Three Physicians, One Mission: The DPC Model Driving Valiant Primary Care Forward

In this episode of My DPC Story, Dr. Rachel Trupe, Dr. Adam Henry, and Dr. Luke Pittman from Valiant Primary Care share their journey into the world of Direct Primary Care (DPC). These three physicians, all trained at Indiana University School of Medicine, transitioned from three separate conventional healthcare system residencies to open their DPC practice in Zionsville, Indiana, seeking more autonomy and a better work-life balance. The episode highlights their motivations, including burnout from high patient volumes and scheduling challenges in traditional settings. By forming a partnership, they have successfully established a practice that prioritizes patient relationships and personalized care. The doctors discuss the misconceptions they initially had about DPC, the importance of understanding the financial model, and their strategies for rapid growth without significant marketing expenses. They also emphasize the value of having supportive partners and a shared vision, which has been crucial to their success. The episode serves as inspiration for physicians considering the DPC model, offering insights into the potential benefits for both doctors and patients, and reinforcing the supportive nature of the DPC community. Join the conversation to learn about the transformative power of DPC in redefining patient care.

FREE 1 month trial - HEIDI HEALTH PRO: As Individualized As Your DPC.

FREE Alternative to Up TO Date: OPEN EVIDENCE

Transcript

Dr. Maryal Concepcion: 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. Rachel Trupe: 1:50

Our story is interesting in that we are three docs who all went to the same medical school and practiced in three different health systems in our community and all were simultaneously burning out within our own zones. And after one coffee meeting in November, about one year ago, we sort of had this like moment where we all said like, you know what, we're ready to envision things differently. And three weeks later I had put in my notice and we opened six months after that.

Dr. Luke Pittman: 2:16

name is Luke Pittman. Board certified family doc, before doing DPC was between urgent care and onsite clinics, but also I spent some time working in health IT, specifically VC and launching health IT businesses which I still enjoy. But. Got to a point where the 12 hour shifts were way too long and context switching between a bunch of different activities got tough and want to be at home with a young family and said, I got to move on and found these two partners and launch what is now Valiant Primary Care.

Dr. Adam Henry: 2:47

I'm Dr. Adam Henry. I'm an internist and pediatrician. I formed Valiant Primary Care with Dr. Luke Pittman and Dr. Rachel Troop. And essentially we got our lives back from what we were doing before. More, more freedom, more decision making, more autonomy. And it's been a blast.

Dr. Rachel Trupe: 3:07

I'm Dr. Rachel Trupe.

Dr. Luke Pittman: 3:09

I'm Dr.

Dr. Adam Henry: 3:09

Luke

Dr. Luke Pittman: 3:09

Pittman.

Dr. Adam Henry: 3:10

And I'm Dr. Adam Henry,

Dr. Rachel Trupe: 3:12

founded Valiant Primary Care.

Dr. Adam Henry: 3:14

In Zinesville, Indiana. and this is our DPC story.

Dr. Maryal Concepcion: 3:23

Dr. Adam Henry is a board certified internal medicine and pediatrics physician who trained at IU School of Medicine. Passionate about patient centered care, he specializes in complex cases, point of care ultrasound, and wilderness medicine. Inspired by Christ's example, he built his practice free from insurance constraints. Outside of medicine, he enjoys family time, Brazilian jiu jitsu, and outdoor adventures. Dr. Luke Pittman is a board certified family medicine physician with experience in urgent care and on site primary care. He holds an MD MBA from IU and has worked in healthcare innovation as VP of Healthcare Solutions at DeveloperTown. Passionate about Direct Primary Care, he values deep patient relationships and improving the physician experience. He enjoys cooking, traveling, music, painting, and coaching sports. Sports with his wife and four kids. Dr. Rachel Trupe is a board certified family medicine physician as well, and former Ascension St. Vincent doctor. Named on Indianapolis Top Doctor in 2023, she is passionate about reshaping healthcare and empowering patients. She loves traveling, international service, and making memories with her husband and three children. If that is not a dopamine hit, I don't know what else is for your fine podcast listening today. It is so exciting to have three amazing physicians in Indiana today with us, because it is not common to have three physicians who are all of the same mindset that they are going to decide and follow through with creating a DPC. So Dr. Troop, Dr. Pittman and Dr. Henry, thank you so much for joining us today.

Dr. Adam Henry: 5:00

so

Dr. Maryal Concepcion: 5:01

much. Each of you came from. not only the same medical school, but then you went to different healthcare systems. And so I think that that is such a, a great representation of, well, it ain't greener on the other side. So tell us.

Dr. Rachel Trupe: 5:15

Yeah, I think in my mind, I was in St. Vincent's for the last almost 10 years after residency, which was also at St. Vincent's and wonderful colleagues. I can't say enough positive things about the people I've worked with, but our system is not set up for success for the average family medicine doctor. So we were overwhelmed with a huge volume of patients and our central scheduling team Over the last few years has been transitions to a different state who don't necessarily know me or my patients or my desire to spend extra time. And it honestly, like the last year, it got so bad that my next available appointment for an acute or a chronic health need were nine or ten weeks out. So people would call in for a rash in November, and I think the central scheduling team offered her to spot in March. And that was a few weeks before I put my notice in. I'm like, I can't give good care like this. It was just completely overwhelming. And I knew when like, I met up with Dr. Pittman and he was saying, I'm thinking we could re envision something. I was just ready at that point. I knew I couldn't keep going in the same way.

Dr. Maryal Concepcion: 6:18

would dumbfound me if there were not listeners out there who were like, oh, but my wait time to see me for acute care is longer than that. So it's really disgusting that it's such a relatable experience, but just so maddening because It, we see also that this is happening, especially with specialty care. So primary care where things are, most commonly addressed and then specialty care. It's like if your heart, craps out on you before I can see that's not my problem. That is the way that the scheduling works in my clinic. And so, Dr. Pittman, let's, let's turn to the mic to you.

Dr. Luke Pittman: 6:50

For me I think the biggest things were 12 hour shifts. Honestly, I'd be the day after a 12 hour shift and I'd be a miserable person. And this happened so many times where I would catch myself being a miserable person. And I'd be like, You're being a miserable person, Luke. Why are you being a miserable person? And I would do some of my own like diagnostics and be like, Oh, it's cause you, that's called fatigue. Like you're tired. Why? Because I worked a 12 hour shift yesterday and I put it all on the line in that shift, or multiple in a row. And I just kind of got tired of being tired. It was just really annoying. But then the 12 hour shifts, I'm missing family time at like 5 p. m. to 8 p. m. windows, really important family time. And I've got young kids 12 to 6 and I want to be there with them. I couldn't coach any of their sporting events because I couldn't commit to regular nights to be available. I couldn't commit to regularly driving to school. I like to cook. I like to cook. I didn't even know when I was going to be home necessarily to consistently be in the kitchen, doing that kind of stuff. So, that was a big part of it. The other, the other part of it was actually in fact, a business related where I've been involved in a number of other projects and like I said, previously working at help ITVC, launched a business. My brother launched another one that felt flat on space and really, really enjoy the business aspects of getting businesses launched, pulling teams together, et cetera. But. All those other businesses had kind of their own issues, whereas in this particular business, I am the mechanism of delivery. I am the top line all the way through to the end line. And so a lot, it, it just made a lot more sense to move this direction than to be context switching every other day and tired all the time.

Dr. Maryal Concepcion: 8:21

I think it totally makes sense. And it's so relatable because especially in this world of increasing use of AI and technology human connection is absolutely needed. And when you are, a person who is able to, then, be a doctor on one hand, yes, but also find a way to be the deliverer of the services like you're talking about, rather than relying on somebody else to do it. The front office, the back office, all of those people. It absolutely speaks to not only you being successful in DPC already, but also your guys, your guys insane growth in under a year. So Dr. Henry, I'll turn the mic to you now.

Dr. Adam Henry: 9:00

So I was part of a, one of the biggest healthcare systems in Indiana and I commuted about 35 minutes down to, to see patients would see about 25 to 30 patients a day. I really appreciated working with my colleagues there. They were, helped mentor me, but it just is, it's a rat race and it's, you feel like a cog in a machine and when I met with Luke and we started talking about DPC, it, I had some misconceptions initially. And we talked through those things and I went like, so literally that day I was just searching and I, I found your podcast and I just started binging on the podcast and I went, I went from, and that's what he talks about. I went from like, oh, I'm not sure about this. Cause I, I had a stable job to like, this is really interesting to, I have to try this or, or I'm not going to do anything else. And it, I just have to do it. And so we had those conversations, those follow up conversations. Around that time, we were dealing with the same scheduling problems in our big system and it's just like this merry go round of patients moving from a doc that's not really theirs to another and it's just, it's not working. One of my colleagues who had been there for 17 years, and I had almost been there for 7 years, basically got chewed out by administration for complaining and trying to make suggestions about, All of the scheduling issues and I saw that situation and I thought I'm not going to stay here another 10 years and have that same thing happen to me. And this is a person who, sees 30 to 35 people a day and is an expert in primary care. Like he can take care of people. learned tons from him and they're treating him like that. So I, it was the nail on the coffin for me. And then I think I texted them that day, or maybe I texted my wife and I said, I, I'm going to leave, I'm going to leave this place and be done with it. So, yeah, I

Dr. Maryal Concepcion: 10:45

think it really speaks to intentionality. Like you talk about the podcast, but I think that also just, Knowing that people like us are out there when people hear about DPC when they hear about another way it's just like manifestation you're thinking and your spidey senses are up and Open to different things and the fact that you saw you're attending treated like that or not you're attending you saw a colleague being treated like that who It's like, to me, it always boiled down to like, if you don't have the doctors, how are you going to get your magic admin codes, man? Like, how are you going to drive your Teslas? But for, for us as DPC doctors, it is so important. And I'm so glad that it was impactful to hear other people's stories. And now you guys are part of the fold in terms of getting the word out there that like, you are human beings, you deserve to be treated as physicians, as people who have families, and you deserve to be treated as physicians. In a place where you can take care of yourselves to be taking care of others. So so with that, I want to go back to medical school because every you guys all went to Indiana University School of Medicine, correct?

11:49

You got it. Yeah. Yeah.

Dr. Maryal Concepcion: 11:51

So. Like, I can pull from my days at Creighton, but I can't pull from your guys's experience. Was anything in your medical school days and especially your residency days that really honed you in on the quality care and being able to identify when quality care is being impeded on by external forces, whether that be insurance or admin, et cetera.

Dr. Adam Henry: 12:14

I think, I think I came out of residency one, tired. But two pretty, pretty oblivious to all the mechanisms in place within healthcare still. I mean, it was a residency is a grind and it's, it's busy, but I think just getting out and like the corporations make you think you have a decision making capacity and you really don't. You have zero, you have zero capacity. And I think it was more of like, Oh, after two years, like. This is how it is. And that's kind of how I felt when we started talking like, okay, this is, this is how it's supposed to be. This is all medicine is. Just got to keep moving forward, that's, that's, that's kind of how it felt.

Dr. Luke Pittman: 12:51

Yeah, so two things. One, I'm going to actually go a little bit further than that and then talk about an experience I had in residency. I, I come from a family of surgeons who founded their own practices separately. And I, I remember having this conversation with my grandfather growing up where he would say, Hey Luke, you need to understand that when I practice, the physician and I use the hospital. That's not at all the attitude of modern health care. The attitude of modern health care is the patient is the hospital's patient or the system's patient and the system and the patient use us.

13:19

Yeah,

Dr. Luke Pittman: 13:20

it's like that's an entirely different attitude of agency, right? That I think is reversed in DPC. Where no, no, no, the patient and we and the patient have a relationship and we and the patient utilize other health care resources. The other experience that I had was in a committee with the C suite in this organization that answered to our CEO and we would connect every quarter and I just remember sitting in some of these meetings where they're talking about things and I'm just thinking, like, how, how in the world was that not previously delegated to a lieutenant and how in the world is that we're having a repeat conversation on the subject with all of these people who are at what level of this organization? I'm like, there's not a chance in the world that I'm going to survive in a giant bureaucracy like this. When this is effectively the C suite having these types of conversations, I'm like, I've got to find something very different. But it took me some time to get the DPC. It wasn't immediate.

Dr. Rachel Trupe: 14:16

I think I came out of both medical school and residency maybe more naive and I don't know. You come out and you're like, the system is the system. You don't even contemplate that there could be a different way to do it. So we're just trained in the system. And so I came out just full of optimism and excitement. I love my patients. I love the variety of primary care. That's probably why I chose it. It's just, I love doing something different every 15 minutes. And. I think it took a few years for me to sense that things weren't going well and to understand my, when my patients coming back to me and saying, my insurance didn't pay for this test that you ordered. And now I have to pay this large sum of money. Why did you do it like that? And realizing we have very little control over how everything works and then learning about it. And. Understanding how insurance and our healthcare system is set up, which we're not trained in in school. So my journey took longer to sense the problems within the system.

Dr. Maryal Concepcion: 15:15

all of your words are hitting home so much for me. And again, I'm sure the listener. Dr. Henry, you mentioned how you had some misconceptions about DPC. And the podcast and talking to Dr. Pittman and Dr. Troop helped change that. But I would love if each of you could share. Any misconceptions that you had about DPC on the journey to opening Valiant Primary Care and how that is no longer at all a misconception because you have actual proof that these things that you may have thought before are not true about DPC.

Dr. Adam Henry: 15:47

Yeah, I think, so my initial misconception was I thought there was well, one that it was only certain types of people could do DPC, only certain types of patients could do DPC, it wasn't as applicable to all, to all types of patients, and I actually thought that the, like when you set up a DPC, I don't know why I thought this, I don't know where I heard that, but like the organization actually, paid for every MRI, paid for every CT, paid for every x ray, paid for every lab as a bundle, as a bundled kind of So I thought that that's got to be really hard to do to set to set that up and to organize that and it almost felt like setting up a I don't know an insurance company for, that kind of thing, but what's been fascinating is you meet people and vendors and organizations who want to want to connect with you want to serve patients and you get to help guide your patients through that. And that's a, that's a really big deal. Really big deal.

Dr. Luke Pittman: 16:38

And I actually think to that, to that point, the prior point about the DPC can be for a variety of patients and some of the misgivings. One of the things that we had a lot of conversations about towards the beginning is we all have done some amount of international work and care about it quite a bit. And have seen this particularly practicing as three as allowing for that to continue and that not every DPC has to be the same. As far as how they get set up and what they offer price wise, but then the benefits of membership, et cetera. And so like, it was entirely up to us about our pricing model, like nobody else, just the three of us made a decision about the pricing model. Like it's just the three of us making a decision about panel size, all these factors that we're making decisions about. So it's like, if we don't want our DPC to have this or that or whatever, That's our choice to make, right? If we want our DPC to work for a patient population that can afford XYZ, then it's like we can make those decisions. Likewise, if we want to discount for families that we think otherwise there's not a chance in the world they could afford it, but it's in our hearts to care, guess what? We own the business so we can make those decisions to serve people like that. Which is, I think something that we had to, work through a lot of those types of things. Get where we are.

Dr. Rachel Trupe: 17:51

I agree completely with what Dr. Henry said just in terms of like I thought this was more for a, a wealthier patient population where it turns out in real life, we have a ton of, we have farmers, social workers, teachers just people like us who we serve and live with and are in our neighborhoods or in our grocery stores, like we are serving our community, and it is not necessarily the wealthiest of the wealthy who are signing up for this. But it's. People who value either the relationships that we've developed or the what we bring to the table and price transparency and that type of thing. But I think what they haven't mentioned yet that I particularly found surprising was I assumed that I would be a little bit bored. And I say that that sounds bad But I've liked I've been busy in my prior role where I was seeing 20 patients a day and bouncing from room to room And you never sit down often don't eat lunch You Never have anything to drink. Never go to the bathroom. The traditional full day. And so I was thinking through like I'm gonna go to a direct care where I see like four patients in a day. I'm just gonna be sitting around and twiddling my thumbs. And that was one of the things I was nervous about. And it turns out that when you run a business, set up the art galleries you are cleaning your facility, doing faxes, doing, calling specialists, setting up meetings with other physicians, and also we have grown very quickly. So, we are never for one moment have been bored. We've been constantly challenged and engaged and we, we do a book club when we don't have other patient responsibilities that the three of us participate in with another retired family doctor. And so really the whole experience has been very fulfilling and engaging and that's been a fun surprise.

Dr. Maryal Concepcion: 20:12

And I will just put an FYI here for the listener, Dr. Troop is already on a waiting list, man. And they just opened in the summer of last year. So amen to that. Now when when it comes to your guys's misconceptions, as well as your previous experience, your training in residency and medical school, and your, your desire to practice a certain way and have the time to practice with your patients I would like to ask you about that. What, what was it that really bring us into the moment when you guys were speaking with each other that made these thoughts malleable into something that it has become valiant primary care because Dr. Pittman, you mentioned how you had experience with DPC. I'd love to hear more about that. And. Dr. Troop, you had researched DPC for quite some time before you guys had this conversation. And then, Dr. Henry, I'd love also if you had, particular words that you heard from other guests on the podcast or things that really made you commit to, yes, like I'm in versus thinking more about could be for me.

Dr. Adam Henry: 21:15

Yeah, I think. When I would hear people talk, one, they sounded very genuine. They sounded at ease with the, with the new position they had. I think that when I heard, when I heard people talk about the relationships they had, and I remember people having just wonderful patients that would come in and even like check on them. They were worried about this new job that they started and bringing them food and stuff. I don't know. I think that's what drew me. I mean, I've always, what we've, what we've tried to do too, is it's the relationship first. That's what changes people's health. And having the opportunity to just focus on that. And as we kind of, we're talking and forming this and putting that first rather than quality measures and bureaucracy and everything, that's really what I think ticked it for me. And I can remember us all looking at each other cause we had a follow up and we're like, we're going to do this. We're going to, are we going to do this? Like, I remember that and it was like, yeah, we're going to do this. Let's do this. It was just so fun, so fun to do.

Dr. Maryal Concepcion: 22:15

Love it. And Dr. Whitman, how about you? When you mentioned that you had some experience with DPC before and also, I mean, just leaning into your Opening other businesses and being business owner before I'm sure that that had to have impacted your your level of I can do this in terms of opening your own business as a business slash medical clinic.

Dr. Luke Pittman: 22:41

Yeah, it's funny because I think if there were three, if of the three of us, the one of us who I think could have been more likely to open on their own, I think it would have been Dr. Henry. Okay. Honestly, really? Yeah, I do. I honestly believe that. But I think like for me, it's just like, so blatantly obvious. I just do better on teams. I just love being around other people. And if I were by myself, it would just be totally nuts and not a good way. But like, I needed a camaraderie and I need like, I like some good high fives every once in a while, some out of words. Go a long way for me and some jokes, some, some, some good dad jokes. Everyone's

Dr. Adam Henry: 23:13

high five and patients.

Dr. Luke Pittman: 23:14

I love high fives. That's part of the membership is free high fives. But anyways I, my first exposure to DPC was actually when I was working for the health IT VC fund. They were, they had previously invested in a medical record system that was serving DPC. And also they were vetting a team that helped transition DPC or non DPC document to DPC. So got a whiff of it there and had, and participated in some of the diligence and helping the non clinicians of this BC fund understand the model of practice and where this might be going. So that was my first exposure to, it was actually not clinical at all. It was from a, Hey, what's this new thing? Business wise, what are the implications? financially, et cetera, technology wise, et cetera. But at the time I was practicing urgent care and working for the PC and just like, I needed time out of residency to calm down and chill out. I needed time to be in a clinic where the stakes were lower and I could clock out of it. Like if I had gone straight into a primary care clinic out of residency, it just would have been a hot mess. And I for sure would have been done after two or three years. And I wouldn't even be clinical at all. I don't know what I'd be doing, but thankfully. Did take that time to calm down, um, an organization I was talking about, they, they had some conversation about me being a CMO of some sort of DPC like entity. And I'm like, how, how could I be a CMO of this entity if I've never actually practiced DPC? Like, that just doesn't make any sense. But still seeds were planted. But again, it really wasn't until I, I, I hit that threshold of like things have to change and I need my nights back. But one other thing I would add about this is I, I, we built a financial model like, like pull out Excel spreadsheets and like dug into it to build a model which was a big, a big deal to me to see, okay, what, what are the factors that really matter the most? And you've changed this percentage and you change this and change that. Like how much is it really going to change our outcome? And you, you can, by doing that exercise. Can start to sift through the variables and find the ones that end up probably mattering the most, as far as the businesses, likely financial success. So I built our financial model, which by the way, to our audience, I'd be very happy to work with any other doctor on their model, but, but for us, I remember building this, pulling out the equations over a period of time and being like, Holy smokes, this works. Like the assumptions that we built into it were super conservative. Cause that's what you should do. And I pull, and I'm literally, I'm like copying, I'm like screened like these formulas and I'm like, Oh my gosh, like. The way these numbers, that's what I think it was like that night or something. I go back to a partisan, like, this is ridiculous. So that other business I launched with my brother required a significantly larger raise to get launched. And so I was just chit chatting with him about it. And he was floored at how little it actually took to get a clinic from zero to, to this financially, at least. And time wise and I think for prior experience, that was a big deal for me to have. Been able to build some conviction, build some judgment around other models of other, just other types of businesses, other resources, assets coming to this and it was like, Oh, this is, I'm not gonna say it's a layup, right? It's a lot of work, but at the same time, it's like the fundamentals are there. And again, we're like, we are the unit of production. It's like, ah, this is fluid. This has to be done

Dr. Adam Henry: 26:25

So Rachel was the closest one to our current practice. She, maybe 10 patients a month, maybe 15, and it was like 150 in six weeks or something like that. He is an animal. When it comes to seeing patients in the best way. I mean that in the best way. She blew out

Dr. Maryal Concepcion: 26:45

the

Dr. Adam Henry: 26:47

proforma. Yeah.

26:48

Yeah.

Dr. Luke Pittman: 26:50

It was crazy.

Dr. Maryal Concepcion: 26:51

It's, it's amazing when you're happy with what you do and you're getting valued for it. It's, it's incredible what, what, what that brings to fruition. So yeah. Dr. Troop, how about you in terms of your, your research in DPC?

Dr. Rachel Trupe: 27:06

It's a good question. My mom's doctor, Dr. Dornfeld. She's been on your site before as well. So she transitioned to direct care a few years back. And so I had friended her on Facebook at some point and we've had, I shadowed her when I was a med student, like many years ago, too many years ago. And so I knew her already. And as she was doing her journey, I was following along with her and watching her posts, watching her Facebook posts. books watching her become very successful and very happy. And so that was part of my research there. And I joined the Facebook DPC physicians, and I joined the DPC, Indiana physicians, and I was just like a little fly on the wall, like watching other, these conversations happening and being a little jealous, honestly, thinking like, I wish I could do that. But again, I was nervous to do it by myself. I'm. social, bit of an extrovert, like to be surrounded by people. So the idea of just opening up a little one room show, just me by myself, didn't float my boat. And so when Luke's like, I'm ready and I think we should do this, I think we could open it a few months from now. Like he was, he was raring to go. And I knew I had a safe way to be able to do this. And he's got the MBA, so, and, and he, he, he made a little joke about how we just threw together some Excel spreadsheets. This man is a wizard at Excel.

28:21

If

Dr. Rachel Trupe: 28:21

there was an exam on how to do all things Excel, he would have like created the exam, to be fair. So, he built Proformas with like thousands of hours of like data. putting through this. And so having an MBA backing us up and being able to say like, I can handle the business aspect. You guys helped me figure out the clinical. And that was a really helpful partnership to develop.

Dr. Maryal Concepcion: 28:42

Incredible. Yeah. When, when you say formula like in family medicine, mine, I'm like baby formula, not Excel formula is my default. So that is amazing. So let's talk about now this growth that we've been alluding to you guys opened in the summer of 2024. And Tell us one, how, like, where are you in regards to your numbers in regards to, like, who has joined Valiant Primary Care, but also, like, with, with Dr. Troup being close to new patients and Dr. Henry and Dr. Pittman, you being, still accepting new patients has DPC rung true after being open for the many months that you have been open already.

Dr. Adam Henry: 29:21

So I'll say this as I explained what DPC was to my wife, And as we talked about it, she was saying that that seems way more humane and not, not even, not even just for like for positions, but for the patients to, and it's something we've, kind of kept in mind and it, and it has, it has felt more humane and it has felt more fulfilling just to see patients and to take care of them and to, visit with them and to visit in their homes if necessary and to be there when they're when they need something urgently it has felt so much more filling than running, running the treadmill.

Dr. Rachel Trupe: 29:55

and Dr. Henry's closing in on 200 patients now so he's he's had his own very successful quick growth as well in six months, not even six months he opened in August so we're not even at six months yet. I'm around 300 patients. So I closed in December to news right now. And a lot of that is not because I'm any more qualified than any other physician in our group here. It's just I practiced five minutes away from here. So when I left and then subsequently opened up Valiant just a few weeks after leaving. I didn't take really any time off. My patients Googled, found me immediately, and then just started signing up and drove because there's no other primary care doctor in Zionsville, Indiana, who can get somebody in within like nine months. And our community is desperately in need of primary care. So when people called around, many of them did their research. They'd call IU, they'd call St. V's, they'd call community, they'd see like, what are my options? And they would be offered a spot for, for, Like the next year. And so when they're contemplating their choices, they were like, it made sense to them, we were not terribly expensive compared to some other direct cares in our area. And so we were a really great option. And so they just started signing up. And when, when I closed, I strongly recommend my partners. And so like anybody that's called in looking for me initially is now signing up with Dr. Pittman and Dr. Henry. So that's been part of our growth has just been. Lack of primary care in our area and people know my name already.

Dr. Adam Henry: 31:19

I mean, I think she made a big splash right when it all took off and then like the ripple effects affect Luke, Luke and I, which was

Dr. Rachel Trupe: 31:27

also on all the Facebook moms groups, it's like a mom in the community and all my kids, like, or I'm on all these very regularly and so I can't. I'd be giving advice and talking to people about things and was very, like, active in the Facebook mom groups. And so, as soon as, like, I left and we started forming this group, that was, like, the talk of the town at this point. It was like, hey, here's a really cool option. And a lot of our patients were tagging us in it and mentioning us and telling other people, hey, you guys should join Valiant. We haven't had to spend like more. I think we've spent like 20 on marketing. Our entire marketing has been Facebook. And some of the free groups and communications that have come from there.

Dr. Luke Pittman: 32:09

And I would say to be fair, like, it is true that our community is underserved, but to be fair, Rachel is very well liked because she is likable. She is a great doctor.

32:19

Thank you. And I

Dr. Luke Pittman: 32:19

had this experience Multiple times with both of you guys, where I'd pick up a phone, patients say, Oh, I used to be a patient of Dr. Troop. I used to be a patient of Dr. Henry, have a chat with them and somewhere in there the patient would slip a, and if you're anything like them, this is going to work. If, if, if she trusts you, then I do too, or, things like that pretty consistently which, which like right out of the gate was really encouraging to hear still, still doesn't, I don't get tired of that, but hear that not infrequently about you guys. So yeah, there's a little bit of a supply and demand problem in this community, but you're also good docs, that's, that's fact, science even.

Dr. Maryal Concepcion: 33:00

Yeah. And I think that when you have people who go into DPC, there's just this level of like, I want to do better and that I'm choosing to do DPC. So I don't even, I don't even question, what you're saying, Dr. Pittman about Dr. Tripp, as well as the both of you, Dr. Henry and Dr. Pittman. And and I think also it's like, That's a badge of honor that Mariel can't necessarily handle like being in a Facebook mom group like that's just a whole nother level of like, that's, that's a lot. So the fact that you're, you're, surviving and thriving, and, you're seen in that group or those groups, but also you're seen now. As part of Valiant Primary Care. Amazing. So love that.\ And because you mentioned marketing and the, the marketing budget being on the, the shoestring end of things I want to ask what are other ways that you found really promoted the rate of growth that you guys have seen on all of your panels? Because I get it, Dr. Tripp, with you mentioning the Facebook groups that you were known in the community. fine, but there's always the, the culture that we're dealing with as a country, but I only do what my insurance pays for or my insurance covers. So what other strategies can you look to that have really helped you with your growth overall?

Dr. Adam Henry: 34:20

So I'll say Rachel and Luke are both very good about following up with people, having them come in, sit down for a meet and greet, talk 15, 30 minutes, see that we are genuine, see that we have. We don't charge people a sign up fee. There's no standard amount of months you have to sign up for. We're just trying to be good physicians in a community and take care of people. And I think that has led to word of mouth and that has led to, Oh, they can actually, they actually care about people and, Oh, they can see me today or see me tomorrow, that, that I don't have to wait that long. It's, it's really. I think word of mouth has been very beneficial for that.

Dr. Rachel Trupe: 34:59

And not to go back to the Facebook groups too much, but I'm on all the physician Facebook groups too. I'm like a 10 different physician Facebook groups and our physician colleagues really have pushed us hard in their own patient basis. So a lot of gynecologists who are delivering babies and the moms are like, I've got a child with extra needs right now. Like who's going to spend that extra time? And so Dr. Henry's like, I'll go visit your home. I'll, I'll do my newborn visits at your house. My dermatologist has sent like multiple patients to us. Multiple gynecologists have sent people over our way. Other pediatricians in the area who have their own direct care. They're the moms of the kids that they are seeing are coming now to go see us. And so we can't thank our colleagues enough for really like, I pushed it out there on the Facebook groups. They figured out like where we were and now they've been really helping market us, which has been really honoring.

Dr. Maryal Concepcion: 35:53

I love that. And Luke, from the data side of things, if you can pull out any marketing trends that have worked like word of mouth

Dr. Luke Pittman: 36:00

uh, I was having this conversation with my brother last night and he's like, how are you finding new patients? I'm like, dude, I've, I've got a number that I cannot see more new patients a month and do a great job. So it's just not a problem at this point. From a. Like what's what's coming in? Some knickknacky stuff. One is, is just acknowledging that this is a service that people do in fact actually want, right? I'm not being a nuisance by selling the service, right? I'm helping people by selling the service. Oftentimes where people get stuck up on, on joining is of course, financial, that people have to make decisions about that, but it's just life. You have priorities. It's like, why didn't you go see the doc? What's cause life came up. Why didn't you get vaccinated? It's because, life came up. So like, one of the things that we'll do is after we do a meet and greet or somebody expresses interest is like schedule, follow up with them. It's like, I'll schedule notes to myself or schedule notes to my partners, where it's like they express interest, they clearly value this sort of thing, but they need a couple more nudges. And it's after the second or after, another reminder, Hey, just thinking about you. If you have any other questions, let us know. Oh, I meant to sign up. I meant to sign up. No, I really did. Oh, great. Here's the enrollment. Just make it super easy. I tell patients, I'm like, if you use the enrollment, it takes 15 minutes if you actually fill the papers, but if you don't fill the papers, it takes three minutes. So I'm like, I want to lower the barrier to just experience it. Cause once you're experiencing it, you're staying.

Dr. Rachel Trupe: 37:26

Luke does a really good job at like what we call like the trickle effect where he just trickles it a little extra comment here, a little extra comment there and reminding them that he exists and seeing what barriers he can overcome just over a number of months. So if anyone who's had even a vague interest is usually getting a personal like offer for a cup of coffee with him or he's like, I'll come to your house. Let me come over to you and I'll talk to us, talk to you guys about what we do. It's amazingly high, like conversion rate for people who are vaguely interested who then sign up.

Dr. Luke Pittman: 37:55

Well, so actually, so, so, so since you're thinking about who we're talking to here, like we're talking to other physicians, right? It's like in this world, there is a sales cycle, just like there's a sales cycle in other business worlds, right? So it's like, I've been in sales cycle. You're trying to sell to a hospital system and it's going to take you 18 months if it works, right? But actually the decision maker to this, the person you're selling to is actually very close. It's usually actually the person you're talking to. The value proposition, I think it's actually very clear, very crisp, and that might be something people need to work on. The alternative to us is actually horrible. And so I think, and then there are some tactical things that people can do on the backside of somebody expressing interest that you can help make sure that you close that deal if you will. And it sounds weird to say it that way, but like, that's actually kind of how it is. Like you can think of it as a sales cycle that you're working people through funnel wise is, something as early as somebody has vaguely expressed interest or even things like, I'll just give you a ridiculous example. But if somebody said, Hey, I told my friend about you guys. Well, if I leave the ball in their court, then I'm leaving it to chance, right? But if I say, Oh, tell me about this friend. I'd be happy to reach out to your friend. If you'd like, as long as you feel okay about that. And if they give me the number of the balls, now in my court, I can send a message to that person. I can give him a call. Hey, so and so told me about you thought you might be interested in our services. Just wanted to, let you know that we exist and we'd be happy to have a chat with you. Like real simple, like little things like that increase the probability that a person is going to get what they want, which is this service.

Dr. Maryal Concepcion: 39:27

I really love that, that you got to, the, the idea of lowering the barrier so that they start experiencing DPC as soon as possible. Like at our practice, we we have a person's initial visit fine that's scheduled, but if anything happens in the meantime, we're still able to address them just as if they were a patient yesterday that we start immediately taking care of a person once they sign on to our practice. So I, I really love that call out of how to make the word of mouth grow in DPC because people are experiencing it right away. And I want to ask here, just because, I have asked this of other doctors, but on your guys's website, did you see any change in, people asking about the practice or signups after Dr. Troup put her panel closed notice on your guys's website?

Dr. Luke Pittman: 40:15

When did we put that up?

Dr. Rachel Trupe: 40:17

December.

Dr. Adam Henry: 40:18

Yeah.

Dr. Rachel Trupe: 40:19

Harder.

Dr. Adam Henry: 40:19

I mean, people would still message through the website and they would say, Hey, I'm interested in Dr. Troop. If I can, I'd like to sign up with her, or I'm happy with the wait list. And can someone see me? That, that kind of, that kind of stuff. So, I feel like the numbers have stayed consistent. Like the reach outs to us have been fairly consistent still.

Dr. Maryal Concepcion: 40:37

Because you guys, have this this secret weapon in terms of Dr. Pittman and his MBA and,

Dr. Adam Henry: 40:43

wrong secret weapon. Yeah, we got a lot of weapons. Dr. Krupp. Those are two main, those are two main weapons.

Dr. Maryal Concepcion: 40:52

How did you guys together decide what was going to be your way of tech stacking your clinic to make it so that you could get these people in, your patients, your members in an experiencing Valiant Primary Care as soon as possible after they had decided, yes, I'm going to be a member.

Dr. Adam Henry: 41:12

We went to pediatric DPC mastermind. Go ahead, Rachel.

Dr. Rachel Trupe: 41:17

Oh, no, go ahead. That's a good

Dr. Adam Henry: 41:18

start. So we went to a DPC mastermind, pediatric DPC mastermind. And that was a great opportunity to be like, what are you using? How do you do this? Talking to everybody. Talk to Phil Boucher, talked about how do you manage stuff? Should we get certain messaging apps? Should we not? Should we pay for certain messages? Yes. Should we not? And we settled on an EHR that let us. Start to enroll people and gave us time to enroll people and then we could just activate them. So Rachel had like, I mean, she had, it was over a hundred people ready to go like on the first day. And so then she just started, scheduling people as soon as she was done with her previous position. So that was a, that was a really big deal. We ended up we needed a good messaging app, HIPAA compliant messaging app. So we essentially have those two things linked EHR and our messaging app. We we've played around or I played around with, HIPAA compliant task managers, things like that. And that's been helpful. And then what else? I don't know. I'm, I'm horrible. Honestly, I'm horrible. We use an accounting software. I send a zoom link out or whatever. I don't know. I don't know why I'm getting better at it. But it's, it's it's a process.

Dr. Luke Pittman: 42:30

Well, it's funny. It's like, one of the interesting things about how this has worked from my perspective is like, I don't know, for some reason I would have thought some of these things would be like more methodical and like super straightforward. And it's like, they're really not. And so one of the ways that our team works is we were juggling earlier today was move, fast, break things. And it's like, make a decision and, and figure that one out. And it is one of the benefits of having three of us is if you've solved the problem for yourself, you've probably actually solve it for the clinic. Or, like when we're negotiating relationships with the local lab, right? It's like, okay, it's nice. It's nice that you're handling that because I'm gonna go handle something else. And so we're always actually end up solving problems for each other. So the tech stack was interesting in that. It wasn't like there was crispy clear. This is the exact tech stack that everybody should use. And it's like, no, actually there's an incredible number of options. But the worst thing to do is to not make a decision to move. Right. It's like the pricing's fine. The core function's fine. Like let's move, but let's also acknowledge that there's a chance that we're gonna end up, migrating sometime from now, but let's not migrate every six months. But let's move.

Dr. Rachel Trupe: 43:36

Yeah, we actually, we read that in the first, the book that we read to start this whole thing off. It was like startup DPC by Paul Thomas with the plum health group. And one of the big points he had like two thirds of the way through was decision paralysis can kill it. Like you gotta, you gotta make a decision. It'll be a good decision. It doesn't have to be a perfect decision, but make a decision and go, because there's a thousand decisions you have to make when you're doing these things.

Dr. Maryal Concepcion: 44:00

And I think it's a great point because you only learn from what, you experience. And so if you made a decision that is, and this is going out to the listeners, like if you made a decision where you're like, Oh man, like, damn, I made that decision. It's like, great. Now, you know what works and what does not work for you. So I think that it's really important to call that decision paralysis out. Cause it can be a real thing. When you're like, yes, I'm an MDDO, and I'm a parent, and I'm a business owner, and I have to vacuum the floor today, and I have to clean the sinks. Like, it is a lot of hats that we are wearing. And so decision paralysis is definitely a thing that I think people experience, sometimes as this thing that came out of nowhere, because if you go from zero to like 100 patients on day one, or if you're slowly getting patients, and then all of a sudden, boom, somebody, does a social post, and then all of a sudden, you have this massive amount of people calling, you don't necessarily know all the time how you're going to deal with what decisions are coming down the pipeline, depending on how much is on your plate. So I think that that's super, super important.

Dr. Rachel Trupe: 45:02

It's been very helpful having all three of us be good teammates in that because if my patient calls and I'm in the middle of a two hour long intake process, Dr. Henry, Dr. Pittman are more than happy to take the phone call from that patient, especially before we had any staff support, and they would schedule them an appointment or help like, oh, you need a med refill. I'll type up exactly what you need and make sure Dr. Troop gets this message. And, and vice versa, when Dr. Pittman's patient calls in, like, we all were simultaneously trying to answer all the phones and do all the faxes and like just help each other.

Dr. Maryal Concepcion: 45:32

So talk to us about that there, because especially as, you're, you're going beyond the onboarding and you're taking care of. of the patients as a whole at Valiant Primary Care, even though a person might be assigned to, one of the three of you. How do you guys, and I know now you have a staff person, but bring us back to the days before you had a staff person, how did you manage your backend? Without staff,

Dr. Adam Henry: 45:53

Rachel took off really quickly, so she was seeing patients. So Luke and I would come in, Luke, initially, I, I took a little time off in between jobs and we would schedule people, call people, just take care of all that, all that. I mean, it was just kind of like, we weren't seeing as many patients initially, so it, it, it worked that way.

Dr. Rachel Trupe: 46:13

We got to a bit of a challenge spot though, and we are, we're very grateful. Luke's wife is a nurse practitioner. She actually came and gave us some weeks of time where she ran our faxes and phones for a while while we, before we'd hired anybody. Just to be a support person. And, and my husband also, like there's times he's, he has answered some phones and I, I trained him how to sort faxes and to send them to the right physician. So, like, that's it. He did a number of hours of just fact sorting for me over the summer before everybody was going. And so, and just having this like supportive people in our lives who are willing to volunteer some time was it made a big difference

Dr. Luke Pittman: 46:47

with our communication system. We've got four different numbers. Each doc has one plus the main line. And so generally we each cover our own and then we, we joined together over the main. And so just depending on what comes up on the main, you can kind of triage it to somebody else or handle it yourself. I mean, sometimes you just know my partner is busy. My partner is stressed out. My partner is doing something else. Even as their patient calling in, it's like, no, I got this one. I'm going to take it. So we can get the problem solved, same with like meet and greets. Like if we do a meet and greet and I know this patient is going to talk to Henry, like I'm still going to show up for the meet and greet because this patient is going to be talking to other people and it's good, it's supportive to Dr. Henry for this patient. See, there's other people. So it's, those are the sort of things where you just kind of work through them and yeah. Show for each other. Because it's like if Rachel has to pay

Dr. Rachel Trupe: 47:32

for each other, right? Like if Dr. Pittman's in the middle of doing something and he did a home visit the other day that lasted a few hours But one of his patients might need to be come in and get a strep test like dr Henry and I would be more than happy to see his patient and do an acute visit for any of his people and vice versa

Dr. Luke Pittman: 47:49

Yeah, that's right. And we also had growing pains related to how do we handle call. Call it a point person rather than necessarily call. So we, we, we cover our own stuff during the week, but on weekends, we've got somebody who's on point. So if, if my patient calls in and they're really complicated, but Dr. Henry is the point, like there's a chance I might still end up getting involved just to me on how complicated the situation is. But it does allow for a little bit of separation of church and state, can actually put the phone down and chill a little bit. And also coaching patients on what technology to use, how to communicate with us. Number one is don't ever not communicate with us because you don't know how to, like, there's no wrong answer to get to us, get to us. But if you are paying attention, then like, yeah, we are going to, let me coach you on how best to, if you call versus text versus email versus, versus so we definitely had growing pains related to that.

Dr. Adam Henry: 48:39

I think just having us having excellent communication from the get go was the biggest thing and we could tag each other. We could say hey, could you cover this? Hey, could you do this? i'll take care of faxes right now I'll you know, you go see that patient. That's that's that's just how it worked I mean, we did a meet and greet this morning kind of going back to what luke was saying With everybody going to meet and greets and yeah, rachel's full but she came to the meet and greet and that that shows our team You see who you're going to work with if, if a patient would prefer a pack with a female physician, like we, we allow that we're not going to, we're going to cover each other in that way. And I think, I think people have responded very positive, positively to that.

Dr. Maryal Concepcion: 49:19

And here, I'd like to ask about, the three of you collaborating on the day to day to, run your DPC, because I think about this is sort of tied to decision paralysis. But when it comes to being an entrepreneur, And a physician at the same time and a lot of, a lot of anxiety and guilt can come out of like, did I respond to that patient? Fast enough. Could I have done it differently? Can you speak to the fact that there's three of you and now you're staff person, but there's the three core of you that are together to potentially help each other work through these moments of like, I'm a little bit uneasy on my feet right now. And is this normal?

Dr. Luke Pittman: 50:02

First I say shout out to Megan. She's crazy, super helpful, huge deal. The other thing is that actually a lot of our patients are business owners or live professional lives and they can appreciate that. We are starting from near scratch. Now, thankfully there were pioneers that came ahead of us, but at the same time, like we're learning and I think that's okay to be honest about, be human about in part, because it like, yes, the responsiveness matters. The, the, that level of customer care does matter, but also we are human. And also we are learning and like there was a time when it was practically every single day we were adding something to the clinic. Now it seems like it's every two to three weeks. We're adding a new function to the clinic and patients see that when they come back, they see like, Oh, you guys didn't draw labs. Now you do. You didn't provide vaccines. Now you do. And so I think that there's actually some amount of. Margin built into our relationships with our patients. They understand. But also it's interesting because the three of us do have a little bit of different communication style with our patients. And we see we've got, we can pull out reports on that too, which Rachel did, I think recently, which was pretty funny.

Dr. Rachel Trupe: 51:06

Yeah. Some of us appreciate text. Like I'm more of a text person. The true millennial as it was and others prefer more of this phone conversations. And so it's just interesting seeing the data come out of our tech stack. They'll send us reports on how we tend to engage with our patients, who does more videos, who does more of telephone talking, that type of thing.

Dr. Adam Henry: 51:26

There's, there's definitely some training that of patients, right. And, and learning how to work with each other. So yeah, I think it, it is interesting. Like, I guess I. I shoot for responding in a reasonable amount of time. I want them to call if there's a major concern. I think part of that's still me coming away from, having almost 3000 patients at this big corporation. And I'm just, I'm kind of like just getting used to this new way of doing things where, I'm doing it myself. I don't, there's more personal touch with it, which I enjoy, but it's just a different Different way of doing things.

Dr. Rachel Trupe: 51:59

Essentially we all work a little bit differently and we are have a different style with our own patients And so we're don't we don't please each other so if Dr. Pittman wants to let something simmer for a little bit and really think about it and come up with a crafted response hours later He'll do that and if I want to like Immediately respond within like two minutes of somebody messaging that I might do that. And so the our tech stack allows for our conversations to be directed to the right person. And so we just operate all slightly differently. But we all do a great job.

Dr. Luke Pittman: 52:31

Yeah, I think it to the Also the point of just working as partners is like it wouldn't make a ton of sense to leave a system where you feel suffocated To go work with partners where you feel suffocated, right? Like in some ways we're similar, but in other ways, we're definitely not the same And allowing for there to be some flexibility in personality and temperament in communication Care, vocabulary, et cetera. We definitely have conversations about some things do need to be uniform or some policies need to be more standard. But then there's also quite a bit of flexibility on, on how we do things. Frankly, even in pricing, sometimes we need to get flexible depending on the scenario and we allow for that. Depending on the subject.

Dr. Maryal Concepcion: 53:10

And when it comes to you guys thinking about the fact that you're speaking with other physicians, especially who some of them out there might be thinking about, should I partner? Could I partner? Would it work for me? Et cetera, et do you guys have any words of wisdom specifically addressing that person who wishes to open up a DPC with another physician, especially if they may or may not really know them professionally before, venturing out into DPC land together.

Dr. Rachel Trupe: 53:41

We interviewed a doc who was, who did that Dr. Holiday, and she gave some very specific advice. And she's like, you have to run through, like, go back to like your ethics debates in med school in your second year and walk through every challenging question that you can think of that you might have a different approach to, because nothing kills a partnership faster than feeling like ethically or morally that you're not aligned with somebody. So we went to a coffee shop and we spitballed every toe curly question that we could think of to each other to see, not if we were the same person, but could we be comfortable with how my partner chose to handle situation X, Y, or Z and be morally comfortable with the new clinic that we created and just sort of be aligned in our values. So that was probably the best piece of advice we could have got is just to really make sure that we're aligned well.

Dr. Adam Henry: 54:30

I'm going to attribute this to Luke. And I think When we were having discussions and figuring out our documents and our, our goals, I want to say you had talked about, we need to think about not only joining but like leaving what would, what would it be like to leave our practice. And then we also talked a lot about like, what would the fourth position like, what, what would be good for the fourth position to, To be what would they what would they consider beneficial in joining our practice? So that's that helped guide a lot of conversations.

Dr. Luke Pittman: 54:58

Yeah, it's kind of you say that I you know For me, I I've worked with other partners in other situations And number one is I really like that generally speaking doctors don't have to tell you that you know how to work hard They just do but there are people who on partner on paper Could be a partner, but in practice aren't. And I think it's kind of hard to describe how is it that you can know that this partner is in fact actually going to be a partner, not just somebody who also owns this business with me. And I, and I do think that fundamentally there are some like very core principles that align us. You can see the name behind Rachel. I mean, I think part of it, there is courage that it takes to move forward. That, but also I think a huge part is. Is that I do honestly believe that we genuinely authentically wholeheartedly care about the people that we're serving. And I do honestly believe that they are lovable fundamentally. And so to us, it was about how do we build a business to reflect the fact that these people are lovable and should be served very well. And I think that's ultimately what aligns us is what we believe about the human condition. Then it's about operationalizing that. So like we disagree on stuff for me. I personally didn't really start feeling comfortable with our partnership until we started fighting. And then it was in fighting, we, we joke, we joke that it's, it's, it's not like fighting, right? It's just like, we joke that we, we horse around about stuff, the white glove,

Dr. Rachel Trupe: 56:27

slap someone in the face with a white glove,

56:29

like

Dr. Luke Pittman: 56:32

really disagree about something and then work through it. Come out the other side of it and go, yeah, we're still partners.

56:39

Yeah. Let's

Dr. Luke Pittman: 56:42

keep going, so at this point we've had plenty of things to disagree over and it's like, we're doing good.

Dr. Maryal Concepcion: 56:47

Like going from dating to marriage. So this is definitely a work marriage between the two of you.

Dr. Luke Pittman: 56:52

And I told somebody else, I'm like, I don't know that I could have done a partnership like this without having been married for a time. Because not everything can matter.

Dr. Rachel Trupe: 57:00

Yeah. Learn what to, what to make a deal about or what to, what to dig your heels in over.

Dr. Luke Pittman: 57:06

And I think we learn each other on that too, is like, okay, this might, Dr. Treat might tend to care more about this and I'm going to honor that and whatever, same with vice versa. And then, but then sometimes you just have to disagree and say it.

Dr. Maryal Concepcion: 57:18

And I think that's healthy. It's like, I agree to disagree is, is okay to say, and it doesn't mean you respect a person less. It doesn't mean that you're going to take, any less good care of a, of a patient. That's why there's the art of medicine. Awesome. So, I'm going to ask you guys some rapid fire questions I just really like. How Dr. Henry, you mentioned like people were authentically being on this podcast and sharing their stories. For me, I'm excited to add a little bit of another layer to that. So could you guys share one book, podcast or resource that you recommend other DPC physicians and entrepreneurs check out

Dr. Luke Pittman: 57:57

The book, getting things done saved my life. Shout out Dr. Reza Balagha for giving that to me. But the other one I want to highlight less specifically related to DPC, but if your DPC is successful, I hope you read this book, which is called venture deals. So if you find yourself in a situation where you want to be investing in other things, like investing in technologies, investing in real estate, whatever venture deals, I think super demystifies that space and the vocabulary of that space. And it's good for physicians who are not native to that vocabulary to. Get a once over on that vocabulary from a safe source like a book rather than find yourself live talking about term sheets and whatnot. I love that book. He's amazing.

Dr. Maryal Concepcion: 58:35

I'll link those to your guys's accompanying blog. Awesome. Great.

Dr. Rachel Trupe: 58:39

We also, we use StartupDPC by Paul Thomas was our how to guide. So we literally went like chapter by chapter during like about a year ago in January and just started knocking off his checklists. And so we created our own checklists and then we're able to take it from there.

Dr. Adam Henry: 58:54

I liked Doug Farago's book. To about starting a DPC, which was

Dr. Rachel Trupe: 58:58

the official guide to starting your own direct primary care practice.

Dr. Adam Henry: 59:01

It's very candid.

Dr. Rachel Trupe: 59:02

Yeah,

Dr. Adam Henry: 59:02

Thinking about podcasts. I think I would say People have maybe i've already said this but white coat investor is really good I mean just just because I think you know We had worked all for a little bit and thankfully all of our houses were in order to do this And that made a big difference I think in being in quickly getting things up and running

Dr. Luke Pittman: 59:21

I love lore. I think lore is great. It like totally helps my mind escape. It's like just the right tempo, just the right material. I love it.

Dr. Rachel Trupe: 59:30

I'm, I'm going to disappoint you because I do not watch, I do not do podcasts. The not very much, and yet here we are talking. But this is like a new thing for me. Dr. Pittman and Dr. Henry both love podcasts. So I was, I've been trying to be more mindful, but my thing is more like, I love medical thrillers, so that's, that's what I do. Not a podcast, but Freda McFadden is my favorite author. She does all these thrillers, and I believe she's an actual physician. That's a, a book name she goes by, and so I read her stuff religiously whenever it comes out.

Dr. Maryal Concepcion: 1:00:01

I'm thinking and I'm sure that Dr. Henry and Dr. Pittman are too, but I'm like, bad doctor, like there's so many bad doctor podcasts out there that are like right up your alley. So just like keep an open eye on those. Keep an open ear. Love it. Love it. When you guys look back on your journey so far, what is one piece of advice that you'd give to a physician considering DPC, but who has not yet made the leap?

Dr. Adam Henry: 1:00:28

They need to explore, they need to go out and talk to people and explore and just go to a conference, talk to people, see what it's all about. Don't sit there. That is, that is what I would say. I mean, we, I think we, when we went to DPC, Peds mastermind, that was a very, I don't know, coalescing moment or congenial. I can't think of a good word. Everything kind of crystallizes like, okay, like this is how our direction to go. Like this is, it was helpful.

Dr. Luke Pittman: 1:00:59

Yeah. Sounds ridiculous, but I build a financial model. And if you don't know how to then call us.

Dr. Adam Henry: 1:01:06

Learn, excel,

Dr. Rachel Trupe: 1:01:07

learn, excel,

Dr. Luke Pittman: 1:01:09

story. That's serious. That's serious. I mean, like it's, it's just, it's so helpful because you have to be able to book verbalize your assumptions, which are worth wrestling over, then test those assumptions to see how does this affect me? And I think one of the things that's crazy nerve wracking about people when they found a business is the financials of it all. It's like, okay, we'll have a plan. The way to build a plan is to put it on paper,

Dr. Rachel Trupe: 1:01:34

we all want to be just as optimistic like you can do this and you can do this because it's an amazing thing and I think a lot of more people should be looking into it, but there are direct cares that do fail. And I think a lot of times like you have to be able to be very knowledgeable about what your income is going to look like and how much you have to save and what are the different ways you can be building those models up and see what you need to be able to do. It's huge. How

Dr. Luke Pittman: 1:01:58

about you, Dr. Drew? What, what was, what's one of yours, your risks?

Dr. Rachel Trupe: 1:02:01

I was going to say, talk to other docs who are doing it. Like if you go to the DPC mapper and just find some other direct cares in your area and just take that doc out to coffee or lunch, it'd be like, let's sit down and talk through how did you do this? What made you do this? Get those real life things. I think I've talked to 20 doctors now of people who are either thinking about it, have thought about it. We're thinking about signing up for it. We're debating whether or not it could work in their lives. And it's just a cup of coffee. Like that, those conversations are invaluable.

Dr. Maryal Concepcion: 1:02:29

And I will say, especially for those who are listening to the podcast my DPC story. com, you can go to the mapper of previous guests and you can look around your area. Because if you're like, I don't really know, like what I would say to these people a classic example is Dr. Anand Mehta. He's had so many people comment that, Because of hearing his podcast people reached out and said like, how do I do this? I'm afraid to do this, etc, etc. And so I think that there's definitely ways to follow through make contact with somebody who has done it and Find the things that are relatable to you or are addressing the fears that you have and there's nothing like it

Dr. Luke Pittman: 1:03:09

It's a super friendly community. I mean, none of us got to where we got without a lot of help from a lot of other people and it's like incredibly generous community has to help people are definitely going

Dr. Maryal Concepcion: 1:03:20

And just this is going more into you guys as individuals even more. You guys have families on your website, on your about page. There's a lot of outdoorsy stuff going on. You guys, two of you are in vests. I'm like, yeah, like if there's a Subaru in the background, I don't know, but I would love to hear what you guys have been able to do in living your lives more fully and peacefully because of DPC.

Dr. Adam Henry: 1:03:47

I had a mentor in medical school who was heavily involved in the wilderness medical society and now having more time and flexibility. I'm actually going to their winter conference like this Friday. So, so, and I'm super excited about it and super excited to go learn and go to Colorado. And it's yeah, it's a lot of fun.

Dr. Rachel Trupe: 1:04:06

And I did like for the first time, like I joined a gym and the first time in my life, I just never felt like I had time to do that before with my previous job. And now I just make sure I block those time spots off and take time to try to take care of that. And then, I don't know, we, we do fun stuff out with the kids. Like we've, my husband's known for, he builds a luge or a toboggan run in our backyard every single winter and all the neighborhood kids come over. So this year I've been able to be more participating. I can ride the luge. I can help bandage kids up when they hurt themselves on the luge. But those types of things, just being able to be home more consistently.

Dr. Luke Pittman: 1:04:42

I've been able to do more cooking, coach kids sports. And then recently I went back to playing lacrosse, which was so good to be back on the field. Like, oh man, it just feels right to be. Stretching those legs out, getting full speed, maybe pulling a couple of muscles here and there. So good.

Dr. Adam Henry: 1:05:00

I think our tagline needs to be DPC ride the luge.

Dr. Luke Pittman: 1:05:07

We'll put that through the marketing committee. We got to talk about that.

Dr. Maryal Concepcion: 1:05:11

drop ship so that way you don't have to spend a lot of investment making those t shirts. But oh my gosh, it's amazing. So I am so grateful for you guys coming on to the podcast and sharing your journeys as physicians and physicians who have chosen DPC. I am so excited to continue the conversation in our patreon community. We're going to be talking about the future of Valiant Primary Care as well as lessons learned So definitely, take this episode listeners out there and think about, how it has mattered to these three physicians to have each other and remind yourselves that you have a community, even if you don't have another physician at your clinic, just like, Dr. Pittman said, this community. Is out there and this community is very different from a community of only fee for service doctors. We are here to help each other. So again, thank you guys so much for joining us today. Thank you so much. Thank you for listening to another episode of My DPC Story. If you enjoyed it, please leave a five star review on your favorite podcast platform. It helps others find the show. Have a question about direct primary care? Leave me a voicemail. You might hear it answered in a future episode. Follow us on socials at the handle at My DPC Story and join DPC Didactics, our monthly deep dive into your questions and challenges. Links are at mydpcstory. com. For exclusive content you won't hear anywhere else. Join our Patreon, find the link in the show notes or search for my DPC story on patreon. com. For DPC news on the daily, check out dpcnews. com. Until next week, this is Marielle Conception.