, and then you also have a system in which it hurts us every which way through prior authorizations or just payment delays or no payments or taking back payments, whatever it is, it truly is death by 1000 cuts. I wanted to know what was your inspiration throughout this entire journey. 

Dr. Kurlanski  18:18  

Um, I don't know. Like, I mean, I saw what you were doing, and I saw what Grace was doing. And then, you know, I met some people, some other friends that you'd interviewed, like Melody Strouder and who I really love, and she's done some great stuff with minimally invasive surgery. And then Kristina Janson  who's, like, super fun to talk to, and she's just hilarious, and I love her dearly. And I don't know, it was just fun to kind of riff off everybody, like, what do you do for this? What do you do for that? And so, you know, that was really inspiring. And I just love these younger generations, just to think, I mean, I kind of like the idea of also leaving a legacy, you know, like of, you know, just not just not opting out and saying, like, Fine, I'll take my ball and go home, kind of mentality. But also, like, trying to make it better for, like, the future, the future generations, it wasn't easy being a mom and like, working so hard and like, late and like the kids seeing me charting at home, you know, it they see all that stuff, and they see you going in on the weekends and rounding, you know, doing, you know, moms at home at a seven o'clock at night because she's doing a towing amputation. Like, you know, they don't really appreciate, like, what that means, you know, I mean, I mean, I know the patients appreciate it, but your kids don't, you know, so I don't know. I think that was kind of motivation, like, you know, is a just to be a role model that you know things could be different. You know they are and things will be different. I think if, because I think you know people in the younger generations have a better sense of work life balance, or, you know, not killing themselves working because. I mean, this is it. I mean, 50 hit. And I was like, wow, this is kind of getting real. I'm not getting another shot at this, 

Dr. Tea  20:08  

but you're, you're giving yourself another shot by doing something totally different. How did your patients receive that? Were you able to tell patients you were opting out because you had mentioned you were part of an ACO? I'm not very familiar with that. I don't think we have a whole lot of that out here on the west coast, but I've heard about it often. Are you, do you have, do you have access to your own patients? Or was that kind of off limits? How does that work? 

Dr. Kurlanski  20:31  

No, I had access to the patients, and I could tell them. And so the patients that I saw on a regular basis for like, diabetic foot care and like that, it was like having a breakup conversation, like, 20 times a day, like, somebody, I'm really sorry since, but this is going to be our last visit. Like, I'm opting out of insurance. If you want to continue to see me, I'm happy to see you, but I understand and hear the names of three other doctors in the area. That would be that agreed. If you don't want to see if you want to use your insurance, you can, you can use them. So one doctor in there, you got a lot of referrals for, like, the diabetic foot care, um, and so there was crickets for a bit. So it was maybe about a year of, like, you know, three patients in the office, four patients, and then, um, but then people started coming in, and, you know, then I had time to see them, and some of the old patients that I had seen, like, years ago that we told them we didn't take insurance, they're like, I don't care. Like, I still want to come in. I'm like, so it's rebounded over, like, the last year and a half, definitely. But for a bit it was like, What did I just do?

Dr. Tea  21:38  

How long did it take you to recover? Because I know for me, when I opted out of Medicare, I was in the pits for like four months emotionally

Dr. Kurlanski  21:45  

it was, it was, yeah, there's the emotional recovery and there's the financial recovery. Um, luckily, I had like, two people that had kind of ridden through like, all the different decisions that I made. So, um, my medical assistant, who's been with me for eight years now, and so she saw all of it, all the people, all the bad hires, all the bad EMRs, all the bad patients, like she's gone through all of it. And I asked her, like, you know, if I do this, are you with me? And she's like, Yeah, I'm with you. So she's like, and so, and then my virtual assistant, she's gone through, she'd seen me through two EMRs, now we're on the third, and she just rolls with it. Like, whatever I tell her to do, whatever I throw at her, she's like, Okay. And so, you know, other people that were here that I don't think they would have, and that was, like, one of the things too, was that I had a bad hire, and I had someone that worked at another podiatrist office and, like, and then had opinions how I should be practicing and doing things. And it was like, how she was at the other practice and that that was kind of a motivator to me. For me it is like, Okay, I'm not aligned right now. I need to, you know, so I let her go, and then it just kind of threw some gas in the fire. And then I was like, All right, now I really know what direction I want to go, because that was not it. So sometimes I need to see, like, I don't know. I think it like I hadn't did a LinkedIn post on that, like that, like my worst hire was, like my best, I don't know, somehow it would like really worked out for me,

Dr. Tea  23:22  

what has been a realization for you that you didn't expect or a pleasant surprise with direct care? 

Dr. Kurlanski  23:30  

Um, I'm seeing younger people, like younger patients, like people in their 20s, like my kids age, that are coming in, and I didn't see them when I was taking insurance. So I feel like there's this people who worry about, Oh, what, how are we going to take care of our older people? And like, I don't know that we were taking care of our younger people. So because some people are coming in and, like, I saw a 23 year old today and and a 29 year old today, and I don't know that I saw them when I was, you know, taking insurance, and I think maybe they didn't come in because they didn't, you know, they had a really high deductible or, or my schedule is so full that I couldn't get them in too, because they're, you know, if I'm chock full of, like, you know, 30 patients of routine foot care, diabetic foot care, like, and people would tell me, like, Oh, wow. I you know, you were booked out for three weeks or four weeks or four weeks for a new patient appointment. I'm like, what do you know? And so now I have same day appointments or next day appointments. So it's really nice to get, I think some of these younger kids in, 

Dr. Tea  24:33  

Do you feel like you're steady on your feet now? Or do you think, what do you think about the situation you're in now?

Dr. Kurlanski  24:41  

I think I've, I've kind of reached a level where, yeah, I'm comfortable, but I'd like to grow somewhere. So now I'm trying to figure out, like, how to build this up even more, but at the same time, I don't want to burn myself out, you know. So because that can happen, like, you know, that's another thing that you are. I've, I've kind of find myself sometimes, am I, am I doing too much? Or am I submitting to too many people? Or, you know, this, you know, trying to have that still maintain that good balance, so kind of still have to kind of check in with myself and make sure I'm not I'm not burning myself out too because you can still burn yourself out with direct care. I mean, you can still make all the mistakes like that you were, you were, you were doing when you were taking insurance. You can still hire people that aren't aligned with your vision. You could still overspend. You can still not budget well. You can still, yeah, things still happen or could happen. Yeah,

Dr. Tea  25:33  

I totally resonate with that. Even though we have an easier practice, we can still burn ourselves out, because, characteristically, we are just creative problem solvers, and we are just constantly looking for solutions after solutions. But people are really wanting to know when they start to opt out of insurance, when they can feel a sense of safety that they made the right decision? How long did it take for you to feel like I did the right thing?

Dr. Kurlanski  26:00  

About two years, I think, after, like, after, like, looking at it with my account, and going through, like, you know, and I'm saying, like, how much I made, and they're like, that's legit. And I'm like, Oh, you made some legit money. I'm like, okay, and like, I'm paying myself on a regular basis. Like, I, I use Profit First, and, you know, I can have a whole conversation on that, but that's really, like, stabilized my cash flow. So I know, like, it's the flows there. I know I'm getting paid. I know I'm contributing to my simple IRA. I'm, you know, I'm setting money aside in my business for, like, a rainy day fund. I have money set aside for taxes, my rent paid, like I'm not sweating payroll, like it's normalized. My like, cash flow is totally normalized, which is kind of weird to think, because I my AR is zero at the end of the day, every day, all day, like, you know, you know where people have they don't know if they're making payroll, and they have like, $80,000 in AR, like, out there to insurance, but they don't know when they're ever going to get that money, or if they're going to get all that money, and they still have like, you know, five, six people on payroll, and maybe a payroll of like, $30,000 and they're, like, they don't know if they're going to make payroll. 

Dr. Tea  27:15  

You answered a question before I even asked it. I was just going to ask you what your favorite business book was, or a quote that you live by to help you move through the hard times of just business ownership. 

Dr. Kurlanski  27:29  

Um, yeah, I listen to loud podcasts, like in the earlier days, like Alex Hermosi and the Prophet first, like Mike Michalowicz. And it's just like, just keep going. Just keep going. You know, just keep going. You know, just keep swimming. Like Dory, like, just keep swimming and, and I think that was it just like, you know, getting good at sales. I mean, you're not selling, but you're like, getting people on board with, like, your protocols and things like that. And so it was just helpful. I mean, listening to all those things were helpful. And just to really just keep going, keep going and and not to do more, but do what I'm doing better. So don't keep adding things like shiny object syndrome. Like, you know, it's easy, so easy to get sucked into shiny object syndrome. Like, oh, just buy this new machine, you know? But rather than buying machine, machine, I'm, like, double down on to the machines. I'm, I'm, I have. So like, do more laser, do more Shockwave, do more swift, you know, all of those things. Do more orthotics. So rather than, like, let's introduce some new product here in the office. Just keep doing what you're doing and do it well,

Dr. Tea  28:36  

I love that because Mike Michalowicz also wrote the Pumpkin Plan? Yeah, I love that book too. So it totally goes aligned as to how we make this a business that works for us, and we're not burning ourselves out because we're constantly adding new things. So that's something that I can certainly live by myself. So it sounds like your next level is just to refine what you already have and expand. So keep on reading, keep on growing podcasting. And is there anything else you would like to share with the listeners as to how to make this work for them?

Dr. Kurlanski  29:13  

I think it's one thing to jump in. And I'm also thinking about, like, none of us are gonna do this forever, right? So also like, how do we get out of it? So now I'm really starting to think about the legacy of like, this is great. Like, I want to create this, but I just wanted to be reproducible. So that means that someone else could just step in and take over, and it's like, okay, here are the tools. This is how you do it. And have that kind of business where I just, I show you how to do this, and you can do this, not that we're like a flash in the pan, and, you know, in 30 years, no one's doing direct care anymore. So my goal is to disrupt the system and keep it disrupted and and have and have like the younger generation come in, but also have it in a way that us the older. Generation can pass it off, but have it still be an investment. Not like, Okay, I did this for 30 years, and I'm going to shut the, you know, walk away and shut the lights off, you know, the same time. It's, it's, you know, creating a legacy for both, like, both generations. 

Dr. Tea  30:13  

Oh, I love that, yes, make it available to future generations so that they can just walk into it. It's a turnkey practice. 

Dr. Kurlanski  30:21  

It really is, yeah, turnkey. Yes, exactly, turnkey. 

Dr. Tea  30:24  

Well, awesome. I really appreciate you being here, and thank you so much for sharing your journey. Any last words,

Dr. Kurlanski  30:29  

I just keep on keeping on. I guess it's kind of like riding a bike, like I can explain to you how to ride a bike, but until you ride the bike, you don't know what that feels like. You don't know how to balance and stuff like that, or stop or whatever. Like, I can tell you how to do all those things, but it's one of those things you just have to do. Like, if you want to be direct care, just be direct care. I can't. Like, it's, I think we over intellectualize it. Like, how do I do this? How did that do that? Like, I didn't have all the answers when I started, and you're never going to have all the answers when you start. But like, if we can figure out how to do all these things, if you can get through med school and through residency, we can do this, you can do this. 

Dr. Tea  31:08  

Yeah, awesome. So together, we're going to make more direct care doctors. We're going to put them to resolve the world of physician burnout. Yes, well, thanks so much, and thank you for listening. I will catch you all next week. Take care, everybody. 

Dr. Kurlanski  31:23  

Thank you. 

Dr. Tea  31:25  

Thank you so much for being here with me. If you enjoyed this episode and want to hear more, please like, share and subscribe so more people like you can have access to another way of practicing medicine, the direct care way. Let's connect. Find my info in the show notes and send me your questions. It might be the topic for future episodes. 

Dr. Tea  31:44  

And lastly, if you remember nothing else, remember this be the energy you want to attract. See you next time you.