From Urgent Care to Unfiltered Doctor: Dr. Dana Mincer’s DPC Story So Far

Today we hear from Dr. Dana Mincer, founder of Love Health Direct Primary Care in Fort Washington, Pennsylvania, to share her personal journey and the transformative impact of Direct Primary Care (DPC) on patient care and physician well-being. Dr. Mincer discusses her background in holistic and integrative medicine, shaped by unique experiences in Switzerland and Italy, which informed her passion for reimagining American healthcare. Dr. Mincer candidly addresses the widespread issue of physician burnout, drawing from her own experiences of exhaustion, depersonalization, and disillusionment within conventional healthcare settings, especially during the COVID-19 pandemic and her time in high-volume urgent care. She explains how DPC allowed her to break free from the rigid constraints and time pressures typical of value-based care models, granting her the autonomy to practice truly patient-centered medicine, focus on preventive care, and build long-term relationships with patients and her community.

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Transcript

Dr. Maryal Concepcion: 0:43

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. Dana Mincer: 1:31

Direct Primary care to me is like the yoga of medicine. It is the lifeline for patients, for providers, and for entire communities. I see it as a tool to make our. Society to leave our communities better than we found it. I am Dr. Dana with Love Health, DPC, and this is my DPC story.

Dr. Maryal Concepcion: 2:05

Dr. Dana Mincer, DO is a family medicine physician, entrepreneur, and founder of Love Health Direct Primary Care in Fort Washington, Pennsylvania, known to her patients simply as Dr. Dana. She combines her background as a division one athlete daily Yogi, and soon to be certified yoga teacher with her medical expertise to bring a holistic integrative approach to healing. Her passion for reimagining healthcare began during residency when after being diagnosed with two autoimmune conditions, she experienced the shortcomings of both conventional and functional medicine. That journey inspired her vision to reconnect body, mind, and spirit, and to restore trust in the physician patient relationship. In addition to her thriving DPC practice, Dr. Dana co-founded Verity Advisory with her fiance, Tommy a CPA, and business strategist. Together they consult with businesses on building cost-effective, transparent healthcare benefits, and alternative to the traditional big five insurers. She's also the host of the Unfiltered Doctor podcast, where she brings raw, honest conversations about medicine, leadership, and integrity outside of medicine. Dr. Dana is a mom, personal trainer and outdoor adventurer who loves bouldering skiing and paddle boarding with her family. Her bold mission is to leave the world better than she found it, and to inspire others to believe the same is possible. Welcome to the podcast, Dr. Menzer. Thank

Dr. Dana Mincer: 3:24

you. Thanks for having me.

Dr. Maryal Concepcion: 3:26

This is such a treat. We met each other for the first time at the FMMA conference earlier this year, and it was so exciting to see you again in Denver at the hint Summit and Rosetta Fest combo there. And I will say that, you know what I loved laughing at, at remembering what happened at Rosetta Fest was that people thought that you were you were literally selling a, a, a cardiovascular product because you were like, all over cardiovascular health and preventative medicine and lifestyle medicine. And I was like, no, she actually has her own DBC. And so we're gonna be talking about that today, but I just wanted to call that out because even people who didn't know you could see your passion. So thank you so much for joining us today.

Dr. Dana Mincer: 4:09

Thanks for having me again. I appreciate you bringing that up. That was, I forgot about that. And that was very, that was, that was very humorous.

Dr. Maryal Concepcion: 4:17

Love it. So I, I wanna highlight something from your past, which I think is awesome because you had studied visual communications in Switzerland, so totally different country, totally different way of delivering healthcare. And something that has not been highlighted, specifically Switzerland's example on this podcast. So I'm wondering if you could talk to us about your experience in Switzerland and how that helped mold your ch your medical career.

Dr. Dana Mincer: 4:43

Yeah, so this is, it's so pertinent with all of the different ideas going around, at least for me, about a single payer system and what's the solution. And you know, while healthcare was free in Switzerland, I think it really showed me that a single payer system is not the answer. When you're, when you have that experience of being, and, and I was right on the border, I was in Luo, so it's the portion of Switzerland that drops down into Italy. And actually my boyfriend at the time, and I was, this was 20 years ago, was in a motorcycle accident and he needed skin grafts. And it was like, and when he was in the accident, he was actually in Italy when it happened. So I had to go down there and get him from the hospital there. So I got to see both Swiss hospitals and Italian hospitals. And what was very clear to me was, this is not what most Americans would be happy with, with healthcare. Not that they were like the, like the doctors, I'm not saying anything about the doctors per se, but the, I mean, it was sort of chaotic. The wait times were crazy were worse than here. No one had privacy, like people were 10 people to a room not even curtains drawn. And and I just don't think it would be an acceptable level of healthcare. So I think that really got me thinking when I came back and decided to go down the path of medicine, which I think I had been frightened to even try earlier on in my life. It really gave me a perspective on like that argument with, oh, we need a single payer system. We need a single payer system. And it really swayed me against that and I realized quickly we had to find other solutions.

Dr. Maryal Concepcion: 6:32

Sure. So dovetailing on that, I'd love to hear how your experience in medical school was because you went to the Philadelphia College of Osteopathic Medicine and. MDDO school, you know, we get pretty quickly exposed to the way that healthcare is, you know, accepted culturally right now in this, in this country where insurance is healthcare. I wanna ask here if you had, you know, very stark thoughts about how this healthcare is different, this type of healthcare is still not optimal. Comparing it to what you had seen in both Italy and Switzerland.

Dr. Dana Mincer: 7:08

Yeah, so a little bit about the osteopathic portion. I, one of the things that I loved about Switzerland and Italy was the way of life. It's a much different philosophy. You have breaks throughout the day. Things shut down for mental health time. And I, you know, as a former division one athlete, I had also been dealing with the aftermath of a lot of just wear and tear on my body. And I saw an osteopath in Switzerland. In Switzerland, it's two different tracks. You're either in osteopath or sort of like chiropractic almost, versus physician track here. Or you're an md. There wasn't a combination track. So that osteopath really opened my eyes to. What I sort of already intuitively knew, which was the connection of structure, function and spiritual values and mental health. And he really helps me a lot. So when I came back to the US I started realizing, oh wait, there's a combined path almost like I can do osteopathic school and I was gonna be a non-traditional student because I didn't go back to med school until I was 28. So it just so happened that osteopathic schools were known to be a little bit more favorable or look more favorably upon non-traditional students. And I think that's really what, what called to me. From that perspective, I'm so glad I did it. You know, there are a lot of osteopaths who you go through osteopathic medical school and you have extra time spent in labs so that you can really fully understand structure and function. We have a really good understanding of the anatomy and physiology of the body, of the body, but. A lot of people don't use it in their practice. And, and that's fine. I think it really shaped my practice today and how I view the whole person, why I really push toward a more holistic lifestyle medicine oriented practice. And although I don't specialize in osteopathic manipulative medicine and I, I will refer out oftentimes to neighboring physicians who do do that.

Dr. Maryal Concepcion: 10:29

That's great. And I think that's helpful also for people who are listening and they're very early on in their medical careers and trying to hear the difference between DO and md because I know it was a very vague discussion when I was applying to medical school back in the day, so that's wonderful to hear, hear. Now, you also are a family physician like myself, and that is a whole layer of, you know, choosing a specialty that's a lot of, you know, dabbling in lots of things versus focusing on one area of the body. And so I'm wondering if you can also share with us why family medicine.

Dr. Dana Mincer: 11:03

Yeah, you know what? It's funny. I almost I almost went into emergency medicine and I'm like, I'm so glad I didn't. I really have this incredible faith in the universe, God, whatever you wanna call it. And I truly believe that I have guidance that's larger than me. I'm so glad I went into family medicine now. I think I would've completely burned out in the emergency room. I'm too much of an empath. I'm at times, I've been called the super empath, probably fall into that category. And while it was exciting in a lot of ways, it, it's a lot of the stuff that you see in the emergency room is very, very challenging. Not, not that it's not challenging in different ways with family medicine, but I love. I love that I have the, the space now to have authentic connections with my patients and the ability to have a long-term relationship with my patients. I love, I love that. I think, I don't know how we can have a positive impact on someone without those two things. Right? Because those, those, that creates a situation of trust. Mm-hmm. You have to have a mutual trust and a mutual respect in order to have an effective exchange of ideas. And certain conversations might not be easy conversations, you know, if I'm a stranger to someone, and I, I, I realized this quickly. I, I worked urgent care for a long time because I was single mothering, and that was the, that was the space, the only space I knew within the insurance system that would allow me to go home and not be just like overwhelmed with charts on weekends and evenings. And I couldn't do it. I had an infinite home and an older child. I realized pretty quickly I don't have any space with this person that I don't know, and that's coming in for a seven minute visit. To sit down and talk to them or even ask them like I feel like they might feel like it was intrusive if I was like, what's going on in your personal life? Like, how was your relationship with your partner? Do you feel safe? Is it, you know, like these questions that you're supposed to ask that need to be asked. But there was no comfort level in doing so in the rush system of insurance-based medicine. And so I realized very quickly like that I, well, not very quickly, but after I had been in urgent care and I had done outpatient addiction medicine for a while, so I had a little bit of contrast in that regard that there had to be something else because I wasn't helping people and I was band-aiding.

Dr. Maryal Concepcion: 13:28

Yeah. And I, I think it's ironic because I just spoke with a bunch of chief residents at the uc, Davis residency network yesterday and right before that I had talked with residents from my former residency. And I, I just find myself being so uncomfortable when I hear fellow physicians, fellow family physicians talk about how it's great that they'll see so many patients in a day. And when I calculated out what the average was, it was like 12 minutes or less per patient. And they were, you know, with happy, smiling faces talking about how they're not allowed to do ob, they're not allowed to do this or that, and they can't see this particular population. And I'm like, D. I'm so sorry, but does anyone see the problem here? And it's very, very uncomfortable sometimes for me, and I've expressed this on the podcast and to other people in person, but it's it's very, very hard sometimes once you've seen what healthcare can be like to unsee what healthcare can be like. So, I, I also wanna ask here, because even just, you know, being an, an empath, a super empath in your case I'm also glad you didn't go into emergency medicine because that, that is rough, especially these days when there's even more demand on er physicians. But when it comes to your being able to be empathetic because of your experiences in healthcare, I'm wondering if you could talk to us about how you intentionally then shifted from the, you know, the, the, the service models that you were in to opening direct primary care.

Dr. Dana Mincer: 15:00

Yeah, so I. I think it's really important for us to be vulnerable and share our vulnerabilities. And so I'm gonna share something that I'm not proud of now, but I I was that individual that you were just talking about. So, I was at an urgent care that's a chain urgent care, and they were known and it, you know, before COVID, especially for 14 hour shifts, so it was like you would do a seven and a seven, so it would be a double, but. And then at the parties we would brag about because we would get paid on productivity. So like the more patients you saw, the more money you could make. And we would sort of joke about it and brag about oh yeah, I saw 85 patients last shift. I mean, 80 to 90 patients in a 14 hour shift was, was, was more the norm at this place. Wow. And while that was great in one way, because it gave me a lot of exposure to acute stuff, like I knew I could, I could maneuver acute things quickly and realize what tests I needed to get done quickly it quickly wore on my soul. I and I didn't even realize why I was so miserable or unhappy. Right. I didn't, I didn't know why initially I wanted to quit medicine. COVID hit. And the situation just got worse in some ways because the initial COVID, I feel like I saw more acute illness, like the wor worse illness. Mm-hmm. And people, I had more than a handful of patients coming in in respiratory distress that we had to send to the emergency room. It was very scary. And during that process, I actually, I have a background as a personal trainer and I am a former D one athlete, and I really started doing more positive habit coaching and I started experimenting with fitness stuff online and on social media because I didn't even know what I was doing. I was just like, I have to get out of this. I have to somehow, and I don't see a path out. Simultaneously. Thanks. Actually, thanks to my mom who's, she was one of the first female physician assistants ever. She from, she graduated from Rutgers, I think she said there were like five or seven females in her class. She's in her seventies now. And I had been connected with the DPC docs group online on Facebook, and I'd been sort of just stalking, I call it, where you're just, you're, they let me on the group, you know, I'm sure a lot of people do this. I, it is, and you and I just read, I was just reading other people's posts and I was afraid to post anything or ask any questions, but I was at least reading. So I knew this other avenue existed, but I was also overwhelmed thinking, oh, this is gonna require like me to give more of myself, and I have nothing left to give. I don't know when that turning point was for me in terms of like when that transition happened where I realized I just had to do this. I think that, i'm really grateful for my now fiance who is a really rational and kind human. And he and I had a lot of discussions. We were actually looking into just buying some sort of business outside of medicine completely. And my uncle as well, who's pretty rational, CPA you know, him just saying you have to do something in your profession. Like you have to, you, you, I don't know if he said it like this, but for me I almost thought like I didn't go back to med school at 28 with a six week old infant for nothing. Like I sacrificed so much of my life for this, for this, and I don't know, at a certain point I just decided that it was time to make the jump. I didn't do it the way that other people do it with a ton of planning. I just was like, well, I'm already 10 99 at urgent cares.'cause I got fed up with being forced to cover shifts. Not that I didn't wanna help people out, but I was single momming still at the time and I was. I, I can't do this anymore. So I, I went completely 10 99 and I was like, I think I have enough good relationships with all of the urgent care owners around me that I can just pick up shifts. And again, thanks. Thank thankfully to something larger than me, I was able to do that. So for the last two years of my career, I was 10 99. And what that did was that gave me the space to really experiment with other things, and I was able to get like two regular shifts per week and then pick up extra shifts on top of that. And then as I transitioned into my DPC practice, I was able to talk to my. Employers and say, Hey, listen, could I drop to one shift a week initially? Would that be okay? This is what I'm doing on the side. I need to do this for me. And again, I relied on that authentic human contact with someone who thankfully they understood me and they were able to accommodate and they understood that, that I needed to do this for myself. And so that was sort of my entry point into direct primary care. I hadn't even gone to a DPC conference in person yet to tell you the truth.

Dr. Maryal Concepcion: 20:00

And I, I will say that you're pointing out that you don't necessarily have to like to be able to, to open. And I will put here also that as you're describing how you picked up shifts and you you know, you were, you had a good relationship for those listeners out there who, you know, might want to do something like Dr. Menser is mentioning, but might not have those relationships, I definitely encourage you to check out the Rise Up Summit. A couple of weeks ago I interviewed the two people that I'm working with to put together this DPC Locums and Direct Contracting specific conference. So if you are wanting to do your own direct contracting, not going through locums agencies, this is where to go to learn all of that as well as more stuff about DPC. So, check that podcast out. That's exciting. Yeah, we'll put that we'll put that link in the notes. But. So let's fast forward then to, you know, a little over a year and a half ago because you are now at about 200 patients. It's a very different world, and, and that's fairly quick, you know, in terms of going from in terms of how you mentioned you didn't necessarily have this, you know, long business plan that was zero zero pre signups.

Dr. Dana Mincer: 21:05

Yeah.

Dr. Maryal Concepcion: 21:05

Yeah. So tell us about how, how Love Health Direct Primary Care launched.

Dr. Dana Mincer: 21:12

I, so that's, yeah, that's a really interesting story. I think I made the decision, we made the decision, I should say, for me to do this. And I that I think in two months I was up and running, like I put this intention out into my ward. I was already doing my yoga every day and. Channeling my intention and things started to fall into place. I happened to be interviewing for a medical director position that I knew I could do part-time. And right downstairs in the same building, there was this place called Flourish. And I'm like, what is this? And I just, and it said, appointment only on the door. So me being the Gemini that I am, I'm like, I think I can, it looks friendly. I'm just gonna walk in quietly and see what's going on in here. So I walked in and it was all women in here. And one of the, I said, well, what is this place? And she said, well, this is like a collective, like we do behavioral therapy. And then there's the owner of the space is a pelvic floor occupational therapist. And you know, we have a, a nutritionist in here and we have massage therapy and. I said, well, I've been looking for a space and this is sort of my idea of what I'm gonna do. You know, it's hard to just tell random people about, you can't just say DPC'cause they don't know, especially in Pennsylvania. And I said, well, is there any can I rent a room here? Is that what you're saying? And there's a shared space. And she said, actually we have one room left. And in I think it was that week on Thursday night, we're having a, a networking thing that you should come to. And so I cleared my schedule because I, I have my kids on Thursday nights. I cleared my schedule and I just showed up and it was like 60 women all in one spot. And they're all different areas of providers, right? Most of them out of network, right? Most of them. And Danika was here who had sort of made this space. She took out a large lease and then Subleased and I took the room like within a couple days she sent me the lease and I took the room. I had one room to start with. And that's, that was the birth of, of love health. That was, I had looked into a couple of other places, but they were all gonna require, you know, they were retail. So I had to$50,000 in a build up fee. And I'm like, I can't do this. I can't take this risk. I have children at home. And that, that was the birth. And I, I would, I always tell people this, that I really believe in trying to start, if you're starting this without going into a ton of debt mm-hmm. I think there, we have so many options for space share situations that can be very supportive these days. That I really think that's an ideal situation for anyone wanting to start a direct primary care practice because you, that's really how you contain costs. And in my mind it's really how we can con continue to keep our membership rates affordable for, I always say affordable for most people. If my membership rates are less than what you pay for your cell phone or your cable TV every month. And that's an affordable rate to me at least.

Dr. Maryal Concepcion: 24:13

Yeah. And I, I love that you're mentioning, you know, ways to be innovative when it comes to finding space to keep your overhead low and to keep your membership as part of contributing to your overhead low. Dr. Marcy Meyer was one example of this season on the podcast who talked about she's got space and she's I would love if somebody came here and, you know, used the space as an incubator space before they moved into their own. And so, you know, it's, it's a very different world than the non-compete BS that we see in the Fever Service corporate models. So, tell us about the name, because I'm wondering with, because there's some listeners out there, I'm sure who are asking the, the chicken versus the egg question, what came first? The the lease? Or did you have Love health and tell us about the meaning of love health.

Dr. Dana Mincer: 25:00

Yeah. So I had, let's see. I am. I had the lease first before I had the name. The name was born actually, well obviously from years of, of just experience before that, but the actual birth of the name was on a phone call with Keen, who, if you don't know Keen, you know, at Atlas. And and I, I wanna just give him some, some thanks to like, helping me work through the name. I wanted something simple and I wanted something that really communicated like what I was trying to do in the world and love just acting from a place of love, speaking from a place to love you know, that was really what I could think of. That's what first came to mind, and I, it's, it's something that I wish that I would've had as well. Going through the system, I, I, we didn't touch on this yet, but when I was in my first year of residency, I was exhausted and I was actually to the point where like I was having trouble swallowing. I couldn't swallow liquids and I was fatigued and exhausted and I. I couldn't get time to take off to like care for myself. And this is a prime example of how our medical trainings, traditional medical training, even if it's osteopathic, it does not teach us any type of self-care. It just doesn't. And I ended up going to the GI doc who you know, was on call and I was like, I, I can't swallow. I don't know what to do. And so thankfully I was able to get time off just for that day to like, he took me in and scoped me and then I was able to get to an endocrinologist. So I was, I was hit with Hashimoto's and eosinophilic esophagitis like within a couple weeks I think of each other. It was just a disaster. And I realized, you know, for the EOE at the time. I went to one of the top people who was doing all the research at one of the top institutions in Philly. And I just, and even with, with endocrine, I just was sort of grossed out and disgusted with the care that I got. I felt very rushed, I felt very gaslit. And when I brought up integrative options, or even just the idea of like an, an elimination diet, instead of swallowing steroids every day, I was made to feel like I was less than I was made to feel like I didn't know what I was talking about and how could I even be considering this? I, I know the research, I'm a doctor, like evidence-based medicine. And then that led me on the path to like trying out fully functional medicine. And I, I felt equally but in a sort of different but equally sort of turned off in a way because I felt like there were like 20 different supplements thrown at me and that, and it was overwhelming the amount of testing and I. I just, I needed to find a median, like I needed to find a somewhere in the middle. And I feel like that really has been a theme of my life in general is recovering from my own autoimmune stuff. And not to mention when I was, I, in my late teens and early twenties, I, I was suffered from such horrible anxiety and depression. At one point I was hospitalized. So, which these have all been blessings because now it's I get it, you know, I, I have patients coming in and I can look at them and honestly say I understand and these are all of your options. And let me just, let me just tell you like, medicines can work so much on this, but I, we really need these lifestyle interventions to have you be in a happy place. I can tell you I'm on the other side right now, you know? So anyway, I just realized. Early on, and I think, I don't know if I realized it at the time, but this really shaped how I structured my DPC practice in terms of I wanna communicate authentic love for people. I'm very humbled. I, I am blessed that people are finding me to act as their humbled advisor. And I'm grateful for that every day. And I wanna bring that love and gratitude to my moment to moment interactions in the world. So I think that's really the story of how love health was born.

Dr. Maryal Concepcion: 29:15

That's beautiful. And I will ask here too, because as you speak to these things that have happened to you in retrospect, are a blessing because they're enabling you to be the person you are today. And I love that because I think that that is what we all are doing, but sometimes we don't necessarily recognize that past experiences are a blessing in disguise. before this interview, you were mentioning that your burnout level was a 10 out of 10 before you opened DPC. And I'm wondering if you could speak to the, the differences now and where you are on that quote unquote burnout scale because you have this practice where you can be in a relationship with your patients.

Dr. Dana Mincer: 29:56

Yeah, so I just wanna put this out there. I'm probably working more now than I was before, right? As an entrepreneur. It's just nonstop. And we have four kids at home between the two of us, and we go back and forth between two different states because we met long distance and it's about five, five to five and a half hour drive and we make it work. And but. I, I wanna just point this out, that oftentimes in the, when you're in the midst of the burnout, you don't see it, right? It's the same concept as I say, like I, I, some, I find just because of my past experiences with narcissism in a relationship I have, I'm attracting people that need some assistance in that arena. And I liken it to the same thing, like when you're in some sort of abusive relationship or oftentimes you don't see it in the moment. So I, I think that if there's, you know, other people listening to this that might think that they might be a little bit burnout, it's sometimes it's worse than you actually think that it is in the moment. And that takes a lot of sort of being present and mindfulness to be able to come to terms with really, at what level are you? And, and then there are other people that are sober burnout that they're. On the other spectrum, and they're feeling suicidal because they're so burnout and they don't even realize, you know, why, how, how the suicidal ness and the, and the burnout are connected. And I, I just wanna make everyone know that, that there's, there's, there's an alternative. There's definitely an alternative for every horrible emotion, even if it feels at the end of the world there's, there's always an alternative for that. It just might take a little time to come around to and so now, you know, before I remember even as a burnout urgent care doc, I would talk to other docs if they were willing to listen, especially if they were younger than me. And you know, a lot of the messages that you get are like, patients were calling frantically throughout the day. And the urgent care doc is busy. And in our area it was single staff, meaning like one doc on service at a time. That's it. And, sometimes people would express in meetings like that. They were frustrated with patients being ridiculous and calling throughout the day. And I tried to give people another perspective and say, hold on, wait a second, let's flip this around. So you ca you're the patient, you came in before closing last night and somebody gave you an antibiotic and you're now having a medication reaction, you think to this antibiotic, which is common. And now there's a new doc on the next day that doesn't know you and you're used to calling around the primary care doctor that you called said, we don't want to deal with this, go back to the urgent care.'cause we didn't prescribe the medicine. But then the, that primary care doc couldn't see that patient to begin with. That's why they ended up waiting in urgent care for two hours to see a doctor for five minutes max. And they're expecting that nobody's gonna call them back unless they continue to call frantically. So are we gaslighting this patient by calling them crazy? And my answer to that is yes. This is our, we're creating this chaos, we're creating this situation by, you know, by being in this system. The system is creating it. I wouldn't say the doctor itself. Mm-hmm. But so, I would always encourage people to just think about things from that perspective. If you had more time, if you had calm during your day to some extent. And obviously not every day is calm. I had a patient emergency this morning that I had to do juggling act for a little bit. But what would your empathy level look like, if that makes sense. I got to a point where I realized I didn't want to hear what patients had to say. And I was like, that is not who I am in the world. This is not who the universe, God, whatever you would've created me as this and something is wrong here. I need to really sit down and examine this. And thankfully, I, I'd already, I really, I really, and I'm not trying to convert anyone to like a different religion, but I really thank my yoga for this. I, years before that, I had started a daily yoga routine and it wasn't like I'm going to a yoga studio every day. It was like I come home or I get up in the morning and I do my 15, 10 to 20 minutes of yoga once a day. And I really credit that to giving, being able to give me some insight into the fact that it was me. I was burnout. I didn't wanna hear anything more than a superficial level'cause I didn't have space for it. It's like mm-hmm. What I see it with teachers a lot of the time, a lot of teachers can relate to this, where they're going. And my, my daughter's soon to be stepmom is actually a first grade teacher. And I remember having this conversation where it's it's, it can be challenging, but so you're going, you're going to school all day long and you're, you're like dealing with first graders all day long and then you have to come home to a first grader and it's just nonstop and you have no energy left to give, there's no, you have no oxygen to put on yourself before you, right. There's not that concept. So, I guess that was a long-winded answer to. I am working more hours now and entrepreneurship is definitely not for everyone. Let me put that out there. It definitely takes a certain human to be an entrepreneur, and if you are not that person, that is totally okay. I think it's really important. There's a couple good books that I can recommend for people to read to determine if you are of that spirit or not. But that's also leads me into another thing of why I realized very quickly that going into DPC was larger than just me. I realized that for myself, I couldn't just stop at opening my DPC practice and having my 400, 600 patients, that there was something deeper in my gut that was like, I have to keep going. I need to get to more patients. I need to provide employment. That's like lifestyle medicine, employment to other providers. And it just was, it was larger than me.

Dr. Maryal Concepcion: 35:44

That's awesome. So I definitely want to hit on what is happening to expand the mission of Love Health. Yeah. But I wanna ask here before we go there, what is your typical week like?

Dr. Dana Mincer: 35:53

So the great thing about DPC is I can structure my week however I want to structure my week, which is awesome. Like I always envision this as for anybody that comes on as a provider that's not, that's not running a business. Just manage your 400 to 600 patients and you can set your hours to Tuesday, Wednesday, Thursday, and you know, just be on telemedicine coverage for the rest of the time if you need to. Or you know, like I go down to to my, now it's my other home. I mean, it's just'cause we have to manage two households in two different states.'cause we have. You know, joint custody with exes and kids involved. But I go down to Virginia for one long weekend a month, and that's, it's, I love my, I love our home down there. It's in the woods. And I can do that with DPC. I have a one o'clock parade at my daughter's school and you better believe it. I'm gonna be there because you only get that chance once that doesn't go, like your children are only having that experience once. And you know, and then there are other times where it's you know, when my, if, if I don't have my kids, I, I work late, like Mondays and Tuesdays, I work late and I work long. Sometimes I'm here at the office until 11 o'clock at night. But I'm also doing way more than just dealing with patient stuff, like I'm developing a business. And, and my kids may have an activity on those evenings with the other parent that that they're doing and that's just not an activity that I go to on a regular basis. And, and that's okay. But overall, you know, like I have long days on Mondays and Tuesdays when I'm having my kids, and then I have shorter days on Wednesdays, Thursday and Fridays, and I can drop my kids off at school in the morning. And I, and actually this morning I rode my daughter to school on, we have a double bike. She has her own bike, but she's going to her dad's house this afternoon. So, so, and she was having a little bit of a hard time getting outta the house and so I was able to shift some things for her and we gotta school a bit late and we could take care of her emotional needs. And then on the days that I have my kids, I'm able to do a hard stop when I need to at three o'clock to get outta here in time to pick them up. So it's actually really nice. There is some juggling that has to happen. Sometimes they need to watch a TV program in the evening for 45 minutes to an hour while I get on the phone or finish up a couple things. So it's definitely a little bit of a juggling. But overall I think it's much better control. I don't feel guilty. I don't have to request. From someone that I have time off. It's, it's really just incredible in that, in that instance, and if I have a sick kid, the best thing about it, and I'm so grateful for my patients, and I, I, I share my personal story with most of my patients. At some point as they come on as patients, and they all know that I'm a mom and so I have a sick kid. My kids either gonna come in with me to the office or I switch my patients over to telemedicine for the day. And that way I can be home, you know, and I can be present. So

Dr. Maryal Concepcion: 38:44

I love that and I, I'll say. That is something to expect in DPC almost. You know, I have so many patients who they hear the kids shouting in the background and they're like, just call me later. We don't need to have this visit right now. Just call me later. And you know, even if it's an acute thing, they're also fine with, you know. Deal with what you have to do and then call me when you're free. I'll be up late tonight, or whatever it is. And so I, I love that. This is a, a thing to expect when you do have a relationship with a group of people who also value you as a, as a person. And they understand that helping, you know, take care of you in terms of being members of your practice, helping you financially, but also making sure that they're taking care of you so their doctor can be there for them. It, it's a very different cultural sh cul, it's a very different culture shift compared to what we have in the fee-for-service clinics where you're seeing a patient every so and so, so many minutes. So I love that. so now let's talk about expanding the mission that you have at Love Health. When you talk about having expansion of lifestyle focused care delivery, I'm wondering if you could also talk to us about how your, your patients are not seeing you every 12 minutes, how you're delivering personalized lifestyle medicine focused care to your patients, and then how you're expanding that into the, the greater community.

Dr. Dana Mincer: 40:05

Yeah. So, one of the things that I spent a lot of time contemplating was why lifestyle medicine was a separate specialty. I Sure. You know, I, I realized I think that, and not everyone's gonna agree with me on this one, but I think that there's two main reasons. The one is that. As physicians, we are not taught lifestyle medicine. We're not taught self-care in any, in fact, going through the entire system between med school and residency is like completely abusive. It's just, it's a terrible system where you get a, you get high touch and a lot of hours, but, and I'm not saying it's not necessary the amount of hours, but it does not teach self-care in any way, shape, or form. And so if you can imagine like a lot of people just go straight into that. It's like they just school, school, school, school. And there's not really like a life experience in between that outside of studying. And it's about, you know, just I need to get good grades so I can get into med school. The other, the other issue with separating it was that the time issue,'cause lifestyle medicine takes time, right? I need to, there's a lot of stuff that we need to talk about. And you just can't practice it within the guise of, of a seven minute to 12 minute visit. It's impossible. Even I find even half an hour visits. I need more time. Yeah. So, so basically I initially started by just saying, well, again, I was lucky because I'd had zero patience when I started. And we literally, I, I think the only thing that I've put money into was I tried to get a website that was like SEO optimized. I just tried to get a little bit of help with the website and above and beyond that it's just been word of mouth and, and so, so my initial appointments sometimes were like two hours and sometimes they could still be close to two hours depending on what people have going on. You know. sometimes my, I had up an appointment the other day that went almost two hours for an initial patient. They just, they needed that. Sometimes my initial appointments end up turning into more of a positive habit coaching, or more like a ther a mental health, spiritual health, therapeutic interchange and exchange. And my followup appointments. I've been still tweaking this. Initially I had, I, I wanted, so we wanna be able to show metrics and so I have my visits pre-coded first with CPT codes because I wanna be able to pull data from that so that I can show that to employers.'cause I realized quickly, like that's the, that's one of the best ways that I can actually show them value is to code everything. So my follow-up visits were coded and initially were half an hour and I actually just recently changed them to 40 minutes because. I just realized with who I am and who my patients are, people just needed more time and I'm gonna, you know, experiment with that. Obviously there are still acute, more acute visits that I'll squeeze in, but I always try to tell people, listen, like for I, I wanna make sure I see people same day for issues that they're having. And that doesn't always mean they're coming in in person. I have a lot of visits that I can do over telemedicine, even if it's a musculoskeletal type pain issue, I can oftentimes do that and I have them, can you push on your neck? Can you push here? Do and I can do a full physical exam that way. And I'll usually tell people like, Hey, this is an acute visit. I'm squeezing you in. It's just, it's a 15 minute time slot. I try to give them that expectation in advance and people are totally okay with that because really, where else are they gonna get seen same day other than urgent care? You know, and I think people have an appreciation for the fact that I'm like just moving things around and making time to get on with them. So that's how I structure. I don't know if that was like really an, an answer of like, how I structure things differently than insurance-based system. Mm-hmm. I try to just really make sure we're giving people time. And then obviously just like the general model of it makes it where we are able to get back to people same day. I just, I imagine myself before going into medicine, having an issue, even if it was just like I had a really horrible sore throat. I don't know what to do. It, it is 10 minute conversation maybe with people just to figure out a plan. And most people are reasonable about Hey, I'm not, I'm leaving the office right now, but can you take some ibuprofen gargle with some warm salt water and can you pop in tomorrow at this time and I'll do a throat swab on you if it's still hurting. Mm-hmm. And most people are totally okay with it. They just, they need a, a sounding board to figure out what to do. You know, I had another patient this morning that I was, I was actually more concerned for something and I ended up ordering A-A-C-T-A of the neck just based on the symptoms that she was having. And I am lucky because I've made partnerships with imaging centers and I've, I've been going direct to physicians and organizations and I called up the imaging center. I said, Hey, I need you to get this patient in. They didn't have a, like a, a, a blood test for kidney function within the last month, but she's healthy. She's had one done in the last year. This, these, this is the issue. And voila, they're taking care of it for me. And they're actually. Doing the, the the precert for me as well, though I did use open evidence to, I love that by the way. I use open evidence to fight with insurance companies all the time because I can say, these are the symptoms that my patient's having. This is what I need to order for them. I need you to write a letter to the insurance company listing with, with, with citations why they need to be, you know, covering this test. And so I was able to send that over to them for assistance as well. So I guess that's where things differ, you know, and when you have more time, also, we don't have to refer, like I had a patient who I previously probably would've sent to hematology, but I was like, she didn't wanna go. I said, I totally get that. Let me do a little more research. Lemme see if there's any additional tests that maybe hematology would be getting that, that, that I can get for you. And just to double check and then we'll regroup and you know, it's amazing what you can do with time.

Dr. Maryal Concepcion: 46:00

Awesome. And it's amazing what you can do with time. Fueled by transparent pricing and ways to be innovative in healthcare because you're not tied to insurance. So wonderful to hear your your way of creating a DBC ecosystem and expanding it where you are. So I love that. Now, I want to close with the fact that your. You are doing all of this for your community, but you're also continuing to take care of yourself. And as you pointed out a, a few times now, self-care is not something that is, you know, typically taught in med school in the way that we become doctors.

Dr. Dana Mincer: 46:40

I've taught yoga before and I've been a de yogi for a long, for many years now, and I'm finally sitting for my 200 hour teacher training certification that has a trauma and somatic informed certification with it as well. And the first step toward realization of truth is awareness, right? I see this over and over again with burnout. There's a lot of anxiety and sometimes depression that comes with burnout, and we're looking for quicker fixes in the form of SNRIs, SSRIs, different medications or people are like saying, I'm exercising every day, like I am weightlifting. And, and there's, I really try to distinguish between, two things. What are you doing for your 10 to 20 minutes of daily self-care slash cortisol lowering activity? And most of us don't have that type of regimen intact. Like it's just not even people think about yoga and they're like, I don't have time for that. I have to get to a yoga suit, or I have to get to the gym. And most yoga classes are an hour long. I mean, it's the same pattern. I see also with the positive habit coaching that I do within the realm of weight loss. I hate calling it that. As a personal trainer as well myself, it's like people see it as an, it's an all or nothing thing. Like I'm either gonna get to the gym or I'm not. Like they don't, there's not a middle ground. So I, I would highly advise anyone who's in that space to just. Put a YouTube video on. Don't motivate yourself.'cause by the way, motivation is a word that should be stricken from the English language. It is the stupidest word I've ever heard it. I don't know who invented that word. If, if, you know, if you could please write me and tell me who invented this word. We have reptilian brains. We are not motivated. We are creatures of habit. So we need to stop relying on motivation. Right? You just need to get 10 to 20 minutes a day. Put any YouTube video on. I can make suggestions. There's, there's, I do it myself. I even even though I teach yoga, I don't teach myself yoga. I put a YouTube video on'cause I have a lot going on. And just get to a place of 10 to 15 minutes once a day where you're. Yoga will allow you to get the physical energy in your body out like the physical asanas prepare you for shiv asana, which is a resting meditation. Most people that I know cannot just go sit down and meditate. It's gonna drive you crazy. It's gonna feel so uncomfortable, like you're jumping outta your skin. It's and you are not alone in that. This is most of the population that I talk to. And so doing something to prepare your body for a quick rest and relaxation is gonna help tremendously. And I don't know any other way better way than doing that and being able to start with that two minute meditation at the end. That's going to bring more awareness to your current situation than that. I can't tell anyone what the right thing is to do for your life. Like I, I see you. I respect your sacred autonomy. I respect your sacred humanity. You in the end need to know that. But what that two minutes of time will do, and maybe it expands to four minutes or five minutes, that will help to, to really deepen your connection to your intuition, which a lot of us have lost over time, and that in itself will help you decide what the next step is for you. For people that are considering DPC or some alternative, I would say just call one of us up. Like just there's a whole network of us right? And if somebody called me upd, be like, Hey, can I, can I just come in and talk to you and figure out, you know, what's your, you know, what does your practice look like? There are times when I'm busier and I'm just like, I cannot do this right now, but I'm also in startup mode. But I'm sure there are a lot of us who are not in startup mode who are more than happy to say, yeah, come on into my clinic. Come observe, whatever, come see about what's happening. And just like that Facebook group with the DPC docs is really, really, it's a helpful forum. It's, it's active all the time. Plus there are statewide DPC I'm a member of the PA DPC docs and then the Virginia DPC docs and, and just, it's, it's a great place to start to see if this could be a good fit for you or not. So, and I just wanna put this out there for anyone that's really struggling with burnout or depression or feeling at all, like you're having suicidal thoughts, I want you to know that I have been there. I get it. And there is another side. There's al, there's there's, there's the opportunity to get to that other side. And you just need to reach out for some help. Who is the, is it Dr. Pamela Weibel, right? Mm-hmm. That, that she's amazing. If you're suffering at all. She's got an incredible support group online as well. I find that oftentimes going inward and making some changes to the external stressors will create a whole new reality for most people.

Dr. Maryal Concepcion: 51:29

Thank you so much Dr. Minur, for joining today and sharing your story.

Dr. Dana Mincer: 51:33

Thank you so much for having me.

Dr. Maryal Concepcion: 51:37

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.