Finding Her Lionheart: Dr. Maria Rutmann’s DPC Pediatric Practice in Rural Maine

Today we hear from Dr. Maria Rutmann, founder of Lionheart Direct Primary Care in northern Maine. She discusses the transformative power of the Direct Primary Care (DPC) clinic model as physician burnout and healthcare system challenges escalate nationwide. Dr. Rutmann shares her journey from working in a traditional fee-for-service hospital group - where mounting administrative demands and loss of autonomy led to emotional exhaustion - to reclaiming her purpose and joy in medicine through DPC.

Listeners learn how Lionheart DPC empowers physicians to practice value-based care by fostering lasting patient-physician relationships, personalizing health experiences, and eliminating the barriers of insurance-driven healthcare. Dr. Rutmann emphasizes that DPC not only improves healthcare access in rural areas, but also allows doctors the time and freedom to provide comprehensive, preventative, and patient-centered care. Families in her community have experienced the convenience and rapid responsiveness of the DPC model, sometimes avoiding costly and time-consuming ER visits and walk-ins thanks to direct communication and same-day appointments.

This episode also highlights how DPC serves as a solution to physician burnout, supporting practitioners to reconnect with their sense of purpose, maximize patient outcomes, and enjoy professional autonomy. Listeners considering DPC - from those facing moral injury in fee-for-service settings, to those interested in community-driven, flexible healthcare - will find practical advice, heartfelt encouragement, and proof that a better way in healthcare is not only possible, but thriving.

Keywords: physician burnout, healthcare access, direct primary care, DPC, value-based care, physician autonomy, patient-centered care, rural healthcare, medical practice models, Lionheart Direct Primary Care.

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Transcript

Dr. Maryal Concepcion: 0:04

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. Maria Rutmann: 0:53

you can do this, no doubt in my mind, you can do this. Will it be easy? No. You're gonna have doubt and it's gonna be challenging, and you're gonna have to troubleshoot my, you might have to make some sacrifices along the way, but you can absolutely do this. You made it through medical school, you made it through residency. You may have made it through fellowship. You are a smart, capable individual. And I would encourage everybody to just really hone in on their internal fortitude that perhaps has been quieted down, whipped out of them, perhaps because of the demands on the system. I would encourage everybody to dig down inside to their sense of purpose. I really strongly believe that we are all, no matter what you do, you can be a CEO, you can be a janitor. It doesn't matter if you're doing your job well, honorably, honestly, you are contributing to the world in, in ways that we might not even understand, right? Like it's a, that, that ripple effect your patients need, you, your community needs you, you can't pour from an empty cup. You will be a better doctor because of it. So absolutely find that roar within you. You can do this. No doubt in my mind, anybody can, we all have to lean in into our own strengths, delegate what is not our strengths, but you have something to bring to the table. Everybody does. You absolutely can do this. I'm Dr. Maria Rutman of Lionheart Direct Primary Care, and this is my DPC story.

Dr. Maryal Concepcion: 2:34

Dr. Maria Rutmann was born in Venezuela and completed her medical education at the Central University of Venezuela or UCV in 2011 at pediatric residency at Miami Children's Hospital. Now Nicholas Children's Hospital in 2014 after residency, Dr. Rutman made the beautiful state of Maine her home quickly falling in love with the peacefulness of the county and its kind, hardworking, tightly knit community. Also falling in love with one Mainer in particular her. Husband Lee Smith As a mother of two young children, she understands the challenges that come with raising happy, healthy children and treats each of her patients as if they were her own outside of her medical practice. Dr. Rutman is an avid scuba diver, swimmer and non-fiction reader. She has an interest in interior design and is currently learning German and has the cutest clinic doors known to mankind. Welcome to the podcast, Dr. Rutman.

Dr. Maria Rutmann: 3:30

Hi Marielle. Thank you for having me.

Dr. Maryal Concepcion: 3:32

This is such a treat. It was so awesome meeting you for the first time in person in New Orleans and then it was such an even bigger treat when we got to meet each other again in Maine for dinner. So this is such a treat and it's just a call out out there to people If there are DPC doctors around you or if you're gonna be, flying somewhere where there's DC doctors around you call people up. It's just so wonderful, especially this time of year to be around, family and be around people who are supportive and people who are like, oh my gosh, guess what I did in my clinic? And it just makes you so excited to hear other people's stories. So, getting into Dr. Ruttman's story, I would love if you could start us off with where do you live, because when I said in your bio the county as a Californian, I had no idea what that meant and then I learned about it when you and Dr. And Doctors Lucas were telling me about what the county is in the state of Maine.

Dr. Maria Rutmann: 4:30

So I'm in northern Maine, the northern most part of the continental us. I'm not from there. I married a county boy. So, it's, it's home now. But I grew up in Venezuela, so it was it's a big change. I've lived in Miami, I've lived to New York and I feel like I keep going up north and I'm gonna end up, up there in the North Pole with Santa

Dr. Maryal Concepcion: 4:50

Good time of year for that though, so. Oh my gosh. Yeah. I mean,

Dr. Maria Rutmann: 4:53

well,

Dr. Maryal Concepcion: 4:53

we're used to the snow and the cold, so just bring it, right? Yeah. And. In terms of Maine, just for, just for clarity for the audience, especially if you're me and you have you, you're state centric on your geography and that's not the state of Maine. Maine is freaking huge. Can tell us about how huge it is.'cause I was like, what? It's New England. Whatcha talking about? What? So you guys were educating me on the state of Maine and so I, I really wanna set the scene for, what, what the state is like. And then let's talk about access to healthcare.

Dr. Maria Rutmann: 5:24

Yeah, so Maine is massive. People think of it as a very small state, but actually driving from Portland, for example downstate to where I am, it's a good four and a half hour drive, and I still have about an hour and a half north beyond where I am to reach Canada. But you know, healthcare is a bit of a desert here in a way. So my town in Presca, we serve I don't even know, but it's a huge radius. I have patients that will drive down an hour and a half. To see me. And the same with PE people that are like an hour and a half south of where I am. The closest like biggest center that I have as a referral center is Bangor, and that's smack in the middle of the state, and that's a two and a half hour drive.

Dr. Maryal Concepcion: 6:05

something I wanna call out here too is that you are a DPC pediatrician in particular. And we're at a time when DPCI, I, I have said this throughout the whole like existence of my DPC story, but we are always at a time where DPC is, is wanted and needed and even in Presca. Talk to us about your, your pediatric population because like here in Arnold, we're an hour and a half from the nearest nicu. But like I think about every time I go to a school production, I'm like, there's a lot of kids up here. There's like multiple elementaries, not as many as Sacramento, but there's multiple elementaries and I think about not all these kids are part of the practice yet. Like where are they going for healthcare after January? So, for your population being, within four hours of both Bangor and Portland, I'm just wondering what do patients have to access in between all of those

Dr. Maria Rutmann: 7:00

spaces? It's been certainly challenging. So I've been in the area for approximately eight years and in the time that I've been here, I've seen many smaller practices and surrounding towns close. So right now we're basically down to two, decent sized groups, my old group and, the two bigger hospitals in the area, I guess. And that particular group has survived over the years, primarily with Locums. So it is very challenging. But precisely because of that, I saw an opportunity because like you said, where are these kids gonna go? Right? And, and there's no alternatives. Like DPCI, I believe is a fantastic option, but, it might not be the option for everybody and that's okay. But, but families can choose when there's diversity of options.

Dr. Maryal Concepcion: 7:45

Absolutely. And I, we will definitely get into the personalization of your practice and your delivery of care to your patients, but I, I think about that is so true. It's not for everybody, but for the people who have joined on your practice, I am so glad that they probably have, a completely different outlook on what healthcare access is now. And I'm wondering if you can give us some examples of comments you've heard from families about DPC is I won't go back because Dr. Rutman did this for me, or, as a member of Lionheart I experienced this.

Dr. Maria Rutmann: 8:22

It's, it's been a wild ride. It's been so rewarding and fulfilling to see people receive it so well. So oh, so many stories come to mind, but, but here's, here's what fuels me is that being a small community, I know the bulk of my families, these are not strangers that I'm seeing, right? They are my kids' classmates. They are kids of friends of mine. They are my baggers of the grocery store. So providing a certain level of care is. It really is a almost like a duty to me. It, it really fuels a different level of, of purpose for me. Because you're, you're not in a big city. It's not anonymous. These are people that I'm seeing all the time, right? So I, I really just wanna do the very best that I can for them. So, for example simple things simple stories. So many come to mind. I think people are really, really valuing the convenience. So I had a mom that was blown away, just this was a couple of days after opening because she got up at 5:00 AM The kid had been coughing the whole night. She decides, oh, I'm gonna take him in. Suddenly she remembers, oh, there's an app. So she just self scheduled an appointment. I saw the kiddo by the time it was like nine 30. They had an antibiotic at hand by 10 and out they went out the door and they had a really busy weekend coming up. So she was like, this would've been a whole ordeal in traditional practices.'cause now you're. Calling being placed on hold. Sometimes you get the busy signal, they don't call you back, and sometimes you waste a full day just trying to get an appointment. And this is a busy mom, like she works a full-time job. So she was super appreciative of that. I've also had situations of like after hours, stuff that we can troubleshoot via text and people don't have to go to the walk-in clinic. Simple things like colds or bigger things like I've already, sutured and glued and stapled kiddos. And again, they're not waiting three hours in an ER and getting a hefty bill. So, families are absolutely loving it. Particularly the, the convenience and the ability to text me

Dr. Maryal Concepcion: 10:19

for anything. Amazing. And I, I am laughing a little bit here because having seen your practice go from supplies in your garage to, you know what, what it is now, I'm like, I'm like, yes, she used the staple remembers our like, it's so good. But I, I wanna ask here, because of you, not necessarily not being from born and raised in Maine, but being born and raised in Venezuela and then going to Miami and then going up north as you described also Santa, like if you need a, a remote DPC, I'm sure you can get in with Dr. Rutman, but, I, I think about what is it that drew you to the county? Because I think about there's people who are like, I don't ever see myself practicing in rural America, especially if like you've seen places like Miami. So I'm wondering, what was it for you that drew you to this community that you are a part of and that you are serving with your practice now?

Dr. Maria Rutmann: 11:16

People are just incredible here. They're kind, they watch each other's back. They're hardworking and honest and I, I've never seen anything like it again. I've always been a city girl. So this sense of like we got each other's back is, is really incredible. I remember when I was pregnant with my son so many folks dropped off meals and, people that I, I knew, but I wouldn't have expected that level of dedication, or for example here, there's a lot of farmers too. And this summer there was a gentleman whose combine caught fire and within. You had other farmers in in the area, this one, cleared this and that one, brought whatever the heck tractor, I don't know much about it. It's like a foreign language to me. I'm still learning. But the point is that they pulled together, they contained the fire and were a significant help to the fire rescue responder crew that was there. And it's, it's just really inspiring. But from a medical standpoint too, I just love that in rural settings you are just forced to do more for the patient. And, and I like that challenge because you have to be cognizant that for any little specialist is, a two and a half, four hour drive for a patient. So I think we, we get to practice richer medicine in rural settings.

Dr. Maryal Concepcion: 12:34

That's so beautiful. I love that. And I feel it's another t-shirt that needs to be made that rural medicine is richer. I love that. when you were in Venezuela, when you were in medical school, did you always wanna be a pediatrician?

Dr. Maria Rutmann: 12:50

Honestly, no. I, I'm so scattered. I have many, many interests. I think my first love was surgery, but here's the problem. I, I don't bounce outta bed at 5:00 AM like my husband does. So very quickly, I realized that as much as I liked surgery it was not going to be conducive to a healthy lifestyle for me. But I had lots of interests. I was the kind of student that went through every rotation, just really, really liking everything. I fell in love actually with pediatric cardiology before I fell in love with pediatrics. And I, I've always worked with kids. I was a summer camp counselor. I, taught swimming lessons and all the things like, I've always loved kids and how funny. And how they surprise you with the most random comments and you just chuckle the whole day after you see them, right? But but no pediatrics, actually I, I did it wanting to pursue pediatric cardiology originally.

Dr. Maryal Concepcion: 13:40

was it pediatric cardiology in particular that drew you to the Miami program, which is now Nicholas Children's Hospital? Correct. I

Dr. Maria Rutmann: 13:47

did, we, what was it, about a year and a half worth of an observership there with the cardiology team, which was, they were nothing but welcoming and amazing and supportive. I, I will forever be thankful to all my attendings there and the nurses and fellows that I worked with. It was just an incredible experience. But I was there for about a year and a half while I was in parallel taking like my steps and stuff before I got into residency. So it was, it was amazing.

Dr. Maryal Concepcion: 14:47

When you were in Miami, I can just imagine that even though there's a lot of specialists having. Having a big center, you're probably gonna do a lot, especially in the world of pediatrics and even yes, cardiology absolutely, like you're mentioning, but just the amount of specialists that are there. You, you get exposure to a lot of things that you might have interest in as well. So I'm just wondering about when you went through residency, what did, did you have the goal of leaving Miami and did that change how you approached, which attendings you would rotate more with, or, which, which rotations did you set specifically for your externships? I think about Dr. Lauren Hughes saying how she knew that she was gonna go into her own practice after, so she intentionally, networked with attendings differently, knowing that she would, want to connect with these people after. But she would also want to work them, work her patients up as well as they would before contacting them a, after she opened her own practice. So I'm just wondering what was your experience in terms of designing your residency to be able to be an attending after?

Dr. Maria Rutmann: 16:02

Oh my goodness. There's a lot of layers to that question because I'll be perfectly honest I shifted gears multiple times while I was in training. So I went in completely a hundred percent passionate about cardiology in pediatrics, pediatric cardiology as a second year match. And I had gone to a couple of conferences and met with a few fellows, and I realized very quickly that it was not only competitive to get to, but more concerningly. It was very hard to land a job after training. And I got a serious amount of cold feet to the point that I withdrew from the match. And then I was like, well, in parallel I was doing PICU and I fell in love with picu. I had very little exposure to picu as a medical student in Venezuela. So this was just like, oh my gosh, this is amazing. I can do CICU and I'll just pivot and, and do that. And then third year came around and that's when the, the PICU match happened. And for personal reasons at the time I kind of shot myself in the foot a little bit and only applied to a couple of programs and didn't get in. And this still stinks to date, but you know what I don't mind sharing it because sometimes in life. Sometimes, actually, oftentimes in life, the magic happens in our hardest moments. So it was in third year residency that because I didn't get in into ICU, I shifted gears and I said, well, I'll just do primary care. At the time I was on a J one Visa. I'm like, it's, it's gonna work out. I'll just. I was single. I didn't have kids at the time. I'm like, I'll just save money. I'll go somewhere rural where I can get rid of my waiver requirement and also get to practice like again, richer medicine. And and then once I get that out of the way, I'll go back into fellowship. And it was a complete leap of faith to coming to Maine. I didn't know a soul. I just, I loved the group that I was with and I just felt a pull in my heart to come here.'cause I just felt at ease here. I kind of wanted to experience four seasons and something different than, than Miami. Financially it makes sense too, again, because I wasn't in an expensive city and saving was a goal of mine. But fast forward, this was at a point in my life that I was like. I am, I am done dating. Like I'm so done. This is just not for me. And I was totally at peace with the fact that it was just gonna be me and my golden retrievers because I'm not a cat lady. And and what ended up happening is that a week after I moved here, I met my husband and four months later he's proposing. And I will take that what felt, I guess at the time, as a failure of not getting into ICU any day because it, got flipped it. And it, it has now been the biggest blessing because I would not have my husband and my kids and this practice and all the life that we've built here in the last eight years had it not been for that. So, it still hurts a little bit, but I'm, I'm thankful it, it was a blessing.

Dr. Maryal Concepcion: 18:57

I'm so grateful that you shared that. But also I think about how. You, you talk about the match and we are, we're all familiar with, people in our classes, friends that we know who had to scramble. But I think about even in this time in medicine, people are losing their jobs. Just like my husband was replaced by a non-physician model. So it's I just, I, I think it's so great that you shared because just that the idea of when, when stuff hits the fan and you're like, this is the worst ever. But it's as you shared the, the present, it's like the past eight years have been only because. This, this really like heart, like this thing that hurts still to this day happened, but without that happening, you couldn't have had what you have now. And I think that I, I, I, I say that especially to those doctors who may have been replaced by nurse practitioner, may have been told that like their jobs getting eliminated because of lack of funding or whatever it is. But just know that like you're still doctor, whatever your last name is, and that doesn't change whether you're employed or not. And I will say that it, it sounds a little pollyannish to just like. Echo what you said. And it wouldn't have hap your life wouldn't have happened had that not happened. But you know, I I am, I am with you. And that things happen for a reason. And if it sucks so bad that you're like, I, I don't know how to get out of this mind space of, I, I I, I don't see the purpose in what just happened to me. If you feel devalued, please call a DPC doctor who is near you in another state practicing in the same specialty. Just because we can see things on the other side that we couldn't when we're in the thick of it. And so if you are listening, yeah. If you are listening, you are so valued. And I, I, I think that, that, that is so necessary to hear in this time where PE and VC are really impacting healthcare continually, even I mean to the point now where especially kids and people on Medicaid and Medi-Cal are gonna be suffering. So, with that, I, I wanna ask you about then your experience with your group because, your, your group definitely was a, it was a fee for service group, but I'm wondering if you could tell us your experience there and what was it that made you transition into Lionheart DPC?

Dr. Maria Rutmann: 21:34

So, my group was really phenomenal. The whole time that I was there, I really enjoyed it. So, I was in a group of six I for service, hospital-based, inpatient outpatient model. The group was always fantastic. You had different personalities and different styles, but at the end of the day, everybody would kind of get to the same conclusion and outcomes. So clinically, we all trusted each other and parents just kind of gravitated to whoever they felt the most comfortable with. And it always worked out great. My issue has never been the group but the reality is that the job changed and morphed quite a bit. And in the eight years that I've, I've, I was here and it kind of reminds me of that, story of if you put a frog in boiling water, it jumps out. But if you put it in lukewarm water and you gradually turn up the temperature, eventually it, it doesn't jump out and eventually it dies kind of thing. That, that's, I felt like kind of was happening with how medicine was changing. And, and not just because of the, my hospital, but that's just the landscape of medicine currently, but I just felt like we were losing autonomy and basic things like scheduling appointments were getting shorter. We were seeing down the pipeline, people retiring or needing to grow the practice again. I mentioned that. And a few other practices in the area were closing and recruitment was just extraordinarily difficult. So, all of it compounded. My hospital also went through a big merger a few years after I, I came then you had the pandemic and I mean, the temperature was just rising really quickly for me. And I, I think it boiled down to yes, moral injury. But largely because as physicians we have all the responsibility. And none of the autonomy. So I, you can't practice that way. Like you gotta give me some level of leeway to say, Hey, I need more time with this patient, or this process isn't working, or this metric doesn't make sense. Why are we chasing this? Or, okay, I understand that we have to chase it for financial reasons, however we're doing the work and not getting, not getting it credited. So can we fix whatever's happening in the background? And it, it gets exhausting to work that way.

Dr. Maryal Concepcion: 24:12

And I'm just wondering when,'cause it, that's another beautiful statement. We have all the responsibility but not the autonomy to achieve that. What were some of the things that you tried to make changes in your, in your group? Especially because you just explained that there was a merger that had happened. Because I'm wondering if there was an example of how the autonomy became even less after the merger?

Dr. Maria Rutmann: 24:41

Yes, for sure. So when I came here our rural hospital was kind of its own little thing, you know, I remember interviewing with the CEO and after the merger, everything was getting dictated by downstate in an effort to standardize and, consolidate. And I, I mean, I understand it from a business perspective, but you, you have to also from a business standpoint understand that the county is a very different thing then? Eastern Maine Medical Center in Bangor. And so I wouldn't say that it was just me. I feel like our group as a whole, we were really trying to convey like, we need access. If you don't want our patients to end up at the walk-in clinic or in the ER plugging up an eight bed er that's staffed with one physician at nighttime. We need to be able to fit people in the same day. And, and that was just getting harder to do again, for a mix of things, administration requirements and managing higher volumes and shorter visits, et cetera. So it's just, it's just not one thing. Right. It's,

Dr. Maryal Concepcion: 25:42

it's all of it. Absolutely. And as you described the temperature getting hotter, what, at what point did you say, this is, this is not the way that I can continue going forward in my medical career?

Dr. Maria Rutmann: 25:58

Well, I can't look back at one particular instance, but. In general, it was a feel of this is bleeding into my home life. I was coming home feeling like mashed potatoes. I have two toddlers and I was just like sitting on the couch. They're just like, I don't even have the energy to play right now. Dinner, what, what? I have to make dinner. I was just like not functional at home. And I am generally a pretty. Upbeat positive person. I don't consider myself to be especially moody. And I found myself just like borderline depressed. And it was, when day after day my husband would come in, Hey, how was your day? And I'm like kind of like eor. I'm like this he's gonna start hating me. What is happening? That's on the personal side. On the, on the patient side or, or the practice side. I think what really broke me was when we went to all 20 minute appointments, with the exception of three for the day. Which honestly at that point you're running so behind and you got so much inbox work to do that it's all the same. But in parallel with they took out away our scribes. So, that was, that was just a punch in the gut because how, how do you do more with less constantly, right? Yeah.

Dr. Maryal Concepcion: 27:13

Yeah. And. That's so real. And I'm guessing that they're, that the listeners are translating that into their own experience, what they've seen and been through in their own practices. Like how do you do more with less, less time, less resources? That's so ridiculous when you talk about the scribes being taken away. I think about that in the hospital when we were practicing in fee for service the hospital provided scribes and billers and coders, but for the outpatient doctors, if you would like that, absolutely you can have it. You have to pay for it yourself. But but if you're a hospital doctor, then we can, we'll help you out. It just, it's, it's so, it's so ridiculous and especially when we think about what we, you and I are doing now in that it's totally opposite of the way that our practices have been created and built and the way that we're flourishing now. When you were in this place of, I'm feeling. Work in affecting home life. The practice itself is just not tenable to the quality of care I wanna deliver. How did you start learning about other ways of practicing and had you heard about DPC first or were you ever thinking about your own private practice in fee for service?

Dr. Maria Rutmann: 28:26

Well, for start, I, I might choke up here'cause this, this is, this is amazing. It was you, it was because of you. And never in my wildest dreams had you asked me a year ago, would I've ever imagined that I was going to be sharing my story on my DPC story because it was actually my husband who's very much an outside of the box thinker. He found your podcast and he sent a link to me and he said, Hey, check this out. Have you heard about DPC? And I hadn't, to be honest. Or at least not. Like really tried to wrap my head around the model and I think I said this to you when we met, but it's, this is really full circle, but it, it was you and and this, the episode was so compelling and I remember just, reading a little bit online after that. And then fast forward, what I did is I took a few days off. For staycation and I bought the on demand DPC summit from 2024, and I just sat there with my computer for a few days and did the whole conference right at my living room. And I think it was like three or four days maybe. And then by the end of it I was like, I'm doing this, I'm doing this. There's no question this is happening. And this was back in October, 2024. And so from October through let's see, like February, March, I was just like planning. And then, after work every day I would just chip away, start it with, by the domain and pick a name and get a logo and meet with the lawyer, set up the business and, get a fax number and da, da, da. All the little things. And finally gave my resignation letter. What was I, I think it was February in the hospital. I got done in May. And all through the summer, I just worked full-time in the clinic. So our our space, I absolutely love it. I poured my heart and soul into it. I love interior design and I really wanted a space that conveyed. A sense of peace a sense of welcome, that people would walk in and immediately like their blood pressure would lower. And, and I think we've achieved that. It's very rewarding, but, but it was a complete gut job. I mean, this place was a mess, and mind you, in rural Maine. And there's not a whole lot of commercial options. So this was a complete gut job. And so I, during the summer, I basically GCed the project which I'm, I'm thankful that I had the luxury to take that time off, both for the practical needs of gce, eing the job, but also because I, I really needed to heal. It was so amazing to just spend the summer with my kids and feel human again. And, and I, I think as physicians, we are wired to pour into others constantly. We're not very good about taking care of each other ourselves. And that was. Really eyeopening to me. I guess I, I, I hadn't realized how stressed, how flat, how numb I was until I just, I don't need to sound dramatic, but I, I felt like coming back to life and being myself again during the summer. And we opened in September.

Dr. Maryal Concepcion: 31:26

Beautiful. And I just think about and I'm also cheating'cause I can see you as we're talking, but it's like you have a picture of a lion behind you and I just knowing that your practice is lionheart, DPC, it just, and yes, I worked at a zoo for eight years, so I can technically hear John the lion like doing his thing in the morning and shouting. But it's I, I mean, you, you. Recognized where you were, you recognized that mashed potatoes is not a great feeling to be feeling when you go home and you like, you just went at it when it comes to watching these summit recordings, listening to podcasts, connecting with people, and so Lionheart, just from your story is so representative. I can, I can, it's just, it's so i'm just gonna keep going and I'm gonna roar and go do yes, do what I need to do and be me. And, but I'm wondering at, at what point did you choose that name? And because I'm thinking with other people out there, you don't have to have, my name, medical clinic or whatever, it's like you can have the autonomy even with the branding and the naming of your practice. So how did you choose Lionheart? Well, that, I'm

Dr. Maria Rutmann: 32:38

glad you asked'cause I love the name. So it's, it's multiple layers. It, so I'm Christian and it was really, I, I, so I started out trying to figure out names, something related to Maine and I was coming up with nothing couldn't really land one that I was in love. And, and I remember that afternoon, I was, I just okay, I'm just gonna think about something else. And I sat down to do my Bible study and suddenly it was like lying.

Dr. Maryal Concepcion: 33:05

Like lion?

Dr. Maria Rutmann: 33:07

Yes. Lion lionheart. This is, yes, this is perfect. I don't know, I started brainstorming, but to backtrack a little bit it resonated with me because the lion symbolizes courage. And I think I needed that at the time to step in into a different model. But patients also needed to step into a different model themselves. I. I'm inspired by Lions. How in the wild, like they're very strategic together. When they hunt, for example, they take care of the young together. They're a community based animal. And that's again, something that resonated with me because that's what I'm trying to build within the clinic is community and trust and partnership. There's also, little stories that for example, one of my very first patients in in the area, he was about two when I started seeing him. And I remember checking his ears and I was like, Hey, there's a little lion in here. And he got the biggest kick out of that and he is now 10 years old. And that young man, every time that I see him, every time Marielle, he asks, is the line still in there? Is the line still in there? So to me, the line also, it's so precious. Yes, it was just representative of that relationship built over years and that trust. And I've had, this particular family, I, I can think of many things that we've gone through. That trust was just a key component of the outcome. And so the lion symbolized all of these things, but, but first and foremost, just, just faith and, and, and praying about, praying for courage to do something different and do it well and, and trust that there's a bigger purpose for it. And, and I found it in DPC because I can take care of my patients better. I really can provide better wholesome care for people in a way that would, it is just impossible in fee for service.

Dr. Maryal Concepcion: 34:57

Incredible. And I will call out here, that courage, I very much manifested in the best business cards ever, and I, which I still have yours. It is Dr. Rutman gives me her business card, and she's this is, this is a thick business card. It's like super professional and like you hadn't even finished gutting your clinic. You stu your stuff in the garage, but you I, I, I, I wanna, I ask here like, why a business card? Why did you make the business card like you did? Because you didn't have your doors open yet. And but it was still okay to have a business card and start making claim to your future.

Dr. Maria Rutmann: 35:34

Yeah. That's so funny. So the, the practicality of the business card itself was a, a recommendation from a good friend of ours who's a, a very successful real estate agent. And she was like, get the thickest ones that you can get because people feel bad throwing them away. I love Jane. She was actually the one that introduced me and my husband. So, she's, she's pretty amazing. But then as far as, yeah, I wasn't ready, but, but I was ready, like it was happening and, and I think sometimes we tend to focus so much on the finish line that we discredit all that we're accomplishing along the way. And in my heart, even though things were still in the garage I could see it clear as day in my heart and in my mind, like to, to the littlest detail, like where I have like stickers on my reception area and the exam rooms. It was in my heart and in my mind it was so clear. So. It, it was just, yeah, that little card was just symbolic of what was to come.

Dr. Maryal Concepcion: 36:35

And it's so beautiful and I, I hope that, especially for the listeners who are in this moment of whatever, but they're thinking about DBC or planning DBC or even if you're going through rebranding, I will say that too. Like the idea that you just shared that it's like you were ready. Like that, that is not determined by, if you have everything to this point open and you're ready to see your first patient in person in your physical space, you might not have a physical space, but like when you are, this is what I'm going to do in your head. Mm-hmm. You deserve to have a business card. You deserve to have your website, you deserve to have your social media handle. Those are things that are, it's, it, it's, it's healing for our souls. In that, we are literally. These things reclaiming autonomy that we should never have lost in medicine.

Dr. Maria Rutmann: 37:29

A hundred percent. And we are also very, tend to be very goal oriented result driven folk. And going back to the business card is silly, but I remember when I finally got them after printing, I ordered them on, on Canva actually. And, it was just a simple little business card, but it represented so much because at that point the website was up and running. The fax number had been selected, which in which was linked to my EMR. So like my EMR was ready to go. I had a physical space. I had the logo, I had the business, I had my color scheme, I had pictures taken. I had open social media accounts, which I, I don't love social media. That was a pain in the butt to put social media accounts and get them up and running. Like it was all these little things. And it was, I felt so proud.'cause it's like I am making progress. I'm getting traction. It felt amazing.

Dr. Maryal Concepcion: 38:21

Absolutely. And I, I've loved, seeing progress in visual pictures, like throughout your journey so far. But I have to now, I have to now call out what I mentioned in your bio, the world's cutest doors ever, because you talk about community and you talk about, having the sense of being together. I mean, to the point of even both parents and kids have their own doorways. Tell us more, please.

Dr. Maria Rutmann: 38:47

So when I started just daydreaming about the space, I really wanted it to be child friendly and have it just be fun, I thought about, oh, do I put like this fun little play area in the waiting room? And then, well, I got here. Well, okay, the waiting room's a good size, but it's not that big, so I can't do that. And I, I remember checking on Pinterest and I saw this playroom with the doors. I was like, oh, wouldn't this be amazing? And I ended up connecting with a very, very talented, gentleman who did the doors custom made here, and they're solid maple. They go perfectly with our design. But when I met with him the first time and I showed him the picture, I'm like, can you pull this off? So it's like a little four foot door in, inside the, the big door. And you could just see the creative spark in his eye. He was like, oh yeah, this is gonna be fun. And immediately he's like clearing his desk, starting to draw stuff. So it was, it was just really fun. But it was symbolic of, how do I say this? It was like just a visual representation of of just having a space that's fun and for the kids. It's, it's not the other way around. Oh, we're gonna repurpose this space and I guess we'll throw pediatrics in there. No, it's I want my patients to feel at ease when they come here. And sure enough, when I had my open house and I had the first few patients come into the clinic and they went through the little doors, I, I teared up because the sense of joy in those kids' eyes, they've never seen anything like it. They were having so much fun and now, like they're not scared to come here. They I had a good compliment from a mom not too long ago. I was actually taking care of a laceration for their little guy. And he's hurt. He's like legitimately hurt. And the mom goes he was bawling his little eyes out. And the minute that I said, we're going to see Maria, he stopped crying. He was looking forward to it. He was excited. I was like. That's amazing. That's, that's perfect. That's exactly what I'm shooting for. Oh, and get this, you're gonna love this.'cause I'm all about like symbolism and stuff. So I went to pick up the color for the the doors and, and the gentleman that was doing them he goes, I can do lacquer. Just go to, whatever hardware store and get any color. Sherwin Williams, Benjamin Moore, I don't care. Get whatever I can do any. So I went over and, they have the big wall with all the samples and I'm like, oh, this dark teal, this is perfect. Teal's my favorite color. It's the color of our logo. I pulled it out. You wanna know what the name of the color was? You Venezuelan CI was like, this is perfect. This is meant to be. Totally meant to be. That is

Dr. Maryal Concepcion: 41:16

awesome.

Dr. Maria Rutmann: 41:17

Yeah. So I know just little things like that teeny tiny things, but it's just joy is just sprinkled all throughout the space and I absolutely love it.

Dr. Maryal Concepcion: 41:25

That's amazing. And I just, I think about, our kids are little in age, but it's I think about how even with Nolan, our youngest, who just turned five I'll say, he'll, he'll have some issue and I'll be like, would you like help with that? Or, you got it? Mm-hmm. And usually it's, you got it, but it's yes, the safety of you as the doctor, you who they're seeing this personalized space, but just, I go back to the door because it's like I can even open my own door to my doctor's appointment. Thank you. Parent of mine. You can stay behind as I enter my own door like it is, I can see Nolan just like going nuts. So when we visit Presca, I'm gonna be like, we gotta go check out the doors first. Oh my God. Sucks. So awesome. Hundred percent.

Dr. Maria Rutmann: 42:09

A hundred percent. In, in, in this. Same train of thought with when we did the remodel, the bathroom, that the space had only had one sink. And in the remodel we actually added a sink. Sink. And it's at a lower height at the height of a child. Precisely because of what you're saying because it's, it fuels a sense of independence and as a parent, you, you wanna nurture that. Right. So, I can think of many times that I picked up my daughter at whatever. Mall or something, bathroom and ah, you're squishing my belly and my sleeves are wet. And it's like this whole thing, right? But here the kids are like, oh, wow, I can do this. This is cool. And like the toilets, like I got like seats that have a little toddler potty training seat inside the seat, and little things like that the space is truly meant to be for them. I was also very intentional with the colors that I use throughout the clinic. Again, I said teal is my favorite color. But other than that, I really kept it with a very neutral calming color scheme. Precisely because kids are overstimulated nowadays. Parents are overstimulated, people are coming into the office, everybody's slapping. And, and again, I wanted it to be a grounding, calming space. And I think we've,

Dr. Maryal Concepcion: 43:16

we've achieved that. That's awesome. And in terms of the space itself, can you give us like a, can you just give us a, a description of the visual layout. So if you enter the front door, what does your patient experience in terms of the waiting room that's not used for waiting and the, what, what is beyond there?

Dr. Maria Rutmann: 43:39

So it's the layout is, it's an L-shaped the shorter part of the L is more like staff office space. So have a little break room. My office is there and a second bathroom where I also have a washer dryer to take care of like washing the gowns and stuff for the patients. But then the longer part of the L is the waiting room and then our exam rooms. You walk in, kind of in the corner, the first thing that you see is the reception area where I'm sitting at. Another story about when we remodeled the space actually had a, one of those little sliding windows,'cause it used to be, I don't remember what business was here many years ago, but it, it had one of those doors at a window, sorry. And I told the contractor, I'm like, can you, can you take this out and fill it up and sheet rock over the side? I don't want this. He's you sure? But wouldn't that be useful? I'm like, no, I hate those. They're so impersonal. It's like an immediate barrier when you walk in to a doctor's office and people are on the phone and they slam the thing at you. I hate those. So, I was very proud to rip that out of the space. So when you walk in, we have, we have an open desk. And I think it, it immediately, it conveys that sense of we're at the same level. We are friends here. There's no, division of you patient, me, doctor. Not at all. It's like we're in this together. But then we have five exam rooms. I know in my heart this is gonna grow. I've only furnished three out of the five. But yeah, it's it's been a wild ride and it's been fun.

Dr. Maryal Concepcion: 45:04

And tell us, I, we've mentioned the garage a few times, but it's tell us about your strategy in knowing that like your clinic is happening. It's like it's already in your head. What are some of the things that you look back now and you're like, I am so glad that I had these things because you're already open and treating patients

Dr. Maria Rutmann: 45:26

well. I, I'm just really proud that I had very few things. I was like, oh, I forgot that. It was really cool that because I had time, I was able to think from the bigger items to little, little gritty, I need two by two Gs or whatever. I, I think my favorite tool so far has been the vision screener. I, it's expensive as I hesitated to buy it, but you know what, it's, it's been remarkable because so nobody in the area has it. I, as pediatricians, we are big on prevention and what you see with patients that develop, lazy eyes and amblyopia and all of that is that a lot of kids can't complete a vision test until they're four or five. And by that time, if there's an issue, it's, it's well progressed. And oftentimes if you're picking up earlier, it's, it's because a kid has already developed the lazy eye on exam, right? So, that to me was just the epitome of preventative care. That doesn't happen in fee for service, because if you look up the reimbursement for a vision screen, it's like less than$10. So why would any hospital system, because they're all strapped for cash, would buy you a$10,000 piece of equipment. They're just not going to. Right. But for me it's, it's with the way that our overhead works and because the numbers in DPC are different I can do that. And I'm doing screens as early as six months and I've already had a really, a really good couple of pickups. And, and then you give the family a fighting chance to tackle this before it becomes an issue, right? Because it takes a while to get the kid used to wearing glasses or it takes a while for the patching to actually work or even for them to tolerate it. And then you get to, God forbid, the point of surgery and the surgery's not always effective either. So talk about something with like permanent consequences that now I'm able to pick up because of this fantastic tool. So that, that's one that I love for sure.

Dr. Maryal Concepcion: 47:19

I love that. And as you were thinking about it, I'm like, one, my snarky comment. My head was, and I'm saying it out loud definitely not enough money to buy a vision screener, but definitely enough money to put your logo on an arena for sports like that, because that absolutely makes sense. But also on a more serious note our DPC pediatrician she comes to the home once a year and the boys are like minus the shots. The boys are like, man, I'm so excited. We get to show her, we get our Legos set, and then that, when that vision screener comes out, man, it's oh, everyone needs to be quiet. We gotta shut the lights off, guys. It's, it's a big production by my kids because that's how they're experiencing the doctor. And so it's I love that you're mentioning that, especially, I, and I think about this, we're both rural. It's like the tools that we have, like we have a like anter I guess that's what it's called. Yeah. An audiometer. And I, I think about these are tools yes, we can use for our members, but these are also tools you can use in, if you're doing, especially pediatric clinics.'cause we're, we're talking pediatrics here. If you're doing community health fairs or whatnot, I mean, you already have these amazing tools and usually because these tools are so, like the, the modern day tools that we have, these are things that like you don't typically see in fee-for-service clinics a lot of time. So it's even one way of marketing your practice and how it's different than other practices. So I think that that's a, it's a great tip. When it comes to you mentioning the person who was like, oh man, I'm so excited to do these doors for you. Do you have any tips also on working with the community in terms of having them come on to do projects for you? Because, we've talked in the podcast before about do you barter, do you not barter? How do you approach it given that some of these people could also be members as well?

Dr. Maria Rutmann: 49:15

I think, I think it's a case by case basis, right. I've, I was very blessed that literally every single contractor we worked with was extraordinarily talented. And, and, and it was fun. And I was here all the time, so I really got to know them. I know that a few are thinking about joining. I've had a couple that have already joined. And I just, I think my advice for people would be don't just focus on the membership. Don't just focus on the money. Be a good person, do things right. Be a kind human being. The money and the business will follow, honestly.

Dr. Maryal Concepcion: 49:48

When it comes to opening day, your practice is ready with the doors, with the, the colors, with the welcoming environment that you've created, how was the community response? Because people, like you said, they already knew you as part of the community.

Dr. Maria Rutmann: 50:04

It was really positive and it was very, very exciting. I had businesses in towns and flowers and friends and family that don't even have kids just stop in to say hello. And there were patients of mine that came in that hadn't seen over the summer and, with peds, like they changed to match, right. So it was, it was just really cute to see. I had a couple girls come here and do face painting for the open house, and we had I ordered some macaroons and cookies with the logo and stuff from a local business. So like we're, we're just really trying to keep everything local and a few teachers of my kids came by and I, I don't think I even have words to describe how fulfilling that day was. The, just people cheering you on people. Saying wow, I'm glad that you're doing this. I can see that this is gonna be good for the community. I, I love having options. I love what you're providing. And, families talking not just about care for their kids, but it led to really good conversations about insurance and, and care as a whole, right? So like people are, it's almost my sense is that people are frustrated with the system, but they don't quite know what the options are. So it was great not just to do that for me as a practice and my pediatric patients, but, but for families and adults and businesses to start thinking

Dr. Maryal Concepcion: 51:25

outside the box. It's so true. I literally just had a conversation with somebody whose doctor went to concierge medicine in Texas, and I was like, did they, did they even know about DPC? So I think about when you talk about that people might not know that DPC exists. This is why I'm so grateful for now you, not even just listening, but now sharing your story so other people can hear your story because this is what matters in that. We have representation as independent physicians who are in communities all over the nation. I mean, I, I was so excited to bring an example of Dr. Katie Bird Greer, who's practicing on reservation land, like Amen. Rural doctors like you and myself, people who are like Dr. Natalie Gentilly and Dr. Kirsten Lynn, opening an MSO where there's billboards of people with Super Bowl ads and they're thriving. So it's there's so many examples of how DPC works, but knowing that DPC is a thing and that concierge medicine is different, these are such important facts to know about medicine as of today's world of medicine. I love that your community was so welcoming, but I'm wondering if you can talk to us about the conversations and how they went with people who were like, but I don't necessarily know what this is compared to your old practice with you taking insurance. So how did you talk to families about what you're doing and has that changed? Because now we're in November, you opened in September, and I, I would assume that even just in that short time, you're. Personalization of how you talk to parents has even changed.

Dr. Maria Rutmann: 53:03

Yes. You grow in, in confidence, I guess, to talk about it and,'cause I don't like coming across as salesy. Right? I think we all struggle with that, but we also see the value of what we're offering. And, and I think you grow in that confidence to, to talk about it. Not from a salesy angle, but just this is really cool and you need to check this out. Right. But, but it's, it's, how do I say this? People have different needs. And I think what I'm finding is that I have a little bit of a melting pot of reasons why people join the practice. So I have the folks that value the convenience. I have the folks that value me because they trust me as their provider. And then I have folks that see the cost savings because they are uninsured or they're about ready to drop their insurance. And so I think my advice for folks would be to find what is motivating the other party and try and identify those barriers or the challenges that they're facing to have just a productive conversation, right? Don't just approach it from the elevator pitch sales angle, but just these are human beings. You are an alternative. How can is this gonna be a good fit? I think my favorite part of the conversation is when I tell people it covers all of your visits, the monthly membership covers all of your visits. And they look at me kind of funny. I'm like, yeah, and like to drive the point home. I'm like, doesn't matter if I see you one time that month or seven because you had a terrible sinus infection. Like you don't pay a penny extra. And they're like, oh. And then suddenly it's in perspective, right? Because I pay more for my phone than what my mom monthly membership fee is. A pedicure is, 75, 85 bucks depending on where you live. A massage is hundreds of dollars. So it really boils down to what people value, right? Some people, like I said, will value the convenience. Some people will value the savings. Some people value you. And I think, I think they need to understand the value before they come on board.

Dr. Maryal Concepcion: 54:59

I love that answer. And I ironically just came from dinner in Sacramento with a DPC doctor who's practicing in Elk Grove, and we were talking exactly about this. Like the, the, the way that I think of the pitch, so to speak, is very different than what, what I thought the pitch was like when I opened. And it's very much more of what you're describing right now. It's tell me about your access to healthcare. What, what is, what are your biggest frustrations? They will tell you what they want to hear, and it, it's very common that, when and when we think about marketing and you need multiple passes for a person to actually hear the message that is changed. The, the, the number of passes needed is changed when they're telling you what they need upfront. So I think that that is really great. And I, I, I thought about this too, just on your website, when you have services listed, you have, InBody scan, you have medical ear piercing, you have fourth trimester care. And I, I think that it just speaks to that you're doing this anyways, but also just the way that it's called out on, in different sections on your website, that might be what the person is starting. To experience your clinic by, but that's not it. There's way more that goes beyond just those services.

Dr. Maria Rutmann: 56:12

Yes. And, and I have more in the pipeline because I think what I'm trying to identify is areas of need. And I love learning. I love a challenge. That's one of the things that over the past few years has been hard for me is that every day look the same. I get bored easy. I'm too a DHD for it, right? So, like I'm in the process of getting my lactation consultant certification and I'm doing a course on doing tongue ectomies for my tongue tie babies, and just, I, I would love somewhere down the line to incorporate allergy testing in a safe matter as well, because again, those are things that people are just waiting months and traveling far to, to get answers for to, so, that's been really interesting to incorporate. And I love the freedom. To do it in, in terms of time. But also in terms of I don't have to ask any administration for permission of Hey, what do you think of me offering the service? I can just do it. I love that autonomy because I'm growing and, and at the end of the day, the patients are gonna benefit from it as well instead of just cutting through administrative red tape,

Dr. Maryal Concepcion: 57:15

And I think also for the listener who hasn't checked out your website yet you even have a note that says if you are. If you're needing a service, let me know what you're needing because there's more services coming and I might be able to deliver that. I mean, it's very it's, it's, it's almost like asking an open-ended question, it's like mm-hmm. There's not necessarily a, A, B, C, D or E there's no other. And it, it allows the community to, think about oh, I, I actually do need this service, but I haven't been able to find it anywhere else. So I think, I think that's very lovely that you have that on your services page, on your website. Thank you. Yeah, thank you. Going into the next year, I'm wondering,'cause we were talking about he just healthcare access in Maine and how it is being impacted already, but I'm wondering what do you have on, your, your plans for next year in terms of strategies that you're thinking about already, that are already built out in your head and. What do you think about and where are you when it comes to growth with another physician or another non-physician provider joining you? Because like you said, you expect it to grow. It's just a matter of taking it day by day and that will happen.

Dr. Maria Rutmann: 58:24

Yeah. I think my goal, my, my dream not necessarily with a concrete timeline'cause I'm just trusting that it'll happen when it's meant to be. But I would like to bring in an adult provider the amount of families that have told me when is there gonna be an option for us as the parents is crazy. The access to care in the adult world is, it's, it's really heartbreaking up here. My dad for example, not too long ago he had an appointment, he's in his late seventies. The office had to reschedule him. It wasn't him that missed the appointment or anything like that. They pushed him out like five months. So, there, I, I, I see a need, a true need. And I would like to be a part of the solution for people. So that's, that's probably my biggest one. As far as marketing I'm just trying to remain flexible and, and we're all learning as we go. I don't think there's a cookie cutter way, but like one fun thing that I actually just solidified in the last week is that we have a junior hockey team in town. This is the first year that this team is playing. They're called the Northern Maine pioneers. And I initially had approached the team to say, hi, Hey, can, can I be of service to you somehow? Because I mean, honestly, where are they gonna go, right? Pediatrics is gonna say, these young men are too old for us, they're not gonna see them. Adult practice is gonna be like, oh yeah, we'll see you. Here's your appointment in April. Right? And then walking clinic can't really handle concussions or what if they're struggling with mental health?'cause they're away from family. I mean, we got kids from halfway across the world, right? So I'm like, I think I can meet their need. So, we, we put a little package together for them and over time I've actually gotten to know quite a few of them, and they're really remarkable young men. And they embody what Lionheart is, right? Like they're being courageous, they're being bold, they're pursuing their dreams, and I'm just like totally inspired and on fire by all of them. So, I'm actually gonna be their doctor for the whole team now for the season. And that was a complete curve ball, right? Two months ago. I, that this wasn't even in my radar and it, it just happened and it feels right and, and it's been fun. And it's helping me grow too because, now I'm taking care of these like really competitive athletes and younger adults, which is a little different than what I've done in the past. And, and and again, it's just fueling that sense of purpose. I spoke to or have spoken to a few of their parents and let me just say that there. Gratitude for a peace of mind, I guess, for having somebody be there for their boys, who there might be men, but to the parents, they're still little boys. It's it's, it's really sweet. It's really endearing and that's why we went into medicine, right? To be good to people and do things right. And I needed that. I missed that. Does that make sense?

Dr. Maryal Concepcion: 1:01:07

Absolutely. And a huge congratulations.'cause that is awesome. Thank you. And I, I think that, even the, the pairing of you, you described it as a curve ball, but it's like you being in a moment where you could be open and they needing a doctor who was open enough to take care of them in the manner that you can, again, it's just things happen for a reason and that's a beautiful pairing. And I, I know that they're, they're just going to be experiencing healthcare so differently and especially things like hockey. And so, and excuse me, not soccer, hockey and football, the things that I'm like, oh my God, I dunno if you've never played those kids of mine, but I, I I would be so much more I would be so less anxious as a parent if my kid had a deep c pediatrician like you. And that's, that's why we have dp, C-P-A-D-P, ccp, pediatrician for our boys. So I think that's awesome.

Dr. Maria Rutmann: 1:01:59

yeah, they've been a perfect example of the value of access because there was one morning, for example, that I was dropping off my daughter at school and I get a call from one of them and says, Hey I think I may be concussed. Can you see me today? I'm like, yep. I'll see you at 10 Swing by the office. Easy, right? It was just so easy. Or I've already troubleshooted not just with them, but with other families. So many things via text. And, but again, you're coming out of this place where there's a relationship where there's trust, where communication is easy. It's instant, right? You're not going through playing phone tag or what's that game like that you kind of sit next to each other and you pass along a message. By the time it makes it through the whole group, the message is completely different. I feel like telephone that happens. Yeah. Great. I feel like that happens in, in traditional practices, because you're going through, a couple of front staff members, maybe a couple of nurses are amazed before the, in bouncing the message back and forth. It dilutes the situation. Not only does it create a delay in care, so, um, yeah, the, the value of having communication with your, with your provider, with your doctor is just, I, I mean, in my mind, it's priceless. It's, it's one of the things that I love the most about DPC.

Dr. Maryal Concepcion: 1:03:05

What would you say to other DPC doctors who are not at this moment, letting that lion heart of their own out into the world and they're, they might be quashing it.

Dr. Maria Rutmann: 1:03:19

So one of the things that I love the most about DPC is the time that it allows me with the patient. And I'm not just talking about like me not rushing through life. It's when I can actually get to the meat of things by listening to people in, not just a five minute appointment. I can spare you from unnecessary referrals. We can tackle things better, we can tackle things efficiently. I remember I had a patient not too long ago that they had asthma and had seen multiple providers along the way. And when I spoke to the parent, they were like doing all the things right, like they were on the right meds and like, why is your asthma still a disaster? It shouldn't be this way. You're, everybody's done the right thing. So it occurred to me like, can, can you show me how you're using the inhaler? And they were using an A chamber. And they were just, kind of like spraying it to the kid's face and putting it down and the kid was not effectively getting the medication. And that to me was just such a eyeopening wow, like this is this, this is basic, right? Because nobody took the time to teach this family how to use the A chamber. That was a fa like a failure right there. Granted, there could have been miscommunications along the way, people sometimes leave overwhelmed, I'll, I'll give everybody involved, grace. But it was, it was just like, wow. So it's little things like that that I think having time with your provider is, is crucial, but also, again, when we can tackle a lot without having to refer you and, but, but it takes time, right? So, it, it's just for me that's, that's one of the biggest values in, in direct primary care for families.

Dr. Maryal Concepcion: 1:04:55

So powerful. Well, thank you so much Dr. Rutman, for coming on and sharing your story. Thank you, Marielle,

Dr. Maria Rutmann: 1:05:02

for having me. This has been wonderful. Really. DPC I think saved my career. You hear that often. And thank you in particular for putting this out there because you are such a heavyweight in the community and you are reaching people that I, I don't think I, I don't know if I would've come across DPC had it not been for you. And, and, and I'm thankful for your efforts into putting this podcast together because you're changing lives by getting this information out there.

Dr. Maryal Concepcion: 1:05:32

Thank you so much. That is so sweet. Oh my goodness. It makes my day. 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.