From Burnout to Refresh Health with Dr. Naima Spradley

In the premiere episode of Season 5, Dr. Naima Spradley, a board-certified family medicine physician and owner of Refresh Health, shares her journey from dreaming of becoming a doctor at age five to experiencing burnout in the traditional healthcare system, and eventually finding her passion in Direct Primary Care (DPC). She discusses the importance of personalized patient care, transparency, and the holistic approach she adopts in her practice. Dr. Spradley talks about the challenges of transitioning from an employed physician to a DPC practice owner and provides actionable insights on budgeting, marketing, and maintaining a balanced lifestyle. She also highlights her goals for the future of Refresh Health, including expanding her practice to encompass conferences and retreats. This episode offers a compelling story of perseverance, transformation, and the quest for a more fulfilling way to practice medicine.

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Transcript

Maryal Concepcion: 0:57

Hey there, my DPC story listeners. Well, we are officially in season five! I am so excited to bring you another season filled with inspiring stories from incredible physicians who have embraced direct primary care. This season, you'll hear from even more amazing doctors who are redefining what relationship based care looks like on their terms, for their patients, and for the future of medicine. Thank you so much for being a part of this journey. Whether you're a longtime listener or just discovering my DPC story, this season is for you. So let's dive in and celebrate the power of DPC together. On to the episode! 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. Naima Spradley: 2:24

I am Dr. Naima Spradley, owner of Refresh Health, and this is my DPC story.

Maryal Concepcion: 2:37

Dr. Naima Spradley is a board-certified family medicine physician. She is originally from New York City. She is one of four siblings and the only medical doctor in her family as every one of her siblings as well as her parents are in education. She knew at the ripe young age of five that she wanted to be a doctor and took all the necessary avenues to accomplish that. She attended St. Matthew's University School of Medicine in which she received her M. D. and she enjoys traveling, exploring, and learning. New cultures and dancing. She moved to Maryland after completing her residency and had been practicing there for the last 10 years. She opened her DPC practice called Refresh Health in October of 2024 in Maryland and has been soaring ever since.

Dr. Naima Spradley: 3:24

Welcome to the

Maryal Concepcion: 3:25

podcast, Dr.

Dr. Naima Spradley: 3:25

Spradley! Thank you. Thank you so much for having me today.

Maryal Concepcion: 3:31

It is so wonderful to welcome you as the first guest of season five. Thank you so much listeners also for tuning in today. What a wonderful time to be recording your story where you have just come from, Doing your due diligence to research DPC opening last fall. And now you are continuing to soar in 2025. So again, it's so wonderful to have you on. I want to go back to this idea that you wanted to be a doctor and you knew you wanted to be a doctor at the age of five. So please tell us what about medicine? What about the art of doctoring spoke to you when you were that young?

Dr. Naima Spradley: 4:08

Yeah. So it's, it's just so funny. I, I remember my mom always telling me that I came up to her when I was at the age of five and I told her that I wanted to be a doctor. And of course at that age, you know, many parents are like, sure. Yeah. You know, you want to be a doctor today, tomorrow you may want to be a ballerina, you know? So but they realized that I continued to come to them. And let them know that I did want to be a doctor. And I could just remember my mom worked a lot and I could just remember some days I would be in her room. Her feet may have been hurting. And so I was massaging her feet and she would just say to me, you know what, you really have healing hands. And, at that age, I didn't really know what it meant, but all I knew was that whatever I did. I was making her feel better. And that made me feel better. And it just really kind of brought it to light when, my friends, we would want to play dress up and they're like, I'll be the teacher, you'll be the student. And everyone was so excited to be, teacher and student. And I was like, wait, why can't we switch it up and be doctor and patient. And they were just like no, let's put a student and teacher, which I understood. But I was just always so fascinated in the body and what I could potentially do to kind of help people feel better.

Maryal Concepcion: 5:35

So I love hearing this because knowing especially that you have a young daughter who's eight at the time of this recording, I think it's so special that you are, this icon and this role model for her, not only as a mom, but as a physician, especially in a world where the number of black physicians is ridiculously low. And, that's a whole nother podcast, but for your family to have been full of educators, and then for you to become a medical doctor, I wonder if you could talk to us about how your family, you know, during weddings and phone conversations, how they may have influenced your journey in medicine. Because I know being a doctor myself, there are some days in applying for medical school, even where it's like, no, I can't do this. I can't do this. So tell us about that. Because I think That also can help the audience understand this, not only did you have this desire at age five, but it continued until you got your MD.

Dr. Naima Spradley: 6:34

Yes, absolutely. So my family, we are all very close knit. They are super supportive of everything that I do. And even my parents, when I first came to them at the young age of five they tried their best to make sure they could support me in whatever way they could, especially at that age. And so what they did is they would look for all these different summer camps where I could build my math skills or my reading skills or my science skills just to kind of immerse me in different things that could actually prepare me for my ultimate goal of becoming a doctor. So yes, as I kind of got older into junior high school and high school, my summers were more uh, education based and, math and science. While some of my friends were vacationing, but in the long run, I'm so grateful that that's what it was because they were slowly, but surely preparing me to reach my ultimate goal. And even once I got to medical school my mom, she kind of traveled everywhere with me. So medical school, she was there with me and I was at St. Matthews, which was based in the Cayman Islands. So I lived there for two years. And then when I transitioned to Cook County, Loyola in Chicago she made sure that she was there to assist me and make sure that I, I was comfortable going in there. And she's just been really pivotal in my whole life. Process with this and just my family in general, they just have been awesome and just continue to be awesome.

Maryal Concepcion: 8:14

I love that. It makes me warm and fuzzy inside hearing that. Now tell us about how you went from being in medical school and then having all the specialties open to you that you could have chosen from and you chose family medicine, which as a specialty, I'm biased is amazing because you have the ability to take care of generations and generations when it comes to the things that are most commonly affecting people that you and I see every day.

Dr. Naima Spradley: 8:45

Yes. So, yeah, you're absolutely correct about that. And you know, you have family medicine, which I'm biased. I love it. But there's internal medicine that I had to choose from as well, but what I really, really liked about family medicine is exactly what the word is. It's family. So you're starting from what they say, cradle to grave. So you're literally starting with the newborns and you can literally, and I have taken care of patients that were 100 years old. So it's just so great. And then on top of that, getting experience with delivering babies and assisting with C sections. And so it really fit what I wanted because I really enjoyed building relationships. I really enjoy Knowing families and I just knew that this was where I needed to be

Maryal Concepcion: 9:39

incredible and you then went on to, Cook County and that for the millennials listening like Dr. Spadley and myself. It is Hollywood famous. However, Chicagoland is a very tough place to practice medicine. And so can you talk to us about how you chose to go to Cook County and how was your experience there that transformed you as a person and as a physician and fueled you with, the tools to become a DPC physician later on?

Dr. Naima Spradley: 10:08

Absolutely. So It's just so funny because when I was applying to residency programs, I was looking for a residency program that would fit me and my personality and my residency program. Fit the bill in every way because I really thrive in small groups and my residency program was a small close knit residency program. So, our attendings were like moms and aunts to us and uncles and my co residents were like friends and, and cousins and sisters and brothers to me. And it really set the stage for me. Me being able to go out on my own, Cook County is no walk in the park. I am so grateful that I was able to immerse myself in the culture there because, it really prepared me. To pretty much see the worst of the worst there. So when I would go out on my own, it would be like, okay, I've seen this pathology before. I've seen this before. I know how to handle this. And it just really prepared me to give me the confidence to be able to say, Hey, I've seen that. I've treated that. I've been hands on with that. And, I know how to, to handle it and just seeing the pathology in Cook County was just so amazing. But at the same token, it was a little disheartening to me because I realized that black communities specifically have such a mistrust. In the healthcare system, that they would literally let their health decline to the point where they were coming in in diabetic, you know, COAs essentially, or DKAI should say. And. needing to have amputations of their limbs or needing to start dialysis because their kidneys were failing them because they didn't trust coming into the doctor's office to address their issues. And so that right there made me know that I knew I was on a mission to rebuild the trust in Black communities, as well as bridge the gaps where there are, because there are gaps, unfortunately, in the Black communities when it comes to health, when it comes to their knowledge on health, and just how they need to treat themselves in order to get the treatment that they need from physicians.

Maryal Concepcion: 13:27

And accessing a doctor that Especially if trust is an issue, a doctor who is of the black community as well. It's like there's some females who want to see only a female doctor. Dr. Jenny Lee Las Vegas, she talked about how a lot of Korean patients will drive from California to see her how did you take your next step after residency how did you intentionally choose your next place of work to continue on with your mission?

Dr. Naima Spradley: 13:55

Yes, so coming from New York, a lot of my family migrated here to the DMV area. So I knew after being away from them for so long, I knew I wanted to start becoming an official attending in the DMV area to be close with them, to have that support with that transition from residency to pretty much being out on the real world and practicing on your own. So when I was looking for job opportunities, I knew that I. still wanted to be in the space of the underserved population because I feel like I connect very well with them. They trust me and I gained that confidence just in residency. And when it was time for me to leave, so many of my patients just gave me so much. Gratitude and just appreciated everything that I did for them and they connected with me. So I knew that I wanted to bring that. Into when I became an attending and so when I picked my job, I knew it was going to be in an underserved population so that I can work with the people that need it. The most the people that do not have the knowledge on basic. You know, medical care, the people that have the mistrust that need to have that trust rebuilt and the people that are going to appreciate what you do for them and really take heed to what you say and, and really try to do something better for themselves. So that's where I knew I needed to be, and that's how I decided to pick my very first job out of residency.

Maryal Concepcion: 15:34

now as an attending Your first job was in Maryland and you practice there for about 10 years love that family was there love that your decision to choose a job was mission driven. Bring us back to Dr. Spradley who was starting out because at some point you had to have gone through the contract negotiation. You know, the, the wooing of you to that practice, how did that go for the listeners out there?

Dr. Naima Spradley: 16:00

Sure. So of course, you know, as you go through each phase in this process, you grow as a person. Yeah. And so I feel like I grew as a person in residency with all of the knowledge that I gained, I gained confidence along with it. So I knew my worth. And I knew that, starting out as a new attending, sometimes, you do have to make sacrifices in pay because you are new. And sometimes people are taking that chance with you, but I knew my worth and I knew that I wanted to make sure that where I did go. They would be able to see my work as well. And so just the negotiation process, I made sure that they realize that I am confident in what I can do and the care that I could give and the asset that I could be to their organization. And, once you kind of let an organization know how much of an asset you can be. It's like you're flying after that because now they're like, okay, what can we do to get her into the door? And so they offered me quite a few different things. I was able to get some loan repayment. So it was just really a great feeling to see yourself grow as a person and to know your worth and to actually present that to people when you are applying for a position.

Maryal Concepcion: 17:26

I agree. I think that, You don't necessarily even realize it sometimes during your third year that you're no longer a first year and again, I'm talking about family medicine residency, but when it comes to that, wow, people actually want my skills and me as a physician, it's a wonderful feeling now talk to us about how you bringing value to the table did not match them valuing you as a physician as your career continued.

Dr. Naima Spradley: 17:52

Yeah. So I want to say probably around year six for me, or maybe year five. I just started to really become, I don't know, the love for medicine was starting to decline and I didn't like that feeling because I felt like as physicians were losing autonomy, we were not being heard, we were not being valued. And. When you feel that way, just like any other person or any other career, you start to lose the spark that you had when you first started out because you want to be seen, you want to be heard, and you want to be realized that I'm worthy of being treated as I should. And that's in any career, let alone being a physician, someone that's helping and teaching other people about self worth and about health. You want to make sure that wherever you are, you know, pouring into an organization, they're giving that back to you as well. And I just noticed that it was just a decline in health care each year that I practice and a level of. Just uncertainty for me, and if this was the right path for me, and I hate that I had to feel that way, but you know, sometimes you start to question things when you're in a situation that you feel is not beneficial for you physically mentally, and is more of a downer for you per se than an upper.

Maryal Concepcion: 19:26

And I think about the fact that you wanted to be a doctor. At the age of five, and how did you deal with You know, this is, this is what I worked so hard to do. And that disillusionment that was being paired, because some of us have guilt, some of us have just anger, because it's like, I cannot even believe that this is not in alignment. And some of us don't even realize until somebody calls them out, or something happens that's drastic, and they realize, so how did you deal with knowing your value, your dream that you had since a little girl that you achieved. And then this feeling that, oh, wow, like, I'm losing the spark of what I had my entire career.

Dr. Naima Spradley: 20:10

So it came to a point where I knew that I had to look for another path. I knew that I could not continue another 30 years in medicine in this condition. And unfortunately I started to experience burnout and that came at about the five going into my six year mark. And, you know, you hear about it, people mention about it, you read about it, but it's a different feel when you're actually going through it. And you don't even realize you're going through it. For me, it looked like I just was really down and out. I felt very fatigued. I would have stomach issues, nausea just a lot of gut health issues and a lot of anxiety. And I couldn't understand where it was coming from. And I started to kind of really look into it and realize that all of those things that were happening were really coming about, especially Monday through Friday. So during the week, it was the worst for me. And I kind of was able to connect the dots and realize that this is burnout. You know, I would literally cry in my car before I got to the door to go into the office for the day, because I knew what was coming. I knew that I was going to come into the office and, you know, There'd be piles and piles of messages or paperwork or, or things that I didn't get a chance to get to the day before that I needed to complete on top of the things that, I needed to complete for that day. So just knowing what you were walking into, what I was walking into, just really, really, made me realize that this wasn't for me and I needed to do something because burnout is real. It's a real, real issue, especially in the medical community.

Maryal Concepcion: 22:09

And I just think about you in the car crying. And then having to listen with an open heart and an open mind to make medical decisions after that. I mean, that is just, so heartbreaking to hear. And it's so heartbreaking to know that that is so relatable to so many of the listeners out there. So tell us about you having this mind space of, I need to do medicine differently. I cannot do this for the next 30 years of my life. What did you do that led you to finding about direct primary care?

Dr. Naima Spradley: 22:40

So when I got to the point that I knew I needed to move forward, I seeked help as we all should when we're in a situation that is a bit too much for us and I did get a therapist and she gave me some great advice and told me that I really needed to consider scaling down to part time to see if that could help a little bit with what I was experiencing. So when I was at the job that I was at when I was experiencing the burnout, I was full time position and I knew that I wasn't going to be able to scale down to part time with them. So I had to start planning my exit strategy. And I, actually had a colleague that I was working with that was leaving the same organization. And she mentioned to me about DPC. And I had never heard about it before, but I was intrigued because the way that she presented it, it really seemed like it was something that I could start to love medicine more again. And I. Did my research, of course, because that's what I do. And also, she actually introduced me to the DPC Facebook group. And so I was doing my research and I'm like, wow, I'm hearing all of the different things that direct primary care could offer. And I said, wow, this Seems like this can be a new chapter for me in my life. And then when I joined the DPC Facebook group and I just heard all the inspiring stories, the success stories, it was like, okay, it's not one person only. This is something that I could absolutely be successful at because I've seen it happen for multiple people in these groups. And that's when I knew that direct primary care was going to be the path for me. And that's when I kind of started with the research journey and knowing that I was going to have to put things into place.

Maryal Concepcion: 24:43

Beautiful. Beautiful. And I love that. It is so true. That hits at the heart of this podcast, the stories where we can relate to each other and have a community and know that we're not alone out there. Absolutely. For those people, especially who have experienced burnout, you know, it's so important. So thank you. When you were researching, you know, finding your spark again in, in the hope, the future of your practice being able to survive under the direct primary care model. I want to ask there about. Your transition into DPC because I, you know, going from an employed position for 10 years to, Hey, I'm going to open up my own practice, you know and you just like myself we got some cojones cause we don't have MBAs going along with our MDs. How was that transition for you? Did you have any fears, financial you know MBA related fears when you were making the jump?

Dr. Naima Spradley: 25:46

Absolutely. So I think what, what really made me say, Hey, I have to get out of this is unfortunately when I was still working as an employed physician I had a unexpected tragic loss of My daughter's father. And as women in general, we go into fight or flight mode. And so it's more of you're on overdrive to figure out, okay, how can I still pursue what I wanna pursue, but how can I deal with the, the grief that I'm dealing with and still be able to provide the care that I need to provide? And. When I had that event happen to me, the job that I was with was, I just could not believe the amount of just no, no sympathy, no empathy towards me. They, they didn't even want to give me time off to attend the funeral. It just really put into perspective. What the insurance based health care system thinks of us physician, we are considered robots. We are supposed to be hamsters on wheels where we just go, go, go, just see more and more and they forget that we're real people dealing with real issues and having to navigate those things without the support. of somewhere that you spend more time with than you do your family. At work, you know, it, it was just really disheartening to me. And I think that's when I kind of put the cape on and I said I can't do it anymore. This is it. This was the final straw. And this is when I started to put. My research into action.

Maryal Concepcion: 27:47

I'm so sorry that that happened. And, it's disgusting. One, but two, it's also disgusting how common this devaluement is, even to the point of, not even having any decency to be able to support your employee when they're trying to attend the funeral of a loved one and the father of your daughter, I mean, just, oh my God, it's so maddening. The insurance driven fever service way of doing medicine. Glad you're on this side now, but I hate that this, this stuff causes trauma for us when we are, in these experiences. So When you are putting your research into action, what did that look like for you in terms of time to open for, for those listeners out there who are thinking about DPC, planning DPC, especially, how much time would you say went from the, Okay, I'm done with research. I'm going to start putting this in action to opening day.

Dr. Naima Spradley: 28:47

Yeah. So for me, I have to say it may have been a little bit longer than I wanted, because just like most people that have been in a career or specifically in medicine, We have a security blanket and that security blanket is seeing a paycheck every 2 weeks. Okay. And just like with anything else, when our security blanket is. In jeopardy of being removed, it makes us very, very uncomfortable and it's hard to jump and and do what you need to do because you're so programmed to one way of things and in true actuality. It's just a barrier to where you really need to be and where you need to go to grow. And so for me being a single mom and having to take care of my daughter, that was the first priority. And so I knew that I couldn't just go out there and as much as I wanted to just leave and, and. Just go. I knew I couldn't do it right away. And so I had to strategically plan it out. And so it did take a few years for me before I said, you know what, I had something else that come up that I won't necessarily get into that happened. But that was the turning point where I then said, okay, this is it and I'm moving forward. And so I want to say. Early last year, really started putting my research into action. And I want to say around April, from April to when I opened in October, that is the time that it took me because even though I had been doing all that research, you do so much research, but you got to put stuff into action. And so for me, it was from April until I opened into October. And that's where Everything just started to, I feel like I just blossomed and I said, I'm no longer putting my dreams on hold because life is too precious. I want to be an inspiration for my daughter and for her to see that doesn't matter what kind of obstacles are in your way. You can still do what you're set out to do and what you're destined to do. And so it literally took me from April to October, when I opened to actually find a facility to, you know, do my budgeting, which is key. You have to make sure that you budget because you have to know. how you want to start your DPC. Some people want to start it lean, which is what I wanted to do. Some people want to start off big and extravagant, which to each his own. So you have to really think about what you want to do and budget before you actually start making financial decisions.

Maryal Concepcion: 31:46

You mentioned previously that you had student loans that the company helped pay off when you started as an attending. Speaking about low overhead keeping it lean, budgeting, how did you financially make the leap into DPC?

Dr. Naima Spradley: 32:02

Yes. So two ways. Number one, I did have some savings that was going to be directly invested into my business. And then also my dad what he does, it's, it's four of us. I have three siblings and he always said to us that whenever we decided that we wanted to start a business, We would have to present a business plan to him and pitch our business to him. And he would be willing to invest and help us fund our business. So that was one way with the help of my dad as well as my mom, they both helped me to fund some of my business along with the savings that I had. And I had to make sure that I budgeted first. So when I gave them my business plan, it had to have a budget on there as well. And that helped me because then I knew, okay. These are the things that I need to really spend my money on right now. And these are some of the things that I can hold fast on until I start growing as a business. And having that business plan along with that budgeting plan is what's going to be key. And like I said, I knew that I wanted to start lean. I knew that I did not want to take out huge lines of credit or huge loans from the bank. And I was able to accomplish that by setting a lean budget. And making sure that I stuck to that budget.

Maryal Concepcion: 33:39

when you were pitching your business plan, and when you were coming up with your budget, did you already have the name of your practice Refresh Health established? Absolutely.

Dr. Naima Spradley: 33:50

Absolutely. So actually, when I started looking into the DPC model itself that's when I started trying to create a name and I ran through a few different names, and they just didn't hit. The center for me, they didn't hit my heart. And it's just so funny because sometimes things come to you when you least expect it, but I was just sitting down watching a show on TV and I think it went to commercial and there was a commercial that came on and I think it was for like a soda company or something like that. And the word refreshing was either said or came across the screen. And I was like, wow, I thought about the word and I said, okay, when I hear refreshing, of course you thinking, okay, you quench your thirst if you're drinking something, but it gives you a sense of kind of resetting, renewing just kind of sereneness, just feeling rejuvenated and Just a renewing feeling, an at ease feeling. That's what refresh meant to me, and so I thought, okay, well, I'm not going to do refreshing, but Refresh Health would be the perfect name because it stood for everything, the vibe that I wanted to produce for my patients, and just for myself as well, going into the office. And that's how I came about with the name. And I made sure as soon as I came up with the name to go on. And claim the domain. Okay. I knew that I had to go ahead and purchase my domain because people think of names. It can come to somebody else just as easy as it came to me. And if you don't secure your domain, when it comes to you, you run the risk of not being able to have the name that you truly want to have. So I had my name for about 3 years before I even opened my practice.

Maryal Concepcion: 35:50

I love that. That is such a pro tip for listeners out there who are in the planning or thinking stages of DPC a 12 to 20 investment to have as an annual fee for a domain that is yours can absolutely be a little nugget of hope and light, especially in days of burnout. So I think that is such a great pro tip. Now tell us about April to October. You've budgeted, you have your domain, you have your out. How did the first days of refresh health go once you opened your doors?

Dr. Naima Spradley: 36:29

So, you know, leading up to it, I just kept telling myself, Oh my God, I'm going to be so nervous. I'm going to be just overwhelmed. And I had all of these feelings in my head that I was going to feel. And when I launched my practice, it was a feeling of relief. Surprisingly, all those negative feelings that I thought I was going to feel. It was the total opposite. I felt relieved. I patted myself on the back because I said, wait, I really did it. All of this research, all of the time and the effort and the doubts that I wouldn't be able to do it because I'm not a business person. I'm not business savvy. I'm just a physician. It all changed when I opened those doors. It was so relieving to know That, yeah, I did that. That was me. I did it. And so it was really a sense of relief and confidence and kind of also like, okay, I opened the doors. Now it's time to start getting this business to grow. So I have to start getting some patients in.

Maryal Concepcion: 37:41

Love it. And tell us on day one, did you have any patients already pre enrolled or did you start with zero patients or what was your status when you opened the doors?

Dr. Naima Spradley: 37:51

Yes. So when I actually opened, I had already been doing some marketing. So I already had a few patients that were pre enrolled. And, I have to be really transparent. In my last position, I had been there for about four and a half years. And I had gained quite a bit of patient panels to the point where if I wasn't there, they were not going to see any other doctor. It didn't make a difference to them. So I built a lot of trust with a lot of patients. And so I was expecting to see such an influx of people coming to my office because they know me, they know my worth, they know how I practice, they know how I made them feel as a patient. So I was just like, Oh, I'm just going to have this abundance of people rushing in the door. And I gotta say, that was not the case, you know, honestly. I think part of that is, or the main part of that is that A lot, if not most patients are programmed to only know to use insurance for their health care. They only know about insurance, insurance, insurance when it comes to health. They don't know about paying out of pocket to actually receive care. Quality care to receive care where you feel heard, you feel valued, you feel prioritized, you don't feel rushed because you only have 10 minutes to talk about a concern that may have been going on for months and months and they're not used to getting that type of care and seeing the benefits of getting that type of care. So when they heard that, oh, Dr. Spradley doesn't take insurance. It was like, Oh, okay. No insurance. This is foreign to me. And a lot of them did not buy into the concept, but that's where it comes into play that you have to know what your worth is. You have to know what you're not going to settle for. And you have to know that sometimes you have to teach people, and eventually they will come around. Sometimes they just have to learn before they come around. And I learned that myself, that even patients that in the beginning said no to me, started to slowly trickle in when they realized what the benefits you have when it comes to direct primary care. So don't be discouraged because there's some people that have their practices that grows so fast. And then you have some people that their practices grow slowly, but at a rate where they can still survive. And for me, I prefer a slow survival rate because I'm able to still kind of adapt. and acclimate myself into becoming a business owner as well as a physician while I'm still able to see grow and generate revenue.

Maryal Concepcion: 40:53

And especially because you had your I'm talking so like a parent when I say this, but you had your head on straight when you had your budget. And your business plan guiding you along with your experiencing the act of being a business owner, a physician entrepreneur. So I love that. And I do think that it definitely speaks volumes to your patients loved and trusted you. Those people who I'm talking about, especially the ones who are like, well no, thanks. Not for me. Well, actually, Dr. Spradley, I really need you because I can't find you anywhere else. Yeah. Cause there's only one of you. And I say that to each and every one of the listeners as well. But I want to ask here about your marketing strategy, because you said you had done some marketing before you opened and then came back. You know, you've continued to grow. So how did your marketing strategy start and how has it gone or how has it transitioned since?

Dr. Naima Spradley: 41:49

Sure. So of course, when just starting out with marketing for me, it was I had a lean budget. So everything that I had to do had to. The lean. Okay. And so I wasn't able to go get a big marketing firm to put out all these Facebook ads or ads or Google ads, which costs. It can cost thousands of dollars and so I literally had to put my foot to the pavement and go around and get my name out there and I literally any and everybody that would listen to me, I would speak about my practice. I would go on to sites like Eventbrite where you can find all the different events that are going on, free events. Some paid events and I would literally go on and looking for health fears that may have been going on in the community. And so I would go to these health fairs and I would speak to anybody that I could about my business and get a booth and, and talk about your business. Or even if you can't get a booth, There's so many people around, you can just ask them a simple question. Are you happy with the care that you get from your physician? Or what would you like to see different in medicine? And that's a way to spark up a conversation to let someone know what they're missing out on, which is direct primary care. So I literally had to do all of the footwork before I could start paying. To get any type of marketing strategy going.

Maryal Concepcion: 43:29

And what have you found is the type of marketing with the biggest ROI in terms of patients signing up to your practice?

Dr. Naima Spradley: 43:37

So for me I had some ads out and they didn't do as well as I thought they would, but for me, actually putting your face out there. So I do a lot of social media posting now. And it's so funny because number one, I'm an introvert, have always been an introvert. And when my family started seeing me actually posting things, they could not believe how much I had blossomed into a new person because I was never a social media person. I would post a few pictures at the holidays or my daughter or something like that, but I was never one to be on the camera talking. And that's what I am doing every week. And so it's just amazing for myself to see how I've grown as a person. When you become a business owner, you reach heights and you do things that you would have never thought you would have done. I mean, some of the talking and engaging with people that I do, I would have never even thought that I would be the person to spark up a conversation, let alone. Talk on camera about my knowledge. I'm very humble. I'm very quiet. And they call me the silent killer because I bring it on, but I'm very silent when I do it. And so for me to actually put myself out there, I think that's, what's been the best marketing strategy for myself, because people can relate when they see you. They can relate. And that's what really, really helps to get your clients out.

Maryal Concepcion: 45:18

I love that. Now tell us about your website. Beautiful. So refreshing. is peaceful. it's very different than a typical website, especially because you're offering services that are with you at the end of the rainbow. It's not like, It's you coding at the end of the rainbow and then they'll get a magical bill later on. You have your memberships and then you also offer lifestyle medicine and then weight loss management. So can you tell us about April to October and even prior to that, as you had been researching DBC, how did you decide to come to these particular service offerings at Refresh Health?

Dr. Naima Spradley: 45:57

Sure. So yes, just to kind of talk a little bit about my website, the web designer that helps me, she was amazing. It was like, she knew exactly what I wanted to show my patients and it really came out awesome. So I get a lot of compliments on the website and I'm just so excited with how it came out because it's giving off the vibe that I absolutely wanted it to give but in regards to my services, yes, I knew that I was going to do primary care, but the parts that I really enjoy doing are counseling and I knew in my previous practices. De counseling was limited because the time was limited with the constraints, and I knew that whatever I offered in my practice, there was going to be some type of counseling or holistic approach to it. So I wanted to make sure that I had something to offer to everyone. So with regular primary care, what they call the westernized type of medicine medications, can be something that a lot of patients look to get. And the thing with that is I have a lot of patients that are like, Hey, Dr. Spradley. Okay. I have high blood pressure. Just give me the medicine because I know I'm not going to put in the work and the effort to really work on things that I need to work on to get my health better. But then I have some patients That are like, Hey, Dr. Spradley, you know, I don't want medicine and I really noticed that, especially after the pandemic hit so many patients wanted more of a holistic approach to things. They didn't want to have medicines on board. And so that's where I really started looking into lifestyle medicine because I knew that I wanted to do the counseling part of it, but I also knew that I wanted to bring on the holistic approach to it. That's where lifestyle medicine comes in. So I always make sure that my patients that sign up for lifestyle medicine, which is a different package than my primary care package. I make sure that I sit down with them and I let them know that we have to have realistic expectations here. We have to set small goals and then long term goals because at the end of the day, not every medical condition can be managed only with lifestyle changes. A lot can, but we have to know that we're on the same page and aligned in the same light to know what we can do and what we can't do. And so if you are going to be. ready and motivated and all you need is an accountability partner, which will be me. Then that's when lifestyle medicine is for you. And then of course, to do the weight loss management piece, that was a no brainer because what we need to realize is that managing our weight and having a healthy weight is not only for physical appearance. But it's for mental stability as well and mental purposes. I have seen so many patients that were considered to be obese or overweight and they lacked self esteem. They were depressed. They had anxiety. They suffered from depression. So many mental health issues because it's tied and I always tell my patients this, I say, you're forgetting the brain is an organ just like the heart is just like you would feed into the Your heart, if you had a heart condition, you have to feed into your mental health just the same way. Because when your mental is not right, that's when you physically start to feel things as well. So I always make that analogy because patients don't realize, hey, oh, my heart is an organ. Like, yes, the brain is, is, is an organ, just like the heart, you know? And so, making that analogy makes it much more realistic to understand that way. And managing weight goes hand in hand and lifestyle changes play a major role in weight loss.

Maryal Concepcion: 50:18

And I think it's so empowering for yourself, but also for your patients that they're working with a doctor who has lived and breathed those experiences too. I mean, you spoke about how your gut health was was so affected by job. You crying before you went in to see your patients, you described anxiety and it's like, absolutely. These are things that we go so fast because our brain is thinking all the time. And then we've, we absolutely see that in our patients that like, Oh yeah, I got to take care of\mental health as part of my whole body. So tell us about how. You're on social media, your marketing, you have patients already established in the different branches of your practice. How do you go through a meet and greet? Does somebody say, Oh, I'm interested in lifestyle medicine or weight management before coming to a meet and greet with you? Or do you figure out what, what direction they would like to go to during the meet and greet?

Dr. Naima Spradley: 51:21

Yes. So when you go onto my website, refresh health. org, you will be able to schedule a consult. And when you schedule a consult, It takes you to my calendar link and I have three different calendar links. So one is for primary care one is for lifestyle medicine and one is for weight loss management depending on what they click on will give me a heads up on what they're interested in After they've looked at the services on the website 15 minute, phone call with them And when I do that, it gives me more insight on what would actually be the better option for them. Some people already have in their mind, I want to do the lifestyle medicine because they are trying to come off medicine or scale down off of their medicine in a safe manner. And so they already know, Hey, I want to do lifestyle medicine. And as long as it is a condition that We feel both, we can try to do that only lifestyle medicine four. Then I do say, okay, let's go for it. I do have some patients because my weight loss management program to. Is meant for patients that may just want to focus only on weight loss, so they may actually have a primary care doctor and they just say, I just need a doctor. That's going to give me the time that I need. Hold me accountable. Be able to generate a nutrition plan with me and an exercise plan with me and be able to offer me different forms of. Treatment or medication, if that's a need, sometimes people just need that extra help and they may not be able to get it from their regular primary care doctor that may be in the fee for service base that doesn't have the time to actually keep them accountable. And give them what they actually need. So when they schedule, they may have a idea of what they want to do. And sometimes I may present a different way or outlook of what they're looking for to let them know. You may actually be a better candidate for this particular program as opposed to this.

Maryal Concepcion: 53:36

So can you give us an example of that, because I can absolutely think of examples from my clinic, but I would love to hear what the example is from your community and from your patient panel, because It is so true. Everything that you say in fee for service, for those people who have experienced it in residency as an attending it can be really frustrating and add to that burnout when you want to address something, you know how to address something and you don't have the time to do it.

Dr. Naima Spradley: 54:03

Absolutely. So I can actually just speak on a patient that recently joined my practice and he had a primary care doctor. And when he called me, he said, she's not a bad doctor, but she just doesn't have the time. And he had then went on to tell me about some of the things he's struggling with medically. And he had a diagnosis of a liver issue. And he was seeing an endocrinologist and, he's had workup done. And there's just some major lifestyle changes that he has been struggling with staying committed to. So I felt like he was the perfect candidate and he signed up for the lifestyle medicine program initially when he set the console and I thought he was the perfect candidate for that. Because for the condition that he had. If he truly stayed committed to some of the lifestyle changes that we would actually go through and me hold him accountable to, I think he could absolutely be able to reverse what he was dealing with. And that's what he was looking for. So he was the perfect candidate for that lifestyle medicine program because. He knew he didn't want medicine and actually he didn't need medicine for the condition that he had. He just needed the time and the accountability on how to stay on task with his lifestyle changes. So that right there is an example of where having different programs can absolutely be a benefit, not only to your business. But to patients as well, so they can utilize the services that you have the knowledge and ability to provide.

Maryal Concepcion: 55:51

Tell us about how you do the accountability because absolutely I agree that accountability totally matters. And also the fact that you have the time to do the accountability matters. But in terms of organizing your day, how do you Go through your primary care patients. If they're focused on cough, colds, all the things we see in primary care stitches versus the patients in your panel who are specifically weight loss management or lifestyle and who might need more of that high level regular touch through accountability.

Dr. Naima Spradley: 56:25

Yes. So I made my packages in a sense where they are not really intertwined. So it makes it a little bit easier because my primary care package will come along with same day or next day visit. Or same day telehealth visits or in person but my weight management program is specifically weight management. So they don't get the perks of what my primary care patients will get. They can't call me up if they're in my weight loss management program and say, Hey doc, I have this call. Can I come in? So I have to make an established boundaries. Which is a huge word that a lot of us do not use or practice, but you have to establish boundaries on what you're going to do for each patient. So for my weight loss my weight loss management patients, I hold them accountable by saying in the beginning of our weight loss journey, the first one to two months. I will call them weekly to see if they have done the things that we said they needed to do. Not just taking medicine, but are you making the nutrition changes that we discussed? Are you, Committing yourself to your exercise regimen that you discuss, have you committed yourself to getting the appropriate amount of sleep that we discussed? And so that's how I hold them accountable by having, like you said, that high touch with them, because if they know they're going to get a call from Dr. Spradley, they want to get an A plus on that report card. They don't want me to be like, okay, what's going on? You're looking like you're going to get a D out this week. Okay. We want to stay on the A plus status. So it's really funny because it takes me back to how I was telling you in childhood, teacher and student and me and my childhood friends playing dress up at the age of five. And now I feel like I'm in a sense in a teacher student position. Because my patients want to get a pluses when I call them to, to make sure they're being held accountable. And so that's one way to hold people accountable when they know that there's someone that really wants to see you win. And they're going to make it their business to help you along the journey. And that's the same for my lifestyle medicine, you know, program, depending on what we are trying to focus on. I hold them accountable to what we discuss needs to be addressed within a certain time frame.

Maryal Concepcion: 59:05

And I can just imagine what seeds of trust you are more robustly planting in the community when somebody is playing bridge with their friends or whatever, and is like, Oh yeah excuse me, I gotta go. I gotta, Dr. Spradley's calling me like, what, you know, so that's amazing. And I think that you will continue. I expect that you will just continue to see the fruits of your hitting the pavement, going on social media. Even as an introvert and also taking amazing care of your patients. So tell us, what do you see happening for Refresh Health in the next five years?

Dr. Naima Spradley: 59:40

Wow. So I'm, I'm just so excited to really see how my practice and my business is going to grow. I've been working with a business coach, which has been amazing. And What I get benefit wise from my business coach is she really opens up my expansion. She expands my thinking. I would have never thought of some of the things that I could do or the measures that I could take or the levels that I could go to without having someone to really open up Pandora's box for me. And so I really see my business expanding outside of the medical office environment. I am planning on doing conferences for patients, retreats for patients just doing different things where patients don't necessarily have to feel like they're in a medical environment to receive the care The knowledge on how to handle and take care of their health, how to be proactive with their health, how to prioritize self care, because when you prioritize self care and you take care of your health, you will start to see yourself grow in other areas of your life. And that is what's key. I really love doing women's health and making sure that we are prioritizing us because we wear so many hats for some women, their moms or guardians for others, their caretakers to their family members that are aging for others, they're trying to be career women they're trying to be business women. And so a lot of the times our health. And our self care falls to the wayside. And so I am on a mission to make sure that we prioritize our self care and our health so that we can be the best version for everyone else in our life and for our patients and whoever we come in contact with.

Maryal Concepcion: 1:01:45

I hope that that is a moment that people are saying wait, I'm going to stop and rewind and play that again, because so empowering and I think about how you are able to say that because you have experienced everything that you have experienced from dreaming and achieving your dream to become a physician, to choosing an amazing impactful specialty to being devalued as a physician and coming through everything that that journey brought in fee for service. For the listeners to get a little bit more about this person who is refreshed in their journey in medicine and who is a patient. practicing DPC physician. I have some lightning round questions for you. So first thing that comes off the top of your head, what is the best piece of advice you've ever received?

Dr. Naima Spradley: 1:02:37

I think the best piece of advice I've received was to go after what you want and don't stop until you get it.

Maryal Concepcion: 1:02:46

And what is your favorite part about being a doctor now as a DPC physician?

Dr. Naima Spradley: 1:02:51

I think my favorite part is just seeing the results of what patients are doing because they just light up when they actually see, Oh my God, I'm off of my blood pressure medicine or I've been down 15 pounds now and just seeing that reward, it really puts a smile on my face. And so I think that's just kind of the best part of it all, just seeing the result.

Maryal Concepcion: 1:03:15

Love it. What is one thing you do every day to keep yourself balanced?

Dr. Naima Spradley: 1:03:21

So I actually take time out every single morning. I make it a point for me to wake up an hour early before everyone else in the house does. And I actually practice what I'm preaching, which is self care, pouring into myself. Self improvement and ways on how to develop as a person as well as a physician. I do want to just mention I, the way I was able to actually start waking up an hour early because I am not a morning person. Never have been, but now I am. I started reading a book called The Miracle Morning and whoa. What a life changer it was for me. It really puts a lot of things into perspective and really lets you to focus on self development and putting yourself first and self care and how that all helps with every avenue of your life.

Maryal Concepcion: 1:04:21

And having read your bio what is your favorite form of dancing?

Dr. Naima Spradley: 1:04:27

So I don't know if anyone has heard of Afrobeats, but I absolutely love Afrobeats. I love dancing to that type of music. But I also love just like hip hop and R& B. I just really enjoy dancing. But Afrobeats is my number one.

Maryal Concepcion: 1:04:44

Love it. And what's one thing you wish patients understood better about DPC?

Dr. Naima Spradley: 1:04:50

The value that it holds that they could really benefit from the time and feeling heard and feeling prioritized, all the things that they really just don't get in the traditional healthcare setting.

Maryal Concepcion: 1:05:05

And in closing, last question, what would you say to fellow physicians out there? Especially speaking to those people who are experiencing similar experiences like you did in fee for service, or who are planning DPC but are not necessarily sure when it's going to happen.

Dr. Naima Spradley: 1:05:25

Just do it. Just like Nike says, just do it. You know, like I mentioned, it's hard pulling that security blanket off and you don't necessarily have to, you can still have side gigs while you are focusing on your business, but just do it, go out there. Life is so short and we always push back our dreams and always make excuses on why we can't get to where we want to get. Or, just kind of letting the time pass, but just do it. Go after your dream. What's the worst thing that can happen? You, you, you fail, but you can say, I tried, I gave it my all. And if you believe enough in yourself and know that you're worthy of getting what you want, you're not going to fail.

Maryal Concepcion: 1:06:12

And you continue to prove that every single day. So, so excited to talk with you, Dr. Spradley. Thank you so much for sharing your journey today.

Dr. Naima Spradley: 1:06:20

Thank you so much

Maryal Concepcion: 1:06:22

we have covered so much ground today. It was amazing speaking with Dr. Spradley, learning about her journey into medicine, her opening of Refresh Health and what's going on today and where it's going in the future. So if you'd like to continue the conversation, come join us over on the Patreon community. We're going to be talking about mindset, the patient experience, and making sure one's DPC practice truly serves you in the long term. That's a wrap for this episode of My DPC Story. Thanks so much for tuning in! If you've enjoyed the show, please take a moment to leave a five star review on your favorite podcast platform. It really helps others discover the podcast. Got a burning question about Direct Primary Care? Leave us a voicemail and stay tuned. You might just hear it answered by a future guest. Follow us on your social media platforms at our handle,@mydpcstory, and join us for DPC Didactics, a monthly virtual space where you can join me as we dive deeper, answer questions, and troubleshoot challenges together. Find the link@mydpcstory.com. For exclusive content and behind the scenes access, look for my DPC story on patreon.com and for DPC News on the Daily. Be sure to check out DPC news.com. Until next week, this is Maryal Concepcion.