Direct Care Movement: An Interview of Dr. Maryal Concepcion by Dr. Demetrio Aguila

Today Dr. Demetrio Aguila, a Direct Care surgeon and Host of the Direct Care Movement Podcast interviews the Host of My DPC Story, Dr. Maryal Concepcion.  For those listeners new to the podcast, or for those who are always happy to hear a DPC doctor talk about before and after opening a DPC, today you get to hear some of our Host's back story. Dr. Concepcion, a family physician and DPC pioneer in rural California, shares her journey of leaving fee-for-service medicine to open her own DPC practice. The conversation highlights the freedom, flexibility, and genuine patient relationships that DPC offers, contrasting it with the restrictions and burnout found in traditional healthcare systems. 

Listeners will hear practical advice for residents and medical students considering DPC, the financial realities of running a membership-based clinic, and tips for overcoming staffing challenges in rural areas. The episode also dispels common myths about DPC and discusses the growing movement toward patient-centered care. Hear more from Dr. Aguila at the Direct Care Movement podcast on Apple Podcasts!

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Transcript

Dr. Maryal Concepcion: 0:52

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. Demetrio Aguila: 1:41

Hi, I am Dr. Demetri Aguila, and I am the host of the Direct Care Move-in the podcast that talks about direct care and, uh, and medicine in ways that you hadn't thought about before. Uh, we ask questions and we dig into the topics that either you didn't know you had permission to ask about, or that you didn't know you should be asking about. We're gonna dig into this and a whole lot more with our guest today. I am so excited to be joined today by my Filipino sister from another mother. Uh, Dr. Mariel concept. Hello, Mariel. How are you today?

Dr. Maryal Concepcion: 2:13

I'm doing good. Thank you so much for having me.

Dr. Demetrio Aguila: 2:14

Oh, it's exciting to be, it's exciting for you to be here. You're the host of, uh, of your own podcast. And why don't you tell us a little bit about yourself?

Dr. Maryal Concepcion: 2:23

I am indeed Filipino. I, I am born and raised in Sacramento. Lots of Filipino roots in Sacramento still. I went to uc Davis to explore medicine and then eventually landed at Creighton University. School of Medicine, became a family medicine doctor and chose to focus on rural medicine because I like to do full scope care. And that brought me to, residency in Modesto, California, where I was able to. Make sure that I focused on rural medicine and my externships and I was able to make sure I got my numbers to be able to do colonoscopies after I left residency. And my husband, who's also a family medicine doctor, we both moved to Arnold, California, the town where I'm living in sitting now, about 4,000 people in the Sierra Nevada foothills. And I have been here since 2015 with my husband and we worked for Adventist Health, a big well-known nonprofit, A corporation in Northern California as well as many other places around the United States. And we experienced the, uh, unexpected. Journey that nobody had told us about medical school, that we don't actually matter as doctors. Our training and our ability to do art and medicine with our patients and have relationships with our patients didn't matter. And we unfortunately experienced the threat of being fired unless we saw more patients per hour. And this is while we were pregnant with our second child. So I was about to lose my insurance. Uh, while being a doctor and seeing patients and being pregnant, unless I signed the contract that said, I would go faster, see more people per hour. If I worked for another company, the company we worked for would own our money. If they needed us in two different places, they had the right to move us. Our rates for RVU relative value, um, units would never be renegotiated. Just totally. Untenable reasons to sign a contract. And so I left my fee for service job as soon as I could after taking a seven month maternity leave and opened my own DPC. And prior to that, going to your call at about the podcast, I did start my DPC story And I'm very proud to say that it is the top podcast in the nation about direct primary care featuring physicians who are sharing their stories about how they left fee for service and have chosen to operate their own dvcs in every environment possible in the United States of America, rural, urban, everywhere it works. So I'm super excited to join and have more people your audience hear more about, um. What DPC can do for a person's medical career, especially if they're intentionally looking to do DPC, which is where a lot of our younger colleagues are focused on, and a lot of our colleagues who are wanting to leave fee for service are also focused on as well.

Dr. Demetrio Aguila: 5:38

So awesome. It's so exciting. And think about the irony of this, right? So here we are, we're two Filipino physicians, parents of Filipinos, and uh, and we had to go and both of us at somehow or another ended up in Nebraska and some point, uh, or another in our lives, in our careers, we had to go to Oklahoma City to run into each other.

Dr. Maryal Concepcion: 5:58

Yeah.

Dr. Demetrio Aguila: 6:00

So that is, that is how things work these days. For sure. Exactly. For sure, for sure. And you know, most of your listeners aren't gonna know this, but we've been trying for months to coordinate our schedules to get together and do this. And I'm just, I'm so delighted that we're able to finally make it happen. So I'm, I'm, I'm excited beyond words, uh, because I, I wanna hear your story. I want our listeners to hear your story. Um, now. You know, you and I obviously are very familiar with a lot of the handcuffs that, uh, that you, you had placed on you. I mean, they were the same ones that I was facing, uh, when. When I was looking to go into practice on my own. Um, but I think there are a lot of our listeners that aren't familiar with the, some of the challenges that they're gonna face when they, you know, when they're getting ready to graduate from residency or fellowship. Tell us a little bit about, so that learning curve, what was it, what was the stuff that you signed that was in your contract that you had no idea was in there and you had no idea what any of it meant until it, it finally mattered?

Dr. Maryal Concepcion: 7:03

Yeah, so I think. It goes back to just the idea that some say, you know, we were quote unquote called to medicine, and some say we chose medicine. Either way, we enter a career where we're intentionally going to build relationships with people in order to help guide people's medical journeys. So I don't wanna say it's like, you know. Excusable naivete, but in terms of my world, I didn't expect to be intentionally screwed over contractually. I expected that people would be on the up and up in medicine period, and so it was very disheartening to me to hear from my own employer, you know, if the threat of you will be fired. By October 31st, unless you sign this contract. And the person who handed us that used to be a physician recruiter, it's just impossible. And, I've heard other people on my podcast share, there's, clauses about. Noncompetes in California, it's not enforce, it's not enforceable unless you work for Kaiser. There are certain agreements where it is enforceable, within Kaiser, and then other people have shared that there's clauses about, like you can't even own your own social media. Like that blows my mind because it's your life, your content, but yet you don't own yourself. And it's actually not surprising when you think about. When you become an employed physician, you don't own your schedule, you don't own your scope of practice, you don't own the time per visit, you don't own your career. So when it comes to contractually, when look back, thinking about how, even though I'm not a contract reader. I would've definitely taken my contract not to a healthcare attorney because healthcare law is a, an elective in law school, but I would've taken my contract to a small business attorney.

Dr. Demetrio Aguila: 9:23

Yeah. Uh, you know, I, I had, uh, taken my contract to an attorney and he warned me. He warned me. He said, okay, here are the places. Here are the typical things that are in there. Yours is pretty typical. It's actually pretty generous here, but here's something that's typical that, uh, is likely to, to end up biting you later on. And of course, what did I do? I was like, wow, that, that's not gonna apply to me. I'm, I'm gonna be really happy where I am. And sure enough. I wasn't, uh, I ended up getting painted into a quarter and you could argue, you know, I did that to myself and on some level I did. Right. But there wasn't anybody there to, to really guide me. Um, and that's, mm-hmm. I think that's one of the things you and I have, we've talked about is that, you know, so many of us go into medicine and we, we have all kinds of people to guide us on the medical and surgical side. We don't have anybody to guide us on the business side. What are your thoughts on that?

Dr. Maryal Concepcion: 10:17

I think that definitely, thankfully the tides are changing in that you and I did not have that, but you and I are contributing to the ecosystem where we're helping our colleagues who are making the transition, and that's why I'm so proud to be here with you as not a nurse, as a doctor. There's nothing wrong with doctors, but I mean, nothing wrong with nurses, but we're Filipino doctors, which is something that you and I joke about in person. Dr. Grace to Hodges, Dr. uh, Dr. Fred Vigar also, the four of us saw each other in Oklahoma City and I just think about, I just scrolled'cause my kids were shutting. Um.

Dr. Demetrio Aguila: 10:53

That's one of the joys of period t PC knock, isn't it? Having that kind of flexibility.

Dr. Maryal Concepcion: 10:57

Yeah. Like I'm, I'm sitting in my son's room because this is the only place where I'm not opposed to you screaming, but yet it's a holiday. So there you go. Sure. Remind me the question again, though.

Dr. Demetrio Aguila: 11:07

Sure. So, guidance you Right. You know, mentorship and, and, and, yeah. And people to show us the way.

Dr. Maryal Concepcion: 11:13

Thank you. So when it comes to you and I, where I scrolled was. Being proud of people like you and I being present as Filipino doctors, helping be mentors and people that are in existence and successful to show others coming up in the ranks of independent medicine, that it is possible. I will say that. The uniqueness of the ecosystem and direct primary care and physician entrepreneurship is that you have people like us who are teaching from the perspective of, we wished we would have known this. If we were in your shoes right, and that's very different than ivory tower people who don't actually see people who don't actually struggle with contract agreements, who don't actually work for corporate medicine and want to leave. Um, it's very different for those people to advise our colleagues versus us who are colleagues.

Dr. Demetrio Aguila: 12:48

Sure. So I have conversations with residents and fellows and medical students, and I talk to them about direct care, and I'm sure you have a lot of these same conversations and, you know, they're curious, but at the same time, you know, some of the, some of the more outspoken, uh, trainees will say to me, well. You know, Dr. So-and-so my attending, or Dr. What's Face, or Dr. What's her name, said that, you know, this direct care thing is kind of crazy and, you know, and, and, and that I shouldn't do it and I I shouldn't be, you know, pulled in by all the hype and, and have the wool pulled over my eyes. How do you answer those questions when medical students or residents ask you stuff like that?

Dr. Maryal Concepcion: 13:28

I would definitely ask them, tell me more, because I would love to hear all the myths about direct primary care and direct care in general, especially you as a surgical specialist have made the jump, right? So we've heard all of these myths and I lean into tell me what the beliefs are, the myths are from that individual person. Um, I will definitely also attest to the direct primary care. And direct care is not for everybody. I will say that when you are gonna call out a system like Direct Primary Care is, you know, pulling the wool over your head. What is becoming a part of the fee for service system like that's worse than pulling the wool over your head. That is literally shackling yourself. To be not a physician, you're literally a coder and a person to be a cog in the wheel of not the business that you own, or the business that you can change the mission of, or how your business affects patients or your community around you. So I definitely would say, you know, just in my response in this moment, I sound very defensive because. I think that in general I am defensive when it comes to people defending the fee for service system and discouraging people, especially our younger colleagues from choosing direct primary care or even to, uh. Hold direct primary care as an option, as equal to fee for service. And that's something that I struggle with in California Academy of, uh, family Practice, um, the organization where 80 to 90% of our family medicine residents are employed. And then look what happens when they're six to seven years into Kaiser, if they even make it that far. So I think that to that person, I would be a little less defensive, be more engaging in the moment, but also call out the BS of the person who is making those statements. Sure.

Dr. Demetrio Aguila: 15:36

The person who generally doesn't know a whole lot about direct care medicine and specifically direct primary care medicine, making all kinds of blanket statements about what it is and what it isn't. For the listeners who aren't as familiar with Direct Primary Care, tell us a little bit about your practice and how is it different than, you know, what, what you saw when you were working, you know, for, for the man, so to speak.

Dr. Maryal Concepcion: 16:01

Yeah, so I will say that I worked for the system for like a month, shy of six years, and then my husband worked a little over eight years for the same system. The reason he left was because he was let go because a nurse practitioner in the state of California with 4,600 hours of supervised care, quote unquote, is basically a doctor. Though those listeners who might be in California definitely know that that is a thing in most states. In this union. It is okay for nurse practitioners and non-physician providers to practice without physician oversight. And so that is, uh, the trend. So when it comes to the practice of Direct Primary Care, in my world, I love to say that it is only because of Direct Primary care and only because I was able to be a physician entrepreneur that I stayed in rural America and that not been an option to not be an employee, I would not. Remain, and my husband and I are the only physicians you can see if you're pregnant in the entire county. If you need something removed off of your face. If you need an IUD, if you need a circumcision, we are the only full scope clinic that a person can go to. When my husband was relieved of his physician because my old clinic or our old clinic went to a non-physician model, or you no longer have access to see a physician if you wish to. The company denied our community access to a full scope. The last full scope insurance accepting physician. So the mission of our clinic is very much driven around. Or excuse be driven by what are the needs of our community? And so it's constantly changing based on like, no longer does our old clinic offer blood draws, but we offer Quest blood draws for our members and non-members. Um, so our practice is remain is, it's still full scope. We are not doing, um. Insurance at all in terms of we do not accept insurance for our services. Our patients pay us typically monthly, like a gym membership or Netflix subscription. Um, we use a patient's insurance, which we encourage everybody to have some kind of insurance for catastrophic things. Um, they can use their insurance for paying for mammograms or in our practice we can say it's$230 at the nearest uh, imaging center. So our patients are becoming educated in insurance. And then what does healthcare actually cost? Because we teach our patients and our culture is very representative of that. Insurance is not healthcare

Dr. Demetrio Aguila: 19:00

for sure.

Dr. Maryal Concepcion: 19:01

So my husband and I were very grateful because we have a four, almost five, and a just turned 8-year-old. We're able to, like right now being home with them, technically they're watching a movie while I'm talking with you, but, um, they're able to be with us and we're able, like I took them biking this morning around the track, walked the dog with them and then made a video for their fundraiser.'cause they're selling seas candy for their, you know, holiday fundraiser. Like in what world would I be able to do that if I was dying on the vine? At my old fee for service job.

Dr. Demetrio Aguila: 19:40

Sure. I mean that's, you know that, I mean, here we are recording this podcast, right? And I have the flexibility to close the office on Veteran's Day. You know, I mean, I'm a veteran of 22 years, and this is the first time I've been able to close the office on Veteran's Day, only because I get to be my own boss. That's one of the great things. So, okay. So you've, you've talked a little bit about some of the, some of the advantages for patients, uh, of direct primary care, you know, access, uh, and, and affordability. You know, one of the things that I often hear from, uh, you know, from physicians who are thinking about direct care is that, well, you know, sure you make it affordable for everybody else. Well, how the heck am I supposed to feed my family? How am I supposed to keep the lights on? How am I supposed to do this? You know, when. Before I was seeing 30 or 40 patients a day. I mean, you know, if I spend an hour with a patient, I mean, I, I, I'm, I'm not gonna make any money. How, how can I possibly have any hope of, of taking care of my family and paying down my school debt while, you know, I'm making things affordable for everybody else? I, I don't have anything to live on.

Dr. Maryal Concepcion: 20:50

Yeah, and I will say that you are correct in terms of affordability of our practice and direct primary care compared to something like a concierge practice where in California you could pay$40,000 plus that doctor's still going to bill your insurance for services. Where direct primary care typically does not bill insurance for our services, and so on average.$75 to a hundred dollars per member per month is what we're looking at across the country. For direct primary care clinics in particular, and I call that out specifically because we're not doing surgeries in the surgery center or, you know, putting people under, having, you know, hip hardware, uh, needed in our inventory. And so for direct primary care outpatient services, if you think of the mass. A typical medical family practice clinic will run it like 72% overhead and you can work on that overhead and cutting it down because you don't need the biller. You don't need the coder, you don't necessarily need the transcriptionist. You could have IA do it for you at a much cheaper price. Or excuse me, I just said ia. I'm thinking Iowa ai. Excuse me. Very, very Midwestern. There. Um, that's right. But when it comes to the math and how the math, maths, I definitely would say one, take a step back and say, well, how come so many people are doing it and how many clinics are opening every single month and are becoming full quickly? Like how does that work? The general question, you can fill that out with your own answer. The second thing I would say is that if you think about that member per month and the way that the compensation is driven, meaning the physician works directly for the patient and no longer for the insurance company, the physician sets a price just like any other service, like a restaurant or, uh, you know, a store that you would buy retail things from, and then the patient finds value in it and pays the doctor. So people like myself who are seeing patients, quote unquote, we are not seeing them in the sense of every single time we see them is pennies on the dollar. If that, and that number of pennies is not determined by what CMS and the insurance company, and then our employer decide to take from that pennies on the dollar. Our prices are determined by what prices we set and what our patients pay us. So when you think about that, it's a different system for fee from fee for service in that our reimbursement is driven by the value that we bring to our patients and the value that our patients find in us. So, calculating out. Backwards is what a lot of people do. Like what do you need at the end of the day to make it sustainable financially? Do you need to pay a mortgage or student loans, whatever it is, daycare fees, you have medication you need to pay for, whatever it is. And then you can envision if you have, you know, a practice that has patients with a panel paying on average 75 to a hundred dollars per member per month. How many patients do you need play around with that number? Will that suffice if you don't have that number on day one? Okay. If you don't have that on day one, could you do other things to pad your financial status as you're building up your panel? Are there ways to be creative in doing DPC, like offering your services overnight for another clinic or, you know, doing locums? We just had a whole summit on that, um, with flexed staff. So there's definitely different ways that people can create their financial reality with direct Primary care is the core of what their medical practice is centered on, and the beauty of it is there's no. Only one way to do it. The options of how to do that are limitless.

Dr. Demetrio Aguila: 25:10

That's awesome. So let's say for instance, you're talking to a second year resident, right? Family medicine resident, obviously that's what you're most familiar with. So you're talking to a second year family medicine, me medicine resident who's curious about direct primary care and is thinking, Hmm, how am I gonna do this? What's your advice to that second year resident? What, you know, what do you tell'em? What's the, where do you go from here? Do I need to go work for Kaiser for, you know, x number of years? Do I need to go work for some big hospital or the VA or whoever before I can do this? Or what would, what would you if, if you, if you could go back to those days when you were a second year resident. What advice would you give yourself?

Dr. Maryal Concepcion: 25:48

Yeah, this one's not too hard of a exercise because I'm frequently talking to residents who are in their first through third year of family medicine residency, and I will say that in second year you really feel like you actually can fit into your shoes. Like you can do an overnight admit. You can take care of people in the ICU, you can deliver a baby and know pretty solidly what you're doing. When it comes to what I usually tell people and what I would advise the listeners is, what do you love of all of those things? I did not love hostile medicine. I did not love not sleeping. So I love prenatal care. I do not like being on call for deliveries. I love deliveries while I was in residency'cause I had to be there, but. I will remember those, those deliveries fondly and I will not do them again. When it comes to ICU Medicine, emergency room medicine, that's just not my journey. I'm much more comfortable being an outpatient doctor, but paying attention to what you want to do and what you like to do, I think that is definitely. What should be at the core of anyone's future, future decision, whether they choose direct care, direct primary care, now or later. And then beyond that, I would definitely say talk to people who have done what you think you're gonna do. Going to Kaiser, going to Sutter, going to direct primary care, whatever it is, and. Just the more and more you network with people, especially in second year.'cause yes, you might have some 24 hour calls, but you have a heck of a lot more time, especially if you don't have kids yet, you don't have a mortgage yet. You know, all of these things. So I would say. This podcast on double speed, read all of the books you can, and talk to people in California. We have our next direct care summit coming up in June of 2026. And there's so many ways for people to engage, especially with people like you and I who are so excited to talk to people about direct primary care and direct care. So it's not hard to find someone who will. Be excited to share their story. Like that is definitely not, not a, a thing to, to find difficulty in connecting with someone in the direct care space. When it comes to then, do you think about direct primary care, direct care, or do you think about fee for service and do you have to do one before the other? I will say that a lot of times I'll ask people like, what is the reason you think you need fee for service? And a lot of times I'll hear, well, I just don't know if I have the skills enough to be on my own. And that's totally valid. But what I will say is that we're freaking physicians. If you got through second year of residency, dang, you got a lot of skills and a lot of things that you are capable of learning. And we never stop learning like. I was listening to you about how you're doing procedures. I'm like, oh my God, that's amazing. Like I have some patients that I wish I could convince to send that to Omaha because they can benefit from your services as a surgeon in direct specialty care. In terms of, you know, when you think about that core of what do you want to do and then you hear you can actually do this in direct care. You start thinking like, could I do that in my town? What types of, uh, materials or supplies would I need for that? Would I need an imaging center? Would I need a network of specialists to be able to refer to how do I access these things? And I think just thinking and going through the exercises of what if that is. Probably more useful than any didactics I ever had in residency.

Dr. Demetrio Aguila: 30:29

That's awesome. So what pushed you over the edge? What made you decide, you know what, forget about all this hospital, you know, employee stuff. I, I'm gonna do things differently. What, what, what made you finally decide, uh, we're gonna do this?

Dr. Maryal Concepcion: 30:46

Yeah, I was quoted in the. American Academy of Family Practice Magazine a few years ago about, um, they pissed off the pregnant lady like when you are a physician and you're about to go on Medi-Cal, emergency Medi-Cal,'cause you're about to lose your insurance and you're a freaking doctor serving patients. That one pissed me off.

Dr. Demetrio Aguila: 31:09

Sure.

Dr. Maryal Concepcion: 31:10

So when my baby and his life was threatened with not being able to access my ob, not being access to not being able to access my hospital that I wanted to deliver at, where I trained, where I knew the NICU stuff, it pissed off the wrong person at the wrong time of life.

Dr. Demetrio Aguila: 31:30

Sure, sure. And then. Made your, well, obviously your husband. He, uh, he left for different reasons. Yeah. What was the biggest challenge for you? You know, when, when you finally made the plunge, what was, what's been the biggest challenge in, in this journey?

Dr. Maryal Concepcion: 31:51

So, whereas some people on my podcast have shared like their definite planners, Marielle was like, I'm done. Rip off the bandaid. I'm going, I don't know what the heck I'm gonna do, but I'm not gonna do this anymore.

Dr. Demetrio Aguila: 32:04

Sure.

Dr. Maryal Concepcion: 32:05

So I was not a big planner. I think that the ongoing challenge for me is, is the people. So when I say that specifically, it is the staff. Staffing is the hardest thing for me because I, my brain thinks so quickly and I go so fast that. I feel that I leave this wake of disorganization a lot in my wake, and that's really hard for a lot of people to work with. And so whereas I can do things and create, you know, workflows and whatnot. Somebody documenting all of that is not the easiest thing and it is not easy. Also, just because I'm a family medicine doctor who does fullscope care.

Dr. Demetrio Aguila: 32:57

Sure. I'm

Dr. Maryal Concepcion: 32:58

um, if I did only, yeah, if I only did one, you know, procedure every single day, I think we'd be well oiled drink. But I just went through like three months of interviewing people for an in-person role. My person that we hired quit 10 days later because they needed to focus on self care and fine, no problem. But it's like I feel in this moment that is the toughest thing for me is to have. Staff that is in rural America that is totally leaning into the mission and is not driven by looking for a position that has benefits as a 401k has way past the minimum wage because. That is the reality at our clinic. We are a growing clinic and we would like to offer those things, but at this time it's not realistic. And finding somebody in person who is okay with that being the reality right now has definitely been challenging, especially in rural America. Sure,

Dr. Demetrio Aguila: 34:14

sure. Yep. Well, that, that seems to be a, a recurring theme. I mean. You know, in our practice, you've heard me talk about this before, you know, we started out with nine full-time employees and four subcontractors, and now we've cut back to three full-time employees, myself included. Uh, and, and just one, you know, subcontractor and, uh. Figuring out who the right people were, that that made all the difference, you know? Um, and I think you hit the nail right on the head. Uh, you know, picking the right people, people who are invested, people who, who are true believers, so to speak. Uh, yeah, that's the key to all of this. Uh, and that can be a big challenge. So, yeah. Let me ask you this. Do you, when you look back on the years that you were working for the system, um, what were the lessons that you learned from that that have made you into a better direct primary care doctor?

Dr. Maryal Concepcion: 35:22

I think the hugest reflection is that I didn't realize that you could become soulless in medicine when that was totally opposite of what I thought. Family medicine was going to be, especially in a rural environment, I truly felt like I was not wanting to go to work. I joke even now, like, oh, this isn't the Medicare physical where I can't listen to you or touch you, and I ask you if you wear your seatbelt. This is the actual physical where we're gonna sit here for two hours or whatever time it takes to figure out what's going on with your life that we need to work on for the next year. And so when it comes to direct primary care, it has really allowed me to become a doctor again too. Work to the highest scope of my training and also to know my patients. Even the ones I knew for almost six years. I know them so much better now because I have had the time with them to have a even better relationship with them and will say that that is. When, when people think about the tangible and the financial rewards about direct primary care, that is something that you cannot put a price tag on that you cannot necessarily like put in a p and l. It's something that you experience, and that's why I say talk to other people who are doing medicine like you or like you want to, because ask them like, why do your patients. Pay you to do this when they could see a specialist in the in the system, and the answers are definitely going to be woven around because my doctor cares about me and my doctor has the time to take care of me. And that is something that I didn't realize still existed, but I longed for it in fever service medicine. So I'm so grateful that this model exists and there's people like you and I who are doing this out there, and that we definitely learned from a great place in Nebraska, like from great how many people, how to be good people with our patients. And so, you know, for that I'm just. Very grateful. And this is the type of medicine that I am proud to be a part of, and especially as a family medicine doctor in this time where, you know, people are losing their jobs because the fee for service system is, you know, being defunded. Uh, you know, that's a whole nother podcast. But what are people gonna do with their careers? This is a great option

Dr. Demetrio Aguila: 38:13

for sure. Going back to true to traditional medicine, right?

Dr. Maryal Concepcion: 38:18

Absolutely. And I think it was another Filipino doctor, Dr. James Goor, who said, uh, that this isn't really innovative, even though that's how I start my podcast intro. That this is old school medicine with modern day technology.

Dr. Demetrio Aguila: 38:33

Yeah, that's exactly right. And that's what we've been saying here. You know, let, let's, let's recapture what has worked for thousands of years all around the world successfully and just add in a few modern tweaks and refinements and, and roll that out. And guess what? That's direct here.

Dr. Maryal Concepcion: 38:50

Yeah.

Dr. Demetrio Aguila: 38:50

So as we see this explosion of direct care in, you know, pockets of the country, and as it becomes a more widespread phenomenon, what's, what's the one thing more than any other that excites you about this movement, about this parallel healthcare economy that we're building?

Dr. Maryal Concepcion: 39:06

Yeah, I definitely would say it is the culmination of patients asking for this, employers asking for this, physicians asking for this. People who are health policy supporters asking for this, uh, even with the government still shut down on the day that we're recording this, um, people who are in policy maker roles on Capitol Hill want this. So I will say that. It's really hard to find someone who is not pro PEVC healthcare model that is not in favor of how can we make direct primary care. Simply primary care.

Dr. Demetrio Aguila: 39:54

Yes. How, how do we make it mainstream again? Yeah, exactly. So as we finish up here, we just got a few more minutes left. Um, what is the one thing like. The one thing that you would like for medical students, residents, and fellows to know about direct primary care that you didn't know when you were in their shoes?

Dr. Maryal Concepcion: 40:20

What I would say is that, and this might be really, unexpected. But I would say to them, please know that you matter. Your uniqueness as an individual is so needed because that's what patients want. Patients go into direct primary care because they want their physician and the relationship with their physician. So the things that make you unique. That I feel the system tries to beat out of people. Direct primary care and direct care is a place where you're celebrated. I would say that it's not necessarily like a, I would read this book or listen to this podcast type of sentiment, but it's more remember that you freaking matter, that you are a freaking doctor and we need you. And patients need you and there is a place where you are so valued and you are supported where you can thrive financially, professionally, emotionally, and your patients will promote that and will, you know, become believers in what you're building.

Dr. Demetrio Aguila: 41:40

That's awesome. Well. I just gotta say thank you for agreeing to be on this show. You're one of my heroes and I, I really look up to all the work that you've done and, and all the, all the great stuff. You've, you've helped people like me and other people like us to, to do and grow. Um, how do, I mean, obviously I know how to get ahold of you, but how do our listeners find you? Um, because I'm sure there are a bunch of people out there who are gonna listen to this and they're gonna say, I wanna know more. I wanna. I want to do this, I want, when I grow up, I wanna be like Dr. Ion. How do I see that?

Dr. Maryal Concepcion: 42:19

Absolutely. Well, I definitely would say 2026 is going to be even bigger than 2025 has been for my DPC story, but my dpc story.com is the home of where to find the, the root of the content. I will say from there we have a mapper where you can find doctors by specialty. You can find doctors, geographically who have been on the podcast. And then beyond that we have a contact page where if you have any questions, please just send them our way. You can leave and leave a voicemail. And then we have, every month. I do an open office hour, basically, where people can come ask questions, lifetime. And then we have, our quarterly magazine. That has been such a awesome experience to put together for everybody. We've had so many things in there. Again, we're coming from the perspective of like, what would I. What is it that I would want to, wanted to have known had I been in the beginning stages of my DPC? So we have our next issue coming out, in the middle of December. And then, we're hoping to finally release our patient stories and definitely we're doing a lot more in the, education space. So like I mentioned, we have a conference coming up, but my dpc story.com or on any podcast platform, you can look up DPCA, direct primary care and you'll find my D PC story.

Dr. Demetrio Aguila: 43:49

Awesome. Well, thank you so much. Do you have any other last thoughts you wanna share with everybody?

Dr. Maryal Concepcion: 43:55

Well, I think that. Especially if one of the myths that you're telling yourself is, I could never do direct care'cause I'm a surgical specialist. Listen to more of these episodes because I absolutely love that you're doing what you're doing and you know, I just is so awesome. Every time I hear of a way that people are putting to bed the myths of, I could do direct care because.

Dr. Demetrio Aguila: 44:23

That's awesome. Well, thank you so much Mayel, for being a guest on the, the Direct Care Movement. We are so excited that you're able to join us. Remember everybody, if you liked what you heard today and you wanna share it, please do, please share it, subscribe, uh, tell all your friends and tell people that you don't like, you know, make sure that they know about this too, because direct care is the future, and the future is now.

44:49

Thanks for tuning in to My DPC Story. If this episode inspired you, please leave a five star review on Apple Podcasts. It helps more physicians find these stories when they need them the most. If you're new to DPC, you're just beginning your journey. Head to the Start Here age@mydpcstory.com. I've put together a practical startup guide and highlighted the episodes I think are essential for beginners. Got a question or a challenge you want to hear addressed on the show? Go to the Contact Page mydpcstory.com and leave me a voice message. And be sure to check out our my DPC story, Patreon. As a member of our Patreon, you'll find commercial free episodes and extended versions of the regular episodes. There's something for everyone with both free content and a paid tier that helps support the show. Follow us on socials@mydpcstory and check us out online at mydpcstory.com. Until next time, this is Maryal Concepcion.