The DPC NP
The DPC NP
From Pandemic Graduate to Direct Care Pioneer: Kathleen Trocki's Entrepreneurial Journey in Healthcare
Discover how Kathleen Trocki turned her passion for patient care into a thriving direct primary care practice in Bradenton, Florida. With a wealth of experience from working in cardiac and intensive care units, Kathleen faced the unique challenge of graduating during the pandemic, only to dive headfirst into the high-pressure world of urgent care. Hear about the camaraderie and resilience that emerged among healthcare providers during this unprecedented time. Kathleen's journey showcases how she was inspired by the direct primary care model at Florida State University, leading her to create Manatee Direct Primary Care and write her own success story.
Join us as Kathleen shares the lessons learned from blending medicine with business savvy, revealing the strategies behind growing a successful direct primary care practice. Uncover the secrets behind her meticulous patient transition process, the innovative use of software like Elation Health and Hint Health, and the art of setting service pricing that balances financial viability with comprehensive care. From hiring staff who align with her values to opting out of Medicare to better serve her patients, Kathleen provides a roadmap for anyone curious about the world of direct primary care. This episode is a valuable exploration of the balance between patient care and entrepreneurship, offering insights for both healthcare professionals and those interested in the evolving landscape of medical practices.
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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 and welcome to the DPCNP. Today we have a great guest talking to us, kathleen Troch from Bradenton, florida. She owns Manatee Direct Primary Care. Kathleen, welcome to the show.
Speaker 2:Hi, thank you, Amanda. Happy to be here, thanks for having me.
Speaker 1:Yes, I'm so excited to talk to you today. So, if you will just take us back to when you decided you were going to be a nurse, and how did that all evolve?
Speaker 2:Sure, Wow, that's going back quite a bit now, it feels like so. I grew up in a family that worked in healthcare, so you know I was around healthcare from a young age.
Speaker 2:My mother's a retired pediatric nurse practitioner that worked at a community healthcare clinic for many years. So growing up I remember going to her clinic. So health care, nursing specifically, was, you know, kind of part of my upbringing. So when I went away to college I worked on an associate's degree and I was initially interested in psychology. But you know, as I started working on my degree I realized, you know, the field of psychology, at least to me seemed like it could be somewhat limited. So I thought, well, if I go the nursing route, you know I can always specialize in psychology as a psychiatric nurse practitioner. So that's kind of what led my education path, nursing and I never did psychology.
Speaker 1:I was going to ask you when you became a nurse, did you work in the psychiatric floor, or what was your niche?
Speaker 2:I did not, although I think in nursing, as nurses, we all have some psychology that we use daily, right with patient interactions. That's always an underlying piece of education I think that we bring with us to our careers. So I started out at a local hospital working on a cardiac unit, then became a charge nurse on the unit and I hit a pretty pivotal point in my nursing career where I was offered a director, an administrative position. I really enjoyed leadership. You know I got great feedback but the desire to pursue a more clinical route in my profession was very strong for me versus the administrative route.
Speaker 2:So I really feel like that was kind of a pivotal moment in my nursing career. Am I going to pursue, you know, a higher education clinically or am I going to go more of the administrative route? So I had considered doing, you know, furthering my education into a master's health or, you know, family nurse practitioner. So I had considered doing you know, furthering my education into a master's health or, you know, family nurse practitioner. So I chose to go the clinical route. So I then took a position in the intensive care unit, which is where I was for the majority of my nursing career, and then eventually attending Florida State University's doctor of nursing practice program.
Speaker 1:So when did you graduate with your doctorate?
Speaker 2:Oh, I graduated at a very interesting time, May of 2020.
Speaker 1:Ah, yes, it was.
Speaker 2:Yes, it was so I was still working in the ICU at that time, you know, at the very beginning of COVID, which was an incredibly interesting experience, but graduated in May of 2020 and I got hired on as a provider at a local urgent care where I had leaded clinical hours. I explained the story as I was like a little straight they took me in as a student and I just never left.
Speaker 2:so it was really really a nice transition. You know, going from that novice we're excuse me from expert novice, right? So as nurses we get pretty comfortable. I had 12 years of RN experience and I felt like quote unquote, expert in my position and then stepping into the provider role as a novice was, you know, challenging, of course, I imagine, as with most professions.
Speaker 2:So I was in an environment at these local urgent care is privately owned. It wasn't a corporate urgent care. I was in a wonderful environment. I was very nurturing, felt very comfortable and I think that it allowed me to become a better provider sooner than maybe another work opportunity may have provided.
Speaker 1:So that's very interesting that you had to start your nurse practitioner career in the midst of the pandemic, when, I mean, the patient load must have been enormous. And here you were, this brand new nurse practitioner, seeing how many COVID patients every day many COVID patients every day.
Speaker 2:Well, I think our record of patients seen in a 12 hour shift at this urgent care was 132. Yeah, yes it was. It was quite a bit, but our clinic again the urgent care I worked for was family owned and operated, really cared about the and we were one of the only clinics that were fully open out restrictions.
Speaker 1:And we did a lot of COVID testing.
Speaker 2:we set up a drive through I think a lot of us saw those pop ups, if you will. You know for vaccinations testing. We set up a drive through COVID testing station that you know me and to myself and two other ma's ran. So that was really not how I expected my nurse practitioner career to start, but that was what we were dealing with at the time. That's what we were facing, and there was so much unknown that I realized early on as a provider even those who have 10, 15 years of experience that healthcare has ever changed and we are not always going to be experts. So it was a really interesting outlook for me as a new provider and it created a sense of camaraderie, even among the providers I worked with that were well seasoned, that this is new to all of us?
Speaker 1:Yes, how did you hear about direct primary care?
Speaker 2:So I was introduced to the model of direct primary care during my doctorate program. Florida State University did a wonderful job with their curriculum, and in the last two semesters I had a course that was business finance and and it was in that course that we learned about direct primary care. And one of our final assignments, a group project, was to write a business plan for a healthcare practice, and my group and I chose to write a business model for direct primary care.
Speaker 1:Wow. So you didn't go and work for a DPC clinic, you just decided you were going to open up your own. So how did that transpire?
Speaker 2:So that is an interesting story as well. So in 2020, May of 2020, I started working at a privately owned urgent care. One of the providers that I worked with that was a mentor to me lived in a town that was about 45 minutes away and he was familiar he was a physician's assistant, actually and he was very familiar with the direct primary care model, had a couple of friends in different states that had started a practice like that. So in 2021, he launched his direct primary care and so I kind of watched from the periphery. So we kept in close contact. Although I didn't work with him anymore.
Speaker 2:I, you know, would ask him a lot of questions about the startup process and how the clinic was going, and I was able to see you know him build his clinic even during the time of a pandemic, and what a wonderful service he was providing to his community and what a wonderful work life balance that type of practice provided for him and his young family. So I had at that time two young children and another one a third on the way, so the work-life balance was important.
Speaker 2:In 2022, the owners of the urgent care that I was working for bought a or, I'll say, opened a second location, second urgent care. That urgent care had an office space, a tablet that was unused. The owners knew that I had an interest in the direct primary care clinic and we set up a business plan for me to open a direct primary care clinic under their ownership. So late in the year of 2022, I opened well, I started Bradenton direct primary care and got that off the ground.
Speaker 2:That was you know an interesting process and that's I really, although I did not own the clinic, they kind of gave me free reign and said let us know what you need. Here you go, here's the space, let us know what you need. So you know, I remember doing everything from picking out the wall color, the paint on the wall color, decorating the space, creating, developing a logo, all of the marketing materials. And I tapped into, you know, that colleague of mine that had a direct primary care in another town. And one thing that I found to be very interesting and empowering in the DPC community is that it's not looked at as competition when a new clinic opens. We were just about 35 minutes away, you know, from physical location. This DPC provider was excited to share with me the steps in the process. You know it wasn't looked at as a competition, really, really inviting.
Speaker 1:I have found through many interviews that nurse practitioners that are opening up DPC clinics close by other ones really seem to embrace that other nurse practitioner because you're only taking on so many hundreds of patients. It's not like you're trying to get thousands of patients right. So, and you want to be able to know your patients on a personal level, you want to be able to talk to them for an hour if you need to, about all the details of their health. So you limit your clientele to you know anywhere between 300 and 600 is kind of what I'm hearing and so that leaves. Even if you lived in a small town, that still leaves 1000s of people out there that could benefit from DPC that you wouldn't necessarily be able to provide for them because you've reached your max.
Speaker 2:Right, absolutely.
Speaker 1:Yes.
Speaker 2:I agree in that. Again, I think as a is a benefit to both the provider and the patient. So you know that you can tell your patients yes, I will cap out a certain number of members patients, however you want to, whatever term you want to use, so I will always be able to deliver the standard of care for you, because that's what's important to me. It also allows for the provider to maintain a healthy work-life balance, not feel overwhelmed, suffer from burnout you know that's a lot of things that we hear in healthcare in general, no matter what field you work in. So I think DPC, a DPC model, you know, really promote the health and happiness of its employees as well.
Speaker 1:So what happened to Bradenton Direct Primary Care again Started.
Speaker 2:Bradenton Direct Primary Care from the ground up, and in April of 2024, so about a year and a half, almost two years starting that practice I decided to branch out on my own and I opened a team Direct Primary Care under my own ownership. So, although I had started a DPC pretty much from the ground up previously, this was a new experience as I was now the owner. So creating an LLC was the first step and then again, with the previous DPC I started, a lot of the business aspects were already in place because it was under the urgent cares ownership. So starting Manatee Direct Primary Care was almost like starting over for me. I had to select an EMR system, I had to get all of my certifications and permits in place. So there was a lot more of the business component that I experienced for the first time opening Manatee Direct Primary Care and it takes a lot of work and I remember saying over and over again I'm a nurse practitioner.
Speaker 2:I'm medical. I'm not a business person. I don't know what I'm doing, I need help or I don't enjoy this, but it's a means to an end. I want to open this practice. I want to increase access to healthcare for my community, where there's such a great need. So I will accept these business challenges. I don't have to like them, but I will accept them. I will learn from them and in turn, we'll have a successful practice. So that was almost my mantra.
Speaker 1:Did any of your patients transfer over to your new DPC practice?
Speaker 2:Yes, they did, All of them did Well. So Bravington direct primary care is with no longer running.
Speaker 1:Well, and that happens, I mean, for whatever reason, it's not anything that you're saying negative about it.
Speaker 2:Yeah, yeah and that's kind of you know similar situation where. But you know my patient at the time were obviously so important to me that I took a major risk for myself too, in order to assure that I was safer and my patients were not going to be left without.
Speaker 1:Yes, so how many patients do you have, and are you at the goal that you were hoping for?
Speaker 2:So currently I have 85 patients. So currently I have 85 patients and that's something that, as far as having goals of how many patients, you know, I have general projections but I try not to be too hard on myself and too number driven. And again with DPC you have to expect the ebb and flow right.
Speaker 2:People's lives change all the time. People move, they relocate, they get health insurance, financial reasons. So I do pride myself in saying that I have never had a patient membership for dissatisfaction, nor have I had to dismiss a patient from the practice. So I think that's wonderful, that's really wonderful. So my goal currently is two new patients a week. For me that's an easier way to look at productivity, if you will, because again, I'm a clinician. I don't really like the numbers game, I don't like the business game, but it is it's a business and if I want to see people, I got to keep the lights on Right.
Speaker 2:So I give myself a goal of two new patients per week, and that too has allowed slow but steady growth. So it's been very manageable. Because it is just me at this time. So I wear many hats, I think, as most new DPC providers do. I do the scheduling, the billing, the callbacks. I draw the labs the triage, all of it, which I love, you know, I think that's the nerd in me.
Speaker 1:Yeah, that's good. I like that. That just provides so much personal care and personal ability too, because then your patient knows that every single entity within your practice that they need to talk about, they just talk to you because it's just you yeah exactly so it is.
Speaker 2:it's wonderful in establishing you know that, patient provider relationship.
Speaker 1:And eventually.
Speaker 2:So I think my number, my goal, is around at 150 patients, maybe 125,. I would like to hire a part time employee, you know, front office staff or a medical assistant. I want to make sure I think it's important when you're hiring staff to take your time and find somebody who's going to share the same values as you do. So I much rather put a little extra work on myself and be patient and wait for for the right staff member than just get anyone in help and anybody starting a DPC. I think that they'll find it's almost like their baby, right? You, you nurture it, you grow it, you coddle it, and it's really hard to put it in somebody else's hand.
Speaker 2:But, again, if we want to build our patient panel and be as efficient as we can and have the time to sit with the patients and listen to their health concerns and come up with a treatment plan, then you know there will come a point where it's necessary for the more administrative work to be done by another employee. Yeah, that's true, because you have to be ready to do it yourself in the beginning, you got to do it all.
Speaker 1:I just hired my first nurse practitioner because my waiting list had grown and and so under her contract she has to do everything, just like you're doing. She has to do everything herself up to a certain amount of patients and she really gets to decide what that patient number is, because whenever we bring on a nurse or a medical assistant to help her, then her pay is going to go down just a little bit to accommodate for the cost of the employee that's going to help her. So she gets to decide at what point am I, you know, maxed out on drawing all the blood, doing all the PAs, ordering all the tests and doing all that stuff. Now I do have a part-time office manager, so she doesn't have to do any of the billing, she doesn't have to worry about all the membership, you know stuff. So that stuff you are having to deal with. So she only has to just do the nursing job and her nurse practitioner job. So she only has to just do the nursing job and her nurse practitioner job.
Speaker 1:But once she gets to that point where she's like, okay, I need help, then her pay will go down just to accommodate that person. That's the only way I could figure that. It made sense to me.
Speaker 2:Yeah, yeah, no, that makes sense to me as well. I agree, and you know, again, it goes back to that. You have to become business minded and I'm not sure that a lot of our education and training and nursing touched a whole lot on that.
Speaker 1:No, the only reason I'm here is because my husband encouraged me, because he's like an entrepreneur that has opened up so many businesses over the years. He's like let's open a medical clinic, and I'm like, Okay, yeah, that sounds great. He's like let's open a medical clinic and I'm like, okay, yeah, that sounds great Easy, sure. I mean, just tell me what you want me to do?
Speaker 2:I'll show up and see patients. You handle the rest.
Speaker 1:Yeah, and that's exactly what he did. And here I am.
Speaker 2:Yeah, no. And that's wonderful and you know, I had a fantastic mentor in my doctorate program that was a nurse partner in an entrepreneur herself, and she's really who inspired me. I would never considered myself an entrepreneur. That would be something a goal or even a dream of mine.
Speaker 1:But when you?
Speaker 2:look at it from the more personalized standpoint, or well. I'll share a story of really what drove me to want to start a direct primary care. I learned about it during my my schooling during my doctorate program, but working and at the time, I was working as a nurse in the ICU, so I saw people at their most vulnerable.
Speaker 2:I saw people incredibly ill a lot of those people should not have been in that situation had they had access to care. So a lot of diabetic that ended up in, you know, a diabetic coma or with severe complications simply because they could not afford to see a provider, they could not afford their medication. A lot of them had a lot of anxieties and hesitancies around healthcare and that really opened my eyes and I thought these people are here in the ICU.
Speaker 2:they trust nursing we hear it over and over again the most trusting profession. So there is an incredible need out there for healthcare in general for people who either can't afford health insurance or not offered health insurance or have had a very difficult time with the healthcare system and are now distrusting of the healthcare system.
Speaker 2:I think nurse practitioners have a unique ability to bridge that gap because we have that nursing experience, that more personalized touch, if you will, and we have the education and training to do this. And I think that's what a lot of maybe new nurse practitioners or seasoned nurse practitioners who are thinking about on stewardship, but not sure, especially family practice. That's what we are education, training, prepared over.
Speaker 2:So we are capable and I think we have a really actually I know we have a really unique approach to offer to the healthcare system that many, many people can benefit from.
Speaker 1:I could not agree with you more. So I'm looking at your office and those of you listening to the podcast. Obviously it is not video, but she has this beautiful little office. So are you in your own personal space or do you rent space from another doctor? What? What is the situation there?
Speaker 2:Nope, so I rent my own building, so I'm in my own suite, so I am in a professional park that is predominantly medical there and I have a three exam rooms, a kitchen that I turned into my lab, so I have a phlebotomy chair in there, so I draw my own specimens in house and then three exam rooms.
Speaker 2:One of my rooms has a GYN table, so I do women's health as well. One of my other larger exam rooms I set up with two more like aesthetic, like chairs versus exam tables, with the idea of eventually doing some IV infusion therapy.
Speaker 1:You haven't started that yet though.
Speaker 2:I have not started that yet. No, but that is on. That was kind of my six month goal, so I moved into the space in April of this year. So, looking at October, which is going to be here sooner than later, would like to launch that aspect of, or that part of, the practice the IV infusion therapy and I do medical weight loss and what EMR.
Speaker 1:Did you choose?
Speaker 2:So EMR that I chose was is elation health. Again, I asked my colleague my local colleague, you know, got his input on EMR systems and I did. I learned about elation first about a year and a half ago at a conference so I had done a couple demos and felt fairly comfortable with the program. So, and I've been, I've been happy with them. I think it's kind of known as maybe the DPC trifecta. As far as software applications, I use Hint Health for my membership management, I use Bruce for my communication portal and telehealth visits, and then Elation EMR system. Now I know a lot of these software applications are now developing their own combinations, if you will. You know meaning they will handle the communication piece, the membership management and whatnot. But at the moment I do use the three separate entities and they have all worked really well.
Speaker 1:And they don't get confusing having to kind of intermingle all three of the program.
Speaker 2:In the beginning.
Speaker 2:Yes, it felt, you know a little, a little overwhelming and like I was jumping between three different ones, but again, I think in healthcare in general, we're used to having to adapt to new and different systems, so that wasn't as much as a challenge or a struggle to me. Now, when my patient panel grows, it may be something that I need to revisit right, and I think that's another part of you know starting the business what works for you in the beginning at 85 patients may not work when you get to three, 400 patients.
Speaker 2:So I think you have to be open and take time to reevaluate your systems and what's working and what's not, because the overall goal, at least for me, and I think with most DPC providers, is to spend the most time with your patients, caring for your patient, so anything we can do to streamline that process is going to benefit yourself.
Speaker 1:So I'm looking at your Facebook page, manatee Direct Primary Care, and so you offer hospital follow ups, chronic disease management, women's health services and pediatric care. So your clientele is birth to death, basically.
Speaker 2:So the way my membership contract is written. I have it as we accept patients two years, 65 years old, so at this time I'm not. I have not yet opted out of Medicare, so I'm not currently seeing Medicare patients Now. That's something I may revisit sooner than later, but it wasn't you know, opting out of Medicare wasn't something that I was ready to do at the very beginning of my DPC journey.
Speaker 2:And that again is a very individualized personal and business decision for people to make. I know it's a common question and the legality is surrounding Medicare and opting out as a provider, you know, especially in DPC forum. But everything that I've read and seen, you know, I feel that has to be a personal decision and what makes sense for you and your career and profession currently, and then what is your goal? You know, one, two, three, four or five years. That may be something I I readdress in the near future.
Speaker 1:How did?
Speaker 2:you come up with your membership prices.
Speaker 1:I readdress in the near future. How did you come up with your membership prices? So I?
Speaker 2:did a local market analysis which was just me searching, you know, cpcs in the area which, where I am in Florida, I'm on around Southwest Florida but still north of Miami, I'm just a little south of Tampa. And then my county, which is Manatee County name of the practice, there is one I'm sorry there are two other direct primary care practices in the area.
Speaker 2:They are both hybrid practices, but so I extended my scope of search, you know, as far as market value and what other DPCs were charging, and I, you know, came up with a monthly membership fee based on those, those numbers. Now, again, that's something that's very individualized as well. I saw a lot of different membership agreement plans, you know, based on age. So 824 was one price, you know. With the idea that, you know, with the more birthdays we have, the more health complications that come along or the more complex the patient can be, I decided, personally, to stick with a very simple membership structure. So I have a pediatric membership price, an adult membership price, and then I do have several family. Well, we have four or five.
Speaker 1:Could you let us know specifically what those prices are? Sure.
Speaker 2:Yes, so my pediatric for one pediatric is $50 a month. One adult membership is $125 a month, which is slightly higher than the average in my area is around 75 to $100. But I also include in that twice yearly lab work. So you know, on an initial wellness, exam the general labs that we would check. I include in that membership fee and I don't do a lot of additional charges as far as testing in office. So I have EKG, urinalysis, flu, strep, covid. I have an A1C monitor.
Speaker 2:I have an INR monitor, so a lot of point of care testing that I use in the office and I don't charge for that.
Speaker 1:Okay, so all of the CLIA waived testing that you have in your clinic? They do not pay an extra cost for Correct. What about do you offer B12 shots and sinus cocktails or steroid injections or anything like that?
Speaker 2:I do, yeah, so I have several medications. You know your common medication, steroid injections. I do be 12 injections as well. Again, I have the medical weight loss component of the practice that offers several different medications there.
Speaker 2:Now those I do charge additionally for and again, that is really up to the business person in you how much you want to mark up, if you will, those costs. Obviously you don't want to come out of pocket for all of that. You know you have to again keep the lights on and keep the bills paid, but I justified a slightly higher monthly membership fee by including a lot of in-office testing and keeping the medication that we administer in office at a pretty reasonable cost.
Speaker 1:What are your thoughts on marketing to local businesses in the area to offer DPC for employers to give to their employees? Has that been something that you've thought about doing clinic and, if you have, what does that structure look like?
Speaker 2:Yes, that absolutely has been part of the thought process and I think we see that that is a fairly common practice in the DPC community and I think it's a wonderful practice. I have not yet had a business that has signed on, but I did just make a very interesting contact recently and a lot of the marketing the number one marketing strategy is word of mouth. Right, that's still my number one referral source is word of mouth. So I I have a patient who is a landscaper and he got me into contact with his boss just for kind of a question and answer session. I wanted to go to a business owner and ask how can I grab yours as a business owner? Because I was thinking do I spend money on mailing flyers? Nobody reads mail. Do you send out mass emails? It looks like spam. So how do we reach these people? And a lot of the demographic at least for myself in my area of businesses that I was looking at aren't necessarily brick and mortar is right, we're thinking contractors, landscapers, service industry. So how do we reach these people?
Speaker 2:So in speaking with this business owner he said I, you know. I explained what the DPC model of healthcare is, how it can work with businesses to provide health benefits to their employees. And he said well, in hearing this, my first thought is how do I roll this into our payroll process? So why don't you speak with the payroll company? That's who handles benefits? And I thought, wow, that's really really smart idea. And you know you want to compile this list of potential businesses that would be appropriate for a DPC. That can feel like an kind of insurmountable task, but that list already exists with these independent payroll companies, so I have that meeting coming up that I'm very excited about, with a smaller role company managed health benefit for their clients as well. What they said they're seeing more and more year after year business owners that can't offer traditional health insurance, and he seemed very interested in the D model. So I'm looking forward to that.
Speaker 1:Yeah, that just sounds like it would be really beneficial not only to you as the provider, but also to the employer to at least offer acute care and urgent care when their employees are sick. It would take away their time off work and there negates having to take off work to spend time in a doctor's office just to get, you know, an antibiotic or something. I love that concept.
Speaker 2:Yeah, there's a great value and they're mutually beneficial, you know, both for business owners and providers and for business owners to be able to offer health benefit to their employees that they otherwise could not. You know, if they're only optional health insurance, unattainable for a lot of small business owners. So it's definitely mutually beneficial for a DPC provider owner and small businesses out there in the community. And again it goes back to, you know, our direct primary care model, wanting to increase access to care. So these are, you know, local citizens, working citizens, that, at least in my opinion, I'm here to serve help. So that's a great way to reach a greater amount.
Speaker 1:Would you decrease the prices of your monthly memberships for employers?
Speaker 2:I would, yes, so I've you know started to develop a kind of a loose framework as far as a small business membership program with Hint Health I know has a lot of great resources on that component of a practice. But again, it has to be what makes sense for your area, for the market, for yourself, for the practice. So I would offer a discounted rate now, whether that was just a flat discounted rate across the board or if that will vary based on number of employees.
Speaker 2:That sign up I haven't, you know, made a final decision on that, but that was another consideration as well. Are you bringing me four employees or are we signing up 25? You know, I feel like there you want to incentivize this as much as possible. I feel get people on board.
Speaker 1:Yeah, I like that idea Because there are so many small businesses that really struggle to keep employees because they can't offer the benefits. Yeah, absolutely. What is the future of Manatee Direct Primary Care look like to you?
Speaker 2:That is a great, great question. So the goal is to grow the practice to a number of members where I feel comfortable. I know I've mentioned several times about a work-life balance, but that is really important to me having three young children.
Speaker 2:So I would throw it to a number of members where I felt comfortable. You know whether that's 300, 400 to 50. I think that you know that part. I'll just have to see where I'm comfortable. The idea would be then to hire on a second provider, as you had mentioned you've done, and maybe the five year plan and another direct primary.
Speaker 1:I love that. Or if you ask my husband.
Speaker 2:He'd say open five or six direct primary care. He's the real entrepreneur.
Speaker 1:Yes, my husband definitely Like he thinks, as soon as my last kid graduates high school, which is going to be in three years he thinks we're just going to pick up and just retire in Arkansas. Like we're just going to move to Arkansas. And as much as I do want to do that, I'm trying to figure out like okay, I have 500 patients and they're not all going to follow me to Arkansas, so I can't just pick up and leave. And he's like well, just start a clinic in Arkansas and then you can just hire a nurse practitioner to see your patients in Tennessee. I'm like I hate to break it to you, but I don't feel like that's how it's gonna work. Maybe it'll play out that way, but I feel like patients are going to have like a come apart if I'm like hey, I'm leaving, but here's your new girl.
Speaker 2:Yeah, it would have to be a transition. And that's something I'm always keeping in mind too is thinking of colleagues that I know would be wonderful DPC providers, and I make sure I stay in touch with them and tell them about the practice, how great it is to work on. You know, to own a DPC and to work as the DPC provider. So again, I think it goes along with just increasing exposure. So tell your friends and family about it, tell your colleagues. Do you know people that you know?
Speaker 2:nurse practitioners or providers that are disgruntled, unhappy, felt burnt out, you know, is that that's the case and we're not doing the best we can for our patient. So that's part of almost my succession planning, if you will is keeping in mind and keeping in contact with people, providers I know who would be fantastic cpc providers with the hopes of hey, hey, let me grow this thing to where I can bring you on and we can work together, and so you know, just communicating and increasing exposure of the direct primary care healthcare model is really important.
Speaker 1:Yes, well, I have enjoyed interviewing you. This is going to be a great podcast. People are going to learn from you and how you opened it up, so I appreciate your transparency. I appreciate the fact that you were even willing to interview on your tight schedule, so I wish you all the best, well thank you, thank you, I really appreciate it and thank you for what you're doing.
Speaker 2:Again, I think increasing awareness of direct primary care especially, like I said, the unique opportunity nurse practitioners have to bring to this field is something that we need more of. So thank you for increasing that awareness.
Speaker 1:Yes, you're welcome. Thank you so much for joining us today on the DPCNP. We hope you found our conversation insightful and informational. If you enjoyed today's episode, please consider subscribing to our podcast so that you do not miss an update, and don't forget to 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.