The DPC NP
The DPC NP
Charting a New Course in Healthcare: Mandy DeMeritt's Leap from Corporate Medicine to Direct Primary Care Pioneer
When Mandy DeMeritt, a spirited family nurse practitioner, decided to pivot from corporate medicine to launching her own direct primary care clinic, she carved a path through the healthcare wilderness that demanded resilience, innovation, and a holistic touch. Our conversation touches on Mandy's transformative journey from a pre-med student to a healthcare entrepreneur, shining a light on her dedication to treating the multifaceted health needs of her patients – body, mind, and spirit. Witness the personal story of a healthcare professional who refused to settle for the status quo, instead choosing to forge a direct connection with those she serves, creating a space where medicine is practiced with a patient-first ethos.
As we navigate the challenges that come with building a direct primary care practice, Mandy's candid tales from the trenches reveal the obstacles and triumphs in growing her clinic amidst a global pandemic. She delves into the heart of small business management within the healthcare industry, sharing her experiences in expanding her patient base organically, the art of setting service fees, and the delicate balance of nurturing a family while steering a burgeoning medical practice. Her entrepreneurial savvy comes to life as she recounts the strategic hiring decisions and the fine-tuning of her clinic's operations, providing an intimate look at the business of compassionate care.
The episode also peels back the curtain on the innovative side of primary care with a discussion on the integration of functional medicine, IV therapy, and ozone treatments into a conventional practice. Mandy's passion for holistic wellness and her pursuit of additional medical knowledge showcase the relentless drive of a modern healthcare practitioner. Her story is not just about the convergence of medical expertise and business acumen, but also about a heartfelt commitment to reinvent the patient experience, proving that the journey to wellness can be as personal as it is professional.
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Welcome to the DPCNP. I'm your host, amanda Price, family nurse practitioner with two decades of experience, including 16 years as a business owner. Hey everybody, thanks for joining us on the DPCNP, and today I have the honor of talking to Mandy DeMeritt from Tucson, arizona. Welcome to the show, mandy. Thank you so much. I'm so excited to be doing this. You're welcome, so glad that you're here. And one thing I wanted to just start off our interview with is I was looking at your website and I love your health mission and I'm going to read it because it's so awesome.
Speaker 2:Unless you have it memorized. Do you have it? No, I do not. No.
Speaker 1:Well, it says we improve a person's life by addressing physical, mental, spiritual and social health needs. And it says a couple other things, but I specifically think that is so encompassing of being a nurse, being a nurse practitioner and running a direct primary care clinic. It's like the whole package right there in that one sentence. I love that.
Speaker 2:Yes, thank you, thank you. I will probably give credit to my husband for writing that I am not a wordsmith, he is very good with his words. But yeah, really just starting this looking into like I want to treat all of you because you're not just your metabolic condition, you have a family, you have stressors, you have a life, you have work, you have all these things, you have a spiritual life and we're called to address that, I mean. So I want to make sure we're hitting all of those aspects. So when you leave the office you're feeling like I was, I was heard and I was addressed, and I feel better, moving on and moving forward.
Speaker 1:Yes, I love that. So we'll talk about all of the things that you offer in your clinic. But take us back to how did your nursing career get started and how did you get to the point where you became a nurse practitioner and all that?
Speaker 2:Yeah, yeah. So I grew up in South Dakota. I had initially started undergrad to be pre-med and then we had to take a class. It was once a week. They would bring physicians in and talk about their specialties, and pretty much the entire semester they just had men speaking. And there was a week where I was like, are you any women? Like what's going on with that? So they said, yeah, next week we'll have one.
Speaker 1:So they brought one in.
Speaker 2:She was a family practice doctor. She was fantastic. She said I love my job, I love what I do. I'm so fortunate my husband gets to stay home, but when my children get hurt, they that kills me. And she said and then when I am, I get called in to go into the hospital or wherever she was having to go and her kids beg her to stay. She said that it's just so hard and I really just sat there and I was like I don't want to do this. I want to be a wife and a mom more than I want to to have this career, which was crazy Cause I wasn't even in a relationship and my parents had a little bit of a crisis about it, but that's okay.
Speaker 2:So then I ran into my older brother's wife, who's a nursing instructor at my school, and she said why don't you just become a nurse and be a nurse practitioner? And I was like sold, so did that and then graduated nursing school, I moved here right, literally I took my boards, and then I say my truck was packed and I was moving to Tucson and then got here, was here for a year and a half or so. I met my husband, got married. The job I had at the time had a lot of downtime and so my husband was finishing his degree and he was really busy and I was like why don't I just do nurse practitioner school? Kind of just was like Lord, if I'm supposed to do it, I'll get in, because I don't, I'm not going to chase this, I'm not going to apply to all these schools. And so I got in. I was like, well, I guess I'm doing it.
Speaker 2:And so then graduated in 2015 for a little bit, and then I was into corporate medicine for about five years before completely leaving and focusing on my practice.
Speaker 1:So you do know what it's like to work in a clinic that is just taking insurance.
Speaker 2:Yes, yes, and it is not fun. How would you describe?
Speaker 1:your personal life during that time when you were working in that condition, and just your quality of life.
Speaker 2:I mean I worked two days a week. I was thankful to be part-time, but I was still having to leave the house at 6 45 in the morning to get to the office in time to deal with all the messages and all the faxes and all the things you have to go through, and then not getting home till 5 30, 5, 45, depending on how the day went. I was fortunate to have 20 minute slots where the physicians only have 15, but still it's, you know, and I worked in kind of a lower income area, and so your patients are sick and they come in with multiple issues going on, and so you're constantly behind your and I tried so hard to stay on time. That was just. I hate the well you just wait for two hours and see your doctor for five minutes.
Speaker 2:I hated that and so I really tried hard to stay on top of that, and also for the staff, because I was a staff nurse in an outpatient clinic and some of the doctors didn't respect that and they would take their time with their patients and then we're there till six, seven o'clock at night and you have to come back the next day. So I worked really, but it was just I felt like I never saw my children and it was just stress. It was a lot of stress. I would build anxiety for that, having to go back the next week, and it just wasn't. It just wasn't fun.
Speaker 1:How did you know about direct primary care?
Speaker 2:Man, I don't even know. I don't even know how I heard about it, but I had heard about it and I maybe just researching me, just, Marie, I really don't remember how I heard about it, but I knew about it when I started to think about opening my own practice. I talked to a colleague who did more billing side for the corporation I worked for and I was asking her if she had familiar, was familiar with getting the negotiations for the insurance and how that would work, Because I know if you don't get that right, you're going to get hosed and you get hosed anyway. So and she was like just do DPC. So that's kind of what set me in that path of just okay, well, we'll start it.
Speaker 1:So yeah, so it wasn't this.
Speaker 2:Facebook ad that, just Facebook. So it wasn't Facebook. I'm only on social media because I have a business. I'm not a social media fan, I'm not either.
Speaker 1:I never post anything.
Speaker 2:And now.
Speaker 1:I'm on this DPC nurse practitioner Facebook page all the time, you know, drawing in my, you know my confidence and all that kind of stuff.
Speaker 2:Yes, yes, yeah.
Speaker 1:Other than that I don't really do anything.
Speaker 2:Yeah, yeah. No, I'm the worst poster I've all I've created so many posts for and I I don't have Facebook on my phone, but I have Instagram on my phone and I'm like, oh, I should do this. And I'm like, oh, I just don't want the attention. It's too much, I just can't so, yeah, yeah.
Speaker 1:So when did you open up your DPC clinic then?
Speaker 2:Yeah, so my door is open January 1st of 21. Okay, and how's it going? It's great, I mean. I so started it. It was really COVID. So we weren't even that far into COVID and I was like I am over this garbage. It was really crazy because I had a baby. He was like eight months old and he just started sleeping through the night and I'm like, oh okay, what sort of business is logical? I got that book by Plum Health what the DPC, whatever that book is. He owns Plum Health out in Michigan. Have you heard of it? No, I don't remember. Yeah, amazing, he started his own practice. Plum health is his name, is the dpc something and so I got it. I got it end of june of 2020 and started reading it.
Speaker 1:I just kind of started checking.
Speaker 2:Yes yes, yeah. And so I just went through it and I just was. I laid it at the feet of jesus and I just said, hey, if this is of you, just keep it rolling. And I would hit road roadblocks, like something with labs came up and I'm like this is frustrating and I'm like, okay, fine, I'm do it. Well, that's not my personality, so I will just grind on it for days until I solve the problem. And that's really how it was. And I just said, until the road I can't overcome the roadblock or my doors open, and then it just all happened opened in 21. And so, all of 21, I worked two jobs. I worked my corporate job and then I worked for here for my practice, and then I was just going to play it safe and once I'd replaced my income, I was going to step out and Jesus was like no, he forced me out. So I got out and last day was in December of 2021. And then started this solely in January of 22.
Speaker 1:And by then, how many patients did you have?
Speaker 2:Oh, my goodness, I don't have a full panel. I like my panel size. I'm like probably 230, because I'm only in the office. I only want to be in the office about two days a week. I don't even know I'm so bad. Maybe a hundred. That's a guess, that's a big guess, yeah.
Speaker 1:But the fact that you have 230 patients now that's awesome and that's your. That would that's your end goal, like you just want the 230.
Speaker 2:I mean I I have hired a nurse practitioner and so looking at, maybe I'm trying to get more of them to go to her just to build her panel, but I'm fine with where it's at. I don't, we don't do much advertising, it's all word of mouth, and I am. I really just laid it at his feet and been and just said you grow it, you grow it. How I can handle it? Cause I could do all the advertising and I could go hustle for the small businesses and do all that, but that's a lot of intake at once and that's overwhelming and I don't, I don't necessarily want that, I don't want to be, I don't want to be back to co-corporate, but in this, in this model you know what I mean Cause I think there are some practices out there that still do that.
Speaker 2:They're still just hustling and seeing them through and I'm like I want to spend time with my patients, I want to that's awesome.
Speaker 1:Do you have ancillary staff that help you, like a nurse or an office manager or receptionist, anything like that?
Speaker 2:I do have a nurse, but I've hired her to do IV hydration and IV ozone therapy. So all the other things are me or my NP, if she, if she, does it.
Speaker 2:I do have, I guess. I have a student, a high school student, who has to do an internship in an area that she wants to be in, so she'll help me with scanning and things like that, but it's all. I do it all, which is fine. I would love to hire someone, but it's the. You know, you just got to have the money to have it there.
Speaker 1:So it makes sense, because if you choose for your panel to be higher, then it makes sense to hire a nurse. But if you keep your panel lower, then you can avoid the cost of that extra employee and just do things yourself.
Speaker 2:Yeah, yes, yeah, yeah, if you had over 500 patients.
Speaker 1:You probably could not manage doing all the things.
Speaker 2:No, no, yeah, no. If I was anywhere near that, yeah, I'd probably hire.
Speaker 1:So so how did you come up with your fees that you chose? Um, I noticed. I noticed that they're on your website, so I saw what they were. How did you come up with that?
Speaker 2:I. It was a lot of just looking at the local market, trying to be comparable to what is offered here. There's a couple there's really only two that are close. On my side, tucson is very spread out, so there's we have an east side, a northeast side and it's like the northwest side where there are others. It's like a whole nother world over there. You don't tend to intermix too much with that side of town and our infrastructure isn't very good. We have like one interstate so to get over there it's a good 45 minutes, yeah, so that those two were the closest. So really just looked at them. And then I looked nationally. I would search other towns, look here in the state and just feel like is this reasonable? A lot of discussions with my husband like is this reasonable? Do the numbers make sense? My dad was also very involved. He was a small business owner. Does this make sense, you know? And so we felt good. We felt really good about those prices and it's and it's worked. People are happy with them.
Speaker 1:I noticed that you also had prices for people that are not part of DPC. So do you actually have just walk-ins that you are also?
Speaker 2:We don't do. It's not walk-ins, but if people you know I've had people I just want a physical or more acute things, they're sick and they want to be treated for that, then they can. They have those options to sign up for that. For me personally, I appreciated those initially just to help pay off debt, but now I'm just busier, so it's not something that I have the freedom to do all the time and if I if I can fit it in my schedule, I totally will, but it's not. It's not something that I pursue like I used to.
Speaker 1:So it's not overwhelming your schedule. No no Cause. I thought about doing that. It's kind of like a hybrid model where you will make appointments but they're not actual members. And then I started to stress out about well, what if people won't join my DPC because they know that they can just pay as right?
Speaker 2:No, you know, yeah, and for I mean, you have to have your rules with it, right? So I've had people sign up for a membership and then or not sign up, but sign up for that one-time visit. And then they'll say, well, I need refills on this chronic med. And I'm like, well, I don't refill chronic meds unless you're a member. Otherwise, I have to see you at least via telehealth one time a month, if that's what you want to do.
Speaker 2:And my telehealth visit is more expensive than the membership, so it makes sense for them to then join. But that was good strategy on your part. Yeah, I know, I know.
Speaker 1:So I think it's really cool that you've hired a nurse practitioner. So talk to me about the specifics of how did you bring on, when did you know you needed a new nurse practitioner? How did you bring her on and what kind of pay structure did you start her with? Because she probably didn't have enough patients to secure her salary. So how did you do that?
Speaker 2:Yeah, I would say it was probably almost a year ago where I just felt kind of starting to feel overwhelmed, like all these people are signing up and I don't necessarily want all of them. I cause I don't. I don't my kids are so little, I don't want to do this. I don't want to do this five days a week. So I actually worked with her in corporate.
Speaker 2:She quit a few months after I left and we are, we're just really good friends and that was a big prayer going into this of Lord. If there's red flags and we shouldn't do this, please end it, cause I don't want to lose her friendship at all. And so I was in a. She was in a different position where she wasn't needing the salary, so that allowed me to okay, well then, as you gain members, we pay her a percentage off that membership, the membership that she brings in each month.
Speaker 2:But have looked at like, if that she brings in each month, but have looked at like, if we need to get into a position where we have to hire someone, they need a salary for three months. Maybe I cut back on my salary a little bit to allow them to get three months built up and then the memberships that they've earned can take over that. So it's. I'm just very fortunate that in this place she doesn't need that, because I don't know if I would have a year ago, if I would have been able to provide that for her if she needed a salary.
Speaker 1:So so do you now just pay her a percentage of the memberships or is she just making like a base amount?
Speaker 2:She gets a percentage of her memberships. What is that percentage?
Speaker 1:25%. I think, okay, yeah, yeah, and so do you cover her malpractice insurance and her licensures and vacation time and all that stuff.
Speaker 2:I do have her on malpractice and I have offered to cover licensure stuff. But I also contracted with her, so she's kind of her own entity. So at this point she hasn't taken me up on it, but I would more than happy to cover that for her if she wanted to. And how many patients is she up to? Maybe 50. She's picked up quite a few in the last couple weeks, which has been amazing. So yeah, oh that's good.
Speaker 1:So, yeah, so you don't really have a waiting list going, because as soon as someone's interested, they can just fall onto her panel, correct, yeah, yeah, yeah, okay, that's awesome. Yeah, and she seems to be happy with the yeah.
Speaker 2:Yeah, yeah, yeah, I think, yeah, I think she's very happy and it's you know I'm, I trust her and I think that's the big thing is just knowing and trusting who you hire. And and that was the thing going into hiring someone I mean this is something that worked really hard for it and to just hire someone you don't know, that isn't going to necessarily treat it the way you would, was very nerve wracking for me, because this is I mean I've I've worked hard to build this. Jesus has, like, done the most building of it. But you know my, it's your name and like it is just really nerve wracking. So I've been, I was very cautious.
Speaker 2:I knew the nurse before I hired her and trust her. So entering into that you know I had that's why I chose her is because I knew I could trust her and that I'm like girl, it's your schedule. So if you want to see one patient a day, five days a week, go for it. It's you, like you do what works best for you in your life. She also has three little kids, so just I'm not. I trust that you're going to care for the patients and all of mine are probably going to see you at some point and want to see you and not me.
Speaker 1:So there she's fantastic Well, and you've also benefited yourself from the standpoint that when you want to go on a vacation with your family and stuff like that, like you have that second provider and she's a friend, so that's helpful.
Speaker 2:Yeah.
Speaker 1:But you can turn over your panel to her for the week so that you can actually give your undivided attention to your family.
Speaker 2:That's nice, yeah, and she has. We took one. We went out away in June and then again in the fall when my kids had break. And she has, we took one. We went out way in June and then again in the fall when my kids had break and it was nice to just know that she was handling it and I didn't have to answer the messages and deal with that. Very nice, yeah.
Speaker 1:So talk to me about your charting software and things like that. What kind of EMR are you using?
Speaker 2:Yeah, so we recently just switched to Hint. I was using Hint for billing. I was using sad story my husband actually worked for an electronic healthcare record that was local to Tucson and so I was able to use that for my practice for the first couple of years and then, unfortunately, the owner of the company passed away unexpectedly and there were no buyers, and so this last early summer or later summer into fall, my husband lost his job because they were closing the company, and then I was like I have to find a new charting system. I'd had my eye on him for a while and it just made logical sense for me to just switch, because I was already using them for billing, and to think about having to like not only switch a charting system but then also switch all the billing was just overwhelming for me at that moment. And so switch to that, and I've been using them since October.
Speaker 1:Okay, so you're using the hint all in one.
Speaker 2:Yes.
Speaker 1:And how do you like it?
Speaker 2:I like it. I mean, there's nothing that's perfect, so it's nice because you can be charting in the note and still see all the things behind it. You can pull up their labs, you can do that. There's some things with faxing that I'm hearing they're trying to fix. So if you want a fax from the chart you have to download that to your computer and then go over to the faxing site and upload it, so you're not being able to fax directly from their chart. But I've heard that they're trying to fix that. Yeah, they have dot phrases, which is really nice, so you can, you know, make your notes a little bit more efficient. And then they have a lot of consents, like your patient agreements or if you want to make questionnaires. I've made some questionnaires and you can email those to the patients. They'll fill them out, send them back and then they're in the patient's chart. So some of that stuff is. I enjoy that aspect of it.
Speaker 1:Are they also monitoring your membership fees and stuff like that? Or do you have a whole nother program that's doing that? That's, it's all through them, oh awesome, yeah, so you don't have to call your patients and be like oh, your credit card didn't go through.
Speaker 2:Oh, I have to do that. Yeah, no, I if that, yeah, and I'm always like, that's always like. I'm always like did your number change?
Speaker 1:I would hate that I'm so non confrontational. Yeah, yeah, I would just probably see those people for free until. I was just irritated. Yeah, the other nice thing about it is all the labs are integrated and so I have cheaper pricing through LabCorp.
Speaker 2:So when I order, the labs are integrated and so I have cheaper pricing through LabCorp. So when I order the labs it creates the order and then it creates the invoice. So then all I have to do is go over to the billing side and charge them on the invoice. So that's a nice aspect, because before I was integrated with SonoraQuest but I was not integrated with LabCorp and that's where I was doing most of my labs from, and so I'd have to go to LabCorp site and order them and then I'd have to go to him and charge them and it was just this big thing. So that's been a really nice aspect is to have all that integrated.
Speaker 1:Yes, that takes out a lot of busy work that you would have.
Speaker 2:Yes, yeah, yeah, yeah, because.
Speaker 1:I my. So I use LabCorp but they are not integrated with the EMR that I'm using, because I'm using the EMR that I was using when I was a fee for service and it would cost too much money to integrate. So I go through all these faxed labs and then we have to scan them in and do all that. So patients are like I can't see my labs on my portal and I'm like no, you cannot.
Speaker 1:Yes, yes so we're thinking about changing to an EMR that is more DPC friendly, but it's like you said, it's overwhelming, it's an undertaking and I, and plus I, still have almost two years of a contract left on my current EMR. Yes, okay, so I'm just trying to figure all that out. Most of these nurse practitioners that I've interviewed are either using Hint or they're using Atlas MD.
Speaker 2:Yeah, yeah, I looked at that one too. I looked at that one too. But, the nice thing about Hint is because it does my billing. They don't charge me for billing anymore, like where before it was, I think it was like 60 cents a patient once you got over a hundred patients, and now all of that's included and it's just one flat fee for me and my other nurse practitioner.
Speaker 1:I was going to ask you about billing. So if a patient comes in and they want part of like a bag of fluids, are they invoiced or do they pay right then?
Speaker 2:and there, Usually I charge them right there yeah.
Speaker 1:Okay, so the statement is created right there, and then they just pay on their way out.
Speaker 2:Usually their. Their information is on file. So I just tell them like, hey, I'm, you know, this is the cost of X, the labs is typically what I charge the most for. And I said, is it just, is it okay to charge the card on file? And they'll just say, yeah, and then I just charged that. So yeah, okay, that's good.
Speaker 1:Yeah.
Speaker 2:Does Hint do the communication, so do you text patients and do video? Yeah, they do. Yeah, when you schedule the appointment, you can choose it to be either a Google meet or a zoom call, so you can do those. It does send out text message reminders, which you can adjust. It's default is 24 hours. I usually set it 48 hours. They do have a texting capability.
Speaker 2:I chose not to go with their texting capability which makes it a little confusing because now when I send things out it's a different phone number than what I actually use. So my voicemail says this is not monitored, so you need to call this number if you want to leave a message, and most people have listened to that when they've called, and same with the text message reminders. You know it comes out. This is not a monitor box. If you have an urgent need, please text this number.
Speaker 2:Just because the way that they're I use Spruce for my texting and the way that their text messages were set up is you would get a text message to your number that there was a message and hint, and then you would have to log into the app to the website because there's no app, and then respond and I was like that is way too much for me and, spruce, you can't do bulk messaging. Spruce, you can do bulk messaging, which is really great when I'm letting my patients know hey, I'm going to be out of town or I am having her scan, come in the breast ultrasound, and so I was able to send out a message to everyone hey, if you're interested in this, they're coming in in March and you can schedule appointments through them on their website and stuff like that. To makes it a little bit more easier. I'll stay with Spruce. That's good, that's good.
Speaker 1:Is there a particular story that you'd like to share about a encounter with a patient, or something that was just an aha moment for you, or something special that you can remember about this whole DPC experience?
Speaker 2:I mean it really just has been. It's not perfect, right. I mean, you know there's there's stuff behind the scenes that people don't see, that we're constantly doing and we're constantly thinking about it, how to make it better, how to solve this problem, you know. But overall it is just really fantastic and I just want to encourage anyone listening who's thinking about it. Just do it, do it, you won't regret it.
Speaker 2:I'm so in love with small businesses. I mean, I was raised in it, my dad was a small business owner, my mom was, so I'm I, it's just been ingrained in me. But everyone, I'm like, okay, how can we get you to own your own business? What can you do so you can stop this rat race of corporate America and have freedom and enjoy your life and not just be eight to five in a cubicle, you know, or whatever that looks like. So if anyone is just on the fence, just do it. Just start doing research and and ask all the questions and listen to all the things and get in groups where people are talking about it and going to encourage you.
Speaker 2:And I mean I had my haters, you know. You tell them what you're doing and they're doubting you and I'm like, okay, well, first, if it fails, it's because he didn't want it to work. You know, every day I just lay it in his hands and if you want to take it, take it. Some days I'm like can I just power wash? I think a power washing business would be fantastic. That would be awesome.
Speaker 1:I think about. I think about mixing paint at Lowe's or I'm like, just let me work in the paint mixing business?
Speaker 2:Exactly Just something mindless, I can just do it. Exactly yeah, but I I do love it. It's it's just really great. And to be able to be in a place just outside of standard medicine. I am big on lifestyle. What are you putting in your body? What are you diffusing in your home? What are you putting on your body? What are you listening to?
Speaker 2:Like we have so many chronic issues going on and then we don't address any of that, we just throw more medication at them. We'll take another pill, take on, and then we don't address any of that, we just throw more medication at them. We'll take another pill, take another pill and I'll take a bill for the side effects of that pill. And we're just like glorified drug dealers. At that point, like it's not fun, we're not getting anyone healthy.
Speaker 2:And I saw the writing on the wall that if I continued to practice that way, I would be in even more trouble than they already had a target on my back, and so I had to get out because I don't. I don't play that game. I want to get people healthy. I want to. I want people to feel well and to age well and to be able to play with their grandkids and not be in a bunch of pain, and so that really has been, it's just been nice. And then even to be with my nurse and my nurse practitioner of, like, well, what do you want to do? Like I'm, I'm open to suggestions, I'm not sitting here beholden that it has, let's do it. So it's fun to just have that.
Speaker 1:So, yeah, so do you have other certifications on functional medicine or something.
Speaker 2:I would love to. I am trying to figure that out. It's an undertaking and so that is. That is my ultimate goal. Like I would love to be functional medicine trained. Absolutely would love it. So looking at conferences that's kind of people that I've spoken to is like, just get to the conferences that you can get to to figure out, to get the information and then maybe in the future look at that. Just it's a big financial commitment to do that, but that that is like my ultimate dream is to be functional trained.
Speaker 1:Yeah, I took, I took a functional medicine course through Justin Allen at the elite nurse practitioner. Have you? Oh, okay, yeah, oh, it was excellent. Like at the end of this whole program, you get this certification. Now, it's not the certification that you get from right.
Speaker 2:Like IFM or something like that.
Speaker 1:Yeah, but it it at least gets your hands dirty with it.
Speaker 2:Okay.
Speaker 1:You can build from that baseline right there, okay.
Speaker 2:And does it does it talk about like labs and what to order and all that? Okay, how long was it?
Speaker 1:It was hours long, like I think I got about 30 or 40 CEUs, so it took me weeks to get through all. So you, you purchase it and it was a pretty reasonable price. I can't remember how much it was, but it was very reasonable.
Speaker 1:And then you just go at your pace. It's broken up into modules, so you know. So one module may just talk about, you know, leaky gut and you're just thinking all about leaky gut, and then another module is talking about hormones and another one's talking about autoimmune disorders. So it's really awesome and I think it'll be a good starting point yeah, yeah, I love that Okay. Because you already have that mindset. I can hear it in your voice that you want to get to the root cause of people's problems.
Speaker 2:Yes, and.
Speaker 1:I think that's part of what is the reason behind why a lot of us go into direct primary care, also why we want to spend time. We don't want to spend all this time with patients because we just want to figure out a pill.
Speaker 2:We have to solve the problem.
Speaker 2:Yes, we are. Yes, and that's where I'm at now is people are coming, man alive, they're sick and I'm just sitting here going and they you know there's a lot of distress in medicine right now, a lot. I don't know if you're hearing it, but I'm hearing it every single day. They just don't trust what's going on and so, you know, they come to me well, doctor, so-and-so, or nurse practitioner, whatever. My provider just doesn't listen to me. I'm like, well, that's not normal. I, I'm at least smart enough to know that what you're having isn't normal, but I'm just like, not at the place where I can figure out how to solve that problem. So what was the name of that? Again, the elite nurse practitioner. Okay, okay, Elite nurse practitioner.
Speaker 2:Okay, I will literally get off this call and look into that, cause. I just I want more information and my, I've looked. You know, you search, you Google all the things, but just trying to figure out like, what is it Is, that is exactly in it. Sometimes I feel like they're not. I'm like, are you going to talk about labs and how to read them and understand them and what to order? And that's kind of my big thing and I haven't been able to talk to anyone who's done it, or on their website. They're not very clear. So that's what's like held me back, but I will look into that for sure.
Speaker 1:Yeah, you can go down a rabbit hole with the elite nurse practitioner because there's so many courses and he's actually working on a DPC course, which you and I don't need because we're already there. But but like there's just so many opportunities, I think I've taken another of his courses that talks about hormone pellet therapy, which I thought was good.
Speaker 2:Oh, okay, I mean well it's good for some people.
Speaker 1:Yeah, it's just seemed.
Speaker 2:it seemed like too much work, yeah yes, yeah, I mean, I've thought I that's that like thyroid and hormones are the two things that I'm like. I just want to understand them. I don't want to be one of these people that's like I'm gonna do hormones just for the money. I want to do it because I think there's. I think there's space for people who are like I'm doing all the right exercise, I'm doing all the right lifestyle, I've done all the things and they're still just not optimal and they need a little help. And so I think there is truth to our hormones being off. I mean, we're constantly inundated with endocrine disruptors every single day, so that has to be playing into it. So for me it would be more like okay, well, we're gonna, let's figure that out, let's optimize that, let's look at that and then get you to that place or just get you feeling better, so you have the energy to make the changes. You know what I mean? So it's not.
Speaker 2:It's not something that I I looked for a hot minute at doing Botox. I had a nurse one of my friends is a nurse, she Botox. And then I just sat there and I was like, but I don't want to chase the almighty dollar Like I know that if I did that, that would be my end goal and I don't want that, I don't want to chase that. And then I really just started looking at it. I was like I'm so like, what are we burning in our homes? What your laundry deter in good conscious support that in my practice.
Speaker 1:But that's a good segue to what are your side hustles that you're offering.
Speaker 2:So you've got.
Speaker 1:IV hydration therapy and you've got ozone therapy, so talk to me about that.
Speaker 2:Yeah. So I've heard about ozone for a couple years now, and then this last spring a friend of mine made a comment and I knew her sister. The nurse made a comment like hey, my sister got trained in IV ozone therapy. And I was like, Hmm, well, that's interesting. And I didn't do anything with it for a few weeks and then one day I just messaged her and I said your sister told me you got trained in this. Are you wanting to do it? And she said, yeah, totally.
Speaker 2:And so then we started talking and we're in the same mindset of like we want it to be affordable for people. Why? Why is it? The people that have access to the money are the only people who get the treatments that actually work and that are helping people. So that was really helpful in creating pricing, is she? You know? We agreed on a certain structure base because she agreed to a certain amount. She told me what she was comfortable getting and I was like, okay, fine.
Speaker 2:And then we brought in I wasn't sure our market for the IV ozone. I had talked to someone up in Prescott who was doing like five to 10 a week and I'm like that's not going to do a salary and we'd like to get this nurse on full time. Granted, my market's a little bit bigger than than what Prescott is. But then we looked at the IV hydration and she was fine adding that in. So we both took a course through can't remember the name, but watch the videos and then just kind of figure it out. We want to start small, so we started with Meyer's cocktail, started with NAD, we have a glutathione push, just basic saline if someone wants that, and then the IV ozone therapy.
Speaker 2:So ozone is really great in that it helps kind of modulate your immune system. So if your immune system is really ramped up, it'll help calm it down. If it needs to be ramped up, it'll help do that. If you have bacterial infections, viral infections, If you're an athlete that wants to just help enhance your performance, coming up to some sort of meet, you can do that. And it's different protocols based on what your angle is. So some people would be like once a week, some people it could be a couple times a week and my nurse, Joanna, will talk about all those, all those things with the patient when they when they sign up for it. We actually just started that this week and we've already had three people do it Just just sign up, just for ozone, so yeah, yeah, it's been.
Speaker 1:is it something you're putting into a bag of fluids, like what is that?
Speaker 2:Yeah, yeah. So you have, there's a machine and then you have oxygen. So you have to have medical grade oxygen and then it hooks up to it and then the machine makes it into ozone. So what you do is you start the IV, you drain out 250 mLs of their blood just free flow on the floor. Then you pull up 240 cc's of the ozone and you inject it into the bag. So when the blood comes out it's typically very dark, and then as you add the ozone it gets bright red. And so you just kind of shake the bag gently for a couple minutes and let it all get mixed in, and then you just free flow it back in. And how long does that take? About an hour, yeah, okay, it's not. It's not very long, yeah, and I mean it could go faster. You know their veins are they free flow faster?
Speaker 1:So yeah, I wonder if Justin has a course on that, maybe.
Speaker 2:I want to look at it. I mean, it's my whole thing is like I don't want to harm anyone and there's really not many contraindications to getting an active heart attack. They're like don't do it if you're pregnant, but other than that, and you can, it's called you can also do what's called insufflation. So if you have a kid that has an ear infection, you get little tips and you just help it in their ear or, you know, you can put it up your nose. You can do it rectally, you can do it vaginally. So there's other ways to help heal people and not have to always, you know, reach for the medication.
Speaker 2:Not saying that you know, sometimes antibiotics are necessary. I'm not saying that I would. I do have a lot of patients, parents, that are like I don't want antibiotics right away and I'm like, good Cause, I don't like to give them. So, having an option for them to do some sort of treatment if there is an ear infection and like let's just try this and then see where they're sitting in 24 hours and then if they continue to worsen, you know, then we'll do antibiotics.
Speaker 1:So that's awesome.
Speaker 2:How much does?
Speaker 1:IV ozone cost.
Speaker 2:For non-members it's $175. If you're a member, it's $160. Okay, that's not bad.
Speaker 1:No, not to avoid an antibiotic and just make your overall health better in the long run. I've noticed that people are willing to spend a little bit more money if they can avoid big pharma.
Speaker 2:Yes, yeah, yeah, yeah, there's, yeah, they've. There's just a lot of distrust, and rightfully so. I mean, I've gained a lot of distress over the last few years of like I don't know, I don't know. I have a lot of questions now.
Speaker 1:So yes, I'm stressed out about the food that we eat and all the preservatives and the chemicals. And why is everybody suddenly allergic to gluten?
Speaker 2:And why can?
Speaker 1:we not tolerate dairy anymore. Yeah, like all these things that every time somebody comes in now I'm like well, the first thing I have to say is avoid gluten and dairy. And they're like oh, that's so complicated, because gluten is in just about everything.
Speaker 2:Yes, yeah, and just like eat of the earth, like don't just don't eat your beef, eat your protein, eat some veggies. Fruit just stay away from. I mean fruit, depending on their metabolic health.
Speaker 1:so I tell people if god made it, you can have it, if he didn't make it, don't eat it yeah, well, and even if you look at our wheat, so there's, have you heard of einkorn flour?
Speaker 2:so einkorn flour is like the og flour so I've seen pictures of it versus the standard wheat and our standard is so much bigger because they've genetically modified all of it. And then if you look at bananas, just in nature they have ton of seeds and they just modified our fruit to be sweeter and less seeds in your bananas. And I'm like I, just I'm like man, what are we? So, there's, you can buy like they're called, like heritage, heritage seeds.
Speaker 1:I think that doesn't don't quote me on it, but they're like the original. Yes, I know what you're talking about. We bought some and kind of stashed them away.
Speaker 2:Yes, yeah, for world war three, you know future use yeah, yeah, my husband the prepper, yes, I get it, I it, I get it, I get it and I mean, yeah, like, get to know your local people. Go to your farmer's markets, get to know your local ranchers, like learn where your meat is coming from, learn where your chicken's coming from. We do there's good ranchers subscription. We get their chicken because they let their chicken roam free, because chickens they eat everything. My mother-in-law has chickens. She's like, oh, I had a dead mouse and they just tore it apart and they have this cage over there because they live out in the country and so the hawks and stuff like to get at their chickens. So they've covered an area of it and pigeons will get in there and doves and they'll just kill them. They'll like run into stuff and fall on the ground and then the chickens just go at them.
Speaker 1:So I have three chickens. I live in a residential neighborhood but three chickens and my chickens must be snobs. They won't eat anything but their freaking Purina egg-lay chicken food.
Speaker 2:I mean I have put out there apples.
Speaker 1:I have put out there banana, I put out there all of our leftover food. I just set it out there and they look at me like what, uh-uh no.
Speaker 2:So I don't know strange chickens but they give me eggs every day, so that's all we want.
Speaker 1:Yeah, I know she my mother-in-law brings me eggs, I'm like thank you. So. And so my husband got to watching some YouTube video. This guy that he thinks is hilarious, that's a big prepper, and here's like he's like we're keeping our chickens, oh gosh. Well, that's awesome that you are doing all these things that are just getting people back to their homeostasis you know their balance there and that you're using DPC as an opportunity to better your life and better their life.
Speaker 2:Yes, it's such a blessing and I'm so glad that I did it and more people should do it.
Speaker 1:Yes, so if someone from Arizona or a surrounding area wants to reach out to you, are you willing?
Speaker 2:to talk to them Totally. Yeah, I've had someone up in the Phoenix area. She reached out to me through the DPC group. I'm like, yeah, what questions do you have? I'm not here to hold anyone back. Go get it. We're not in competition, there's enough for everyone. And I just want I just want everyone to just be small business owners, even if it's not DPCs Do something different.
Speaker 1:How can someone reach out to you?
Speaker 2:Yeah, so you can call or text me at 520-213-9503. Or you can email me at mandy M-A-N-D-Y at Rincon Health, that's R-I-N-C-O-N healthcom.
Speaker 1:Perfect. Thank you so much, mandy. Thank you, this was great. I'm so glad I'll do it again.
Speaker 2:If you need me back, let me know I'll come back.
Speaker 1:Let me know I'll come back. Leave us a review. Your feedback means the world to us and it helps others discover our show. We love hearing from our listeners. Feel free to connect on our social media, share your thoughts, your suggestions and even topic ideas for future episodes. As we wrap up today, we are so grateful that you chose to spend a part of your life with us. Until next time, take care. This is Amanda Price signing off. See you on the next episode, Thank you.