Making Healthcare Human: Dr. Kainth's Commitment to Patient-Centered Direct Primary Care

In this episode of the "My DPC Story" podcast, host Dr. Maryal Concepcion chats with Dr. Manvinder Kainth about her journey in Direct Primary Care (DPC). Dr. Kainth, a board-certified family medicine physician, discusses how her experiences with healthcare systems in Canada and the U.S. shaped her practice philosophy. She shares insights from her residency, which taught her the intricacies of the insurance-driven system, and how it propelled her towards DPC as a more personal and efficient model. Dr. Kainth emphasizes the flexibility and simplicity of DPC, highlighting her commitment to offering personalized and affordable care at her clinic, Maple Primary Care, in Plano, Texas. Throughout the episode, she provides valuable advice for new DPC physicians on setting boundaries, maintaining patient relationships, and navigating the business side of medicine. This episode is a must-listen for medical professionals contemplating a shift from the traditional healthcare model to a more patient-centric approach. Listen in to gain inspiration and practical tips on thriving in the DPC space.

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Transcript

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.

My DPC (2): 1:50

Direct primary care to me means bringing humanity back to medicine for both patients and physicians. I'm Dr. Kate and this is my DPC story.

Dr. Manvinder Kainth: 2:04

Dr. Manvinder Kainth is a board certified family medicine physician treating children and adults for acute and chronic illnesses with a special emphasis on preventative health and nutrition. As an independent doctor, Dr. Kainth has a personalized approach with each patient, minimizing the influence from the government and large healthcare organizations. Dr. Kainth grew up in Canada and has worked in a number of states including Washington, New Hampshire, Texas, and Minnesota. She moved back to the Dallas area in 2013 to be closer to her family and friends. Dr. Kainth earned her medical degree in 2003 from Baylor College of Medicine in Houston before completing a residency in family medicine at Valley Medical Center an affiliation of the University of Washington in Seattle. Dr. Kath stresses the importance of healthy lifestyle choices over excessive testing, multiple medications, and overtreatment. She believes that her role is to help patients reach their healthcare goals, taking into account the risks and benefits of all treatment options. Dr. Kainth is a member of the Texas Medical Association and the Collin Fannon County Medical Society. She was named D Magazine's Best Doctor in Family Medicine in Dallas and nominated as a Mom Approved Doctor by Dallas Child Magazine. Dr. Kainth takes great pride in personalized care and is currently welcoming new patients at her clinic in Plano, Texas.

Maryal Concepcion: 3:30

I am so excited to have Dr. Cain Thon today. It's been a couple years since I've seen her in person, and for those of you out there who are, wanting to learn more in your second year, third year of DPC, this is definitely a voice to listen to. Dr. Cain has been, as you heard in her bio, in many different places geographically, and And that I'm assuming has gone along with a lot of different exposures to health care. So Dr. Kane, thank you so much first for coming on today and joining us on the podcast. Thanks so much for having me. So when we look at your geographic, travels, I think of an Indiana Jones map flying from Canada to all over the place and then finally landing in Texas. Tell us about your exposure to those geographic places under the lens of healthcare, because I think that that is something that, It's important to call out especially because you've had experience with the Canadian health care system as well as different states within the U. S.

Dr. Manvinder Kainth: 4:29

Yeah, so it's real interesting, I was a child in Canada and I did have some chronic illness in the family so we did visit the doctor quite a bit and I was able to see How having national health care can impact a family. I didn't know it at the time, obviously, but when I think about it, I know that we went to the doctor with ease. There was never a talk about money. There was never talk about getting in. There was just and when you needed to go to the emergency room, you did. And then, I will say when we moved to the States, I was a teenager, and obviously there was still chronic illness in the family, and I remember my mom spending hours on the phone getting prior authorizations for every single office visits that my brother needed, and it was It was just crazy. It just seemed utterly inefficient, and I didn't quite understand it at the time, but I sure as heck learned real quick.

Maryal Concepcion: 5:30

And it makes me want to ask here because that's sadly still. And probably more so, the experience of many people out there in, in the U. S. And they don't necessarily know how to advocate for, what they need, what a transparent, option would be, for example, a TSH that costs 6 and not 200. I know you were young, but in terms of being the DPC doctor you are now, if you were to revisit those experiences, can you share with us any, ways that your mom learned to cope with the system in terms of did she find people to help advocate for what she was doing? she needed to do Or did she ever not do stuff because she couldn't get access to something easily

Dr. Manvinder Kainth: 6:18

That's a good question. So my mom is a force to be reckoned with. She is one of those people who will get it done, no matter what it takes. So she learned very quickly how to navigate the system and what she had to do before every single office visit. And it was like, It was almost like a second job, honestly. You have your notebook, you have your prior authorization number written down, so that when you go in for your office visit and they say, Oh, we didn't get a prior authorization. My mom has it written down. Yep. So she, she just learned quickly. And honestly, I don't think She missed anything. She just got it done.

Maryal Concepcion: 6:58

That's awesome. And I, I hope that even just partnering with DPC physicians, more patients are able to have advocates if they're not, able or knowledgeable as to what to do for the next step, or if it's just overwhelming the frustration that our healthcare system puts in our way. So I want to go into the time before medical school because I'm wondering what drove you, what lit this fire to go after the goal that you have achieved of becoming a physician and helping, other people in their own healthcare journeys?

My DPC (2): 7:30

Yeah, so I grew up as a caregiver, that was kind of one of my big roles and, I truly enjoyed it and I wanted to see if that was something I wanted to do. I had the opportunity to be an EMT with a volunteer fire department. It just kind of solidified, my, love for medicine and, helping people. And the biggest things I saw, personally was how a family can really be affected by great health care and how they can be affected by, frustrating or maddening or poor health care.

Maryal Concepcion: 8:04

So with that, Tell us about your residency experience, because you went to Seattle for residency. Everyone has a different residency experience, but I think the common thread amongst residencies is that we are taught in the fee for service way of doing things. So tell us about your experience there and how that, helped you, and how that impacted your journey to residency. After you left residency and became an attending.

My DPC (2): 8:27

Yeah, so I was fortunate to go to a residency where we had great training, both inpatient and outpatient, and we started our outpatient training right away as an intern. And that's kind of rare. Usually it's very inpatient heavy at the beginning. We were taught right from the beginning on how to code, what a modifier is, what a level 1, is, what you need for those things, and that, that is very important if you want to get paid. And they taught us all throughout, those things. And I will say that even though, my residency was great at teaching us a lot of the business side of medicine, they were not, very conducive to thinking of different practice models. All of it was conducive to working for a large healthcare organization. You know the fee for service model. And so I almost feel like residencies in general brainwash residents to think that you should just be a doctor, make sure you're just a doctor, let all the business people do all of the other things so that you can just use your brain to be a doctor. And I think that's a disservice. I think residencies need to show residents what their options are.

Maryal Concepcion: 9:49

And I totally agree. And I think that it's something that to think about, especially if you're a listener and you're a resident or a medical student, and you're not necessarily hearing about different models of practice, you're doing one thing right by listening to Dr. Kainth on this podcast all about DPC, but I definitely would say, Things that most of us did not know, just like you're saying, we did not know about a practice model outside of the insurance driven world. We don't know how much we are worth per hour with our MDs and DOs. And so these are things that I absolutely agree with, if you're a resident, feel empowered because there are physician entrepreneurs like Dr. Kainth and myself who are out there saying that these are important things for you to think about because whether you go to a corporate office, whether you open your own private practice, whether you are, opening a DPC, you're still doing something in the line of business and the business of healthcare. And so how you show up for that and how you get valued under that really impacts your longevity in healthcare and also the care and the quality of care that you can deliver to your patients.

My DPC (2): 10:53

Yeah, you're absolutely right. I mean, the fact that, we have to learn all of these things when we leave, like the steep learning curve after residency, as far as the business side of medicine, it is steep, steep, steep. and I will say that no matter what people think, you have to know the business side of medicine, whether you're in a fee for service model, whether you work for a company, whether you have your own practice, you cannot get away from. learning the business of medicine because you're going to want to know why you're not getting paid enough when you're working for a company. And that is the reality because the reality is your salary will go down almost every single year. And you'll see that it's a pattern. And so in order to learn why that's happening, you have to be able to look at the 20 page financials that the company gives you in order to learn where is all the money going. And unfortunately, usually all the money is going to the business people, not the actual medical professionals.

Maryal Concepcion: 12:01

And that one kills me because it's like, well, without us, you can't see patients. But then, that solution has come through. We don't need physicians. We can just have non physician provider clinics. Fantastic. Back to the physician world, I want to ask about your journey with the physician. Some with your residency definitely teaching you about the insurance driven system, but empowering you I think more than some people out there with how to code properly Those are skills. It's like those are skills that I'm thinking there's audience members who are like, yeah, I did not get that at my residency How did you take? your residency training and your desire to practice into the attending space.

My DPC (2): 12:45

Yeah. The other great thing about my residency is that they showed us the business side of medicine and part of that was how to read a contract and what to look for in a contract. So I was able to take that knowledge. And when I was looking for a job, and I did feel like I needed a job with a company fee for service straight out of residency. That was kind of where my mind was at. That's all I knew. It was great to be able to have that knowledge to be able to get that position, trying to be as educated as I could be to sign on the dotted line basically sign my next few years away to, to figure that out.

Maryal Concepcion: 13:25

And how did that journey go? Because clearly you're not in that journey anymore. You're your your own boss and you own Maple Primary Care. How did that journey translate into you even wanting to look for another option?

My DPC (2): 13:39

Yeah, so I worked for multiple healthcare organizations in the fee for service model and All of them were the same. Honestly, the challenges are always having to see more patients, more patients, more patients, more patients. Every time a year would go by or even a few months would go by and I would see that my salary is going down, but I'm seeing more patients. It didn't make sense to me. And that was the challenge. Everywhere I went. So I knew I needed something different. So with my last position after about two years of being with the company, I did start thinking, what else am I going to be able to do? I got to get out of here. So I thought, okay, I can try again with another company. But I knew that that would be the same. I could consider opening up my own private practice and accepting insurance. Or I could think about doing DPC. Or I could think about doing a concierge practice. And I was fortunate enough to go to a Nuts and Bolts conference, which was just down the street from my practice. And for me, it opened my eyes into DPC that I honestly hadn't heard much of before. I heard of the concierge model, but I didn't really hear about DPC. And what I really loved that I was hearing from DPC is number one, you don't need a lot of staff members to get it started. You can actually do it all by yourself. And so that was intriguing to me because the thought of having to hire staff members to deal with insurance companies just made me ill. The second thing that I loved was that it was affordable. And that is something that is a value to me and something I wanted to bring into my practice.

Maryal Concepcion: 15:30

Well, I definitely think that that is well represented on your website, and we'll get to that in a second, but I want to take a little rabbit hole journey into you going to this DPC conference and then deciding that you're gonna go all the way into DPC. Thinking about the finances, thinking about just the, the many hats that we wear as entrepreneurs. What was it that really pushed you into saying Hey, yeah, I'm totally going to do this period.

My DPC (2): 16:01

Lots of things. Biggest thing obviously was I knew I needed to change and I needed to jump into something. I talked to quite a few people who were doing the concierge model, and again, it was just not something that felt right for me because I wanted it to be affordable to everybody. I love the simplicity of DPC. I mean, how simple is it? Patient pays me to take care of them and I take care of them. That's the way it should be. And I, I would think of DPC as kind of going back to the old days where, you had a small town doc and the town knew you, you knew all the town, and it was just a cordial partnership. And That's kind of what I was envisioning with my DPC.

Maryal Concepcion: 17:26

That's awesome. And in terms of the financial journey into DPC, how did you plan that so that you could go from a corporate job to your own practice?

My DPC (2): 17:38

So I was fortunate to be able to fall back on my spouse's salary and that was the reality at the time, and I don't know if I would have done it if I was just myself because it is a big leap, especially at the time that I was doing it. I did also make it a point to keep my overhead or my starting cost like really, really low. So I knew I wasn't going to be hiring an assistant that I was going to be my own scheduler, my own referral coordinator, my own EKG tech, all of those things. So I I just kept it really lean.

Maryal Concepcion: 18:15

Appreciate the transparency for sure. Thinking back on your opening days, can you give us a ballpark as to how much you invested in your business to get it off the ground?

My DPC (2): 18:25

Yeah, when I look back, it was about 10, 000 to get it off the ground.

Maryal Concepcion: 18:30

Awesome. Now jumping to the website. On your website, above the fold, it's amazing you have your picture, you, but you also have this quote that really, I think, speaks to what was said in the, in your bio, but also just how you how you've shared up to this point. The, the person is Dr. Kainth behind the medical care. So can you read the statement that you have on your website for the audience? And also just tell us a little bit about why you chose that statement.

My DPC (2): 18:58

Yeah. So I always say, I am Dr. Kainth with Maple Primary Care, where we make healthcare simple and affordable. And so breaking that down, making healthcare simple, I feel like our country Makes health care one of the most complicated things on the planet. I don't understand why it's so complicated, or I do understand it's all about money. We know that that's what it is. And gosh, it's just it's utterly maddening how hard it is to get health care in this country. So I wanted to make something that was simple. And to me, the most important things for a primary care doctor is Is it accessible? So easy access and easy communication should be part of the equation. So that's what I mean by simple. I try really hard to allow my patients to directly contact me for their medical concerns. What a concept to be able to actually talk to your doctor and not go through a phone tree and then try to communicate through an assistant. So that's the simple part. The affordable part is just one of my values that I really feel like every country that believes that they are providing for their people needs to have affordable health care. And I don't feel like we have that in our country. And this is my small way of offering affordable health care to most people.

Maryal Concepcion: 20:26

One of the things that a lot of people are concerned about when they open, especially if they're opening as a micropractice, as a solo doctor like you did is this idea of 24 7 call. So can you talk to us about how you opened Maple Primary Care, but also how you're sustainable by addressing this idea of, access, direct access to your doctor, whether that be 24 7 or certain hours of the day? So when I think back

My DPC (2): 20:53

to my younger self when I started this I would have given myself a lecture at that time saying, you need to set boundaries. Boundaries, boundaries, boundaries, boundaries. So anytime a doctor comes to me now saying, oh they want to start DPC, that is the first thing I tell them. Because I would say very stupid things to my patients. Oh if you have a question, just text me. If you have a question, just call me. Yeah, no, that should never come out of your mouth. Like you have to have set expectations from your patients of how to communicate with your office. So now what I do is I have a flow chart for my patients that shows them how and when to communicate with me. And so My rule of thumb that I verbally tell all my new patients is if you have a medical question that you need answered by the end of the day, it doesn't matter what day of the week it is. I want you to text me if you have a medical question that can wait up to two business days. I want you to email that question to me. So that's how I try to coordinate all the communication, because otherwise it's human nature to take the easiest way to communicate, so at the beginning I would get texts all the time, hey doc, I need a refill on my thyroid medicine, or hey doc I have this little rash, or hey doc, this, that, the other, and it's really disruptive to workflow and to life. So I've had to retrain some of my earlier patients on communication, but I think I'm doing a lot better with that now.

Maryal Concepcion: 22:28

And that's totally hashtag normal because that is the journey of a business person. You do business and you learn business and you continue on. And so there's nothing wrong with that for those people who are like, Oh man, that I really, that hits home for me. When you talk about retraining patients, I would love if you can drop some gems here, because that is a thing that, we come into DPC being most of us without an MBA we come in with this culture of, especially for primary care we're really not that important. We're really referralologists in terms of like how the healthcare system overall treats us. When it comes to then having to speak up for yourself, When it comes to money, it's a very uncomfortable situation when those things are involved and I'm wondering how you thought about and how you've, continued to to deliver the, you know what, we're encroaching on the boundaries situation. We got to address this. Gosh.

My DPC (2): 23:26

It is. I feel like it's an art. And I feel like it's also getting to know your patients and them getting to know you like I do truly feel like my patients know that I genuinely care about them, their families and their health. And so when I asked them to do something I'm always asking in a friendly manner in a polite manner. And it's, it never, it's, it never comes off as snippy or anything like that. Now when I retrain my patients of, hey, don't, don't text me that. My words are like, hey, do me a favor and mail this request to me. I'm trying to keep text messages for, urgent same day matters. And most people take that just fine. And again, my patients, My patients know that, most of my patients know hey, it's Dr. K, she knows. She knows what she's doing and she knows she, I know she cares about me. So they don't feel brushed off. I think that's the biggest thing is making sure that your patients feel that they're not being brushed off.

Maryal Concepcion: 24:32

because you are in the Plano area you guys have a hotbed of Texas TPCs. Have you worked with other physicians in terms of if you have to go to visit friends or family elsewhere and you're taking time off physically from your practice do you take the call yourself or do you coordinate with other people in your state?

My DPC (2): 24:52

So oftentimes we will, a group of us will say, Hey, I'm going to be out of town from this time to this time. Would you be able to cover me if I need you to see a patient physically? And that's kind of how we do things here. So we all take We still field all of our incoming calls and texts when we're out of town. And that works fine when I'm in the country. The few times that I've been out of the country. What I tell my patients is, hey, I'm going to be out of the country timing is going to be six hours ahead. I'm going to check my email at this time every single day. You know, Email me if you have, a question that can't wait until I come back. Most people will abide by that. And most people will not contact you because they want you to have a good time. Most people, I find it really cool that anytime I send out an email, because I always try to give my patients a two week heads up Hey, I'm going to be out of the office from this day to this day. I usually get a, oh, have a great time, I hope it was a good, and then when I come back, they're like, oh, how was your vacation, and that's, that's really refreshing coming from a fee for service place where, honestly, patients don't want you to leave ever, and they don't think you should leave ever. Yeah.

Maryal Concepcion: 26:17

And there's definitely, that's been mentioned in the podcast, where a person comes back from vacation and it's in the fee for service world, I couldn't get in to see you because you went on vacation, like that type of tone. Or you went on

My DPC (2): 26:29

maternity leave. Oh, yeah. Anytime you hear that, I'm, I'm just, I'm always just blown away. Baffled by people's audacity, honestly.

Maryal Concepcion: 26:39

Yeah, that's, that's a good word for it. For sure. And that totally is relatable to a lot of people, unfortunately. So When you were opening, because you, you knew already that like one, you, you got the finances covered to you have the, the I am doing this because I can't do what I was doing before covered. And you decided to go out on your own. Did you ever consider joining a group or like another DPC and combined forces there? Or were you intentional about having your own practice? Thanks.

My DPC (2): 27:11

I, I didn't think about it very much, honestly. So I never thought about joining. And part of that was because not a lot of us were doing it at that time. This was like 2017, 2018. So there weren't too many of us doing it. So it never even crossed my mind, honestly. And, and part of it was, I, I think I just wanted to do it for myself too can I, can I get this done? And, and I wanted to be the one making decisions and learning from mistakes and all of that good stuff.

Maryal Concepcion: 27:41

Amazing. let's talk about branding and staffing at your clinic because one, your brand is beautiful, but it's also, I'm going to say it's, I'm going to guess it's got some Canadian, nods in there. Cause you have a very prominent center of your logo, beautiful maple leaf. But also just With you not necessarily having opened your own clinic before, how, tell us about your branding journey.

My DPC (2): 28:02

Yeah, I, I knew for my, so the first step was like, what, what's my name going to be? And I knew I wanted it to be simple. And I knew I wanted it to be, some kind of meaningful type of name. And then the other thing was, of course, What's available in my state. That is a name that nobody has taken yet. And, and then the last thing was, is there a dot com domain address that I can have? That's, that was a big deal to me. I didn't want something that was going to be hard as far as a website address. And I love that I came up with that. Maple primary care, because it's it is a nod to my Canadian roots. And to me, it's a nod to affordable health care. And it is something where people will ask me about it, too. People will ask, Oh, why did you decide to call it maple primary care? Or are you Canadian? I get that a lot. Even in my waiting room, I have, a couple, a few Canadian geese, flying on the wall. It's just, it's just a little nod to it. I don't know. I love it.

Maryal Concepcion: 29:12

That's awesome. I think it's fantastic. And I think also that, just it, it, it goes so well with the statement that you have on the website to keep things simple and affordable. Not to say that Canada is simple and affordable, but the idea of that's what you celebrate in your memory and in your brother's journey in health care from the Canadian health care system. I think that's awesome. Now you mentioned how you opened as a solo doctor, as a micro practice doctor and now you have somebody who is on staff with you. Tell us about that journey to find Larissa and how has she become part of the culture and part of how you take care of patients at Maple Primary Care. It's an interesting story.

My DPC (2): 29:50

So I, so I start the first year and a half. It was just me. I was solo. I did everything. And when you do everything, it takes a long time. And my days were long. So I knew I needed an assistance. And at the beginning, I was subleasing a tiny little exam room from another specialty clinic. Larissa happened to be front desk at that specialty clinic so I will admit that I kind of poached her and but I asked permission from the specialty clinic's owner prior to poaching her, and that's how I, how I ended up with, with Larissa, and feel like Larissa is a great addition because Larissa is a little bit of an opposite from me in that she is high energy, very bubbly and the biggest factors for me was I need an assistant who is kind and who Wants to show up to work every day, I mean, it sounds so simple, but gosh, it is hard to find somebody. Who has those two qualities, which is really sad, but she does. And so I love that. And Larissa was not a medical assistant. So she at the beginning, she was not a medical assistant, but Over the past year she has done her medical assistant degree and so she's become a medical assistant and I'm very proud of her and it's just been nice to see her grow and go to school and enjoy, getting an education too. It's been fun.

Maryal Concepcion: 31:23

Tell us about that. Because, when someone like Dr. Rebecca Bernard, she mentioned how her staff member is not a medical assistant, but she has workflows and stuff to follow. Awesome. But for you, because Larissa has gone from the journey of non medical assistant to medical assistant, did you guys have I'm, I'm assuming just because having gone through medical school myself and being like, Oh my God, I didn't know about this. Now I got to ask everybody about their creatinine, like all of these different things that come up as you're learning. You know about health care from the the patient from the patient care side of things. Did you guys Change the way that she was functioning at the clinic as she Became an MA in terms of like how she onboarded people What jobs you had her do because she went from non medical assistant to medical assistant

My DPC (2): 32:10

honestly, it didn't change too much because I had trained her with everything. The only thing that changed is now I don't need to supervise her for every tiny little thing. Before I would supervise literally everything. Now I don't need to do that because she does know the steps of everything that needs to be done. But I will say that I do put more tasks on her to be able to look at. My next thing to, which I haven't broached with her yet, but I will, is, refill requests. Like, how can you weed out some of those refill requests for me so that that can be taken off my plate? And I think that that's not something I would ever do if she wasn't a medical assistant, honestly.

Maryal Concepcion: 32:56

Now tell us about your patients because clearly when you were a solo doctor before Larissa came on to now it's been quite a few years and so how has your patient panel changed over time and have you had much churn because you're a DPC doctor and people love DPC.

My DPC (2): 33:14

I'll start out by, I had a non compete when I left my fee for service job. And so I knew I had to, location wise, be a certain mileage away, but I was able to capture a very small number of my patients, but that kept me afloat. And I'll tell everybody, and I'm sure you've heard it before, but you will be very surprised at who follows you from fee for service. It is not the people you think are going to follow you. So that was something super surprising for me. So I was able to capture some of my patients, and then from there, it was really all word of mouth at the beginning. And then I will say over time especially over the last year and a half or two, most of my new patients come from online, searches especially Google people search for doctors in the area, they see my reviews and they call to make an appointment, not even knowing anything about DPC or that I'm a DPC doctor. Most people do not know. But when they call the biggest factor that has them sign on, usually is number one, it's affordable. They're most people are like, Oh, that's really reasonable when they hear the pricing. And then number two is when they ask, okay when can you get me in? It's always going to be the same day or the next day. And they're floored. And that's usually how we get them in the door. And of course, we are very friendly. And we are kind and Larissa is a good listener. So all of those things are big, big factors. That's kind of how, the, the patient panel has grown. As far as the churn Yes, you are always going to have patients drop off every single month. The worst month of the year is always January because, oh, doc, I got insurance, so I don't need you anymore. Happens all the time. I will tell other physicians who are thinking about doing this that you have to have thick skin because the people, even people who you have saved their lives over and over will not think twice about leaving you sometimes. There are a lot of those people, so I, I do think as physicians, we have this self guilt always for everything. And I try to tell doctors all the time you've got to throw that out the window. And remember that you have to take care of yourself in addition to the patients and most patients, not all but most. We'll all we'll do what's right for them, especially financially. And they have no qualms about dropping you. They really don't.

Maryal Concepcion: 35:58

with that, about how many people do you have on your panel now and what's your, what's your mix in terms of like older patients younger patients insured patients, uninsured patients. What give us a, some, if you can give us some demographics. Okay.

My DPC (2): 36:13

Yeah, so at the moment, I have about I would say about a little over 300 patients. And my goal is to get up to 400. So my goal is by the end of the year, hopefully getting there. I'll say that most of my patients are adults. I do have a fair number of pediatric patients, but not a lot. And I would say probably at least 70 to 80 percent are insured and various forms of being insured. As far as age ranges and other demographics Thank you. Mostly female. I think as female doctors, we get a lot of female patients. Age range, it's, it's a wide variety. I don't feel like I have one specific or big group. It's, it's pretty, pretty much a wide variety when it comes to adults.

Maryal Concepcion: 37:06

Perfect for a family physician. So that's awesome. Yep. Love it. Yeah. And tell us about your regular week like what is your work day like or excuse me, what is your work week like in terms of, physically being in in the space with patients versus taking care of things from wherever you are remotely?

My DPC (2): 37:24

Yeah, so I do better when I'm at the office and I have kind of set times. That's what does best for my brain and how it works. So my office hours are Monday through Thursday, 9 to 4 p. m. That's kind of like my when I will see patients and then Fridays from 9 to noon. Most of my days I get here about 8 45 ish or 8 55 ish. And the literally walking in the door and patients being roomed and I usually leave somewhere between 30, just depending on what needs to be done. And I know docs who are in fee for service will think it's crazy when I say and then I'll say my average number of people that I see per day is probably somewhere between three to five office visits and then phone visits. It's probably three to five as well. And it sounds crazy, but I'm working my butt off all day, all that whole time. I really am like it's nonstop. And I can't explain what I'm doing, but it's all the things we we do. Checking labs and reading reports and all of those things. But the, the thing I do have extra time for is reading articles, getting onto up to date to see what the latest is on whatever. I can do more research. I can also talk to more specialists about mutual patients which is awesome. I feel like that is really, really helpful for both myself in learning, but also taking care of patients. Again, communication, I think, is really lacking in health care here. In this country. So being able to actually talk to the people you're working with I think is huge. And so that's, that's kind of my days is yeah, on Fridays, I try to leave the office by 1 30 or two.

Maryal Concepcion: 39:13

Amazing. Now, looking forward to the next 5 to 10 years, I'm wondering what you think about in terms of you've reached 400 and then what do you want to bring on another physician? Do you want to expand Maple Primary Care to multiple locations? What do you think about when you think about the future of Maple Primary Care?

My DPC (2): 39:35

Yeah, I, I honestly, I think I'm just going to keep it as is just micro practice. I, And part of it is I don't like complicated things other than, I mean, I get a lot of complicated patients, but I, I like to keep things simple. And I do think bringing on a physician partner while it can be really beneficial for certain things, I do think it can make things complicated. You have to think about how are you going to pay that back. position. What's their compensation going to look like? How much say do they have in the practice as far as making changes? Like it does make it complicated. And I don't, I don't know the average age of DPC docs, but I'm in my, late forties. And I'm hoping not to do this for like lots, lots longer. But I think I'll probably keep it a micro practice is, is my thoughts.

Maryal Concepcion: 40:27

Love it. In terms of your, like the things that you're able to do because you, you get to the office and that journey is real, like 55 past the hour, you're rolling up and you're like, yes, I am not late too. And yes, I'm also opening the clinic while I'm. Taking you back. But because I know that journey well. But when it comes to, the things that you're able to do apart from, having the time, like you mentioned, to call specialists to do educational things for taking care of others. What are you able to do for yourself because of the way that you set your schedule, even with hundreds of patients?

My DPC (2): 41:03

Yeah. I mean, one of the big things is I, I don't take notes home. So for all the docs who are charting at, 11 o'clock or midnight, I, I just don't, we don't do that anymore. I try to get all my notes done in the office and I try really hard not to take it home. And I have work boundaries because otherwise we can all drive ourself nuts. So my work boundary is, I think Try not to open the computer for anything patient care unless I absolutely have to once I get home the other big, big benefit is just the flexibility of having control over your schedule. So simple things like, my parents are, they're older they, you They do not want to take an Uber to the airport, so I am always their Uber for the airport, and so they just, just over the weekend, they told me, hey, on this date and this date, can you take us to the airport from this time to this time? And just being able to say, Yes, I can do that. It's amazing. Just all the little things like if I need my own dentist appointment or doctor's appointment or whatever it might be, I can arrange that in my schedule and I cannot feel guilty that I'm dumping on another provider. Other things like, it used to be that my housekeeper would come on Friday afternoons when I didn't have patients scheduled, but her schedule changed. So now I can block off, some time on a different day when she can come. It's just That, that simplicity is, it for me is huge, is having control of my schedule.

Maryal Concepcion: 42:40

That's awesome. When you think about other intangible things that are possibly misconceptions also about DPC, what's one thing that just comes to the top of your head that you haven't yet touched on?

My DPC (2): 42:50

Just time to do other things too. So I am this year I'm vice president of the Collin Fannin County Medical Society, which is pretty cool. And I'm also on, so I'm on the board. And so we have meetings, quarterly and I have time to do that. And I have time to be able to learn what that means. And being able to do things like that is really meaningful to me. The other big thing I do is I do all, a lot of DPC docs. I do try to mentor other doctors who want to do direct care. So I do get requests quite frequently of, Hey, can I come and meet you and talk to you? And what do you think about this? And what do you think about that? I'm able to do that, which honestly, when you're in fee for service, you don't have time for anything, literally nothing. Like having a student or any kind of mentorship type of position is a drain. You can't, you just can't do it. And I, I like to be able to offer my time to be able to do those things. So that would be one thing I would say is, if you have other Things you're wanting to do, like in medicine or even not in medicine, you actually can make time to do it.

Maryal Concepcion: 43:57

what's one skill that you've had to develop as a business owner that you never expected you would be doing?

My DPC (2): 44:03

That's a great question. Oh, I really didn't expect that I would Have to be really salesy. I don't like being salesy, like I don't, I don't love talking about how great I am and how I can take really great care of you, even though I, I really know that I can. But when you have your own business, you have to be a little bit salesy. Like you have to have an elevator pitch. You have to go to networking events. You have to be able to put yourself out there. there. Because if you don't, patients aren't just going to magically come to you. So that's one thing that I was like, okay, I gotta, I gotta put myself in that role and start getting comfortable.

Maryal Concepcion: 44:47

what's your favorite music to listen to while you're, busily working as a DPC doctor?

My DPC (2): 44:51

Ooh pink martini. My favorite is what I like to listen to. Because I feel like it's. It's, it's upbeat, but relaxing at the same time. And I just think they're such a fun, fun band.

Maryal Concepcion: 45:05

I love it. thank you so much, Dr. Kainth for joining us today and sharing your story. And I hope that it is inspiring and also just really motivating. And and I hope that it also provides those doctors, especially in, their second, third years in DPC just some, some fellowship with your words just because what you have lived through is very normal and I'm sure that there's lots of listeners out there going through the same or similar experiences. So again, thank you so much for joining us today. Thanks so much for having me. This was a lot of fun.

Dr. Maryal Concepcion: 45:35

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.