Sports Psychiatry in Direct Care: Confidentiality, Access, and Athlete Wellness with Dr. Jimmy Moley

In this episode of the My DPC Story Podcast, Dr. Maryal Concepcion interviews Dr. Jimmy Moley, an adult and sports psychiatrist based in Independence, Ohio, who practices through a direct specialty care model. Dr. Moley shares why he opened his private practice right out of residency, highlighting the benefits of direct care—like enhanced accessibility, confidentiality for athletes, and truly patient-centered mental health treatment. He discusses how his flexible, cash-pay psychiatry model allows him to see new patients within a week, provide both medication management and CBT, and address holistic aspects of mental wellness, especially for athletes dealing with performance, injury recovery, and career transition. Dr. Moley also explains his approach to pricing, practice growth, networking with local trainers and gyms, and the rising demand for sports psychiatry. If you’re a physician or athlete seeking innovative mental health support without the limitations of insurance-based care, this episode delivers actionable insights into building and benefiting from direct care psychiatry. For more about Dr. Moley, his services in Ohio and Florida, and sports psychiatry’s unique role, visit jimmymolymd.com.

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Transcript

Dr. Maryal Concepcion: 1:16

Direct Primary care is an innovative alternative path to insurance-driven healthcare. 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. Jimmy Moley: 2:05

I would say that this method of practicing medicine has allowed me to live out my dream of helping patients in a way that makes sense to me. It allows me to deliver what I consider to be high level care in a way that's on my terms, that makes sense, that allows me to address all of the aspects of mental health care that I believe need to be accurately addressed to improve mental healthcare in the patients that I treat. I think it allows me to give ownership of the business and ownership of my life and my drive in a way that working, for other people or other institutions does not. And it really is a way for me to, to live out my dream, to, to really, put into action, why, thinking back to when I went into medicine, why I really started with that vision and, and really bring that to life. So I would say it's for people who are highly motivated, for people who are willing to put in the work and, and to really build something up that is their own and want to really create a vision for themselves and their future. That can be some of the most rewarding work I feel that you can do in this area. I'm Dr. Jimmy Moley and this is my direct specialty care story.

Dr. Maryal Concepcion: 3:09

Dr. Jimmy Moley is a private adult and sports psychiatrist located in Independence, Ohio. He provides high level mental health care, including medication management and psychotherapy services to individuals ages 15 and up in Ohio and Florida. Dr. Moley received his undergraduate degree from the University of Notre Dame, completed medical education and training at the Ohio State University, and is certified by the International Society for Sports Psychiatry. Dr. Moley is a published scientific author. And has been recognized for his work in the field of head injuries and sport related concussion, as well as the intersection of somatic medicine and psychiatry. Welcome to the podcast, Dr. Moley.

Dr. Jimmy Moley: 3:50

Hey, thank you for having me.

Dr. Maryal Concepcion: 3:51

Your episode is coming out after multiple people who I had met at the same time where I met you at the Ohioan Summit. It was so exciting to hear what you were doing because you did so many things that I loved. Just, from your intro at the on summit, you, you talked about how you opened after residency, how you are really leaning into sports, psychiatry, and you even explained to people in the room who weren't familiar with that, with what that was, that that's even a thing. And as we heard in your bio, there's even an international Society for sports psychiatry. So super exciting that you're bringing your expertise to the cash pay model of, of practicing. And I wanted to start with. This fact that you opened right out of residency, that is something that we've had people on the podcast share from family practice, internal medicine, pediatrics, but in this specialty world, tell us about your exposure and drive to go into private medicine versus joining a corporation right after finishing residency.

Dr. Jimmy Moley: 4:54

That's a great question and I think really shapes a lot of the ideas behind why I started the practice. So when I started my psychiatry residency, I, I, immediately started to think, what, what comes next? And, and being forward thinking like that. So I knew that I was interested in sports psychiatry pretty early on. I would say from a, it was time in my first year and one of the best things I think that I did was talk to a number of mentors in the field who do this sort of work and, really learn from their experiences and, and what I kept. Coming across story after story were, physicians who had spent years in academic medicine and institutional medicine, right? That eventually, for lack of a better phrase, became fed up with the system, right, and, and went out on their own. And they pretty much universally described higher rates of satisfaction, better control of their schedules. Better reimbursement rates across the board and just overall greater satisfaction with their life and work. So it became, pretty clear and convincing to me as I gathered the evidence, right. And, not having that experience, but seeing this path that, that so many people had had worn down. And realizing that, that there was a way that I could start this off right away. So I talked to a few different people. I, I did talk to hospital systems, in the area just to gather their input and kind of pitched my vision for sports psychiatry and, and how this could all work. And, and it really did not seem to align right with the structures that were in place. So it became pretty clear to me as I moved through that process that in order to practice in a way that made sense to me, in a way, allowed me to, really enact my vision for what I wanted to do with my career and my life. That, that private practice and direct specialty care of is the way to go.

Dr. Maryal Concepcion: 6:24

I love it and I think it's. Even more relatable these days to so many residents who are asking similar questions no matter what their specialty is. So I wanna ask there, because as you talked with people, and as you just realize this is the, the way for me forward is going to be in private practice, in order for me to have the time I need to practice my specialty to the level that I'm trained to and want to I'm wondering about how you went intentionally building a practice to meet these levels of, autonomy and satisfaction with practice and really, really getting to the avatar, the ideal patient who, is very, very much in sports as well as, their mental health. And so if you could tell us about how you intentionally built your practice, I think that would be really helpful for the audience as well.

Dr. Jimmy Moley: 7:12

Definitely I, yeah, I started to recognize some needs that, that athletes in particular had in the mental health space. So, one of the first and foremost is confidentiality and privacy, right? In an athlete's world, there are a number of different stakeholders in their wellbeing and their performance and everything like that, right? So privacy and trust comes first. I talked to a number of physicians who, had bad experiences where it's, it's sometimes hard to say, that you can establish trust when the team, the organization, the hospital, signed your checks. Right. So it's really, it was kind of, that was the original idea of, of maintaining that independence in order to best serve the people that I'm treating. So that was a big factor. I also think that the way mental healthcare is set up in many instances, in, in large academic settings in particular, is focused on efficiency, right? Is focused on production metrics, RVU targets, and, all of those sorts of things, billing metrics. So, from that standpoint, the way appointment slots are designed, the way schedules are built, the way decision trees are built right, is not really placing the emphasis on the care and the patient themselves. So that's really the way I wanted to design things. I wanted to be able to set my own schedule to allow for more of a, a higher level of care, more holistic level of care. Right, that I feel like mental health care often demands, right? That if we have 15 minutes to, do a medication check, it doesn't address sleep, exercise, diet, social health, and all of these factors that have been shown repeatedly in the literature to play just as much of a role in mental health care outcomes, as do medications. So I really felt, to, to ethically practice the way that I wanted to, to address all of those, determinants of health that this was, again, the right choice for me.

Dr. Maryal Concepcion: 11:10

If you are not yet in direct specialty care or direct primary care and you are tasting that vomit in your mouth when Dr. Malises our views, that is real. So now I would love if you could. Explain to the audience similar to you, to when you meet, especially another primary care doctor who's looking into potentially referring patients to your practice, how do you explain your practice? Because you're in two different states and you also in, you also offer visits in person as well as virtual. So, if, if a primary care doctor would were to come and say, Hey, Dr. Moley, I found your information online. Tell me more about your practice. What would you tell them to describe what you do?

Dr. Jimmy Moley: 11:49

So I, I start off by emphasizing the accessibility of the practice. So I keep my practice intentionally small, and I do that in order to maintain, access to, to early appointments. So my, my, unofficial kind of claim is that I see all new patients within one week. Right Now when you compare or contrast that to other health systems in the area, we're talking probably two to three months on average, right? So that's a big difference. And, and oftentimes when people in the area need mental health care, they, they can't afford to wait two to three months, right? That, that oftentimes is the difference between maybe needing a higher level of care or being able to manage a problem on the outpatient basis, which now when we're weighing cost benefit, starts to change the equation. Right. So I talk about accessibility. I talk about ways that, that patients are able to get ahold of me while maintaining appropriate boundaries, within a healthcare setting. But I do feel like I am probably more accessible, right, than a lot of other physicians. So patients are able to message me directly through the electronic health record. There's no filters, right? That I'm able to, to stay flexible with treatment plans to adjust on the fly, which again, in mental health care, right? We, we don't have often ways to predict how individuals will respond to medications. So that flexibility, I think, is really key. And then really emphasizing, to a primary care doctor or anyone else who's referring, Hey, the, a lot of these issues that you know. Present, typically to a psychiatrist, are very multifaceted, right? So if you're treating, a patient for high blood pressure, that also happens to have anxiety, right? Those things we know are, are very closely intertwined. Mm-hmm. So, I think that that my work, hopefully with the goal right, is to address multiple different health outcomes to address, the wellbeing of the person as a whole. And the idea that, we're not just reducing the frequency or intensity of panic attacks, we're treating the whole person, we're trying to optimize their wellness. And as we move forward, from an illness model to a wellness model, then our goals will change. And, and this is a holistic experience. So that, that's kind of the pitch, and that I believe that, really, when a patient, when we decide to agree, enter into an treatment agreement that we're really agreeing to, to really work on all aspects of their life together.

Dr. Maryal Concepcion: 13:47

Yeah. That's awesome. And I'm wondering in terms of, as your practice has grown because you opened in 2024 and. You are treating people 15 and up. I'm wondering who were the initial patients that came to your practice? Were they patients of DPC doctors or were they patients who knew you? I would love to hear who found your practice first.

Dr. Jimmy Moley: 14:11

Sure. So my initial very small cohort were, were, were patients that followed me from resident clinics. So I moved cities right from Columbus to Cleveland, but there were a number of patients who were able to follow me. So that, that was nice and, and able to, to get things off the ground that way. I would say the bulk of my initial referrals though, did come from DPC docs or, or private healthcare docs. And I think that was a trend that that has continued. I mean, it has expanded right over time, but I think, understanding the model familiarity, right? And that goes for both the provider and the patient, right, was critical. It's just more of a seamless integration. So I think that that was the initial. And then I think also, word of mouth between patients, and I often say that's probably my favorite type of referral, right? Because it means that that patients are engaged and patients feel that they're receiving good, good treatment. So when a patient's able to talk and share and, and kind of build those networks, it kind of organically grows over time.

Dr. Maryal Concepcion: 15:01

Awesome. And so echoed by the many guests who've shared that on this podcast where, the word of mouth is so much more powerful than a print ad, a billboard, super Bowl ad. I'm getting into sarcasm again, but when it comes to the patients who I, I think about as a primary care doctor, there will be something that I am picking up in a patient where psychiatry referral is definitely warranted. And I'm wondering, when a general psychiatry referral is on the table versus somebody who is specifically looking for sports, psychiatry and or CBT as a, an option with their psychiatrist, how do you select, from anybody who has a, a general referral to one that's more specific? How do you. How do you look at that pool of patients to say, this is a great, this person's going to be a great fit for my practice.

Dr. Jimmy Moley: 15:58

Right. So I do advertise, like you said, adult and sports psychiatry and, and there is a very wide variety of patients that I see, right? So it's not just athletes. Athletes make probably anywhere from 25 to 50% of the practice at any given time. So part of, I think my practice is, I, I do have an initial assessment that I meet with the patient. We go through, we outline treatment planning, but at the end of that assessment we do decide is this the best fit, right? And that goes for myself and the patient. So we both have to agree to enter into that contract. So I think that's one thing. And then, I, very clearly state that if, if either one of us doesn't feel it's totally fine to move on and I want them to get the best resource that they possibly can. So I'd say the patients that, that tend to work well within this model and, and have the best outcomes are, are ones that are, are highly motivated. Right. This is something where we are, working outside the system, right? It is, like you said, a direct pay cash model and not shy about that. That is part of the part of the deal. So I think it's patients who are highly motivated, who are really willing to invest in their mental health and, and put in the work, right? It's, it's a little bit more of an active process, but I think that that activity and that that demand on that side also generates better outcomes over time.

Dr. Maryal Concepcion: 17:00

I love that, and I think it's, as you drew, commonalities between specialty and primary care. Previously, I think that that is something that I see much more commonly in our practice as a primary care practice, is that the people who understand that they're investing in paying for their doctor and access to their doctor are much more invested and motivated to, follow through with treatment plans, et cetera. Not everybody, but I definitely would say it's, it's more common. So That's awesome. And in terms of you getting training to do CBT, so cognitive behavioral therapy for those people unsure of CBT as an acronym, I'm wondering when did, did, was that something that you were able to get certification in while in residency or was that something that you did after you had opened your practice?

Dr. Jimmy Moley: 17:48

It's a good question. So it is something that I did do during residency, and every residency program in psychiatry is slightly different, right? I, I'd say every program has some component of therapy training some much more than others, and, and sometimes in different types of therapy. So Ohio State was able to offer, training in both CPT and psychodynamic therapy, and I, it depends on your level of interest, how much they'll engage and kind of provide supervision, training, certification, that sort of thing. So I was somebody who took very well to it. I, I found it very interesting and found that it complimented my work well for patients who wanted to pursue that path. Some of my, probably more rewarding cases are ones where we can engage in both medication management and psychotherapy. I feel like that eliminates some barriers, right? In terms of, of different providers and communication and, and really trust levels, right? There's so much interaction there. So I enjoy it as a big part of my work. I think that it informs a lot of, a lot of what I do, and I feel I, I feel very well prepared as a result of my residency training.

Dr. Maryal Concepcion: 18:40

Absolutely. And I think that that is so powerful to be, talking about different modalities of treatment, all, all from one physician. As a general practitioner myself, I am like all for how many tools can we have in the tool belt? So that is awesome. And I'm wondering, when it comes to specifically the sports psychiatry patients, can you talk to us about you, you mentioned it a little bit, but in terms of the specific health needs that you see with athletes in particular talk to us about what types of things you see in athletes especially. I, I would say the more common things that you would see in athletes, but also the things that are more unique to athletes that people might not necessarily pick up on with a typical, well child check form. Sure,

Dr. Jimmy Moley: 19:25

sure. Well, one thing is that we know that certain, very common quote unquote, bread and butter mental illness is more common in athletes, right? So, for instance, athletes have a significantly higher rate of PTSD, right? Than the general population. Certain forms of anxiety, depression, right? All of these things we know kind of can play in at higher rates, substance abuse eating disorders right across the board. So that, that's kind of one side of things that we know that maybe each of those illnesses takes on a different flavor with an athlete, or is specifically informed by aspects of their, their work and their profession. The other aspect is more of the performance optimization space and unique aspects to being an athlete, right? So we're learning, I think more and more how we can channel, especially therapy techniques to really enhance performance and really kind of, regulate our nervous system and really do things to enhance, heart rate variability, all, all these kind of biometric impacts that, that we have on performance. So that's one piece. And then there's also, very common issues I deal with a lot post-injury. Kind of situations where we kind of treat as more of a grief process. Working through that. I see a lot of athletes post-retirement is another big, you know, a lot of sudden changes, right? With an athlete that really pull into question elements of identity, purpose and, and things like that. So, there are certain elements that are very unique to athletes and like I said, even amongst the common, mental health issues, there's certain things that are about those illnesses that we have to treat and approach slightly differently.

Dr. Maryal Concepcion: 20:45

I love this. And the, the generalist in me is geeking out because, I, I wanna ask here, when you are able to do CBT, when you are able to do medication management, when you are able to be accessible by your patients and you are able to talk about things like holistic care, lifestyle medicine, impacting a person's health, I'm wondering, when you think of a treatment plan for somebody, say just making up a case here a 22-year-old who is was dealing with a sports injury and you know, they're wanting to return to play at a high collegiate level what would a typical treatment plan be? I mean, clearly you can't generalize anyone's care. But in terms of like how you would weave in. Potentially CBT and medication management and lifestyle medicine, because I think this is fascinating. As a primary care doctor, we do this stuff all the time, depending on, we make a recommendation, the patient tries something, we adjust. And I can see it being very similar, but I'm wondering, especially because you are a specialist in psychiatry, how you weave all of those things together. And I hope that this is helpful for people who are like, oh my gosh, I could totally send a patient to Dr. Moley after listening to him.

Dr. Jimmy Moley: 21:54

Right, right. That's the challenge, right? Is how do we, how do we address every issue that the athlete faces? So I, I think therapy is probably more of a universal recommendation at this point, right? That if you're coming to me after a dramatic change or a sudden change, that we need to be able to talk about that, explore things and work on things. Right Now, if you're at a point where you're not able to, to enter into that space because of the mental challenges, then maybe that's where medication steps in. Right. I oftentimes describe, medications as being able to, to raise the floor of the mental illness, to allow you to engage in the work that will allow you to actually recover and start to feel better. So that, that oftentimes is the discussion around medicine. Now, oftentimes, like you said, it is kind of that generalist role in the space. Like sometimes the medication, for the NCAA might require a, a therapeutic use exemption, right? So there's, there's paperwork on that end. There's consultations with the coaches, the other docs, the trainers everything kind of multiple pieces here, trying to, to weave in and, and kind of paint the full picture. So, ongoing therapy, medications when needed, and collaboration with school teams, parents, all of the stakeholders really is, is kind of the fundamental model. And then, like you said, as things start to improve and as we're able to optimize, we're, we're weaving in lifestyle factors, we're talking about sleep, diet, physical conditioning, right? And how we can enhance the medication and the therapy side with everything else altogether. That's

Dr. Maryal Concepcion: 23:11

so cool. And I, I just think that, especially with. I was talking to some moms in the OC about this when we had our California DPC summit just a couple weeks ago. And like we were talking about the, the level of competition that happens between families, especially in high school sports. And so, and my boys are, I have one still in pull-ups and so, it's, I'm not there yet, but I I think that this is, it's so fascinating for people to hear that. Sports psychiatry is a thing and you are delivering that and you do it even virtually as well as in person. So I wanna ask here, especially as you talked about, you know how because this is, this is what we do as direct specialty and direct primary care doctors who are in the cash pay model. You get paid to just be a doctor. And as you like, that includes talking to, potentially other doctors on the persons and the athletes team or or healthcare team or their trainer or whatnot. And so I'm wondering, as you've talked with people for your patients, have you also networked with people, gym owners or sports teams? And how have you gone about that to you just, just share about one sports psychiatry is a thing. Mental health and athletes is a thing. And also that you are open for business in, in case athletes were to need your services.

Dr. Jimmy Moley: 24:29

Right, right. And, and that is a big part of what I do is network, especially in maybe the more non-traditional areas, right? I, I've talked to countless gym owners, trainers, physical therapists, right? And really trying to enter into the space because those are the people that are seeing athletes on a daily basis. I. Right. Oftentimes that relationship is, is a very intimate, trusting relationship, right? Akin to maybe something like a therapist, right? So they're, they're boots on the ground seeing athletes every day. So talking to them too about maybe types of patients that I see, right? Types of things that I can help with and kind of painting. I think real life examples is probably the biggest thing that I can do. So if I can talk, generally about performance anxiety or, or give a presentation about what a DHD in a college athlete might look like, right? And, and how we treat that. I think those are pretty powerful examples. And then, and when I'm make speaking those messages, then it's like, oh yeah, I know so and so that, that might be struggling with that. Right? And might be able to refer them. So I do a fair amount of educational presentations, so that's to, to gyms, high schools training groups around the area where I'm at in Cleveland. The other, there's quite a few gyms and, and kinda, there's a big culture around athletics in the area. So, that's been nice to really tap into that, that group. And what I'm finding too is that there, there is a, a tremendous need and an eagerness really to talk about the mental health side. That's one thing I wasn't quite sure on going in, but I think people recognize more and more that a lot of times this is what holds back injury recovery or performance optimization. Right. So it's really pairing the resources with the tremendous need that exists in the community.

Dr. Maryal Concepcion: 25:52

I wonder, I if you can also point out some trends that you've seen to help support that more, more general acceptance of and wanting to learn about mental health when it comes to athletes in particular.

Dr. Jimmy Moley: 26:04

Right. I mean, stigma's been around as long as mental health care treatment has existed, right? And we've come a long way, and I, I think partly, and due to examples of athletes speaking forward, I, I think the message becomes so much more powerful when you're able to see other people that have gone through similar experiences share their story, right? So if I can, weave in people that I know, or trainers or other professionals in the area who have, who've been through this, right? And I mean, I, I played sports, but also, like I, I'm in a different role, right? Than those people. So I think weaving in those examples is very powerful and, and just really starting the conversation being, making it known that, that I am available and here are the services, right? Can't tell you how many times I've, I've given presentations and, and athletes or former athletes say, oh man, when I was in college, I wish I knew that this kind of thing existed, right? So that, that's half the battle is really making it known that, that I'm out here, that here's the services that I can offer and here's how I might be able to help.

Dr. Maryal Concepcion: 26:54

Very cool. And when you talk about, particular presentations that are really, really attractive and desired by different groups what are some of the most, what are like even the titles or the topics of the the most popular ones that you tend to talk about or tend to be asked to talk about?

Dr. Jimmy Moley: 27:11

I would say probably performance anxiety is probably right at the top. I would say A DHD is another very common topic, right. And I, I would say, honestly, some things that, that maybe don't get discussed as much in popular culture eating disorders certainly one and then PTSD. And, and recognizing the signs and, and saying, Hey, it may something you may have gone through years ago maybe still affects your athletic performance. Right? Or maybe the pressures that you're feeling to, to make a certain weight right in a particular sport or, or, enhance some sort of aspect of your physical performance is leading you to maybe, abnormal eating patterns or, or patterns that aren't healthy of intake and output. So asking the right questions, giving examples, and then highlighting issues that, that I hear, all the time from athletes I think has been the best, best tactic.

Dr. Maryal Concepcion: 27:54

Yeah, I think it's so cool. And, I think about corporations when education type stuff happens and it's not typically that the corporation is having a doctor talk to the community. It's usually like the corporation will sponsor the bags that like carry the swag and stuff. And so I think that, how, how different, even just from the, not just the perception, but the experience of you and your. Your expertise to be hearing a doctor talk about these things that people are wanting to know more about. And just even hearing one acknowledgement, again, like I just, I keep leaning on that that International Society for Sports Psychiatry exists, but also that, I'm sure by just giving these talks and hearing these talks, people are empowered to even know, like how to screen differently or how to, keep their spidey senses up for like, this is something I am concerned about in my athlete. And so just the education I'm sure does so much in terms of even just planting the seed for people who are like, oh, like you mentioned, the, the person who's like in, in college. I wish I would've known that something like this existed. I, I, I am so, I am just, I think about all of the people who are gonna have future athletes or the ones who have athletes and their thinking about. One of your talks. Now. I just think that this is, this is really getting to the heart of, you have on your, your website your mission, vision, and values, but it's it's really getting to the heart of making care transparent and accessible and affordable. So I love this. Now, when we talk about affordability, I I would love if you could talk to us about how you went from residency to opening up your practice with pricing, because this, I think, is a very big challenge and a very big place of questioning from specialists in particular of different fields. It could be outpatient, it could be inpatient, like surgery. It could be. Somebody who's just not used to the idea of, could I have a membership, like in primary care, we're different beasts because we see people for 80 to 90% of things that they're concerned about. But when you developed your pricing I wanna, I, I would love if you can share with us like how you valued your services so that there, it's not like the quote unquote cheap bottle of wine, but it's also not, out of the way to, to make it for only people have seven figure salaries. Because when you're talking about you, your promise to people is pre, pretty much, you'll see them in a week. I mean, and then you, you made the comment about two to three months. I'm like non Calvers County. Like you want psychiatry. It's way more than two to three months to see somebody. And so, I think about, time and expertise is one thing, but also that accessibility is so hard to price,

Dr. Jimmy Moley: 30:35

right, right. No, it's a challenge. It's a challenge for sure. What I, what I did first and foremost was kind of survey other psychiatrists in the area, so I know both nationally and locally, what are, what do price points look like you said, with intention that, that I do, feel confident in the services that I provide that access is worth something, right? That, that, being outside of the system and the level of privacy, confidentiality, appointment length times, right? Those are all unique and I think they have to be priced as such, like you said, otherwise it loses some of the value. And to be honest, like I, I have a lot of conversations and, and a lot of conversations end when I start to talk about price, to be honest. And I think over time you grow comfortable with those kind of conversations. Knowing that this isn't the right product for everybody, but for people who it is the right product for, it's a tremendous service, and I think the price reflects that. And you know it, over time, those conversations, like I said, just become more comfortable. You become more confident in, in the model that you're delivering and you stay flexible too on the fly. I mean, that things can change over time, but, but responding to how patients react, I think is important.

Dr. Maryal Concepcion: 31:32

Talk to us about how you looked at your services when it comes to membership versus one-off services.

Dr. Jimmy Moley: 31:39

Right. I, what's a little bit unique about mental health too, is, is the idea of boundaries, right? And, and, and healthy care. So if we're looking at, a situation with a membership and, and kind of unlimited visits, I, I do think that presents somewhat of a different challenge in the mental healthcare field. Right. Typically when, when we work on an issue we're addressing kind of, whether it's depression or anxiety or things like that. There's, there is more of a cadence right, to the appointments. I also, ideally we're going to move to a point, with kind of specialist care where there's a chance you might be able to just go back to your PCP, right? There's a chance that this is more of a one-off consultation or ideally we get to the point of remission where I only have to see you maybe once every six months. At that, that point, a membership fee doesn't make sense financially for myself or for the patient. So I think this, the structure makes sense more for me right now. And that's not to say it might change in the future or for each individual patient, but I think the goals of special direct specialty care are maybe slightly different in the issues that we see and that the outcomes that we're working towards.

Dr. Maryal Concepcion: 35:05

Totally. And that said, I'm wondering do you have strategy as to how many patients you want to take on your panel to be, quote unquote full? Whether that person is in a membership base, whether that person's just having a one, one-off service. I'm wondering, because this is something that other specialists have asked about, like how do you, if you don't have exclusively memberships, how do you, look at your your forecasting of what your clinic is actually making if your, if your balance is swaying between memberships and one-off services.

Dr. Jimmy Moley: 35:40

Right. I, I think one of the important things is, is to really collect data and try to track things over time. So from the beginning I've been able to, to really kind of track all that data, look at where referral sources are coming from, look how long patients stay, what types of appointment slots that are filling up the most frequently, right? So that's allowed me to, I think, to get an idea in it and kind of build some models maybe that predict and project future growth. So that's important. There's always going to be an element of unpredictability, and I think that has to be just be built in, and I think it's just part of the process, right? That, that some patients are going to drop off, move away, do whatever. And that, that has to be factored in. So I think I mean it, that's part of the nature of it, that it is probably a little bit more unpredictable. But I think, with the, as things continue to grow, I, I, I've gone more based on feel here in terms of, when I'm quote unquote full. Like I do keep slots open every day for urgent or emergent appointments, right? So that, that's something I wanna maintain. I wanna maintain that one week, roughly timeframe to get new patients in. So kind of working within those frameworks, kind of feeling what feels right to me in terms of my bandwidth and, and my ability to take on work, I think makes the most sense where I can still deliver that high level care to the most amount of people possible.

Dr. Maryal Concepcion: 36:46

I love that. And when we talk about unpredictability, I'm wondering if you can share with us any unpredictable moments you've experienced as an entrepreneur because you opened out a residency and you're just like me in terms of we don't have MBAs and yet we're still physician entrepreneurs.

Dr. Jimmy Moley: 37:01

Right. I mean, you could argue the whole thing's been unpredictable, right? That there's no playbook necessarily going into this kind of thing. But, I, I would say, I mean referral, influx is, is all over the place. There's weeks I go where I get, 10, 20 referrals. There's also weeks where I get one or two, right? So I think that I've kind of learned at least so far that, that I kind of have to ride the wave right of that and, and learn to balance that with everything. And, and you never unexpected things happen all the time with patient care. Like I said, patients move away, things change, financial things change. And I just think you, there's a certain amount that I've had to grow comfortable with that, that unpredictability. And I think if there's a, a tendency, I think to maybe get a little bit caught up into that, to maybe personalize that in a way, say, what did I do wrong? Or, tend to, to kind of take that on myself. But I think as you, as you see the trends play out and, and kinda look at things more over time, it, it becomes clear that that's just part of the nature of the industry.

Dr. Maryal Concepcion: 37:48

I do feel that, as physicians especially when there's a lot of, we go into this to take care of other people that, that, that can, that internalization of oh, is the business reflecting me as a person is, is very common, especially in the first, like the opening months of a DPC practice. And I'm wondering for those people who find that. Description of, some weeks you have fewer referrals than others. Really the, the listeners out there who can really relate to that in terms of, especially those people who are opening and they, they might be writing this wave of yes, I had one phone call this week and last week I had a different number. What words would you say to that entrepreneur, that physician, entrepreneur in particular? To encourage them to, recognize their strengths, recognize where they can improve on, and to keep pressing on.

Dr. Jimmy Moley: 38:41

I would say that, what worked for me personally was seeing that as an opportunity to do other things to enhance the practice. So on slower weeks, that maybe meant more networking meetings, right? That meant more face-to-face, kind of going out, doing events, trying to meet with, therapists, other physicians in the area. I was able recently actually to, to launch a newsletter right through the practice or do more advertising or work on the website. Right? There's always things I feel like that I could be doing to, to help build the practice. And to me, if, if the patient volume isn't there, then I'm still adding value. With my time because I, I found, with anything, like anything else, like in life, like the more effort that I put in, right, the better outcomes that I'm going to see. And, and this is hard work to be honest, I mean, I, I've had a number of residents reach out and, and ask about it. And, it, it seems like, oh, you're like, you get to make your own rules and set your own schedule. It's well, yeah, but it's also like a ton of work on the back end, and it's a lot of work to network and, and push forward the business. So it's not necessarily a path for everybody, but I think, if you have that drive and if you have that kind of vision of being an entrepreneur and you wanna pair that with some, care that you feel comfortable with and care that you wanna deliver, then I think the, the time fills itself because there's always moving pieces, there's always things to be done to, to push forward.

Dr. Maryal Concepcion: 39:46

Awesome. And as you mentioned newsletter, I'm wondering if you can tell us about what are you putting to craft your newsletter? And do you have a newsletter specifically for your patients, or do you have a couple of newsletters? One for people who might be interested in sending you potential patients in the future as well as your current patients.

Dr. Jimmy Moley: 40:04

So I have one newsletter. It's you can subscribe through the website and it's a, a really a method for me to just kind of communicate a few different ideas. So I, I do create a section every time to talk about, kind of more recent literature, any kind of recent updates in psychiatry, new technology, new articles, things that are out there in the media, right? That, that people might run into. I do provide, a section for tips or kind of things that are more relevant maybe to this, this day and age, right? So for, for example, I did for June, like ways to connect with nature, right? As the weather gets a little bit warmer around here, ways to kind of get out and incorporate that, into your mental health routine, right? And I, I really want to kinda use it as a space to create dialogue. I actually have a number of patients always that, that respond and it starts conversations, right? It's just ways to, to think about mental health, to promote my work, and to just really, kind of create more of those touchpoints, both with current patients and with, other docs, prospective patients and that sort of thing.

Dr. Maryal Concepcion: 40:54

Love it. And in terms of your. You're going forward. I would love if you could talk to us about what do you see for the future of your practice in the next three to five years? Do you see yourself having more states where you're licensed in doing telemedicine? Do you see yourself adding another doctor to your practice? Especially just given that your practice like especially even by your website the, the, the, the title, and I don't know if this is your actual business or if it's a DBA, but Jimmy Moley, MD Adult and Sports Psychiatry is your tagline on your website. So I'm wondering, in terms of growth do you see other doctors working under your name? Do you see evolving the brand? Where do you see your practice in the next three to five years?

Dr. Jimmy Moley: 41:40

Yeah, that's the exciting part, right? I, I've thought more and more about that as, as we approach the one year mark, and I do think expansion is probably in the cards. That's probably the next move that I look to make. The brand probably at that point expands beyond using my name as the business name. But I think, for right now, I think this makes sense for where I'm at as I continue to grow. And, and like you said, maybe in the next one to three years, I, I definitely look at that because I feel like the model I deliver makes sense. And I, I do, I like the flexibility. I've, I've always been somebody who enjoyed variety in my schedule and time. And maybe clinical care five days a week full-time isn't, isn't the best path for me, right? So if we devote time to the business and networking and things that I've come to really enjoy, I balance that, with the clinical care, schedule and also kind of helping, expand the reach and do educational work. So I think that's the plan right now looking to, to maybe expand here in the short order but also just continue to, to grow and learn. I mean, it, the progress I've made over one year has been, remarkable. I've learned so much. So I'm sure that will just continue to develop naturally as things go forward.

Dr. Maryal Concepcion: 42:36

I love it. And as you talk about, spreading the word about what you're doing and also how you mentioned even residents are asking you about, oh, learning more about your practice and how you're delivering. I'm wondering if you can speak to the, because I would imagine, and I think you mentioned this in Ohio, that just the, the world of international society, the, the world of people who are focusing on sports, psychiatry is growing. Mm-hmm. And there needs to be more people. But in terms of you speaking to your colleagues, specifically in sports psychiatry with how you're doing things as a direct model, do you see do you see larger universities, corporations trying to, put their own flavor to support psychiatry? Or do you see pretty much all of your colleagues just going direct because of the time you need and the, the, the level of which you're working with athletes in particular?

Dr. Jimmy Moley: 43:29

It is an interesting mix and it's interesting both within the US and internationally. I would say the percentage of private docs is probably higher than most other groups, right. Just because of the nature of it and like we've talked about. So I think that's one thing. It does sometimes work well within academic setting. There's a number of places in the US that, that do a really good job of sports, psychiatry, have, curriculums and built, things built into the residency program. So that is definitely a possibility and I think we'll continue to grow. But I also think that there is, probably they have an earlier jump and probably will continue to drive more in the private space just because of the nature of the business.

Dr. Maryal Concepcion: 44:02

Yeah, I, none of that surprises me, especially as you said, the nature of the business. And I'm wondering, especially for those physicians out there who are in medical school or in residency for, I'll restate that. For those who are physicians or future physicians in medical school residency, I'm wondering as you spoke with people, as you made your decision to open a private practice, I'm wondering just in terms of rotations things to look out for when you're pairing mental health with sports in particular, what things do you, recommend people do or get involved in so that, so that by the time that they're working with athletes as a private practitioner they, can have more tools in their tool belt.

Dr. Jimmy Moley: 44:46

I think diversity of experience is the number one thing. So that means spending time, with the sports medicine doc, that means spending time, in the training room with physical therapists, right? On a primary care side, I did rotations through residency and concussion clinics and in pediatric clinics and right wherever.'cause athletes are everywhere, right? They, they seem, they seek the same care as everyone else, so, so that's really important. I also think it's important to get exposure to private practice in training. It's something that I personally didn't get much of through Ohio State. I had to create it on my own. So I think that that's really important because in those systems, it, it's, it's a bubble, right? You're, you see it, what you see is, is what you think is the reality. And that's not always the case when you start to look at how are actually physicians practicing in, in my state, in the country, in my region. So expanding that vision a little bit beyond what's directly presented to you, diversity of experiences, and then also getting involved with some of these organizations. So like the ISSP for example, involves you, they do have a curriculum that residents can do and they will link you with a mentor, not even necessarily in your area. So there are organizations out there looking to, to promote, raise awareness and, and educate like you said, both physicians and future physicians.

Dr. Maryal Concepcion: 45:51

That's fantastic. And for those listening what is the best way to find you, especially if there's people out there who are like, I have a person I need to refer to. Dr. Moley, I.

Dr. Jimmy Moley: 46:01

Absolutely. My website is the best way and has the most information. So that's jimmy moley md.com. I'm also relatively active on Instagram, so that's at Jimmy Moley md from the mo social media side. And you can also subscribe to the newsletter through the website.

Dr. Maryal Concepcion: 46:14

Awesome. So we'll be continuing our conversation about the ins and outs of the business aspect of your practice, but on, on our Patreon. So, thank you so much Dr. Moley for sharing today about your specialty and how you've taken psychiatry and blossomed it into your practice focusing on both adult and sports psychiatry.

Dr. Jimmy Moley: 46:33

Thank you.

Dr. Maryal Concepcion: 46:37

Thank you for listening to another episode of my DBC 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 D DPC story and join DPC didactics our monthly deep dive into your questions and challenges. Links are@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 DPC news.com. Until next week, this is Marielle conception.