JANUARY RESET: Reclaiming Meaning and Presence in Medicine with Dr. Meena Julapalli

Not all misalignment shows up as exhaustion.

Sometimes medicine works - the protocols are correct, the outcomes are acceptable - and yet something essential feels missing.

In this January Reset re-air, I’m revisiting my conversation with Dr. Meena Julapalli, a pediatric dermatologist whose work spans direct care, creativity, and healing.

Dr. Julapalli speaks honestly about practicing inside systems that prioritize efficiency and algorithms, and what gets lost when time, presence, and relationship are squeezed out of care. Her story isn’t about leaving medicine - it’s about reclaiming it.

You’ll hear how creating space for meaning and connection changed the way she experiences her work, her patients, and herself as a physician. This conversation aligns deeply with the January Reset reflections around energy, sustainability, and patient relationships.

If you’ve ever felt that your current version of medicine is technically sound but emotionally incomplete, this episode may land close to home.

January Reset Invitation
Use this episode alongside the free January worksheet, Is DPC Right for You?
After listening, answer one question: Where do I want more presence or meaning in my work this year?

Get the FREE workbook to go along with our January RESET series HERE.

Learn how Zion HealthShare can pair with DPC to protect patients and physicians without returning to traditional insurance. Read more in the Toolkit, our DPC magazine, today. 

If hiring feels like one of the most intimidating parts of growing your DPC practice, read the Winter issue of The Toolkit, our DPC Magazine that includes an educational, step-by-step hiring guide from the Cooperative of American Physicians designed to replace guesswork with clarity.

What do you want MORE of in your practice this year? Download the January worksheet HERE for free today!

Leave Maryal a voicemail @ https://mydpcstory.com/contact

Transcript

1:18

Hey there. Hey there. My DPC story listeners. This is Dr. Marielle conception again, host of my DPC story. Some physicians don't feel misaligned because they're doing too much. They feel misaligned because the work no longer reflects who they are. If that is you, you're not alone. You're, if that is you, you're definitely not. You're definitely not alone, and you're gonna love today's re year episode. I will say here also the January worksheet is DPC, right for you is built for that kind of question. Dissonance, the kind that shows up when medicine is technically correct, but emotionally incomplete. Today's episode features a conversation with Dr. Mina Jula, Polli, a pediatric dermatologist whose, whose work spans direct care, creativity, and healing, and healing through joy. As you listen, don't ask yourself whether you want her practice as you listen, don't ask yourself whether you want her practice or her structure. Instead, listen for what she instead, listen for what she names about, meaning Dr. Jula. Polli speaks honestly about what gets lost when medicine becomes dominated by algorithms and efficiency and what becomes possible again when time, presence and relationship are restored. This episode aligns closely with the worksheet, reflections on energy, patient relationships and sustainability, especially if you've been wondering whether your current version of medicine leaves room for the whole human, including yourself, leaves room for the whole human especially, and including yourself. As you listen, notice what feels nourishing and what feels constricting. You don't need to explain it, just notice it. After the episode, return to the worksheet and choose one place where you're craving more presence or meaning. Write down one small wave that you might explore. Write one small way. You might explore that this month without committing to anything beyond curiosity. So with that, let's get into J. So with that, let's get into Dr. Jula poll's story. 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. In a world where our healthcare system has been increasingly defined by protocols and algorithms that dictate how you can be treated, what should be prescribed, what care will be covered, whom you can see, direct specialty care allows me the time and space to recognize that everyone has a unique body, a unique mind, a unique soul, a unique experience of their illness, and a unique story to tell so that I may deliver care that is unique to them in a way that best serves them and their needs. Fostering a sacred relationship of love, trust, and mutual respect requires time, effort, and effective communication, and it's essential to giving my patients the most exceptional care possible to me. It's my daily opportunity to give love and spread joy through hope and healing. I'm Dr. Mina Jewel Polly of Bluebird Dermatology and The Joyful Path, and this is my DPP story. Dr. Mina Jula Poll is a southern girl through and through. She graduated cum laude from Rice University with a BA in ancient Mediterranean civilizations. She completed medical school, pediatrics residency and dermatology residency at Baylor College of Medicine and Fellowship Training and pediatric dermatology at the University of Colorado. She became board certified in pediatrics dermatology and pediatric dermatology, and served on faculty at Dell Children's Medical Center and Children's Hospital Colorado as an assistant professor of dermatology. After practicing for the last seven years in Austin and Denver, Dr. Ju lip poll knew it was time to return to her hometown of Houston, Texas. She is proud and excited to help her fellow Houstonians with all their unique skincare needs. As a pediatric dermatologist, Dr. Ju Lip Polly has a passion for providing comprehensive care that acknowledges and supports more than just the physical aspects of her patient's skin conditions, but also the social and emotional needs of her patients as well. She believes that when children and families affected by skin disease have a space and community where they feel loved and supported, it empowers and transforms them and profound and life-changing ways on her journey to become a pediatric dermatologist. Dr. Jula Poll has been blessed to facilitate and witness these transformations through her involvement with support groups and camp programs for children and families affected by skin disease. She currently serves on the leadership team of the American Academy of Dermatology, sponsored Camp Discovery, Texas on the Medical Advisory Committee for Paul Newman's Serious Fund Network Camp Roundup River Ranch in Colorado, and is a national board member of the American Camp Association. In addition to her philanthropic pursuits in her local and national community, Dr. GI Poll has also been dedicated to serving children abroad. She has volunteered her time and expertise as a pediatric hiv aids clinic in Otto Africa at orphanages in schools in Nicaragua, with children in adults with albinism in Tanzania. And most recently with people in impoverished villages in Northern Thailand. In her spare time, Dr. Jula Paul loves making memories with her friends and family, especially her beautiful nephews. You will often find her fanatically, supporting her beloved Houston Astros and Rockets, new Orleans Saints and Alabama Crimson Tide football teams hiking up 14,000 plus Foot Mountains exploring the world and being invigorated by all the beauty that surrounds us. She recently traveled to Antarctica to complete her bucket list, stream of setting foot on all seven continents, enjoying and playing music in all its forms, spreading love and kindness, and being the quintessential kid at heart who always finds the joy in even the smallest of things. Welcome to the podcast, Dr. Juli Poll. Hello, so thankful for having for you, having me on. I'm also thankful because when you talked about the algorithms and the, you know, the structured, impersonal, sterile care that exists for patients and exists for medical students and residents going into the world of, you know, working for an employer or working on their own, I love that we are going to talk about something different. We are going to be talking about how you carved out your own place and how you've carved out your own practice and how you've carved, you know, the, the path that is right for you going forward. So I totally dropped that'cause we're totally gonna talk about the joyful path and I, I'm so excited. People turn, turn your, uh, turn your stereos up. Listen, listen in closely. So, Mina, let's start by talking about how you came to learn about Direct Primary Care and where is your practice located right now? So it kind of was a little bit I learned from my brother. So my brother is actually, um, a adult gastroenterologist in Houston, Texas. And so he had been just right out of fellowship. He had always, he had started his own practice, but he wasn't in the insurance model for I think about 10 years before he decided to kind of go the direct route. So I had a little bit of experience kind of with what he was doing. Um, and there were a few dermatologists at the time around the country who were, who were starting to develop their own practices. But for the most part it was something that I just kind of. Delved into and started to learn a little bit on my own. And thankfully there's a lot of, like you and so many other like Facebook groups that have come up that just make you feel like you're not starting from scratch because it's not something that we learned in medical school, you know, especially for a, a pediatric dermatology, which is like a super specialty. Honestly, the only route that I knew was to work in a children's hospital. I didn't know any different, all my mentors had really done that. And so that's, that's just, it was almost like the path was set out for me. I love that. And let's drop a fact there because this is something I did not know until we were prepping for this interview, but how many pediatric dermatologists are in the United States of America? There are only about 400 pediatric board certified pediatric dermatologists in the entire country. So it's a very. Super, super, super specialized field. And you know, the, another person that I think of is Dr. Andy Brokowski, who said on the podcast he's a quaternary specialist because he's the person who people who are specialists in restless leg or sleep medicine send patients to. Because, you know, there, there are complexities that physicians can take care of if they're trained well enough. And you are one of 400 and I, I get it's an approximate number fine. But it's like, that's amazing. That's freaking amazing. Mina, like, I love that you are doing this and I love that you're doing it in the model, um, which you've chosen to, to function in under the direct primary care business model. Well, it's a, it's a specialty that actually arose from pediatrician's interest in Kennedy. So I actually am triple board certified. I trained, I did a pediatric residency, then I did a dermatology residency and uh, then I did a pediatric dermatology fellowship. So there was, it was a long road, but you know what, every step of the way it kind of helped. How I eventually decided to, you know, build my practice. And I love that because, you know, especially as we get into your interview, you know, you have not forgotten yourself and the value of who Dr. Mina Jula poll is. And I, I love that you know that everybody comes to DPC as a business model in a different way. But I love that you were just sensing like this, there's gotta be a different way for me to be able to, you know, be a doctor, but also I love that you had some influence by your family member because it's not everybody who has, you know, a family member who's doing insurance free offerings as a gastroenterologist. So love that. Now, when it comes to you. Thinking that you could only work in a children's hospital to be able to do your job, where do you think that came from? Honestly, that, that's all I knew. Uh, and I will say I always knew that I wanted to work with kids, but I didn't know that I wanted to do dermatology or even pediatric dermatology. It was actually near the end of my med school rotations that I happened to work with one of my mentors, Dr. Levy, at Texas Children's Hospital. And that's when I just knew it's gonna, one of the things when you just know it's the right fit, these are my people and that kind of thing. And honestly, every pediatric dermatologist that I knew, at least at that time was all working in a children's hospital. So it's just. I didn't really think twice about anything else. I just assumed that that's, that's what I was gonna do. And, and never really had a problem with that. You know, I that, and I enjoyed doing it. I loved working in the children's hospital and kind of the, the complex cases that I would get. It just, you know, and we, we'll talk it a little bit more about it, but ultimately came to a point where, where my values didn't quite align in that setting. And when you talk about the, the journey up to this point where you, you realize that the values weren't in alignment with your way of practicing a, your fee-for-service job. And then now what was your day-to-day like? You said you saw complex cases, but in terms of like, what were the expectations at your job? How many patients were you expected to see a day? How much time was each patient given? And was there a wait to see you? Yeah, I mean the typical wait, uh, to see someone in a children's hospital, I would say average. It's probably four months. For some people it's longer than six months or even longer than that. And by the end of my time at the Children's Hospital I, in Colorado, I was seeing close to 50 patients a day, which, so there was a patient every 10 minutes. And the thing, the thing about that is yes, and even then there was a wait time, but I would say on average the amount of time that I was actually in the room with the patient,'cause I had residents as well, this is not even an exaggeration, it was probably between, you know, three and five minutes top. And you know, I would go in and I found myself over time just. I felt like I was on auto report. You know, a patient comes in with acne or they come in with eczema and click, they hit a button and boom, I just kind of just repeat the same, same sort of things, because that's all you had time for. You didn't have time to really address their concerns, their fears, you know, their hopes, their dreams, how they live with the condition, any of that stuff at all. And so they, they come in for, you know, a 10 minute visit. They probably wait a while because we're probably always running behind a little bit. And in some cases, you know, it, depending on where you work, they might have to pay for parking. So they, they wait a long time to be seen. They pay for parking. Uh, they, they finally get into the room with the doctor. They see them for a few minutes and then they leave. And they don't entirely know what just happened or what to do. And then they have to keep coming back because they didn't get that adequate time and kind of assistance in, okay, now you're telling me this knowledge, but when I go home, do I feel comfortable knowing how to take care of myself? And so then it ends up just, you know, they repeatedly have to come back. Because they never got the time and energy in the, in the first place. And it's so funny because when we think about, you know, teaching centers, I hear this all the time from my patients, like, I want the best. I wanna go to a place that is well known or has a billboard. And it's like, that doesn't equal. Quality care, like that's not, that doesn't, I guess, 100% equal. You're gonna get the world's best care, right? Like you might have the world's best team in the area or whatever, but there's not an excuse for a three to five minute visit with a patient. Especially adding all the layers that you talked about. You know, not even having the ability to address the things that really truly affect them. Not just the diagnosis, but the, the things that truly affect the patient and their family. Because when you're dealing with kids, it's like there's regimens that parents have to do to take care of the kids. And that's the whole like, you know, I, I, as a doctor, like I remember I'd be like, okay, I have two hours of sleep.'cause I just like, I, you know, the baby's like less than five weeks and I don't even know how to give Tylenol. Like, you know, basic things like that. It's crazy that I think like if a, if a kid isn't sleeping because they're itching all night, guess what? The parent isn't either. So it's not just happening with the kids, it's the whole family. It's the whole family. And to be fair, I mean, the team that I have, the colleagues that I work with, they're brilliant. But the setting is not ideal to give the best care. Absolutely. And this is why, you know, genius minds like yourself have. Left that system and because you're able to do all the things that you have the capability of doing, but weren't given the space to do or the time to do. So I wanna ask there, because, you know, when I was in fee for service, there were things that I, I wanted to do. Like, hey, like let's automate things so that we don't have to do so many, you know, Medicare, physical, fill out the forms while you're in the, the clinic or you know, like, let's all learn point of care ultrasound because each clinic is given, you know,$5,000 in our local quote unquote market. Like, let's use that money to educate ourselves so we can reduce, you know, stupid reasons for sending people to the emergency room. And that, that like trying to make a difference. That's something that a lot of us feel, you know, it's, we were just like. Talking to deaf ears in fee for service. So given that you, you know, are practicing in your own private practice and you're able to have longer visits and take the time to discuss the things you need to with patients, what were you doing in fee for service that really tried to move your practice in, in an, in a way where you could address patients and their family's concerns better? Yeah, so even from medical school, I mean, it's something that I recognize, honestly, I, I say this all the time. I learn more from. Patients and their families and I will ever learn from a textbook. And so from, even from medical school, I have been involved with camps for kids with chronic illnesses in, in particular in kids with skin conditions. And so there's a camp that I've been involved with in Texas. And when I moved to Colorado, um, I helped kind of start a family camp because again, like we talked about, it's not just the kids, it's the whole family experiencing the siblings experience, especially with a chronic illness. Um, and there was another camp, um, a like a, a winter camp for kids with Epidermolysis, which is, uh, a genetic skin disease that. It's probably one of the phrases that people use to describe EB is that it's the worst skin disease you've never heard of. It's, it's pretty debilitating, but we, the National Sports Center for the Disabled is in Winter Park, and so they have a lot of adaptable technology that we were able to get these kids whose, whose skin normally sloughs off with the slightest amount of friction. So it's very painful. It's like their skin. Constantly burned and, and, and get, can get infected. They are able to ski and dog sled by patting up, um, little ski sleds that they could do so they could, they were able to do things that they've been told their whole lives that they couldn't do. And so, as much as I possibly could, I would refer these kids and their families to these programs because it allows them to be in an environment, a safe environment where they get to do things that they might not have ever get to do. It empowers them with the knowledge that, that, that they're not alone, which I think is the one that realization that you're not alone, I think is the most empowering thing that you can provide a patient. It's a incredible way to give yourself hope and support and encouragement and to know that you're just, you're not on this journey alone. And so I would refer my patients to this, to these things. I would also do workshops outside of the clinic, like kind of love the skin you're in, or like healing circles, which basically I talked a little bit about. How to live and thrive with, with this condition, because in many cases, conditions aren't curable. But that doesn't mean that I can't support them in a way that provides hope and love and encouragement and allows them to thrive, uh, despite of or because of what they have. You know, one of the things that I tell the, the, the kids and families that I get to support is that that pain and suffering that you're experiencing is going to become a blessing. And they first look at me like I'm crazy. And it's like, no, no, really it's the superpower because you are going to be stronger, kinder, and more compassionate towards the pain and suffering of others because of what you've experienced. And the world could use a lot more love like that. And I will say that a lot of these kids get to a point where they finally get it and then they start to become advocates for themselves and others. And then it actually doesn't matter whether their condition is cured or whether they're healed because they're not defined or limited by it. So these were things that were very important for me to actually feel like I was provid. I was actually healing the patient, that it wasn't just, I'm writing a prescription to give you a bandaid for something because that's just a temporary thing. I want you to live and thrive with whatever it's that you have. And yes, if it, if it's cured and you get better, great. But even if you didn't, I did. I wanted them to feel full. No, I think that's so powerful. I, it makes me think about, my first experience in a pediatric hospital was at uc Davis, and in child life there was the 16-year-old who had cystic fibrosis. And you know, she was, she was well known at this place because, at least on the peds floor, because of her diagnosis. And she was one of the most wise. People I've ever met. I mean, she, she totally owned that. She had a chronic diagnosis and she was like, yep. And these are all the things I'm able to do, you know, with this chronic diagnosis, or these are the things that, you know, i, I would like to do. So I'm trying to figure out like how to do things like she was talking about dating, you know, other, other kids with cf and it really, really is awesome that you, you know, we're trying so hard and now you're able to have the space and time to do those things and really continue to make a difference in children's lives. But, you know, when, when I think about the health of the mental health, especially of children these days, when it comes to that full scope. Mentality that you brought to your visits or you tried to bring to your visits, that, that's so what's needed for every single person, especially like, you know, in pediatrics and I, I shared a little bit about this with you, like my belief in, in what I'm about to say before we recorded, but pediatrics. People who see kids have the ability to really change the life trajectory of a whole human and a whole family because you're, you're starting from the ground up. And so I love that the kids whose, whose lives you impact, you're teaching them things that go beyond like what is the diagnosis of your skin? And that, that is what I feel every one of us can do under the DPC model because we're able to have the time to be like, Hey, I totally get that. Like, you know, this is going on, it has nothing to do with your hypertension or your eczema or whatever. But like, it actually still does matter because it increases your stress level, it increases all these other things. So I just, I love the holistic abilities that we have in in DPC. And so when you were going from this space of like, I'm trying to make a difference here. I literally am struggling with like, how am I also seeing visits that are three to five minutes long or patients for three to five minutes long a piece? How did you come to this point of, this is not right for me, I'm gonna do something else.'cause I guess I come from it from an integrative perspective. Like I, I, I mean, I love the, the training that I had, and in many ways it, you know, for example, one of the things that really got me to that realization is about seven years ago, my mom had a spontaneous ruptured brain aneurysm. She was completely healthy before physically, but what she did have was an, an inordinate amount of stress at that time. And so I know in my heart that stress was a big part of, she didn't have high blood pressure, which is, you know, typically the reason why you would have an a, a, a brain aneurysm. But, um, actually her blood pressure was low, but the stress is what kind of, you know, predisposed her to developing this. And the, the medicine that we trained in, it saved her life. What it didn't teach her how to do was to live and thrive in this new state of being where she couldn't physically, emotionally, mentally do the same things that she used to be able to do. And in many ways, the medicine that we trained in gave up on her. She actually was discharged from physical therapy. I, I'm almost like, I wanna say two or three months after her, her since her, um, brain injury because she wasn't needing the national stroke guidelines. And so when you, and when I asked the therapist and the person in front of you, it, like, with the interventions that you're doing, is she getting better? The answer is yes. Which shouldn't be all that matters. Now, thankfully, we had the resources to be able to seek that extra care outside of, you know, an insurance model. But what about all the people that didn't? And I'll tell you, seven years later, she's doing 10,000 things more than they ever gave her credit for. Because of these national, these standardized guidelines that do not address each of our bodies, our minds, our souls are so unique and individual that, that it's not going to be the same. Uh, you know, in, in academic medicine, there's such a push to standardize everything. Part of it's to get funding and, and so like, I understand where, where that's coming from, but we're not robots, you know? Most of the time, let's say they, they do kind of follow the, a algorithm, but a lot of times they don't. And because we're not robotic, we can't give care that's robotic. And so a lot of what I experienced with my mom, while I don't wish that on anybody, I do think having that perspective of being on the patient side of things, it, it was a rude awakening in learning the good, the bad and ugly of healthcare. And so once you've experienced that, you, you, you don't look at things the same way. And, and it just was like, I, I, I wanted to do better. I wanted to do better for my patients and having both of those perspectives and already, you know, I guess already trying to do that, but then knowing that this is not the right place to, for, for that to continue. And in order for that to kind of, to take off, I need to do it in a completely different way. And to be honest, not gonna lie, I kind of, when I decided that that wasn't the right place for me when I left and part of, you know, doing all these programs, I also realized that in that system it wasn't valued. And, you know, doing these quote extracurricular things to help heal these, you know, these patients, it wasn't valued. And that's another reason why I knew that. And, and honestly it came to be something like, you know, seeing the most patients that I can in the shortest amount of ti time possible to make the most amount of money. And when you feel like you're, the way that you care of patients isn't valued and you're more valued for the money that you bring in, it just, at least for me, that wasn't the right place for me anymore. And to be honest. I actually like for six months, I kind of had a little bit of an existential crisis. I didn't like. I had that moment of, do I still wanna do practice medicine? Is this still the right thing for me? Like, what else can I do now? I mean, I spent all these years training, you know, that it would feel like such a waste to not do something. And, and I actually ended up, I traveled the world. I, you know, finished being my seventh continent. I went to Antarctica, I hiked the Alps, and then I did a medical mission, uh, spending a month in Thailand. And finally, I think, just know, kind of feeling more centered and grounded in who I am as a person, that that never changed. That's always there, and I can bring that into the way that I live, love, and serve in the world. Then I was like, you know what? If I'm gonna do this. I'm gonna have to open up my own practice. And the nice thing is I didn't have to start from scratch. I thankfully had, you know, my, my, my dad retired after my mom got sick, but he was always in private practice. My oldest brother was always in private practice. My next brother was always in private practice. So I, and even though their models were a little bit different, I wasn't starting from scratch. And, and that helped a lot because I, I think that that's a hard thing for a lot of people to like, okay, this sounds awesome. But I don't have the, the support, the overhead, the funds to be able to go down that route. I still need to pay, pay my bills, I need to put my kids through, through school and all of that so that I do feel like I had a little bit of advantage in that, to not feel that I was taking a giant leap of faith. Well, I love that. And you know, I just wanna pull out and highlight, especially for those people who are listening, who are thinking about doing direct primary care or planning of their practice, you know, just what you said, like you, you hit your seventh continent and you went to the Alps, and you know, just those things of like, you literally just like, hey, world, like Dr. Julip poll's coming at you, man. Think about that. Like could you translate that into your own lives and be like, Dr. Mandy Bernfeld, she went to New Zealand and like wasn't planning on the pandemic happening, but like she lived in New Zealand longer than I think she was planning on too. But you know, like I love that you didn't lose yourself. Like I freaking love that because it is so like yes, we are totally not robots as patients or doctors, but dang it sure as heck feels like it when it's like what we're valued on, like you're talking about is how many codes did you bring in today? It's like I feel, you know, like the idea of like. The gypsy coyote or whatever you wanna call that role, who like sends the children out. Like, how many, how many rubles did you bring in today? How many, you know, I don't even know what the, the, the lira. Like that's, I'm trying to think of Italian money. Like how many lira did you bring into, like, that's horrible. Like nobody said in medical school. Like, and get ready, because once we let you go and be free, you're gonna have to bring in as much money as you can. And you're defined by RVU and, and all these, it's crazy. I mean, we're just, we're we're little cogs and wheels and dollar signs. I mean, totally, totally. So when we talk about that you, you know, continued to live your life and plan to open your practice, what was leaving like for you, and do you have any words of advice for those people who are planning or thinking about leaving? Looking back on what choices you made in your journey to exit, I would say that you have. Do it on your timeline. You're gonna know when, when the time is right. I, my heart knew that I was supposed to leave like about six months before my brain got there, so I, I actually really tried, you know, different ways to make it work. You know, maybe if I worked in a different setting or different clinic or, you know, I, I tried lots of different. Algorithm to be like, I, I mean, I, living in Colorado, I growing up in Texas, I, you know, you get, at least in Houston, you have everything you need. But what it didn't have was nature. And moving to Colorado, I realized how much nature was a part of me. The mountains make my heart sing, and that was the hardest part of leaving. I loved being in Colorado and I still visited as much as I possibly can, but, you know, just the, the work setting wasn't the right thing for me anymore. So give yourself that time. Allow your heart and brain to be coherent in the next decision of your life. And, and it's your timeline. Um, don't allow anyone to push you one way or the other. And, you know, for some people the timing is a right and that, and maybe they're wanting, they wanna save money and, you know, continue in a, in a situation that they may not like for a little bit, so that they can get to a point where that decision is entirely their own. And, and that's okay. And that's okay. So I would say without any judgment, allow yourself, your heart and your brain to align in the time that's. Love it. And let me ask you this, because you had left a center that had lots and lots of doctors, lots and lots of specialists, did it matter to the institution that you left? Yeah, that's the sad thing. Um, I would like to say that like, you know, it was, it was a huge deal for me to leave, but I, you know, I was replaceable, which is, you know, not a nice, nice thing to feel. Um, I mean, I don't think anybody can replace the way that I, I took care of patients. I think everybody does that in an individual way, but as a person to see just an a, a patient, it was, uh, you know, they found other people to, to replace a warm body, to produce the RVs. Yeah. Yeah. And I, I am glad that you said that though. And you know, it's probably a loaded question. It is a loaded question, but when we hear too often examples of. You know, was there a big, you know, uproar about a physician leaving a practice after four years, 20 years? Does it matter when it comes to the business model of the fee for service clinic? It does not flip and matter if there is someone to, you know, uh, make that revenue up somewhere else. And that's where we see, you know, people going to non-physician led care. My husband, I, I've mentioned this on the podcast, was an example of a person who was a physician, rural trained family physician in fever service. And the, the clinic decided, or the, the organization that owns the, the clinic decided to go to a non-physician model like that. That is a thing that medical students and residents and physicians need to hear about because the idea that you might not matter to. Corporation, but you sure as heck matter to your patients and you sure as heck matter to yourself and you sure as heck matter to your family and you sure as heck matter to all of us who are sharing our stories on this podcast now and in the future. So when you decided like, Hey, you know, now my heart and brain are in the same position, we are in alignment going forward. How did you actively plan and open your clinic? There are actually some really wonderful direct care dermatology Facebook groups, which was really helpful because again. You know, when you're working in a big kind of corporate system, all you do is see patients. You're not involved in buying the supplies that you need. You don't even know what supplies that you need. Um, and even just setting up a phone service, setting up a website, setting up a fax, I, I didn't know any of that. And thankfully my brother, because he opened up his own practice, he actually, you know, had already done that work. And so he helped me set up my own website and, and, you know, the fax and phone services and, and, you know, uh, kind of the, the, the structure of it. And then these Facebook groups helped me to kind of, to figure out where to start. Now this is actually an important point. I opened my practice the week we went into lockdown. Oh my goodness. So, so, and you know, to be honest, this is, this is before virtual care wasn't really a thing, uh, very much at all. So I had already planned to do a little bit of teledermatology. I will say now, you know, having, having kind of delved into it for the last couple years, it's not my favorite. I enjoy the energy that I feel with the, with, with patients right in the office. So we kind of discourage it for, especially for new patients, because I do think that's really important to build a rapport with people and, and trust is to have that personal energy and connection. However, that is how we started because we went into lockdown. So that's all I did. I had to do it virtually to start with. I didn't need anything in the office because I couldn't go to the office. So, in hindsight, it actually was a, a pretty nice blessing because I was able to build the practice. Organically, authentically and very intentionally and only spent money on the things that I absolutely needed. And as I was building, that's when I, you know, so it, I, I wasn't, you know, deeply in the hole or anything like that. So it, so that was very helpful. And oh, and, and another thing that I did mention that I think is important to mention, I actually did locums for, for three months so that I could, you know, have the capital to, to, you know. I didn't make anything for the first year, at least I have, uh, you know, that, that capital to support myself on. And, and you know, if you have the ability to do that, I think that was another really big help for me to get going, especially because I didn't know what pandemic to pandemic was gonna happen. And so, and, and, uh, and so that helped a lot. And, um, I still actually kept my Colorado life. So in, in that respect, I still, I'm able to see virtual patients in, in Colorado. And, and it's funny actually, I do have a couple of patients who still, even if they don't see me as a patient, they still, they still keep in touch with me because, because of the emotional support that I can, that, that I give them. So, so I think that helped a lot. There are so many resources out there now, especially because people are realizing, you know, part of being burned out is when you are in a, a situation where you don't feel valued. No one's gonna value you more than you value yourself. And you have to decide how to create that environment that's gonna allow you to feel. Valued and to have meaning and purpose. And I think that that is the key to combat burnout, because that when you don't feel those things we're burned out, we're, we know that we're not in the, in the right space. I love that. And it's so important for people to hear that, especially for those people who are feeling burned out, whether that be, you know, the person who's in fee for service or the person who is in DPC. And I say that because there are, you know, these expectations that like, you have to grow quickly. You have to see like, you know, a million people. And I get it, everybody's finances are different, but even in DPC, that something to listen to, like, and to have that conversation about with yourself to, to say like, are you in alignment with. How you envisioned your perfect practice, you know, in, in three, in five and 10 years in, especially in DPC, incorporates you as a person. Like, I remember Dr. Shannon Schul, gastroenterologist at, at gastro direct in North Carolina. She's like, I would like to be at the beach minimally, I think she said three days a week. And I'm like, awesome. Like that was incorporated in her, in her business model. So, you know, the, the things that we do and how we value ourselves, we get the opportunity to, to translate how that works for our future lives differently than if we had stayed in a model where, you know, where we weren't supported for being ourselves or being valued at all. So that's actually a really good point that you make, is that, that, and this is gonna kind of tie into things that we'll probably talk about later, but I do think it's, it's really important for everybody to really sit and think about what brings you joy. Because I don't think we know, because nobody asked that we don't think about. Uh, so it's actually my favorite question to ask my patients, um, in the clinic. And most of the time they're caught off guard a little bit because nobody ask as that has asked them that question. But I think that's an important question to ask from childhood, even through adulthood, because when we are in alignment with what brings us joy, we're gonna make those decisions that allow us to actually, again, live love and serve in a way that gives us meaning and purpose. Awesome. So when you opened your practice and you know, this, this lovely, you know, ratchet in the spokes of your bicycle wheel of the pandemic happened and you pivoted who joined your practice? Because the reason I ask this is because we had a big discussion at the pediatric DPC Mastermind coming in February, 2024 is the plan right now. So just keep your ears and eyes open for that. People who are interested in going to that conference about the A A P and specifically around equity, the a a p, you know, is believed to, at, at this conference. The, the discussion was that there's no belief that direct primary care is a business model allows for equity. So, you know, would you say that that's a fair statement? Does your patient population, you know, disprove that? Where, who has joined your practice and, and where does Bluebird Dermatology stand? Well, as, as, as we mentioned before, there are 400 pediatric dermatologists in the whole country, most of whom are at Children's Hospital. A four to six month or plus wait to get in to see someone. Doesn't sound very equitable to me. So one of the, the things that was really important about, uh, about me opening a practice was access. So now they have another option to be able to see somebody who's super specialized in something.'cause again, there's not very many of us. And at first I actually did worry that, you know, because it's a cash paid practice that I wouldn't get to see the Medicaid patients. But to be honest, my practice runs the gamut. I see patients who have Medicaid, I see patients who have no insurance. I see patients who have really good insurance, but they still choose to see me anyway. And, and it, it's all across the board. Um, I, I don't have the exact data, but I mean, I, I would say it's pretty even all across the board. And because it was the pandemic, I mean, I, it was like a grassroots effort. I, I couldn't even visit people's offices because, you know, they were doing drive-by stuff. You know, it wasn't even a situation where I could do that. So, and I, this is something I do anyway, but I got pen, I got out pen and paper, and I wr wrote. I a hundred like handwritten notes to all the pediatricians in the area. Now I'll say I, I trained in pediatrics in Houston at Baylor College of Medicine, so all, a lot of my. Former classmates were still here in the area. So I did have, and the thing is like when you go through that kind of residency and you're working 80 hours a week and, and you know, you're connected for life. So, so even though I hadn't seen any of my classmates for a really long time, they still, without any hesitation, would still refer their patients to me. But in pediatrics, because, you know, for the most part, at least in Texas, most kids have insurance. It's still a new kind of concept of PE because, you know, and I'm sure you've heard this a lot too. Oh, you don't take insurance? Well, it, it's almost as if, you know, we don't, if we don't take insurance, then they're not getting the care for free. Nothing is free. Oh my goodness. Nothing is free. It's somebody's, whether it's through your report or, or through the government, somebody's paying for it. It's not free. But I, I will say the beauty of having a direct care practice in many ways is that the people who come to see me are the people who actually want to. To see, see me. And they want a different care than that they, than they've received in the kind of the traditional model. So I, and they already know what they're paying, uh, upfront when they come to see me. So I don't get a lot of people, they're, they're seeking me because they want a different level of care and a different kind of care, and to be able to access that type of care. Not even just like access the doctor when you need to, but like access, the ability to have a doctor who has the time to do all of those things is equity. Like literally that is equity. So if you are a pediatrician or any other doctor who is thinking that like, oh, but is this like, you know, you have to be rich to be able to do this in Rich in dollars. It's like, listen to all these podcasts. Like they, they will, they will share with you over and over that that is not the case. And this is absolutely an equitable way to take care of our communities, period. So with that, your practice is set up so that you have like your pricing listed on your website and you do visits versus memberships. Is that correct? Yeah, which I think was kind of for being so super specialized, that's what ends up kind of working for me. Because here's the thing, when you have the time to spend with your patients for kind of these acute sort of things, they don't have to come back and see you because they know exactly what to do and they get better. So I will say probably 7 70, 70 5% of my patients are new patients. So I don't have a lot, lot of follow up patients or, and if, if I do, it's just kind of checking in kind of stuff. And, but you know, to go back to, you know, when I was working at the Children's hospital, I was seeing almost 50 patients a day, a full day for me. Now it's seven or eight because it's scheduled them every hour on the hour. I al it, it, it's kind of funny. The shortest time is actually spent on any prescription or, or kind of talking about their skin. We spend the majority of the time talking about kind of the daily regimen of, of, of how they take care of their skin, how they love care for it, how they celebrate it, how they honor it, what, you know, how they manage stress. We talk about nutrition, we talk about what brings joy. These are, and it's all relevant. You, you would think it's not, but it actually is all relevant because, you know, one of the things that I talk to when, when I go to, to schools to talk to kids about a joy, which we'll talk a little bit more later, but I, I ask them, you know, I, I, I say that in order to take care of what's on the outside is actually really important to take care of what's on the inside, how you think, how you feel, what you put inside your belly, how you move your body. Because if you take care of what's on the inside. Then it's easier to take care of what's on the outside. So all of it matters. It all matters. I love that. And like you said, we're we're gonna, we're, I swear to gosh, we're going to be talking about the joyful path, but it's like I just, you know, for those of you who are listening and not watching, it's like just the ability to do all of those things that you just mentioned. It's like you can see the joy in your face because it's like, you're free, you're just, you're free to do the things that you, as Dr. Julie Poll wanted to do this whole time, and now you're able to. So I just love that. Yeah. So let me ask you there, when it comes to the growth of your practice and the financials of your practice, when 75% of your patients are new patients versus people who are returning because you're like closing the loop wherever you can, how does that work out in terms of how do you look at your practice or recommend to others looking at their practice, if they are sub subspecialists or specialists who are, you know, thinking about, do I do membership versus do I do one-off visits? Sure. I think it, I think it would depend on kind of the chronicity of the things, uh, the things that you see. For me, that's what works, because I would say the majority of what I see oftentimes is acute. Now, some of the chronic kind of conditions that I see would be eczema or acne. Again, even with eczema and acne, when I spend upfront, if I have the ability to spend the time and energy to talk to you about the what and the why behind something that you're experiencing, it makes the how part easier. So when they come back and see me, it's just like, you know what? You're doing an awesome job. You're doing great. Maybe we need to tweak things a little bit here and there. So for me, it, it just made more sense to kind of do it as a, you know, just a, as they come in kind of model. But for another, uh, another practice, let's say like if you're an endocrinologist and you're treating someone with diabetes, then it might make more sense to kind of just have like a package. So I think it's kind of just different depending on, and you know, like what, what kinds of things that you see. I've had people talk to me about, you know, Hey, what if, what if you did, like, if they came in for eczema, what if you did kind of a package for, you know, their first visit, three month visit? Six month visit, you know, through the first year. The only problem that I had with that is that, that not everybody's the same and they may not need it. You know, they, so I, I don't want to have them pay this upfront cost of something. And, you know, I, I don't think that that, that I would, even if they came in, I would still provide them something, you know, whether it's reassurance or, you know, maybe we can tweak a few things here and there. But, but for me, it just didn't make sense to have them do that upfront, um, when I didn't know that they necessarily needed it. Now, I will say the downside to that is that I don't, just, the primary care mostly has a membership model. You know exactly what's coming in every month. So the downside to the way that I do my practice is I don't, I don't always know. And so that's, that can be a little bit, you know, I'm steady. But it has also given me the flexibility because I have so many other, for me, it's worked out for me because I, I have so many other projects that I'm working on that this, this model has allowed me to work on that. I would never have had time, you know, when I was working, you know, five days a week and seeing 50 patients a day. That, that I'm really happy with the way that it, that, that, that it, it gives me the flexibility to be able to do these other projects. And you didn't leave medicine because you're able to do, you know, this model of care. Yeah. Let me ask you there, because one of the things you mentioned was like, you know, the, this idea of of closing the loop of full scope care and you know, when your patient comes in, especially if it's an acute issue for the experience that you had at the children's hospital, were like, you know, in three to five minutes the parents were like, literally, I don't actually remember what Dr. Jill Leal said, or like what I'm supposed to do. Like I don't actually remember. How do you make sure that your patients and their families are like on point when it comes to this is what you said, this is what you recommended, this is what needs to be done in the future to prevent or whatever. So this is what they get. So I schedule a patient every hour in the hour. Now it's not gonna, it doesn't always take an hour, but I don't ever wanna look at a clock that I don't ever want to feel like I'm rushing with a patient at all. They get all the time that they need to address all their fears, all their concerns, all their questions. And most of the time they're like, and I, I probably ask that question. Is there anything else that you wanted to bring up or, you know, anything else that I can help you with? Any other question that you have? I probably ask them probably three, or maybe it's even more than that, to just make absolute sure that, that everything, and, and, you know, and they have, they have access to my email, so I always tell them, you know, because sometimes when you're in the doctor's office you're like, ah, I don't know. I don't know. I had so many questions. So they can always, you know, contact me afterwards. But I actually tell them that, you know, I, you don't need to take any notes. Because I send them a, it's almost like a dissertation. It's like a giant after visit summary. That basically Exactly. That basically says everything that, that we talked about and you know, has like resources and everything. And that's, honestly, that's one of the things that people love so much because they don't, they, they get to listen. And then, you know, some people are visual learners, some people are, you know, auditory learners. And so they get both. They get both. And so they have something to refer to afterwards as well. And, and that's the thing, like, and I say this with the, with the utmost humility, what I'm providing for the, for, for, for that. There's no other doctor out there that, that's doing this. There isn't. Amen. And. Again, like you're making such an impact on the whole child, the whole family. Like I, I think about the world of rvu, like what RVU is going to represent, like the impact that you made on the future of the family. Like there's nothing. So I love that this is the care that you're, care, again, able to, to give to your patients, but also that they're receiving, right? But that, but that time also gives me a chance to do other things. Like, for example, if I, I had a patient that, you know, needed, uh, a, a, an injection, um, for her eczema and, and normally, you know, parents will do it at home, but this mom was like that, I can't do it. I can't do it. Can you please, you know, do the first one. And so I knew that they were coming in for that. And I asked, I asked the mom, so what's your favorite Disney princess? And so, and she said, spell. I was like, great. That's my favorite too, because she loves to read. And so when they came in. I didn't come in as Dr. Mina, I came as Dr. Mina dressed like bell. And so, so I was dressed as Bell, I had a rose in there, you know, to, to give to her. And so, you know, we, we, that in, in and of itself, I think kind of helped. Like, wait, what? You know, she's not like the scary doctor that's coming in, but also, you know, and to be honest, that wasn't enough. You know, she was still freaking out about the injection. And so, you know, we sang together. We, we used the rose, the breach, called it a breathing rose. Like we did breathing techniques. We did all sorts. I pulled out everything for, for, for, for this visit. Um, and we finally did it. We finally did it, but. I also recognized that it was incredibly traumatic, but I had the time afterwards to recap it with her so that she understood why we did it, what we were trying to do, so that she didn't leave for the visit, feeling like that this was some that she would carry this traumatic experience to for the next time that she had to do something that was really difficult and hard. And so I wanted her to know, I know this was really hard for you, but you were incredibly brave. And I wanted her to know that she had the tools to conquer difficult things in life, you know, whether it's now or later. And so it gives me a chance to make this experience because, because she's gonna experience other hard things that has nothing to do with me coming at her with an injection. But you know, if she knows I had the time to actually recap this experience so that she can learn and grow from it, and she doesn't carry the weight of it through her, you know, adulthood where we all have to work on our inner child because of all the traumatic experiences that we've had. For sure. And I'm gonna drop there'cause it's not like your practice does not just have a costume of Bell. Please tell us about your costume closet. So the reason why I asked the mom, you know, what, what's the favorite Disney character is because I have costumes of all the Disney Princess is probably all the superheroes. You know, you, you need a beat, you need a rainbow, you need the sun cla I have, I have wiggly headbands, you know, for the little kids who, you know, get distracted by just the motion of things. So I've got an entire, entire costume closet. I have a bag of tricks and it just makes things more fun. Um, and that this is not, this is not a, this is, I've. I, I'm the one who celebrates Halloween, not Halloween. I, I, during Christmas, if you catch me then, I mean, I'm dressed up as a reindeer, an elf, a Christmas tree, um, candy cane, Santa's daughter, you know, you name it, I might have my ukulele with me. And so I love it. I love it for those people who are like, oh my God, I want a, I want a costume closet, or I want a bag of tricks. Like Dr. Cindy Rubin had mentioned this particular type of bubbles on, on, um, that she uses in her clinic. Do you have any favorites that you're like, you should totally look into this? No. You know, I love the, the little wands that, you know, have, have the kind of, the, the light that kind of, it, it's mesmerizing. It actually really helps, I'll say, I mean, even without the kind of fancy bag of tricks. So, uh, one thing that I help teach kids, whether it's like an injection or, or let's say they're itching, same nerves that fire, that tell your body that you're itching are the same ones that recognize temperature, sensation. They're the same ones that recognize vibration. So sometimes we'll use like a little handheld massager or we'll use a little cold pack, and these are other kind of tips and tricks that that kind of help. And even, even at home, you know, when they're feeling itchy, I tell them to put their moisturizers or their medicines in the refrigerator and apply it cold to the skin. And that, that's really helpful to kind of, you know, a lot of the, the kind of the discomfort that we experience can be rewired to feel something different. And so we teach a lot of those techniques, whether it's using your breath or even like tapping or you, or, you know, these other techniques that I talked about. Awesome. Like, as we've been going along and we've been talking about the joyful path, like, I wanna, I wanna hit it hard now. So you have had the time to, you know, thrive not only as a physician, but also as, as the human that you are. And so can you tell us what, starting off with what is the joyful path? So I mentioned that one of my favorite questions to ask kids is what brings you joy? And every time I ask that, their eyes light up. They sit up straight, and they, and I've met the most incredible and talented musician, artist, authors. I had a nine-year-old talk who said she liked to rap. And so I was like, all right, can you spit some lyrics for me? And she, she said, I'm the best. I'm me. I'm the best at being me. And I, and I was like, you know, just adult their whole life to, to learn that. And you know that at nine years old I've met, I had a 12-year-old talk to me about cooking. He's gonna be like on Master Chef one day. And I just, I realized that. One. You know, one of my unique gifts is that I've never lost that sense of curiosity, wonder and awe that I had as a child about the world and everyone and everything in it. And that's something that's, that's an inherent superpower that all kids have because they think and experience and feel through their hearts. And so one of my missions is to help kids not lose it and help adults rediscover and remember it. And so the joyful path kind of began as a way to help kids, everybody, but especially kids, discover, experience, cultivate, celebrate, and share the joy of their unique gifts through programs that help nourish their mind, body, and soul. And so, as a side, you know, I also have, you know, a full-time job as, as a pediatric dermatologist. I have been. And some of this also came back to, you know, when I, when I said that the medicine that we trained in helped save my mom's life, but it didn't help her live and thrive in this new state of being. Part of me going down this route of finding other modalities of healing was to help her. But in the end, but what it ended up doing was helping me, and also in the way that I practice medicine and the, the, the tools and resources that I provide for my patients. So I'm trained in reiki, I'm, I'm learning yoga to yoga training, teacher training for kids, heart mass. So many other things, because again, I have this sensable curiosity. I'm like, Ooh, I wanna learn that. I wanna learn this. But one of the things that have stemmed from that, so sometime in the middle of the pandemic, I woke up and three, i, I basically gave birth to three children's books. I have no idea where they came from. I have never had any ambition to be a children's book author, but there they were. And I was like, okay, what do I do with this? And I actually sat on them for a few years because I, I didn't, I realized that I didn't want just any random person to illustrate it. I wanted kids to illustrate it. And solely but surely, I was meeting all these kids with these incredible talents and, and incredible stories themselves. So one of the projects, you know, with the Joyful path is to be able to provide an environment that these kids can showcase their unique gifts. And so I just published a couple months ago, my first children's book, it's called Listen to the Song In My Heart. And it was, it's about what it feels like when you listen to that song in your heart. You drown out all the voices that are telling you that you're not enough, that you are too much or too little. And most of that is a lot of times inside your own head. And you listen to that unique song in your heart, you discover the joy it brings and you celebrate and share it with the world. And it was illustrated by the daughter of a, of, uh, some classmates of mine, um, who. She struggled a lot in school. She just, she felt bullied. She just didn't feel like she quite belonged. She didn't have a lot of friends, didn't feel like she quite connected, you know, everybody kind of just chalked it up to her being shy and anxious. And during the pandemic, she decided to teach herself how to watercolor paint through YouTube and realized that she was actually really good at it. So, and they also recently discovered that she has high functioning autism. So even though she has difficulty communicating in words, she learned that our most joyful way of sharing what's in her heart is through artistic expression. So she literally listened to the song in her heart and put it on the page, and I couldn't be more proud of her. And that's just the first one. You know, I, I've mentioned three. So I guess once you get started with these creative things, they just keep coming out. And so I now am in the process of editing two others, but all of which have been illustrated by other kids with amazing stories in and of themselves. I have two more being illustrated right now and another three in the works, and I don't know, I'm just gonna keep going. So that's, that's one of the things. But I'm also going to, because of this book, I've also been able to go to schools. I don't read the book. I sing it because it's called Listen to the Fog of My Heart. So it's a song, and so I wait till the very end to tell the kids that a kid illustrated it. This is my favorite part because every time I say that, I look out into the crowd, I look into their eyes, their eyes get really wide, and what I see in their eyes is possibility. And that's exactly what I want them to feel, so that they feel like, oh my gosh, a kid did this. You know, maybe I can do something. That you don't have to be a grownup to make a difference in this world. You just have to figure out what it is that, that allows yourself to shine. Because each and every one of us has a unique gift. There are no exceptions. And so it's just been really fun to be able to go out there and talk to these kids about joy. And, and I said I had a costume closet, right? So it's, you know, the main character, Bluebird. So I dress up as a bluebird when I go in. And so I've got wings and everything. So when, it's funny because it, it's received in different ways. So when I, when I do it with preschoolers or kindergartners, they don't really have questions. They have comments that they always like. Can you really fly? Are you really a B bluebird? Do you have wings? And then, but the older kids, I love the questions that the older kids asked because one of them asked me, did you ever worry that people wouldn't like your book? And I loved that question because we've all been there. We all feel rejection, we all fear failure. And in that moment, I mean, the answer to the question was no, because I didn't write it for anyone else. I mean, yes, it's a children's book and it's four kids, but it's something that just came out of my heart and soul. And when you create something from your heart and soul and you put it out there, it grows wings. And I guarantee there's someone out there who's going to receive that message, who needed to hear exactly what you had to say. So the measure of success is not how much money you make or how many likes you receive or how many books you sell. It's that you made a connection and, and, and, and it's, it's fun to watch these kids kind of experience that. And then I had another, a 6-year-old who had a question. He was kind of stuttering a little bit and he was kind of nervous about the question. And then he got the courage and he looks me straight in the eye and he says. What makes you happy. And all the teachers was like, ah. And in that moment I was like, don't cry, don't cry. Just say to the question because in that moment, what I, under he under, not only did he understand the message of the book with, which is, you know, kind of being in tune with what brings you joy in that moment, his empathy came out and he wanted to know what brings me joy, which is like, great, that's what the next book is about. It's about learning what others joys in celebrating those with them. And so it's provided a platform where I'm hopefully gonna build kind of workshops and, and afterschool programs. And ultimately my grand vision is a wellness center for kids. So that, that's where all this is going. Awesome. And every time you, you know, talk here on the podcast at a, at a school with your patients, you're continuing to build that dream. Like it literally, it might not be a physical space in terms of like a single building, but like, you literally are building that every day. And I, I just think about as you were talking about how like you just woke up and you just gave birth to three books. I'm like, I think about how your, your heart and brain were not in alignment, you know, for, for a few months there before you left fee for service. And that was probably what happened also, that like your brain's like, uh, oh, like that, that's what you've been trying to say, heart. So I just, I love that you know, that this is where you are in life and this is where you're going and this is what you're bringing to the world. So, you know, with, with that, I, I wanna close by, do you have words of inspiration in addition to everything you've already shared for those physicians out there who are, you know, exploring, doing direct primary care as a business model, whether it be in primary or specialty care? I mean, it's gonna sound so cliche, but a lot of it just has to follow your heart. I mean, it, it's, it's, it's one of those things that if you listen to the song in your heart, you're gonna know how to build this in a way that helps serve you in, in the way that helps you find meaning and purpose in what you're trying to do. I'm gonna tell you like, kind of one more story because it, it kind of allows me to integrate all the things that I've been training in and putting it together. I had been at this, I, I had gone to this week long meditation retreat where I, uh, we probably meditated for about 40 hours. So I came back and I was, you know, I was still, my heart was open, I was still in this floating state, and the very first patient I saw was a 6-year-old, um, girl who had, uh, who had eczema that had been seen for quite a while and, you know, ups and downs. But in this moment when I walked into the room, I just felt. The energy of the room, just like there was, it felt hopeless, it felt defeated. There was so much frustration. Um, mom was telling me that she was calling herself a red monster that, you know, she, they weren't sleeping because she was itching all night. And in that moment, again, I listened to my heart. I was like, I, I think this is what we need to be doing. And so I had them kind of get into a circle and I had them kind of start to breathe into their heart, in and out of their heart a little bit more slowly and deeply and than usual. So I was using kind of heart map technique to kind of get them in sync. When I could feel that our energy was in sync then, then I had her breathe in love into our heart, breathe out here, breathe in light into her heart without doubt, breathe in light into her heart, read out limitations. And then I had her send that love and that light and that light to her skin. Because so much of life we're always thinking about, why am I not feeling, why am I not getting better? Why is this not working? Same in, in kind of our, our profession. You know, like, I, I don't get it, you know, why is this not like, we're always kind of focused on all the things that aren't working out for us? Instead of what can we do to be in the best state of being, to already feel healed, envision what it is that you want in your life, what brings you joy, and be in that state of being, and those other things will start to align. And then I had her send that love, light and life to her mom for taking care of her because there was so much mom guilt coming from there that I wasn't doing enough to take care of my child. The entire energy of the room shifted. Mom was crying, happy tears. She had this huge smile on her face. She gave me this huge hug, but the best part of it was a week later, mom sends me a message saying that she's doing this exercise that you taught her every night before she goes to bed. She's inviting me to invite kindness to my heart for taking care of her. She became so empowered that she decided to write a story about her eczema, how it makes her feel, what she has to do to take care of it. She shared it with her class. Her teacher was so moved, she asked her to share it with her school. Now this 6-year-old girl who used to be bullied is walks the halls with confidence. She was admired for her courage and bravery. Oh, and guess what? Her eczema's better. I didn't do that. The medicines didn't do that. She did that, and she knows she did that. And she, she empowered herself to create her own story where she wasn't defined or limited by what was on the surface of her skin. And I actually, a couple weeks ago, we, I had a workshop where I was teaching kids the power of creating our own story. And I actually had her as a six, well, she's now seven, but I had her lead the exercise because it's one thing coming from me, it's a completely other thing coming from another kid who's in that leadership role to say, Hey, this is what I did. You can do it too. And so I, I, I say I share that story because I think we've all been in that place where we're so focused on like we're at the bottom of the mountain. Oh my gosh, it seems so daunting. There's no possible way that I can change what's going on in my life. And I think it comes back to listening to that song in your Heart. Like really sitting and thinking about, intentionally, thinking about what is it that brings you joy and then create the environment that that would allow you to manifest that. With that, just know that you can find Dr. Jal's first book and, uh, hopefully, we'll, you know, we'll get the other ones on there as well, uh, in the future on the accompanying blog to your podcast, and you'll find the joyful path, a link, as well as the link to Bluebird Dermatology. But I humbly thank you so much for sharing your story and for all of the, the amazing stories that you've shared about the patients you've taken care of. It just, it, it makes me so happy to hear that, and I hope it has, you know, brought inspiration and joy to so many people who are listening to your story today and in the future. Thank you so much for having me. 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.