From Mobile Medicine to Owning a Building: Dr. Maryal Concepcion's DPC Evolution & Plan for 2025

Today My DPC Story Alum Dr. Amber Beckenhauer interviews host Dr. Maryal Concepcion for a reflection on her DPC journey up until this recording and they have a discussion on key tools and strategies for 2025 at her DPC, Big Trees MD as well as tools Maryal has helped develop for the greater Direct Primary Care (DPC) community.

As always when these two are on the pod, they share personal anecdotes on topics like achieving work-life balance through strategic scheduling and proactive planning. They also tackle challenges rural clinics face, including limited pharmacy access and the importance of community health services. The conversation highlights the impact of entrepreneurship in healthcare, resourceful property decisions, and the importance of the DPC model.

They explore the benefits of the DPC Directory as a cost-effective networking and mentorship resource that can help a person no matter where they are on their DPC journey. They also highlight The Toolkit, an innovative, interactive digital magazine designed to support DPC physicians at any level of entrepreneurship. It offers financial advice, ways to create additional income as a DPC physician, career strategies, and more!

Until next season, subscribe to the newsletter for updates on upcoming online events, courses, and the DPC Toolkit. 

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Transcript

Maryal Concepcion, MD: 1:02

Primary care is an innovative alternative path to insurance driven health care. Typically, a patient pays their doctor a low monthly membership and, in return, builds a lasting relationship with their doctor and has their doctor available at their fingertips. Welcome to the My DPC Story podcast, where each week, You will hear the ever so relatable stories shared by physicians who have chosen to practice medicine in their individual communities through the direct primary care model. I'm your host, Marielle Conception, family physician, DPC owner, and former fee for service doctor. I hope you enjoy today's episode and come away feeling inspired about the future of patient care, direct primary care.

Dr. Amber Beckenhauer: 1:50

this is what Mariel and I just figured out. Our grays and blues and greens, we all, we just match, and we really integrate well. Sisters from different

Dr. Maryal Concepcion: 1:59

misters, man. That's what it's all about.

Dr. Amber Beckenhauer: 2:03

And we're back again. Oh yeah.

Dr. Maryal Concepcion: 2:07

it's so funny because I think about when in the first season, I was like, it was really a, moment of like half, Oh my God, I've run out of interviews. And then half. Wouldn't that be fun if we closed out the season with Amber and me chatting because I love it. It's like Christmas time. It's hot cocoa season. I, it's so warm and fuzzy every time I talk with you. But with

Dr. Amber Beckenhauer: 2:29

that being said, 2025, we're gonna meet in person for that one. Oh Christmas tree, hot cocoa, amazing snow. So you're gonna have to come to Nebraska for that one. So you've had a crazy year, crazy year, so much transition, so much new, so much old, so much brought together, winning, losing, probably screaming, laughing. How's it been working with your husband and getting him ready in this DPC world and your new building staff, all of it.

Dr. Maryal Concepcion: 2:59

Yeah.

Dr. Amber Beckenhauer: 2:59

tell me your biggest favorite of 2024

Dr. Maryal Concepcion: 3:02

definitely would say my number one answer to that would be, I'm super excited to be sitting in our clinic. I am so in love with how it came together. And for those people who are not aware, I'll just give a fast version In 2021, when I opened big trees MD was a mobile First telemedicine home visit model and I didn't have a space and it was just me at the time. My husband was still up one

Dr. Amber Beckenhauer: 3:27

second. Cause I have to tell it from my side of it. And when you say that, then I just want to throw a plug in of what Dr. B here. On the phone with Mariel calls and Ben through smiles, right? And it's okay, she just told you she has this mobile clinic and I'm hearing on the other line. I just packed all my crap into this bag into my car and you can't even believe what I can fit into this. And look how this thing unrolls and I'm like, Oh, ah, like, how come you always find all these great things? Ikea target. Yeah. So like living that life. I'm imagining it because I remember those days. Yeah. And I remember every step of the way and it's so fun because I know what you're going to say next. And I remember that call too. So just keep going. So you start mobile and you're packing all these things into all your gadgets you've found in your like mobile phlebotomy, mobile doctor. Yeah, yeah. Great. Yeah, I love it. No,

Dr. Maryal Concepcion: 4:23

and I really love that call out because it's just like,, an awesome, unexpected walk down memory lane that I didn't think about. But you're right. I remember even the light that I used the other day, I was doing a procedure on a foot and I used my quilter's lamp that I bought on Amazon for Black Friday. But I remember when I had to check off, bring quilter's lamp to person's house to do an excisional biopsy

Dr. Amber Beckenhauer: 4:45

or whatever, you know, I'm just going to say, I remember the day that you called and said, how the hell do I do a pap smear outside of an office? how am I going to modify this? And I'm thinking, Oh yeah, remember the paps in the ER on a like urine. Yeah,

Dr. Maryal Concepcion: 4:58

yeah, totally. And you know, it's, funny because I had done a whole month of obstetrics and gynecology in the Dominican Republic in med school. And we had to do pap smears and exams, on gym what are the spectator benches like, yeah, so we had to be pretty, yeah, pretty MacGyvery, but you know, those days definitely really helped me hone in on what things do you need? I'm so in love with my smart heart still because it's always allowed me to be mobile and to have tech where, sometimes I might or might not have. Electricity and Wi Fi connection. And so, it's really been awesome to just hone in on what do I need in my bag? It makes me a lot less anxious when I do have to do a home visit now because I'm like, man, if you could do that for a year, like it will be okay. And knowing that if you don't have a broom to do a pack, you can use a sterile q tip and it will be okay.

Dr. Amber Beckenhauer: 5:50

I feel like it's hashtag what's in your bag. I feel like that's the good thing for 2021 for Mariel. Hashtag what's in your bag. And do you have enough Q tips? Oh my God. Yeah. Then,

Dr. Maryal Concepcion: 6:06

2022,

Dr. Amber Beckenhauer: 6:07

man,

Dr. Maryal Concepcion: 6:08

so it's always been amazing and I've been so grateful this whole time because I've talked with people like yourself and, you know, I think about when especially in 2022 talking with, your good friend, Dr. John Jacobson out in Kearney and broken bow, but His episode really opened my eyes to like, looking for leases, how to, ask for what you want, how to go into I'm an MD, don't have an MBA. And now I'm trying to negotiate a lease okay.

Dr. Amber Beckenhauer: 6:34

And Dr. Jacobson's a great person to take that advice from because, we all have our. Prior, careers and prior things we do, but John was a banker before he was a doctor and went to school later in life. And I just think as a human in general, he just has great advice and he's just a very sound mind and realistic person. And he's just a good guy to take that advice from. And I think you were always correct in that transition there.

Dr. Maryal Concepcion: 7:01

Yeah, and it was perfect. think a little over 1300 square feet. It was a little like you said, it wasn't the forever home. And I knew that because the bathrooms were upstairs. if a person couldn't come into the clinic because of physical limitations, I just, didn't charge them for home visits and went to their house. But Downstairs. it was so nice because the kids could run around safely. they had their reading tent. And then we had our one exam room with our like free exam table that I lugged over from Napa and our plant wall. And I transitioned the plant wall over when we moved, but I would say absolutely for the space. It's just like my year of being mobile first and telemedicine. I really learned that

Dr. Amber Beckenhauer: 7:38

was your year of vaccines.

Dr. Maryal Concepcion: 7:40

Oh my gosh. For the community. It was. And so having a space really helped with that. We just got VFC certified. So that's like another exciting thing about this year. But back then it was really unexpected. Like I, I did not know ever about what to expect working with your local public health department. And we have lucked out because our public health department is Very much like the administration is very much progressive. And so when it comes to like community partnerships, they're like, Yes, please sign us up. And yeah, that's the only way like, we're still the only to my knowledge, we are the only clinic that still offers vaccination for COVID below the age of 12. In our county, because pharmacies can't do it. But give

Dr. Amber Beckenhauer: 8:59

them an idea of how many miles to the, let's remember back when we really first were meeting and transitioning and we were talking about medicine and, and you going to a Walgreens, CVS, Walmart, anything to pick up a medicine. Yeah. Tell them like, how far away are you talking to these places?

Dr. Maryal Concepcion: 9:16

Yeah,

Dr. Amber Beckenhauer: 9:16

right. And I will don't live like you live.

Dr. Maryal Concepcion: 9:19

This is this is true. Yes, I being from Sacramento, born and raised. Absolutely. Yeah, when I

Dr. Amber Beckenhauer: 9:26

hear Mary males from California, most people are thinking, Oh, you're like rural Nebraska, but in your location, so well, where are you in structure? So people understand the whole VFC and why you would get that and

Dr. Maryal Concepcion: 9:41

Yeah. And, just geographically, I'm thinking like your town is like 6, 000 people. My town's about 4, 000, where I trained in Superior is, 2, 000. and I just wanted to make a clarification. The only other clinic that does it, the COVID vaccines for under 12 is an FQHC like, only for certain insurances. So we're the only clinic that does agnostically, like it doesn't matter who you are. If you need a vaccine, just let us know. But yes when it comes to, you're mentioning these like big box stores and whatnot. Yeah. So people

Dr. Amber Beckenhauer: 10:12

kind of understand what their own DPC, how, that would look, comparison wise.

Dr. Maryal Concepcion: 10:17

So there is this joke that like, we're, two hours from everywhere you want to be If you want to go to the city, San Francisco, that's about three on a good day. But we are in the Stanislaus National Forest. So if you look on a map or if you envision Sacramento, where it's like the bend of California and then Yosemite and South Lake Tahoe. If you triangulate those three, we're in the center. So, there is, and I think literally, I feel like I'm speaking verbatim, but there is one Chinese restaurant. We have a Dollar General. And the nearest target is an hour and a half away. So we're definitely far. And the nearest pharmacy

Dr. Amber Beckenhauer: 10:55

to pick things up past like a eight to five, so this is where Or even a pharmacy in general.

Dr. Maryal Concepcion: 11:00

Yeah. so we do have a pharmacy in town, but this is where I was really, really disappointed. this year we had some challenges getting our seasonal vaccines for insured people, because it's a lot easier with public health. If they're uninsured, but when it came to coordinating, that's a lesson learned for next season. Because there is a mom and pop pharmacy in town and then the nearest CVS Rite Aid is half an hour away, we were not able to run our typical flu season COVID vaccine, RSV vaccine clinic this year, because my contact at the mom and pop pharmacy in Valley Springs, which is 45 minutes away, they closed because CVS was too much of a competition. So I didn't know that they had closed. And then when I needed vaccines that I could order through people's insurance from our contact at one of the big box pharmacies, our pharmacist that we always talked with was on vacation. So this is why I mentioned the local mom and pop pharmacy, super disappointed because I called the owner left a message, and was like, Hey, I would love to see if I can, you run the vaccines for your insurance, pick them up with my vaccine cooler. I've done this at big box pharmacy. I've done this at the mom and pop and like completely no response. So it was, a bummer. My patients went there. Some of them some of them waited until the pharmacist came back and I was able to get some, like all a cart load. Vaccine clinics, but they paid like 46 for the administration fee at the mom and pop pharmacy. And I'm like, is that the reason they didn't call back is because it was their administration fees that I was taking away. And I'm like, my God. So, you know,

Dr. Amber Beckenhauer: 12:31

on a pharmacy note, just speaking about, even some of the perks of DPC, right. Cause we're going to talk a little bit about all the things we offer and like you're pointing those out in your toolkits and your directory and and like even the services, everything. So in these smaller DPCs or smaller towns and small could be anywhere from 2000 to 10, 000, you know, like from 2011 till now and Blair, which is five to 6, 000 after the college closed. I mean, we've already seen three small pharmacies closed and now the only thing available is Walgreens, Walmart, which is also struggling to get medications in and are on a lot of back orders. Sometimes we even are able to get things. Before they do. And then you have Amazon pharmacy causing a lot of that too. But then the town's outlying that people are driving in from Iowa and to Cayman, Nebraska and things like that, they've had closures within the last two years of mom, pop pharmacies because of these larger box farm pharmacies. So I think, there's been days where I've wanted to close our pharmacy and our DPC because we had to pay, a couple thousand just to even get The PDMP or the databank that we have to comply with now, the software for that and doing those things and then the time it takes away from seeing patients because now you're filling. But at the end of the day, I'm always like, no, I can't do this because there's a couple things. For one, It's been huge for those people that their pharmacies have closed. And that's kind of to your point on your mom pop. But then there's also that, like you've said before, so nice to hand them that antibiotic when they're walking out the door.

Dr. Maryal Concepcion: 14:02

Yep.

Dr. Amber Beckenhauer: 14:03

And then there's also a little bit of security, like when COVID came, and even the years after of knowing that even my family and my staff's family were somewhat protected because we had some meds that we needed when all these shortages and everything were happening. So I really feel like. The direct primary care physicians, especially in the time of COVID, showed its value of why it's nice to be independent and not having to follow every rule and make decisions for yourself and your staff and, and your patients and how much they rely on you, especially in areas like you're in. The vaccines and the firefighters and the different relationships you've had with your community, even in those early years when you're transitioning buildings has been huge for your community.

Dr. Maryal Concepcion: 14:46

yeah, I, appreciate you saying that. And it is, true. I mean, this is where I want to continue to be in the future is. making sure that we have a community presence, one of the things I'm really excited about next year is, and I'm like jumping the gun a little bit, but is, doing health fairs because I want to re envision access to a health for access to people get so attracted to going down the hill for their, 45 for their. Flu shot and their blood draw, but unless you're available that one day that it's happening, sorry, you're out and like, you gotta go see your PCP if you have one. Right. And, and so I'm excited to continue to think community based and this is where again, jumping the gun, but this is where this year has been a really good exercise in okay, where do we need to. Solidify the foundation a little bit more clean up workflows. And then how do we intentionally go into 2025?

Dr. Amber Beckenhauer: 15:38

Well, the big guy upstairs heard you and sees you and your vision because He plops this beautiful dental clinic. Oh man. Which that phone call you're like, I really like it. Oh my gosh. Can't get Jeremiah on the same page. I'm like, he'll see it. he'll be with you. the stars will align, which they have.

Dr. Maryal Concepcion: 15:55

Yeah.

Dr. Amber Beckenhauer: 15:55

But, When I saw that property and you sent me pictures, I'm like, Oh my gosh, you can't not get that. Like I want that property. Can you bring it to Blair? But in general, tell us that transition and that heartache of leaving that practice, that the bathrooms are upstairs where you used to have the, Remember the drapes because they were painting and Oh, absolutely. We're doing stress. Oh, just I love it. I remember the late night calls and the FaceTime and the what's the new thing you make me do Marco Polo. I'm so not it savvy. That's got it in the bag. I'm like, What? What was that? Can you spell that for me? Oh my god. I am a girl. She brings me into reality a little bit. That's right. And I bring her down and we just even it out. We just make a good brain, even with our color palettes. Oh my God. That's right. So good. So then you get these pictures and you send them to me and I'm like, Holy cow. And the chairs and the things. What was your thought about that building?

Dr. Maryal Concepcion: 16:49

So, I do agree putting things out in the ether and being intentional about your next move. I think that because you change your mindset to say this is what I want to do. You receive things differently. You talk differently. You look for things differently. And so, at the time energy. Yeah. At the time I had. not envisioned moving anytime soon because we were on a six month lease. It was up and we were on a month to month and it was like, 1300 ish square feet. And then we were paying 1290 a month for rent. And it was owned by a local couple who ran a mom and pop business in the complex that we were at. And so, they didn't press me on signing a lease. And then January, our lease was up.

Dr. Amber Beckenhauer: 17:34

I'm looking back at your pictures of when you sent me that.

Dr. Maryal Concepcion: 17:37

This is good. This is good. In the summer, prior to us buying the building the dentist had decided to retire and the dentist and his wife had built this building in 1991. And I remember when I was showing you like, you know, it would have

Dr. Amber Beckenhauer: 17:52

been about March of this year. Right. Yeah. So we closed. Added 226 days ago. Oh, it was closed. 226. Yeah, we

Dr. Maryal Concepcion: 18:00

closed. Well, no, we closed January 12th was when we closed on the building. Okay. Yeah. It would

Dr. Amber Beckenhauer: 18:05

have been last fall that you sent

Dr. Maryal Concepcion: 18:07

it to me. So they had built this building and I remember the day I called you though, because I was like, Oh my God, there's no doors. And I'm like, there's one room with

Dr. Amber Beckenhauer: 18:16

square feet.

Dr. Maryal Concepcion: 18:17

I know. Is. It was from what

Dr. Amber Beckenhauer: 18:20

was your last one.

Dr. Maryal Concepcion: 18:21

So it was, I think it was 1300 square feet. So it's like, it's like, Oh my gosh. And now there's bathrooms that are accessible. And then we even have a ramp, and we'll, I'll put some pictures of the clinic in our blog, but. Yeah, like it came onto the market unexpectedly and because he had just closed his dental practice literally the summer before. So like I bought a 200 vacuum from Costco and Know if you have a Costco membership, buy your vacuums from Costco, because for the life of the vacuum, even after the 90 days, you can take it right back to Costco and get a new vaccine. On anything at Costco, by

Dr. Amber Beckenhauer: 18:58

the way. I've heard crazy stories there.

Dr. Maryal Concepcion: 19:01

It's there. There's some limited things like randomly, I was looking at their Christmas stuff and they had like gold. Bars, you can't return those, but like you can return a vacuum for the lifetime of the vacuum. And I said vaccine instead of vacuum, but I meant vacuum. But yeah, like I bought a vacuum and that was it. I mean, we had so much stuff from the former clinic space. And so, I bought a few more things, but that was what we had to do was just like put stuff in place, clean stuff, and then vacuum, like steam vac the carpet. And it's like, I will take that any day over build out. But, downstairs is a basement space. I recently got registered with the SBDC and I need to look up what that stands for because I don't actually remember. It's like score, which I learned about in Dr. Julie Gunther's book. Score. org, but this is small business development centers. So they're also a nonprofit that help you get into contact with mentors. But I found that this is much more nimble in terms of actually pairing with local people. Then I have been able to find with score because I'm rural. And so, Like I was talking to my SBDC coach about like intentionally at some point, I might have, Jeremy, your husband come out here and be the master contractor, because I want to build out the basement space such that, Half of it is so a resident or medical student can stay as they're rotating here. Oh, that would be awesome. Yeah, and half could be a space like you have where it's like a community space. I could just

Dr. Amber Beckenhauer: 20:21

telehealth for a couple weeks out there. Bring my, crappy husband. Yeah. Okay, I'm seeing a new Christmas for 2025. The evergreens in California will work too. Yeah. So good. But I mean, even Oh, it just was so perfect. Cause I think about right now, there's a location about that here, 12, 000 square feet, 1. 85 million. Oh my God. Compared to, locally what you were able to offer. I just, it blows my mind, the difference, and it was priced right for you. I just feel it was meant to be because Jeremiah was

Dr. Maryal Concepcion: 20:53

leaving

Dr. Amber Beckenhauer: 20:54

and there's only one other medical location where you're at. Right.

Dr. Maryal Concepcion: 20:58

So, I'm about to be snarky. if you would like to go to physician. Yes, there is only one other location. If you would like to see a non physician provider, then there are two but one is only open Monday through Wednesday and the other one will not see you at all if you are a young child because they don't have access to pediatrics, nor if you're pregnant at either of those locations. And before they used to do labs at the one location, for anybody in the community. And now unless you see their providers or their one physician, you cannot go to them anymore. So, I love being independent to be like, all right, in that vacuum, let's create some more value prop for big trees MD. Amen. Have you seen

Dr. Amber Beckenhauer: 21:39

Virgin river

Dr. Maryal Concepcion: 21:40

on, Oh my God.

Dr. Amber Beckenhauer: 21:41

Okay. So you are the Virgin river practice and I consider ours that as well, just not the beautiful trees and landscaping and Blair, but you have the beautiful trees and landscaping Virgin River of California. Right. So

Dr. Maryal Concepcion: 21:56

one of my dearest friends is Dr. Dipti Mankar in San Diego. And so she, she was the one who said that one day and I was this is really true. And so, there's come out and deliver the babies for you. You can do the

Dr. Amber Beckenhauer: 22:07

colonoscopies.

Dr. Maryal Concepcion: 22:08

Well, I have not done one of those since 2019, so I need to refresh on that. But when we're going between towns, between Arnold and Murphy's, we go through this little like curvy grade. so the joke is when I'm talking with people, I'm like, hang on, if I lose you, I'm going through Virgin River, I will call you right back. But yes, I mean, we are very, very rural. And people would say like, Oh, it must be like a nice thing because it must. be cheaper to live there and I'm like, No, dude we have to pay for target to deliver up here versus going to target and picking stuff up, you know, in the drive, pick up on the way home. Yeah, absolutely.

Dr. Amber Beckenhauer: 22:41

And all

Dr. Maryal Concepcion: 22:41

that. It's 74 miles to SAC international. And so, I love saying second or national. It's so funny. But yeah, the cost of living because of, so many things If I wanted to like I do I want my kids to go to swim lessons year round and it's ain't happening in Arnold, California, unless we drove to Sacramento and it's like I have, had these crazy thoughts of like, every weekend, we will drive to Sacramento so the boys can get some lessons which we have not done yet, but it is very different living out here. But back to the space my husband lost his job in the spring of 2022 and then joined the practice in September. But yes, he was financially, that was the number one reason where he was like, we don't have our income anymore. Like we used to, and we can't buy a building. But I'm so grateful to my cousin who was um, a top realtor for century 21 Canada. Oh, cool. And we went to Canada on a business trip, that's for sure, and we visited with the cousins, but also we had this come to Jesus moment to talk about renting versus buying because, and like you're saying, like you called out that the the price of that property. By you. We were so lucky because this property was valued at over 400, 000. And just the market for commercial space is totally, not what it has been before. It's picked up a little bit, but we were so grateful that because the mom and pop dentist practice that had built this and sold it to us was like, Mm hmm. If you can keep medical services in this community, we will take your price. And so we put an offer for 235 down. They were had listed it at 299, even though it was valued at over 400. And with yes, you're saying dental chairs, we have three of them. We have overhead lights, that you use in a dentist's office in three of them. And We are so grateful and probably my favorite thing of all is that the extra things that came With the clinic was our like 7, 000 autoclave that pumps out a cycle in 30 minutes It's oh my god, cuz I remember and I just mentioned this and when I was talking with Neil I flippin mailed you my circuit binoculums.

Dr. Amber Beckenhauer: 24:45

Oh, that too. But I mean, we have had you have sent me your gum go before. Yeah, to use in case so I wouldn't have to borrow one from the hospital. And, just call your sister and say, Hey, you got a gum go size three and a half. Anybody 1. 6? Anybody? Oh, my God. Yeah. But then yes, you had to mail me that stuff. And we do that. And you just do what you have to do. Yeah. And

Dr. Maryal Concepcion: 25:07

I will say though, that like one of the things that we were so excited to actually do last September was we actually had an open house and like I, Oh my God, my favorite thing though was that, yeah, we had our patients who've been with us really be able to just celebrate cause we really hadn't had space to have a really good like gathering. My family from even Roseville, which is Two and a half to 45 away, they all came and then my favorite was one of our 90 plus year old patients. This is the one who was Dr. C, I'm going to live to a hundred. So my medical care is a dollar a month. And I'm like, you do it, man. You do it. But she was standing there in the doorway. we have these swag bags made those gym bags that you like cinch at the top. Our swag bags came in and she took it upon herself because she was a teacher in her working days to make sure that everybody who walked in the door got a big trees MD swag bag. So if there is a change in background as well as sound, it's because I lost power. And that's always fun, especially the last episode of the season. Good times. I love these life episodes.

Dr. Amber Beckenhauer: 26:11

So we just happen to be talking about rural America when we lost power. And your generator kicked on or

Dr. Maryal Concepcion: 26:17

yeah.

Dr. Amber Beckenhauer: 26:17

Yeah. So I thought that was quite ironic.

Dr. Maryal Concepcion: 26:19

Yeah.

Dr. Amber Beckenhauer: 26:20

Okay. You finally got to have your open house. That was awesome. So we're past the open house and now you're actually physically working in there with your husband trying to function. He's past the beginner stages of DPC startup. How's it working between you two? You have 13, 000 square feet versus 1300, which is way better.

Dr. Maryal Concepcion: 26:40

It definitely is. And it's one of the big pluses is that we can both be here at the same time and seeing patients, because that was not that possible in the previous space. Because, especially for those of you who have not seen the pictures from before, the space is lofted. And so, You have this one enclosed office area that did have a ceiling and walls and those walls were frosted over with curtains hanging, after the frosted walls, but then would go upstairs and then there was just this massive open space and the two bathrooms. And so, it was very hard to do, we could do a cardiac exam up there, but not necessarily a pap smear. So, it's definitely nice to have more space. and we have, with DPC, it's also nice that, we don't have to be in the office eight to five. To do DPC. And so most of the time, I would say, especially now, we have a wood burning fire and it is pretty rare to have Mariel not in front of the wood burning fire. So I literally moved my entire office at home in front of the fire. And then, he's usually working here. So he, I definitely would say that, like, in general, you will swap

Dr. Amber Beckenhauer: 27:44

locations a little bit.

Dr. Maryal Concepcion: 27:45

No, he tends to have, this is his like home base and I tend to stay home and from the fire, we don't really swap from that. But what I will say is that he in general has made comments over the past year that he is very happy that he's doing DPC compared to fee for service, which was really nice to hear just because you can think about DPC and then when you try it, it's like, okay, is this really for me? But the biggest thing that he said was that, the time that he's able to spend with patients is definitely a huge win for him because the biggest, strain for his, Psyche was the, constant back to back patients, but also you have to get your notes done in 72 hours. And that was just, I mean, not that he doesn't finish notes. Does that work for you? You, Maryanne? Oh, man, yeah. this is, this is, again, think I said this too, that was not

Dr. Amber Beckenhauer: 28:30

nice of me, but,

Dr. Maryal Concepcion: 28:32

um, oh man, that journey's real.

Dr. Amber Beckenhauer: 28:34

So I just have to say for all the moments in my life that I feel like I'm incompetent when it comes to it, because. You're beyond me on tier level, man. It was a good day to hear you say you were like 1500 notes behind or something. No, no, I'm over exaggerating, but I felt like, okay, I'm winning at something. Not that we're competing, but I'm winning on the notes side without AI.

Dr. Maryal Concepcion: 28:58

I don't know if this journey is relatable to people, but it's almost like, you finish with school and then you like, don't want to go to school ever again. You finish writing notes with the 14 point review of systems negative unless otherwise noted in HPI and all the note bloat, and then you, like, you don't wanna do notes. And so it was very challenging for me to be like, mm-hmm you actually do need to do your notes, you need to help your future self. so I am very much a person who like writes to my future self because I'm always like. There's one thing that I remember we talked about specifically in terms of working through lifestyle changes. We were talking about this one thing, and I want to remember what that one thing was. And even though I know my patients in general, it's like, I love to have those details. So it's, notes for my purposes. It's not notes for insurance purposes, but those notes are still a lot. And I said this in the last episode that my visits can be up to two hours long. And it's like, my gosh, you know how many words come out of my mouth in that amount of time? Like, that's a lot to summarize. Oh, man. So, so did Jeremiah.

Dr. Amber Beckenhauer: 29:59

So considering that we're like 12 hours post last episode before the internet, Hashtag, what was our 12 hour ago? Because now my new that will go up on my computer is hashtag help your future self. There you go. Because the last one was hashtag what's in your bag. Oh, that's right. Hashtag what's in your bag. It's going. See, you are talking about notes. I'm a heck of a post it note. Like I write notes to myself all the time, but in post it form.

Dr. Maryal Concepcion: 30:30

Oh my

Dr. Amber Beckenhauer: 30:30

gosh. but at least, they're not post it notes to my husband because I learned that early from one of the jobs he did at a house where they left post it notes on everything you needed to pick. So post it notes are only for Amber's use on her computer, not for home projects. But yes, what's in your bag, what's in your DPC bag. Yeah. Oh, man. Yeah. Okay. So this is a deal. Let's talk 2025 because it's real.

Dr. Maryal Concepcion: 31:00

It is.

Dr. Amber Beckenhauer: 31:00

I don't like to say that it's real, but it is. And since I get a plan for my future trip to Arnold in 2025, I don't mind 2025. But let's talk about the cool things that are like. unraveling and, you know, that we're going to unveil in 2025 coming from the IT world of Marielle. cause you've sent me some cool stuff that I've got to look at. Yeah. And I think it's going to just make the DPC community's minds explode. Even if it's somebody that's been out there and they're not new to the world, there's just new literature and new things to look at. I love your toolkit with the sponsors on the first couple pages because some of those are things that I haven't even looked at yet. Mm-hmm Um, and then all the newbies get a look at your directory and find mentors and, it's a little bit of everything compiled into one website, Tell us what 2025 and looks like from your, side of things, not just podcast.

Dr. Maryal Concepcion: 31:53

Yeah, I just love, The idea that I was a fee for service doctor and I have so much, shade about the Medicare wellness physical where you don't touch or listen to your actual patients, you just talk with them. it's such a ridiculous visit and that was, one of the major sucks in my life. And so when that was lifted, being an entrepreneur has been a very exciting journey. it's never a flat road. It's always there's ups and downs. There's a rollercoaster change when you become an entrepreneur. For me, the creative part is where I love being an entrepreneur. And so that's what I'm really working towards. And I've been working on it in 2024. But what I really see is that,, I have connected with people this year who have, challenged me, pushed me, inspired me, all of these things. And I am so excited to be in a more solid place to be creative, but also, especially with, what I'm focusing on is this going back to my creativity is fueled by the experience that I had even starting this podcast. So when I was 28 weeks pregnant and being threatened to be fired. And so upset that like, how did I not ever feel prepared as a physician to ever go through this experience? it really fuels everything that I do. And so when I was thinking about the directory, which it came out, it has been out there for a bit, but it really was not, it didn't have steam. And so give it, give

Dr. Amber Beckenhauer: 33:17

us some hindsight real quick about what the directory is for a quick second.

Dr. Maryal Concepcion: 33:22

Yeah, so as you talk

Dr. Amber Beckenhauer: 33:23

about what kind of created this.

Dr. Maryal Concepcion: 33:25

Yeah, I used to say it's like a Yelp for DPC, but really it's, like an Angie's list for DPC, because if you think about it, you know, say you love company that makes sutures, you know, I'm just pulling out of random examples and you are like, Gosh, I wish other people used your stuff. there's a company that sells urine drug sample cups. I think it's like a 12 panel, 18 panel for like, dollars, like really inexpensive and you don't have to have an account with them. You could just go online and order. And these are the companies that's one thing like I would love as a person who works in cash based medicine now, I would love the opportunity to be able to choose my vendors, and not only do all the work. Yeah. And not only having to go through like what the GPO has, because I think that It's great. Like GPOs are fantastic, but like when they're out of lidocaine or when you're like, I don't know who else to go to. And I want to know options because I don't really like their suture because it really folds up when I'm trying to have straight or proline, you know, these types of things. It's like when you want to hone in on the tools, the tech, whatever, I like to know what's out there to be able to pick. who I want to work with rather than like, Oh, there's only three options. Here you go. Pick one of them. so that's one. And then the other thing was that, as we have seen, you know, the resources for DPC out there are amazing. Lots and lots of resources for like how to start a DPC. My favorite, favorite, favorite checklist is the one by bagel still. that's the one I have on the, my DPC story resources page. When we are business owners, two years and three years and, you start thinking differently about Oh, how can I optimize whatever, or, you know, now I got to hire staff. And so those are the things that I think that, there's not as much resources on. And it's also speaking to that business is really, expertise in business comes from experience. And so this is where I love. Being able to talk with people who, they are HR managers. Melina Palmer who came on to the podcast, she talked about, quality versus value in pricing, particularly was what we were really focusing on and just copy on the website and marketing and stuff. She has this book called What Your Employees Want But Can't Tell You. And so, things like that that are higher level business. acumen topics, I guess, that I appreciate that we are learning from each other. I also appreciate hearing lessons from other entrepreneurs who are really specialized in, IT security or, OSHA, da da da, or whatever it is, but it's always take what helps you and leave what does not help you. Having a concentrated place where people understand what direct primary care is because they're even on a DPC directory, to me that represents that it's a little bit more narrowed of a, pool of people to pull from, but it's still greater than like three or four. Options. So as the platform grows, there's going to be opportunities for people on the directory to engage with, experts on different things because, people can even host their own courses and especially DPC doctors who are themselves, helping other people, coaching other people, having courses of their own. They can be on that and have, a presence and have their, fellow doctors or people who've worked with them leave reviews again, just like Angie's list so that, you have some kind of word of mouth, backing to these listings of these, businesses or people. And so The intention of it was to empower people to find whatever they needed on their DPC journey, whether that be finding a mentor, being a mentor, finding a business partner. And that always changes. So that's why the directory is supposed to be this place of perpetually, you can go back to it no matter what year DPC journey, because your needs are going to change every year, you know. Yeah.

Dr. Amber Beckenhauer: 37:02

And it just makes me think of, fitting in our little zoom lecture hall with our desks. You're like next to each other. Hi, Muriel. Oh my gosh. Hi Amber. Nebraska, California. that was one of our education zoom conferences. So I think of that when I think you're your directory, but what fueled it. So let's go backwards to what you're saying. What fueled that fire?

Dr. Maryal Concepcion: 37:25

When I think about going beyond being threatened to be fired when I was pregnant, part of my journey, I love how our practices are innovative. I love how our practices are nimble and they can adapt. And so I also love, new things that are coming out. I love things that are quality, no matter how long they have been in existence, but I like being in a place where I can appreciate both as well, though, if that makes sense. if something is really good, it's like, you know, fridges from the 1950s, they will never break. And then fridges from 2010, they will break in the next, you know, five years, probably. But, there's different pluses and minuses and I like. to take a look at all of them and then make a decision from there. So, it's that part of me that, is also what fueled the directory. And then also just being mindful of opening a DPC clinic when you are coming from residency or when you're coming from, a salary job like my husband, and then all of a sudden you have no money coming in and you still have to be mindful about paying your bills that don't go away, even though you don't have a job anymore. it's also a place to help narrow down choices to the niche of DPC so that people are not wasting their dollars on, a random marketing company that is a lot of money. And then at the end of the day, they don't understand direct primary care. It's a way for people to find a narrowed down enough, niche focus directory that they can find people and clearly it's going to be more robust as the platform grows. But those are two pieces that fuel. The directory as well.

Dr. Amber Beckenhauer: 38:47

Well, and I think one of the things that really hit home when you just said a couple of sentences ago about you have a bridge from one year and another bridge from another and just different brains, right? and the niche. But to me, what I think about is almost like even an Android phone and an iPhone user, right? we all see things completely different depending on which phones we use or. If we're, you know, windows Mac, but I mean, the main part is, is just knowing that we're all different in how we learn and what we visualize and what we take in and, you know, there's people that might argue like, why do we need all these things? They're so repetitive. And in my mind, I think completely different than that, because you think about. From year to year, how much we change, right. And DPC and if things are staying updated or not as one thing. So, you know, is your directory going to be the most updated newest thing? Absolutely. Right now it sure is. Cause you're just putting all this time and effort into it but. Just even how people can utilize all these different sites, all these different tools to learn and grow based on who really educates one way versus another, your DPC directory might like totally hit home with somebody that hates Facebook. Right. Exactly. Or the other thing would be that I think of is How many times I'm at a conference and since I'm one of the few that does OB and I guess I shouldn't say few because there might be way more now, but at the beginning when it started, there'd be a handful of us and a lot of us were more Midwest, but there's just not enough of us to go around to talk to people at a round table from 7 to 8 a. m. at breakfast, and so I just think about that and how much that could even serve a purpose because you're only at a conference once or twice a year. You're talking about an hour for breakfast two times, so two hours of a 365 day year. That's not very much, but you get on your directory, then you're going to have a little bit more access, a little bit more time to blog or even hear from somebody. So, you know, I think it's great. And I really love the idea. vendors coming to us, on a virtual platform where I don't have to be on a phone call with them. I can just look on there and see, do I want this? Do I not? cause half the time that I am putting something new into my clinic, I'm out there after hours navigating the worldwide web on my own, figuring out who I want. and I'm not necessarily on a phone call. So to have people get on there. And just leave these little, breadcrumbs for me to go on there and find when I have time versus get on a call with everybody. Cause I just don't have enough admin time in my day. I think all of that's great.

Dr. Maryal Concepcion: 41:26

Yeah. And you made two great points. One, yes, on the Facebook part, not everybody's on Facebook and also not everybody gets all of the resources that they're looking for because of the algorithm. And so that's what's really frustrating that if you happen to see a post, if you happen to be on at a certain time of day when somebody made a post or whatever, then you might see something, but those are two frustrating things. portions about Facebook. And also we see that on Facebook, after the person has gone into their first year, the engagement very frequently will drop from that person. the people who are in there three to five years, they don't necessarily engage as much because I would say most of the questions that we see in Facebook in general, are like, how do you get started? what is DPC? And so I think that that's where, you know, where can you find more in the, what do I do as a second year DPC owner, third year DPC owner? This is where, um, Absolutely. the education portion is going to be a huge part of 2025

Dr. Amber Beckenhauer: 42:23

I feel like that's great is it couples along even what you see from the DPC Alliance and the AFP and the summits, you know, where you're having that newbie, set of talks, right? And then you have your second and third year talks. A lot of times the second and third years might not have. Those videotaped or recorded because of expenses or time and, you know, all these things included. But now you have this VPC directory where you might have 2, 3, or 4 plus whatever years of these positions out there online on your directory. And they may be taking that conversation to a whole new level, or they may just be on there chatting or mentoring or whatever may be. So I do, I think that takes that newbie portion that could be on the directory as well. But it takes that second, third year beyond to a whole new level outside of a conference. I think that's going to be great, especially for people that can't travel and get there, you know?

Dr. Maryal Concepcion: 43:16

Oh, yeah. it could be 1, 000 to go to a conference because of hotel and food and airplane. So absolutely. And that was the other thing I was going to say is like, when you're talking about calling a person at a summit, if you know, someone is what, two to four days typically, is a typical meeting. And if you are in a room of fellow physicians who you already are like distant family with and. You're like, Oh my gosh, I've been meaning to talk with you about this aspect of DPC journey or whatever. You do not want to go talk to vendor tables. you don't have time for that. And I totally, know that experience so well because one, I love to talk. And so when I'm an in person summit, even if I don't know anybody, hashtag hint summit 2019, I'm like, hello, Amber, I'm a stranger to you. Tell me about. Procedures in the hospital. And you tell me about Canva. Amazing. It's a real thing. It's like when you are forced to be either with a vendor or present for people or a lecture, that's really hard. So it's an alternative.

Dr. Amber Beckenhauer: 44:18

It absolutely is.

Dr. Maryal Concepcion: 44:19

Yeah.

Dr. Amber Beckenhauer: 44:20

Tell

Dr. Maryal Concepcion: 44:20

us about the toolkit. Oh, man. I'm so excited that it came out. So it's cool. Yeah. So I will say that, again, like I have been so fortunate to be able to talk with people like yourself and guests who have been on the podcast because everybody has their unique journey. And I just love that it is literally. part of my healing and I've said this before, but it is part of my healing Person who was like, oh my god pregnant on the bathroom floor at 28 weeks bulging Pissed off and just feeling completely useless that like I was gonna get fired if I didn't sign their contract And so when I think about the things that I have found useful for myself or the things that I have found useful because a guest said them to me or somebody that I've been, in touch with in 2024 or earlier. Those are the things that helped guide, the toolkit. So, was this mishmash of it would be great to have some kind of publication. that was a couple of years ago, but didn't have the bandwidth nor like the help to do that. And in 2024, I've been very fortunate to make contact with people who are excellent at really helping me get things done. and so When I was talking with Lauren Tancredi, who many people in the DPC space know because she worked at Hint for years doing, really business bootcamp side of things. she's an MBA herself, and then she had this, idea of, taking this mishmash of publication to, hey, what if, you We did a quarterly magazine that had really useful things the community. And so it was this coming together of ideas at a perfect time. And especially during the holidays, it's like, you know, We are, um, like I, the thing that the toolkit opened with this life wheel, I had not heard of it before. Yeah. and so, Angela Mondor, who was on the podcast, maybe a few weeks ago, she is the one who I learned that from. And I just thought it was so cool because I think about it and the way that I presented it in that article was you don't have to download an app or whatever. Like it made me think about how, you know, in fourth grade we used to do mash you know, the little lines on the side and the spirals. Absolutely. Yes. Yes, like people know what I'm talking about, but it's like you literally can do that with your little circle and figure out of the different aspects in your life. where are you and where do you want to go? And being a very visual person that really resonated with me. So like putting something like that out there, but also putting things that a big question that people have is like, and a big fear that prevents people from going into DPC is like, how can I make. Extra income if I wanted to and I opted out of Medicare, you know, there's different reasons why people want to make more income. and if they want to add a way of supplementing their membership income without raising prices, we put tools that are, helping a doctor look at different opportunities there. And so meant to be very, organically useful, but also backed by sponsors who are businesses that are like, we do that. if you want that, we do that already. So it's like you said, the businesses are wanting to connect with the doctors. And so it saves us from having to be like, I don't know who's out there. And I don't have the time to research it because I'm doing 85 things in six different departments because I am the business owner today. Yeah.

Dr. Amber Beckenhauer: 47:35

So one of the things I love about the toolkit, if you guys haven't looked at it yet, sit down with your computer and even virtual, this thing is like flipping pages of a book. You hear the pages flip. So, you know, there's the people that can read on a Kindle or whatever they want. And then there's people that still like the old paper where the pages flip. I love that you hear the pages flip. It's great.

Dr. Maryal Concepcion: 47:57

Yeah, when you look at the place where the toolkit is. so it's at mydpcstory. com, forward slash 12 days of Christmas, the number 12 days of Christmas. but there is an option to download it as a PDF and the entire toolkit is interactive. It's like, flip book, like a kid's book where you can like lift it. I love it. Yeah. you can scroll and click on the QR codes or scroll and click on the buttons or whatever, but, you can download the PDF and get that experience or you can, look at the virtual magazine, which is what you're talking about. And you can literally, hear the page. I love it. that was my favorite way to look at it. And if we're

Dr. Amber Beckenhauer: 48:31

taking notes on things you don't know about your MyBTC podcast CEO here, she also put together her high school.

Dr. Maryal Concepcion: 48:43

Oh my God. No, that was that. Her high school yearbook. It was the med school, Justin's yearbook at Creighton.

Dr. Amber Beckenhauer: 48:50

Okay, even better. You know, when she had all her spare time, she was working on that at Creighton.

Dr. Maryal Concepcion: 48:56

When she didn't have

Dr. Amber Beckenhauer: 48:56

her yak tracks on and was walking across the snow in Nebraska. Oh my god.

Dr. Maryal Concepcion: 49:00

it's interesting because, growing up, it was like, what are you going to be? Doctor, teacher, lawyer? Like, those are the only three options of professions that were put in front of me, but your

Dr. Amber Beckenhauer: 49:07

book editor.

Dr. Maryal Concepcion: 49:08

Oh my God. Amazing. I like

Dr. Amber Beckenhauer: 49:11

you.

Dr. Maryal Concepcion: 49:11

I could have done I mean, I can't do it all the time, but again, this goes back to like being an entrepreneur. You get to be creative. And I just love, being able to do these things, and I love that they're meaningful things too.

Dr. Amber Beckenhauer: 49:24

All right. we could talk forever. We say that all the time. It's a good thing we're not next door neighbors, we never were. but let's end with favorites. So DPC favorites, life favorites, whatever they may be. So maybe people can get a grab bag or a swag bag of assortments for 2025 to throw into their life and, just be creative on their own in 2025 and try some new things. So what do you got for us?

Dr. Maryal Concepcion: 49:53

It's a big question. I'm trying to break it down in my head mentally because everybody is different. Like there are some people who are like, Oh, heck no, I'm not going to be like, I'm not going to do website design. That's on my journey. but I will say in general, high level things for, being an entrepreneur and being a physician entrepreneur. I will say that, one of the things this is also a very general answer, but one of the things that I wish for everybody is that, everybody can be feeling that 2025 brings them closer to, being balanced. And when I say that I am very aware of, even with fewer patients, you can still. again, going back to that life wheel, you can still be doing things that are not necessarily in balance with what you would like to do or in the direction of what you would like to do. Even though I'm able to like go to my boy's things, I want to be less on edge some days when, I want to be home with them and, doing activities with them. And whether it be creating boundaries or whatever it is, wish that for everybody really being able to examine, like, is my life still the way I want it to? Because DPC absolutely allows an easier path for that to happen, much more than fee for service, but still it's like, okay, you still have these habits and how can you adjust those habits? So that. you're still living the life that you want to live. So I'm, always working towards that in terms of like, do I need to have this notification? can I time emails so that they don't arrive a certain time of the day? What do I start my day out with? Being intentional, I think, is one of the like, very vague things, if that makes sense. But I do wish that for everybody, because I think that it makes for a happier doctor, it makes for a happier individual, and it makes for a happier everybody else when you're happier.

Dr. Amber Beckenhauer: 51:31

I like that. a couple things on that, because you and I were talking earlier about, gratitude and being grateful in 2025, and kind of along that same lines of balance. a quick story, even today, twice today, sometime throughout the day when the kids and I were at home, and then tonight putting Rex to bed, my youngest, my COVID baby, he has said to me twice today,, why am I at work? so much or why am I gone so much at work? why can't you pick me up sooner? You know, why am I at Cola's all day, which is his daycare is grandma Cola. He calls her. and you know, it's interesting when you think about that, right? Like I could have guilt and I could feel terrible about that. but I urge people to really think about that. Think about things before they react because you know, I used to have a lot of mom guilt But now I know with dpc i'm more available than I ever have been, you know, i'm still working a lot I'm the main breadwinner. My husband works very hard all day at his business, but We already know from the date time we wake up in the morning that like he's going to shuttle the kids to school and to daycare and, pick them up and get them to sports. Like, that's just how we roll. That's how we're both effective. He likes routine. I like to be with my patients and finish things up at the clinic. But I think what was interesting about what he said was, he sees one thing, why am I at daycare all day? Right? Why are you working all day? Why are am I at daycare all day? And in my head I'm thinking, gosh, I've done a really good job of. Being at all these kids practices being home on the weekends and putting my computer away, getting up early in the morning and working some before they get up so I don't have to do it when they're getting ready for school. And in my head I'm thinking I'm winning, and I am winning. I, because it's different than what it used to be. But what I think is interesting is hearing what your kids are saying and what they see, because even though I think I'm winning and I think I'm doing great, he still doesn't think I'm available. and so what does that look like for 2025? Right. Does that mean that Okay, in my four year old's eyes, maybe I need to be picking him up a couple days per week, you know, earlier than I am now, because apparently he's not making that, correlation that I'm available where my other kids, my older ones, I'm at basketball practice with them, or, you know, I answer their phone call on their phones or whatever. And just kind of understanding what each one of your family members, kids, mom, dad, husband, wife, what they're really saying or what they really need. Because as you know, I mean, we always are thinking one thing, but then when you truly ask somebody, right, it's like, Oh, that's what you needed from me. That's what, you know, and physically asking and working through what they need instead of assuming. And I think, having those conversations with people just makes everybody's life. easier, right?

Dr. Maryal Concepcion: 54:10

Absolutely. Um,

Dr. Amber Beckenhauer: 54:11

but I also think another thing talking about balance is One take home point I learned last year, because you and I were finishing up our annual end of year talk. And, I was really working 2024 was a really big focus on, just setting. A lot of, routine for my clinic, because we finally have the ability to do that and then making sure that my employees got some things that really paid out for them for all the time they've spent with me through this transition, but then also like, what was I going to do for myself? So I can make that happen. And I really found that the best answer to that is. And it seems so easy, right? You're saying about ease, but planning that schedule ahead, you know, in quarters or even six months to a year in advance. so in 2024, I went through, and I would do it at least six months ahead where I had days blocked out on my schedule. So then that way when people were scheduling or I was scheduling, I would be going around those so they didn't get ahead of me, right, and get scheduled. And really, If I had to add a day or something going back and making sure, do I really need to add this, right? Or am I doing something for someone else? Can I work more effectively? My overscheduling, taking too many new patients, you know, what am I doing? But not only was I scheduling out, office days, but also scheduling out vacations anything like I literally went and I scheduled a full year, six months to a year and. I went hog wild, you know, I went anywhere from vacations to days off to, all the kids events. And then I just kind of throughout the year decided, okay, am I being a little overzealous? Am I taking too much time away from my patients or, you know, myself? And I just really urge people to do that because even if you're not a planner, it really gives you some guidelines and boundaries ahead of time. When you're not stressed, it's kind of like how we plan out at our house. We write our calendar out for the next year, birthdays and everything, carry it over. You know, but we had really never been doing that for my own office schedule. I was just kind of giving them everything other than a couple of things per month that I would hold aside. And I think that made a big difference in 2024 for me for balance. and now looking ahead at 2025, I'm going to have to put Arnold, California for December. So, I guess that's going to go on there. But, no, I think that's a big deal. Because like this year, my son graduates and he lives in Mississippi, my 18 year old. And so the last couple of years have been really tough having a newborn through COVID and raising him but flying back and forth to Mississippi because my oldest moved down there. The same within a month of my son being born. So, you know, like for May, I already have three weeks blocked out for telehealth or no work at all because I'm going to go down there and I'm going to spend, you know, a week with him and prep and do senior stuff and, you know, I can't do that when I used to work where I did and, My patients, I hope will understand and, and if they don't, then I'm just going to have to utilize my staff to make it worth their time and make it work because I don't want to miss out on that, you know, and totally. And so I just really urge people to focus on that. I think sometimes we get so worried about our practice failing and I think more than not, in the last couple years, I lean more towards, I guess, if you don't like me and how I'm making decisions. and how I'm available, then maybe I'm not the right doctor for you because I know as soon as those kids are in school, I'm going to be so available that my patients will probably hate me because I'll be writing the messages. but right now there's a couple, you know, with my son, just being out a couple, a little bit more for school, kindergarten, and then my other one going away. Like this next six months to a year is my most meaningful year in a long time.

Dr. Maryal Concepcion: 57:54

Yeah. And so

Dr. Amber Beckenhauer: 57:55

I really think people could, find a lot of gratitude, gratefulness, and even balance in 2025, just planning, just scheduling.

Dr. Maryal Concepcion: 58:03

Yeah. Absolutely. And it's ironic because today my change the Google calendar so that because on our website, big trees, MD, our contact page, it says the dates that we're closed our holidays and today it's, it is ironic today my alarm went off to change the holidays for next year. So, we have. Asher Nolan's birthdays on there. we have our wedding anniversary on there. And similarly, like it happened when my husband was still in fee for service. It was like, Oh, but we can't do something now because we didn't plan for it. And so that, journey is very real. And I do agree completely that, on one scheduling out, yes, but two also that, and I feel that as you continue on in your DPC journey. especially if you're already open and you have patients who are seeing you, it gets easier because in terms of like that guilt of like, Oh, I can't take time away. Because your patients know that like, they know over time, you know, that we talk about how like the new patient can be really anxious and like overcall and you know, whatever. And then that eases off. But it's like, our patients definitely, they see the value in what our clinic is bringing with access, with quality of care, all of these things. And so when I'll have, the very, very rare patient who is just like you didn't call me back, even though I said it wasn't an urgent problem, and then they leave the practice. It's I hope you find the doctor that's, going to be a good fit for you. And then you move on with your day, but it's like, yeah. being in a place of, Hey, I'm not stressed out. I'm not feeling guilt because I did plan because I worked intentionally. That is all working towards self care. And if you're going to have a more present you, it's going to allow you to, Um, I'm not going to give this, stressful situation any more floor time than it deserves. And what can I do to fix it? And moving on, that's it. But it definitely gets easier. I will say that. and that's, From the last like three plus years that we've been open.

Dr. Amber Beckenhauer: 1:00:00

Definitely. One of the things I talk about with my staff is typically like if somebody has left or somebody has a complaint or maybe they're upset over a phone call and they need to vent to me, I hear them. I speak with them about it. I maybe vent a little bit too, you know, depending on what situation it is, but I always follow it up with like, where did we go wrong?

Dr. Maryal Concepcion: 1:00:22

Yeah.

Dr. Amber Beckenhauer: 1:00:22

Maybe how did this happen? How did they go wrong? How can we make this next experience look different or better? because I always feel like there's a way somebody could have made things easier, better, or even, just want a different way for sure. And, I am definitely one to say that we're not always right, but There is definitely windows of time where we also say we're okay if that patient doesn't come back. But on this next one, you know, maybe let's treat this a little bit differently, right? but that's how I look at all of life because I always think there's something you can gain from any situation. And so, maybe that's, you know, in 2025 is just what can we gain, right? And how can we make ourselves better in each situation better and just hearing things and hearing people. For sure. Yeah. how about a product that you like for 2025? So I'll start one if you don't know one. Yeah, go for it. Go for it. And this is like totally not trying to like make them have a ton of money because they're not paying me. But this is my favorite thing ever. Have you ever heard of neuro gum? No, I have not. Okay. It is L theanine, natural caffeine, B12, B6. Okay. Oh, amazing. I have not heard of this. One of our wellness conferences we just went to, and I took my staff to, they had these, love it. You can buy it off Amazon. I don't even know how to turn the package, but that's, my thing. I love it. Cause I'm trying to drink less caffeine and. Be healthier. So, uh, well energy and focus neuro gum. There's a product for you for 2025.

Dr. Maryal Concepcion: 1:01:52

Oh my gosh What do you got? So? there's so many options. It's like I'm trying to think I'm like looking around the room to see if there's like a favorite product Have I bought something that has been game changing recently? Let me think about this. Is it like, can it be any product whatsoever? I mean, I just showed you gum. I mean, you could

Dr. Amber Beckenhauer: 1:02:10

wear cabin fever from Walmart. I mean, whatever you want.

Dr. Maryal Concepcion: 1:02:15

so There are so many, but like one of the big ones that comes to mind is, I have this setup where it's this riser for your laptop. That's really compact. And I love taking it so that when I'm at like a hotel at a conference or, you know, wherever, I don't want to have to like crane my neck and look down. I can raise the laptop up by that. It's very again, this is just like, there are so many things that I could go off on. Oh my god. Are you showing us a riser as well?

Dr. Amber Beckenhauer: 1:02:48

so Brooke, our receptionist slash best friend from high school. Um, here you go. This is for the car to travel. But look at this. It's got like little pockets to put little stickies in.

Dr. Maryal Concepcion: 1:03:05

You

Dr. Amber Beckenhauer: 1:03:05

got a spot for your son to sit in. You can put your computer props up there. Oh, love this. Yeah. If she's driving me somewhere. Yeah. Then I'll use that to put the laptop out and work in the car or I'll do it in front of the TV.

Dr. Maryal Concepcion: 1:03:20

I love that. Um,

Dr. Amber Beckenhauer: 1:03:21

that's another great one. Yeah.

Dr. Maryal Concepcion: 1:03:23

What I think we should do is let's put our list in the toolkit, the next issue that let's do it. I love it. Yeah, I love it. Let's do it. Product recommendations. Yes. Because there's so many. Well, I hope you have a wonderful holiday season and I You too. Let's plan 2025.

Dr. Amber Beckenhauer: 1:03:40

Hot cocoa. Evergreen fire. Mm hmm. That's right. And a little bit of love, a

Dr. Maryal Concepcion: 1:03:50

little mini arts. You got to watch it. I will. There you go. Awesome. Love you, sister. Happy New Year. Bye. Hey, My DPC Story listeners, Maryal here. As we wrap up this season of My DPC Story, I want to take a moment to express my heartfelt gratitude to all of our incredible guests who have shared their stories, insights, and journeys with us this season. Your voices have truly inspired our community and made this season unforgettable. So as we get ready for the new season to start again in March, the conversation will continue. We'll be hosting exciting online events, including one to help you map out your goals for the year ahead. Plus, I'm thrilled to announce that courses will be launching soon, offering even more guidance on your DPC journey. If you're looking for mentorship or resources, head on over to our website to explore our DPC toolkit. It's packed with tools and resources to help you build toward your DPC goals for next year. And don't forget to subscribe to our newsletter to stay in the loop on business tips, event announcements, and early access to what's coming next. Thank you so much for being a part of this amazing community. Stay connected, stay inspired. And here's to an impactful 2025. Until next season, this is Maryal Concepcion.