Going Viral on TikTok by Accident: How Dr. Jihan Ansari Built Harbor Direct Primary Care Through Authentic Marketing

Dr. Maryal Concepcion welcomes Dr. Jihan Ansari, founder of Harbor Direct Primary Care in South Orange County, California. Dr. Ansari shares the marketing strategies that grew her DPC practice from patient zero to a thriving two-physician clinic she runs with her husband, Dr. Pedram Ansari. From cold-calling former co-resident Dr. Jose Buenostro to learn about DPC, to filming a TikTok before jury duty that unexpectedly went viral, Dr. Ansari's story is a real-world playbook for direct primary care physicians who want to market authentically without expensive ads or pushy sales tactics.

What You'll Learn

• How a single TikTok with the tagline "I'm the doctor who doesn't take insurance" went viral
• Why the "I'm the doctor that..." hook captures attention on social media
• How she built a virtual waitlist of 10 to 11 patients before opening day using Facebook groups
• Why TikTok rewards organic content and how she uses it to educate patients about DPC
• How to evaluate and hire a marketing team that genuinely understands DPC
• Why she stopped Facebook and Instagram ads and doubled down on Google ads and SEO
• How transparent cash pricing on her website attracts patients seeking alternatives to insurance
• Which community marketing efforts didn't pay off and why she walked away
• How a virtual assistant helped scale onboarding without losing the personal touch
• Working together as a physician couple in one DPC practice
• Serving small employer groups in Orange County
• Boundaries, parenting, and sustainability as a DPC physician

About Dr. Jihan Ansari

Dr. Jihan Ansari is a board-certified family medicine physician and co-founder of Harbor Direct Primary Care in South Orange County, California. She completed her residency at UCSF Fresno alongside Dr. Jose Buenostro. Born in Southern California and educated on the East Coast, she practiced briefly in Canada before returning to launch Harbor DPC with her husband, Dr. Pedram Ansari. She is passionate about lifestyle medicine, root-cause care, and accessible primary care.

Connect with Dr. Jihan Ansari

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Transcript

0:04

Direct Primary care is an innovative alternative path to insurance-driven healthcare. Typically, a patient pays their doctor a low monthly membership and in return builds a lasting relationship with their doctor and has their doctor available at their fingertips. Welcome to the my DPC story podcast, where each week. You will hear the ever so relatable stories shared by physicians who have chosen to practice medicine in their individual communities through the direct primary care model. I'm your host, Marielle conception family physician, DPC, owner, and former fee for Service. Doctor, I hope you enjoy today's episode and come away feeling inspired about the future of patient care direct Primary care. I think in the typical insurance-based world, you really don't get reimbursed, for the, the lifestyle aspect of things for counseling your patients. And. With DPC, you don't have to worry about that because the monthly membership covers all their visits, whether or not you're actually doing a physical exam or more of just a conversation. So I think it's invaluable for lifestyle medicine and I've seen firsthand how change can actually happen with, with lifestyle changes that is just so surprising to patients, but so rewarding. I'm Dr. Jihan Ansari, MD, CEO, and co-founder of Harbor Direct Primary Care. And this is my DPC story. This April on my DPC story, we've explored marketing through different lenses. Dr. Aliya Gupta showed us how to build a thriving social media presence without the ich. Dr. Ashley Eggen revealed how patient reviews and a service mindset outperform billboards. And Dr. Nadia SDA reminded us that clarity and trust matter more than visibility tactics. Now meet Dr. Johan Ansari, who proves that sometimes the best marketing strategy is the one that happens by accident. After cold calling a fellow resident to learn about DBC and opening Harbor Direct Primary Care later to be joined by her spouse, Dr. Ansari turned a single TikTok filmed before jury duty into a viral moment that helps to fill her practice. Her tagline, I'm the doctor who doesn't take insurance now stops Scrollers across Southern California and gets her recognized in her own community. From farmer's market booths, she eventually walked away from to a marketing team. She vetted carefully before hiring to a partnership with her husband that transformed both their practice and their family life. Dr. Ansari shows us what authentic, scrappy, fake it till you make it. Marketing actually looks like when you're building a DPC from patient Zero. Welcome to the podcast, Dr. Ansari. Thank you, Dr. Concepcion. I'm so excited to be here. I love that we're getting a perspective from someone who one has been in practice for years. Two has the experience of working with their spouse in their DPC and three has, the outlook of doing DPC in a state where we don't have protective law for DPC yet. So, it's fantastic to have you on. And I wanted to start with something that I found on your webpage because it helps our patients understand where we're coming from. And on your website, you wrote, I'm so happy you found our practice, because that means you're looking for better care how did you come to that copy in particular and how has that line in particular served your practice as you've grown? Well, first of all, I love that you pointed that out. 'cause when you write a bio, right? Do I write it in first person? Do I write it in third person? What's the best way to go about it? And I guess I just decided to, write it as myself, because at the end of the day, I think patients just wanna hear from their doctor. It's actually one that I wasn't sure, should I take it out? Is it like too raw or personal? But it just came from the heart. I mean, that's why I left the insurance-based world. That's why I think most patients leave it is just to find better care. I appreciate that transparency because when we're doing these things for the first time, like writing our bios, writing our copy, we don't necessarily know what will stick. It definitely helps if we manage our own websites that we can change things here and there. But how have you found that your patients find, things like that, the representation of you in a digital sense manifesting in people, contacting you, and becoming patients. I think that was how it all started. I kind of just had to put myself out there. I was new to this area. I mean, I was born in Southern California, but I hadn't lived here for several years, or practiced medicine here. And I literally just started at Patient Zero and had to put myself out there, my face and my personality as kind of my free marketing tool, but also the only way I knew how to, I love it 'cause it's keeping the overhead low. You are doing the things to get yourself and your personality and your expertise out there. But also, you're talking about a place that you're practicing in now where even though you have roots, you were gone for a while before you came back. Mm-hmm. And I think that that's important for people to hear, especially if they're going to practice in a different place than they went to residency in that, no matter where you land, you're going to talk to patients who want to see you as the doctor. So I think that's awesome. It's definitely possible. I don't think you have to already be established where you are. It's, I think it's probably a lot more helpful to get going quicker, but I don't think it's necessary. Bring us back to pre DPC because as you have shared, you, you were born and raised in Southern California, but then you've seen other places in the country in terms of like how care is done elsewhere. Mm-hmm. And so I'm wondering what was it that drew you one back to California and two to DPC? Yeah, definitely. So I actually did my medical training in California. I was up in Fresno at UCSF. I did the family medicine residency there, which was great. It's a family and community medicine residency. I was able to practice in really underserved communities where mostly our patients were, I would say underinsured, so, on state insurance or Medi-Cal here in California. And so it was kinda like that patient factory is the term I've heard recently where it's, yes, they're getting care, however, it's such fast medicine and the burnout is high. And I think I was forced to learn a lot because it was more rural where I was at. But at the same time, I think just like for, my mental health and my ability to be there for my family I knew it wasn't gonna be a long-term fit. So, that's when I just kind of started, looking at different options and my fellow residents and seeing what paths they took on, and that's kind of how I stumbled upon DPC. um, so Specifically it was a, a co-resident that I knew Dr. Tro who you know and who you have interviewed. He went to the same residency program as I did, and he's very successful as a direct primary care doctor up in Central California. And so I got in touch with him and I kind of just cold called him. And I think, you know, and we've heard from all your podcasts, like everyone in the DPC community is so nice and there is like really isn't that sense of competition or, there's enough patients for all of us, I think we just want the word to spread. And so he just took the phone call and we talked for an hour and he told me about how he started, which was very, brick and mortar. He started from one patient. I mean, I think he is from that area, but didn't go to residency there. And one patient tells another patient that patient tells two patients and it just kind of starts to get around word of mouth. And then he told me about, the Facebook communities and so I was able to make really good connections with some doctors on Facebook i've met them since face-to-face, but just great advice from doctors who are already practicing DPC in the towns they were in. Yeah, that's fantastic. And oh. And I love that, this is in our, in our thirties and forties and fifties and beyond, like this is the one use that I find Facebook is still helpful for is the business networking. Ironically, so I wanna ask you here though, because, thinking about residency, and even though Dr. Stro was a co-resident, the other people in your class, what did they go into? Because I think it's so awesome that you knew somebody that was actually doing DPC When I graduated residency, that was not the case. And so, we see more people clearly doing DPC and visibility is, is more common. But for you, you had this connection. What did the other people in your graduating residency class choose to do? Yeah. I think more traditional based systems, whether it's HMO, something like Kaiser or Scripps or, those local large groups in California. I do have some co-residents who went into private practice, maybe more the specialty route, like sports medicine. I think I may be the only one from our graduating class who started A DPC practice. However, I will say since that time, I've had residents reach out to me and ask about DPC and definitely DPC, curious, and that's really exciting. That it is. And I think that this is why I'm so passionate, especially at our state level of making sure that DPC has visibility. I actually spoke with somebody at the A FP recently. Just shout out if you are a member of the A FP, please join me in the Direct Primary Care Member Interest Group. I'm the MIG chair this year. But I looked at the websites of a FP and five of them had pages dedicated to DPC, even though. 11 plus percent of the membership of a FP is reporting that their DPC physicians and California is the only one that has a significant amount of DPC because of a lot of us being vocal in California. And so I will say that if you are an A FP member bring that up to your state chapter and say, why isn't there DPC, information for people to find because visibility absolutely matters as you just shared. So, here I wanna ask about you talking with Dr. Bruno and making the decision to, to do DPC. How fast was that decision from like when you graduated residency to opening day of Harbor DPC? That was a few years because we decided to stay in the Fresno area because it was a great, great place to, kind of build a family, pay off some student loans. And so we stayed there for a few years and we actually also moved up to Canada very briefly. My husband is Canadian and so I did work in Canada as a physician, kind of doing per diem work for a bit. So it was in that transition where we knew we wanted to come back to California, but we also knew we didn't wanna work in the traditional system. So it was like, how can we make this work? And it was, it was pretty fast. I'm not gonna lie. I think my, my husband thought I was kind of crazy. It, it probably. In a few, within a few months, I was able to kind of, get this toolkit together thanks to, like I said, fellow physicians and the Facebook group and just kind of built, started building the website. We built it ourselves at first and it all rolled into place. I would say we started in the winter and then I was pretty much open by August. just stepping back because of your time doing per diem in Canada, especially at this time where people are like, when I become an expat, where shall I go? Is very common in people's thoughts these days, sadly. What would you say to people who are wondering if Canadian healthcare is better than American healthcare and potentially equivalent or better than DPC in America? It's funny, I think we could dedicate a whole episode to this. I think it's great that everybody there does have healthcare. So if you're Canadian, you have your healthcare card and you can get healthcare. However, it's very similar to the fee for service model, at least the way that physicians are paid. You're paid per patient, and so you are encouraged to see more. I will say that, and the wait times are very long. So, patients are, I don't think are very happy with their care there. I think that they always want improvement and there's always legislation. You have patients going from different provinces just to see a doctor, a primary care doctor. So DPCA is, I would say, a big step up from the healthcare they have there. But if you look at our whole entire, country as a unit, I think we could definitely do better on at least providing some sort of care at the bare minimum for hospitalizations, catastrophic care at least, which they have there, right? If Canadian goes to the hospital, they'll get care and they're not gonna get a huge bill for it. Yep. And this makes me think about your patients who you cared for while you were in the Fresno area. You talked about many people were were underinsured, Medi-Cal covered, I know, especially being a California doctor that Medi-Cal and this is very relatable to people with Medicaid in other states, but it's one great, you have Medi-Cal, but two, who is going to take your Medi-Cal and how many hours away and how many months away are you going to be waiting or driving to be able to be seen by someone who accepts your Medi-Cal? So I'm just wondering in terms of the health outcomes you saw or the things that really, did not sit well with you because of people having insurance but not healthcare access that you wanted to build a solution to by choosing direct primary care. Yeah, I think access was a big part of it and convenience. I think there's so much red tape in that type of system where you can't easily, you literally can't text your doctor. If you need an appointment, it's going to be months out. If you needed a refill for a medication you maybe have been on for years, a blood pressure medication in the DPC world, you don't need an appointment for that. You also can text your doctor and perhaps stay home and not have to come in if it's not necessary. Canada did not have any sort of system like that and, we had to schedule visits and it was, in that sense, extremely inefficient. And I think DPC is all about efficiency because you're, you're trying to, save your, your patients time, but also your self time. So it kind of works both ways, I think. when you were going from Fresno to Canada, back to SoCal why did you guys decide on SoCal in particular versus, elsewhere in the states or elsewhere in California? We are next to some of our family. I love Southern California. I, you know, I went to college in Boston. I have lived on the East coast. My husband is a fan of the West Coast, but not such a fan of the heat. So I think Fresno was kind of out of the question. And then I'm actually, I grew up in the Inland Empire, so that's very hot too. And so it, I just, kind of brought up, well what about, what about Orange County? And we've been here several times and he loves it and I love it, and it's a great place to raise a family. I wish I could say what, there was more thought that went into it, but that's kind of my personality is, let's just try it. I'm not very risk averse and I think that that is something that I will say is, is needed to start your own DPC. Right. You know, That it's, you gotta be willing to take the risk. One more question before we get into the story of Harbor DPC. When you mentioned that paying off loans was part of the reason why you stayed in Fresno after residency before going to Canada, do you have any, tools or tips or hacks for paying off loans that you found helpful that other people can benefit from as well? Definitely. I mean, number one is obviously living within your means. I think living in a more affordable area and usually that's an area that needs you more too. So, I was able to work in FQHC or federally qualified health center and I applied and was able to get the loan repayment, but that was not the federal loan repay repayment. It was I wanna say Cal, Cal healthcares. And that's a five year program. And it's a very hefty amount that you get and you get paid every year. So I was able to pay off my loans that way. In addition to just our salary that was coming in, we just went pretty aggressive with the loan repayment. We knew it was gonna be like short term in order to get to, to our goals in the future. I just didn't wanna deal with those loans. That's how I did it. when you guys were making the decision to open what came first? The, the cart or the horse? This is one of those types of questions. Did you have Harbor DPC as the horse or the cart? And if it was the cart, what was the horse in that situation? I would say we kind of more had a goal of, okay, we don't wanna stay here in Calgary long term. So we need to move, we need to move on something. And we do not wanna work for a big hospital system. So it was more that the horse, I would say the idea, the, this is what the model we're turning to. And then everything else came after that. I mean, we just came up with, the name one night together after going over a few options and that was that. And then we started to build the website. You and your husband open together, and I'm just wondering what, I think about in a married household where there's two doctors, especially two doctors working in the same DPC there's some things that I do and there's some things that my husband does so that I don't forget to do them, and then vice versa. But I'm just wondering in terms of it, it's a lot being a family, being parents, being married, being also, married to a DPC practice. What did you guys do to make sure that it was something that was still following your goals that you would set out to build this DPC, but also so that it was sustainable for you guys as a family? So that's a great question. I mean, I think for us it's worked to our benefit. We like working together. We like each other a lot. And it's, it's worked for us. However, it was in the sense that I kind of, I started it on my own at first, and so he was more kind of funding the DPC. And kind of let me take the reins. And because he was applying for a job out here that he knew would be short term, but he was applying for a job and then he did get a job, so he had to focus on that. And that was more of the eight to five. It was really me I would run ideas by him, but he wasn't really involved in like the every day. And so I definitely had my own way of doing things. It was a little hard at first when he started because I was very grateful when he was able to start full-time with me last year. But. I had to go through the process with him. This is kind of how I do it, and he definitely has his own flare of doing things, which I think is good. His patients love him. But the behind the scenes, oh my gosh, he couldn't have started a better time. I mean, I was needing a lot of help. And so he picked up the slack. I mean, he is just a partner in all senses. And so I think that that was the added benefit of adding on my spouse is that it's someone that I could totally trust to be like an equal in the business because he has an equal investment in it as well. wow, There's so many parallels between our stories. Yeah. 'cause my husband stayed in fee for service so that I could open DPC and then when he came on, I was like we actually do it this way, but how do I say this in a loving way? So Yes, absolutely. Even though we're talking about, like you and I are in dyads with our spouses, like it could be your best friend that, you opened a business with. You know, evergreen Primary Care had three female physicians who are all really good, working together. But I say this because it is possible, it is possible to work with people that you love, even if that's chosen family. You mentioned how he was quote, unquote funding the DPC as you were growing initially. When he came on, was it also impacted by, you had built up to a particular financial level that it would support him as well. Did you have a wait list? How was it fiscally possible for you guys to come together versus him staying at that temporary job? Yeah, so I guess I should preface it with, I know that we're extremely lucky, and I think you feel that way too, that we did have a two income household. So I think there's a little less risk involved knowing that, you know, if this doesn't work out, he does have, at the end of the day a decent salary, and then I could probably work somewhere. With that being said, it was also not easy on him because he was kind of working in this non-ideal setting Right. While I was building the practice. And so that took a lot of, it was kind of a rollercoaster to begin with because you're already super slow at the beginning, or at least I was. And so that just takes a lot of, I guess, support from, from both, both people. However, when we knew that he was gonna start. We had a date in mind and a goal patient goal, patient panel goal. And he ended up starting a bit earlier than that because of a change at his workplace. So it was kind of a good time for him to exit because of the change that had happened. He was being relocated in a sense, and he wasn't happy about that. And so at that time he decided to exit. So it was a little bit earlier. However, I definitely think that it couldn't have come at a better time because we didn't have any staff at that time. So he in essence, took over what a staff member would've done. Right. Plus started taking new patients. So then naturally we were able to grow and we got to that goal that we wanted to set for ourselves, say, in July, right? Like the next month, which was April. And so it just kind of naturally grew from there. As you. Were adjusting to having him as part of the business, how did you guys then figure out like who wears what hats within this business? You said, more admin stuff, but like how did you determine what things under the quote unquote admin hat he was going to take over or be the point person on versus you continuing in on those roles? Yeah, I mean, I think from the beginning he he's always been a lot better at the business side of things just 'cause of, he grew up in a, in a kind of business household. So from the beginning he was helping me with that and so he just, he continued to take on more of that role in terms of the finances. And then as we started to get closer to, looking into hiring a staff member, that was pretty much all him. And he was able to, I mean, I just didn't have the bandwidth for that at all. So he's definitely more like operational, I would say. And then I try to do as much as I can just to stick with patient care because I know he's able to handle everything else. And so naturally my panel's larger currently and his is smaller, but he's able to take on more of, the business side of things in addition to his medical, medical how did your transition to both of you doing DPC work? Because you guys have kids as well. I think it's been great for family life. At the beginning it was very difficult because I was pretty much on the kids' schedule. I don't know if you feel that, but I was on the kids' schedule. And so I would be very, chicken with my head cut off on certain days when I had to get outta the office at this exact time. Go pick the kids up, but then I'm still technically answering phones and on call till five. And then when he joined, it was like a breath of fresh air because I wasn't the only one doing all that anymore. And then we could toggle our schedule. So when I do have to stay late, which obviously some days I do, then he can pick up the kids and vice versa. So it's been great for both of us because he was missing out on all that, working the eight to five. Totally. I, I'm laughing because I'm like, there are still days where we're like I need you to watch this movie on the iPad while I take care of the patients and do not open the door while I'm, while mama is with a patient or dad is with a patient. Because that has happened and because uh, you know, it's such a small town, like things like that happen and it's oh my God, thank God we weren't in a GYN exam when the door opened when, when my five-year-old opened the door. But yes, like the, yes, the adjustments that you have to make I think are way more palatable because we're just, running with our practices and the freedom that we have in them. So that's, that's awesome though that it was a breath of fresh air for you and someone to help in terms of just, doing, the, the kids' schedule with you oh, definitely. And I'm sure our kids would get along very well because they're very much, the second someone calls, it's a patient guys. They just quiet down, they get it. They, or if I have a patient call to take, they get it. And I guess they've just kind of grown up, up around it now. And so it's, yeah, it's funny. It's, I guess it's just our own little culture. That's awesome. So when it comes to your practice you opened it, your husband joined how did you start getting the word out in your community that you were open and what did people navigate towards as you were telling people what type of model you were bringing to the area? Yeah, so honestly it was mainly Facebook and Instagram. I actually had been off of social media. For a few years. I mean, I had my second baby and I just went off social media and then I realized I had to go back on it and get a business account, and I just started posting in local Facebook groups. I started kind of a virtual wait list, and before I knew it, I actually had 10 or 11 patients sign up for this wait list before I even opened. Who are, most of them are still our patients, right. I can't overemphasize how important that tool is. Social media, and I think it's the it factor. You just have to get over. Most of us, at least at my age, are kind of, done with social media in a lot of ways, right? But it's a powerful tool and it's a free tool and it works. And let's go there because not only does it work, it works so well for you in terms of, one, I love that you're educating patients but also you're educating the general public about direct primary care and especially like I, I wanna highlight your TikTok reels especially when you're like your your preview images are very much I'm the doctor that does this. I'm the doctor that does that. So, talk to us about how you came to use social media as a tool for your practice, because I think it's, you've been very effective with getting your point across. And you've definitely achieved, like educating patients on what is possible when a person has a DPC doctor and also what the heck DPC is. I mean, I think, thank you for that. I mean, it was the only tool I really had because we were keeping a really low overhead. So at first I was, I was mainly going into Facebook groups and kind of had a blurb about the practice that was opening and about direct, direct primary care model. And to answer your original question, I think there was definitely pushback in the area. Well, do you take insurance? You know that question, do you take insurance? And then you have to kind of respond. But I think I just wanted to get my name out there so that when patient, when people in the community would start searching on Facebook for primary care doctor, hopefully my post would come up and then they'd start exploring the idea, right. And how it works with or without insurance. And then I think Instagram became more of just kinda like something fun I was doing, because as you probably know at the beginning, you're really not super busy. And so, another DPC doc, Dr. Landon Green gave me a really, he opened about a year before me, and he gave me some really good advice, which was just, you're gonna be so, you're gonna have so much time on your hands and it's, you're not gonna have time on your hands in the future. So take this time and use it really wisely. Don't just sit around your office. Right. So I would just film videos of myself, talking or even just, just with text on them about the practice, about direct primary care, health tips, just whatever came to my mind that day. And I would just try to post one every single day that I was able to. And from there, it just grew, I guess. talk to us about how you came strategically to the types of previews that you have, because it's like, doom scrolling for anybody, it can be a thing, but especially when there's videos involved. Getting the person's in, getting the person's attention is so important at the very beginning. And you have absolutely crushed that. But how did you come to use I'm the doctor that that type of strategy to get that hook once again, it was just a great mistake. I don't know what else to tell you. It's a funny, that's a funny story. So TikTok is always something that scared me. I thought it was for like the younger crowd and but at, but I didn't realize the power of TikTok. So one morning I just got on TikTok, I was sitting at this desk and I think I just used the tagline, I'm the doctor who doesn't take insurance and just explain direct primary care. And I just put it out into TikTok and I let it go. And I had jury duty that day. Okay. And it went viral. I think it got hundreds of thousands of views. And I didn't have reception, obviously I didn't have access to my phone. My husband texts me, he's what? He's not on social media really? And so he's like, you know what is going on on TikTok? Is this, did something happen on TikTok? Is this spam? I'm getting all these calls of PA people wanting to sign up for Harbor. Right. Yeah. It was just, it just happened. Amazing. And, and so then I started to continue using that tagline and a few more went viral. And some patient, some people in the community will even recognize me sometimes is the doctor doesn't take insurance and, and whatever works. Right? And my, my whole thing from the beginning has been just fake it till you make it. You gotta just get it. You just have to put yourself out there, be willing to put yourself out there. And I like TikTok more because you can be more organic with TikTok and just talking to the camera. Whereas I feel with Instagram and Facebook, it's a little more, you have to be a little more curated. So sometimes just when I have an idea, I'll just go onto TikTok and just say whatever I have to say. Love it. When it comes to Harbor and I, I, I am, I'm, I'm like so excited that your social media has really impacted in a positive way, even just, education of the community, but also enrollment at your practice. Part of your website also states that Harbor DBC is a modern, holistic approach that gets to the root of issues. And I'm wondering, did you start with that copy or is that something that you came to as you saw patients and as you were conversing with the patients who were in your community, joining your practice? think at the end of the day, patients just wanna be heard, right? And I think that's what I mean by that is we just, we start with the basics and what their complaints are and their concerns, and try to get to the root of it because we have time to listen to our patients. So I think that's really what. What I mean by that, and the holistic part is trying as much as we can to use, lifestyle and my training in lifestyle medicine to help treat and prevent chronic diseases because we have time to do that. We have time for our patients, and we have time for them to come back in for more frequent visits. And so at the end of the day, I think a lot of it comes down to just being heard and allowing patients to take some ownership over their health and realize where they truly are in their health journey. And that's what I, that's what I mean by that. We are not integrative. We have, we've had lots of calls in the past about that, and I'm very frank with patients. We're, Western trained, we're both MDs, but we really try to focus on lifestyle medicine, medication reduction, and just getting to the root of issues for our patients. When it comes to, the fact that you are physicians doing DPC together, you, you list also that the things that you do that you're trained to do or primary care, urgent care, chronic disease, lifestyle medicine, absolutely. Mental health and more. You mentioned how social media has helped impact bringing people to your practice. You mentioned that patients love being heard at your practice. What is it that on your website in particular helps them put the, the two together? Like This is a place where I feel like I already know the doctor because I saw her on social media, but also this is a place where I feel I can actually be heard. Because again, this is, this is not the common way to do medicine even in Southern California where there are quite a few DPCs in your geographic region Um, I think a lot of patients, I'm not sure if you get the sense they think, is this too good to be true? Right. And so I think they kind of visit the website a few times. They hear me on social media and maybe I'm, on their algorithm and they see my videos a few times. I think they like what they see most patients do. Because at the, at the end of it all, I think. It is old fashioned medicine, right? It's the way that we envision doctors should be with doctor patient relationship should be. So I think it's just that taking that next step because it is something new for most patients. So whether they've just been exposed to it enough times to say, I'm gonna call or I'm gonna sign up. Or they have a family or friend who's already a patient and they can vouch for us and say that they've had a good experience. So I think it's probably one of those two things. In addition to taking care of individuals, you also offer employer services at Harbor DPC, and I'm wondering, especially since July of 2025, have you seen a different conversation or more interest in a conversation with your practice because you are delivering healthcare and not just insurance to employers and their employees? Definitely we don't have a ton of employers, but we do have patients who started as patients and they have their own small business and they now offer it as an option to their employees. So, definitely, I mean, I think the problem a lot of times with health insurance coverage through your employer is that it's just, it's not good coverage, right? Most employees aren't very happy with their coverage, and so this provides a different option when employers themselves are your patients and begin to experience it. They then the conversation can kind of start, and so we have a. Maybe three or four employers small groups, which that's what I'm kind of comfortable with. 'cause I also don't love the thought of taking on 50 employees and then potentially losing 50 patients. Right. So right now we're pretty comfortable with where we're at. Each employer has maybe five to 10 employees under their plan. And so it's, it's worked well and they seem happy with it. I think that, yeah, I'm so excited that that has been the trend for you guys, but also I feel that especially since July at our practice especially, there have been like, as you say, people don't like their health insurance. I had a person come to me and say now my insurance doesn't cover my family's asthma medication. It's no longer in the formulary. And I'm like, would you like to know the cash price of albuterol? Because I could tell you the cash price of albuterol. And it's pretty crazy that I think for us, especially like at our practice, we've found that where there was hopelessness, people are like, wait a minute, then we get the are is this too good to be true? Yeah. Because they're like, I didn't think that I could afford anything to be able to take care of my chronic issue or to take care of myself preventatively because my insurance told me that I could no longer access X, Y, or Z. I think that expands even further to specialist referrals that are very affordable as well. I mean, we work with local, rheumatologists, cardiologists, dermatologists who offer very affordable cash pay options that patients otherwise probably wouldn't even get to see these physicians. Or at least there'd be a, several months wait. So, yeah, I think DPC opens so many different options to healthcare for patients beyond just primary care. When it comes to the admin side of things, as you and your husband are, seeing patients, you're taking care of things after the visits, I'm wondering has your set of tools that help you do your things in terms of the digital tools has that changed much since you opened the practice and as your practice has grown with your husband joining and with more patients joining? Definitely. I mean, I think we started to invest more in things that would help streamline our workflow. So rather than work using our built in, text messaging through our EMR, we now use a separate messaging service that works really well for us that we can both see. And then we actually did hire a virtual assistant and that's working out really well for us. And so she has access to that as well. Then marketing. At one point we did decide to invest in a marketing team. So I think that that was a huge help. But I'm happy that we waited until we had the budget for it, because it's not cheap. So they do the, they revamped our website. They do our SEO our Google ads, and at first they were actually also doing our Facebook and Instagram ads. But I stopped that 'cause I just didn't feel it was, it was helping. talk to us about that, because people are definitely looking into, should I do ads? It's just our version of Should I do a billboard or not? When you say that it wasn't really helping, how did you see that data wise compared to, Google ads that that were that were performing better? So I think it was the conversion. I think that we were getting a lot of like spam or bots coming from Facebook and Instagram and we didn't know if it was real patients or they just didn't turn into true leads. Whereas I think just my own, the posts that I am doing personally will lead a patient to a website or prospective patient a lot better and more organically, or someone will share it. Right, Whereas with Google, I think that was a great investment because when you, search for direct primary care or even primary care, we come up higher on, Google because of what our marketing team is doing. At what point did you look at your overhead and your, your, your profit and loss and say, this is the point at which we can look into a marketing team. Had you researched about how much a marketing team and one that you would want to work with would cost before you got to that point? Or did that come after you had reached a certain amount of income to fund the marketing team joining? Yeah, I think we went through a few interviews with marketing teams and then this one ended up being a word of mouth referral from another DPC doc. So their niche is kind of direct primary care. And then also budget-wise, I did have, i, I don't think I was that busy. I can't really remember how many patients I had at that point, but we were kind of at a standstill. We weren't growing super rapidly at that point. And so we kind of, tailored our budget to, well how many patients per month is this gonna take to, to hire this marketing team? So whether it's, six new patients a month is gonna pay for the marketing, then we feel comfortable with that because we hopefully can grow more than that per month. And then we also knew that we'd probably take some sort of a loss in the first few months until it ramped up. 'cause you do with marketing and it take Google and the SEOA lot of time, a few months. And that's what our team told us. It'll take a few months for things to really show and. As the world of DPC grows, the world of those who support DPC practices is growing too. So I'm wondering in terms of, you had this word of mouth recommendation from another DPC doctor, what types of interactions, questions, when you were talking with this marketing firm brought them to the top of the list in terms of this is the one we wanna work with because I feel that there's a lot of buzzwords, but then there's also does somebody really understand what DPC is? And how have they, succeeded in helping a DPC practice actually grow in terms of numbers of patients? Yeah, so like I said, I believe when I started with them a couple years ago, they had mainly DPC clients. So they had websites as examples. And practices that were already running and who they were working for. So that was encouraging. And then also just the vibe that I think I got during the interview. I'm sure that, some marketing companies are pretty pushy give you these promises. But whereas the marketing team we went with, they weren't really like that. They just, they were very reasonable with their pricing. And so it was sort of, it was, it was, it felt like a good relationship. 'cause I knew I'd have to be talking to them pretty often at the beginning, which we were having meetings almost every week. The price was reasonable and I knew someone who had gone through it and she was doing really well. So. Incredible. And especially as you were starting to work with this team, I'm wondering from those initial meetings you mentioned like you were meeting with them quite frequently. What are some of the, the benchmarks or the KPIs or things that you guys were discussing in order to really fine tune your marketing plan, how your website appeared things like that. the website was a bit of they kind of took what we had originally had and we talked about some other color themes and then we were presented with a few options and chose one. I'm not too picky about things like that. So I was like, okay, we'll go with that. And I really like not having to do it by myself anymore because that's very time consuming. And even now if I need to add something, I'll just text them and then they'll add it for me. And then in terms of what we were looking at from the marketing side, that was a lot of keywords. Optimizing keywords, which did take a lot of time search radius because you don't want to go, too narrow in your search radius, but you also don't wanna be too broad. So you have to kind of find out what works for your patient, current patient panel, how far are they willing to travel and kind of go from there. And then I think just working out kinks in terms of true leads. Right? You'll at the very, at the beginning we were getting the most random calls, like it was the wrong clinic they were trying to get ahold of. It was the wrong state, it was an urgent care or just a totally different type of practice. I mean, now that I think about it all, that's pretty much gone away now and it's very tailored to our practice. And then the the click rate, how often do clicks turn to someone actually visiting the website? Mm-hmm. Awesome. I think that's really helpful, especially for those people who are looking into having a partner who helps 'em with marketing. Amazing. And you mentioned how you initially had a communications platform through your HR and then you changed to different one. Going back to day one, what were your thoughts on what is the bare minimum of a tech stack that I need to have to open Harbor DPC? Because, because, at, at the time it was just you. I wondered, did you think about this is a helpful tool as we grow, especially, what were your thoughts picking your tech stack in the beginning? I think at the beginning it was just what was gonna be the cheapest option. And I mean, if I'm being fully transparent, right, what can, what can I get? That's the cheapest option. That's easy for patients and at some point it just becomes, the patient volume becomes too high and it's too time consuming. So that's when I decided to switch to the different platform where it's just basically its own texting app and you can store notes in it and it basically stores like a chart. It's not necessarily on the EMR, but you can open it like an EMR on your desktop. Do you guys have a process as to like, now that the, the overhead, now that the income is different compared to day one, do you have a, a process for evaluating whether it's beneficial to add something to your tech stack or if it's not? I, I wonder because there's so many things coming out how you guys decide what can help you go forward. I don't know what else there is that's available. I'm not that great with technology to begin with, so I'm good with kind of simple things. Right now what I, what I really need is just the organization of, of texts, right, not falling behind on texts. So, whether or not I'm kind of paging myself, which I never used to have to do in the, in the past, but if there's something that I know I'll, I'll forget or that will get lost because other calls come in. I just basically write a note to myself or page myself and then I can resolve it once I take care of whatever I have to take care of. So I don't know what else they're coming out with now, but. I, I'm kind of interested because there's always things that can use improvement. When it comes to onboarding of new patients versus patients who are already established, how has your onboarding changed because you have a VA helping versus when it was just the two of you? So much more organized. And those are tasks that for the most part, she's able to do now. When we hired her, we pretty much questioned why we didn't do this sooner. Right. And how we were surviving, which I feel like we were barely surviving. 'cause I think you get to a point where it is very beneficial for your overhead to not have staff, but then you, you hit a point where I think your productivity decreases because you don't. Right. And so we've kind of hit that tipping point. But you know, something as simple as getting records, right? So now every new patient, she will ask them, who their previous PCP was and she will get the records and they will already be in our EMR. There's been patients who have signed up online before that hadn't signed their patient agreement. And I didn't realize that until later on. So now she's checking that box. Making sure. At the end of the day though, we still, either me or Pedram definitely talk to the patient before confirming their membership. That's something that's still really important to us. So if a new patient calls and wants to join, we'll have our VA kind of put their information in, but let them know that we are gonna personally call them to make sure it's a good fit before confirming their membership on our end. Fantastic. You mentioned the communications platform and you mentioned how you also stopped doing Facebook and Instagram ad investment. But I'm wondering what are, can you think of any other things that you stopped investing in because you didn't find them helpful for your practice? So for us personally at the beginning, we did do more community events like farmer's markets our kids' school events. We would do a booth, which we love to, donate right to their sports or school, which we still do. However, we didn't find it a good a good use of our time to be at the events in terms of getting leads. So we pretty much stopped doing those. 'cause usually they're on, a Saturday, it's a family day. The kids are sort of helping us with the booth, which can be fun, but it didn't end up really paying off for us. They're kind of exhausting 'cause you're talking a bunch and at the end of the day, at least in our community, people aren't really there to find a new doctor, right? They're, they're there to see like what candy is at the booth and what games are at the booth, but not to actually find a doctor. So I didn't like that salesy aspect of it. So I stopped doing that. I did cut down on marketing, like I said I think that's pretty much it. I mean, I don't know that I have too many extra expenses at this time that I had to cut out how do you guys do your finances in terms of do you guys sit down together and, just hash things out once a month to make sure that everybody's on the right track, or does one of you take point on that? In terms of we would like to do this other thing that's gonna cost money with our practice. How do you guys make a financial decision to say yes or no to that opportunity that you're thinking about? Yeah, I mean I think the body composition scanner is a good example. It was pretty much on my bucket list since I opened. But it's pretty, pricey. It's not the most price ist thing you can get, but it's, an investment. And I think once again, we just, my husband's really good with numbers, so he is well if we do this amount per month, 'cause we do charge for the body composition scan because our membership is quite low. And so we knew how many we, we would have to do per month in order for it to be, to pay off. So we, we kind of look at it that way, how many patients are we getting per month and if we continue at this rate, can our budget allow this? And. Especially because you are talking to residents who are learning about DPC and we definitely see more residents who are seeking out DPC because of the way that we are able to have autonomy in our practices. What would you say to those residents who are thinking, or even, if our fellow colleagues who are thinking about opening that, in terms of overhead, these are the things that you need to have money to invest into your own DPC. Because some people open with a brick and mortar, some people don't. So I'm wondering what your take on, what you would need as the, the bare minimum to open it. I think you really don't need too much. Especially in primary care, we don't need tons of bells and whistles. Right. I basically started with an exam table, my stethoscope, a few other tools that I use on a day-to-day basis. And then added things as I needed them. I didn't order a ton of supplies Right. I ordered them as I needed them. And then probably the major overhead is gonna go into things like, setting up your corporation, your rent, your EMR, and I would kind of start there if you have a budget already for marketing, I think it would definitely give you a headstart, but just kind of be prepared to be spending more upfront and maybe not making you know, what you'd expect to make right away, but it may have longer term, benefits. one thing I wanted to ask also is even at the bottom of your website, you have the, boards that you're certified in. And you also have, where you have gone to school. And I'm just wondering have those have those been mentioned by patients or do you find those are helpful? Specifically when you get patient feedback as to like why they joined you versus someone who's like a non-physician provider or somebody who is like in more naturopathy or in different, certifications of medicine. I mean, I think a lot of patients will join because I'm family medicine. And so I think that that in itself is nice 'cause I can treat the whole family. And then lifestyle has definitely come up as well. I think patients are becoming more aware of lifestyle medicine and I would say those two have been big for me. In terms of other factors, hasn't really been mentioned to me by patients, but I would say just being a family doctor at the end of the day, and I'm sure you can relate, like being able to treat the whole family is just so nice. I enjoy it and I think that that patients enjoy it as well because even in, you know, the typical larger corporations, you have to see a pediatrician, you have to see a family doc or an internist. Usually your whole family is not seeing the same doctor or provider these days. Right. I mean, usually it is a mid-level. Usually it's not, not everybody's seeing the same doctor. So that's what we pride ourselves on, is having two physicians in the practice. Fantastic. I think about this all the time because in our practice we are the physicians, but also in our community. We're the only full scope physicians since 2015 who do all the care that we're trained to do. Which I hate to say in 2026, it's, it's like, what the heck we're in California? But when it comes to. You guys being able to take care of yourselves so that you're able to take care of others. One being a parent is that's a whole ball wax. What are things that you've done in your practice or have found that have helped you you and your husband to make sure that you guys are still, whole people going into the job that is medicine? 'cause it's a heck of a lot of mental and emotional work that we do. I, I joke that even as family doctors we're like, most of our job is being a social worker. But I, I wonder what you guys do to make it sustainable to practice in this model. Yeah, I mean, I think definitely at the beginning my phone was on all the time. I was, didn't have as great of boundaries for new patients just because, you wanna keep your patients, you wanna treat them well, but at the end of the day, I started to realize I can still be a great doctor and treat patients while I don't have to be available 24 7. So I think we mentioned before our kids are kind of used to us taking calls at home, but I always specify, once it turns five, my phone is, is turning off. I used to get more notifications for text messages, like coming to my watch and I don't do that anymore. I just, I know I can respond to something the next day. So I think that that helps me be more present in life. And then I think just having the DPC and making your own hours, I can still. Do what I love doing. I can still cook, bake I love to work out and I still fit all that in. And going to work just doesn't feel like a chore because at the end of the day, I think as a DPC doctor, if it makes you feel good, then do it right. But if it's a com something that you're uncomfortable with, then it's probably, you can say no to it. So that's what I, I love most about DPC. Awesome. And you're a lifestyle medicine doctor, we know that stress is one of the, the pillars of lifestyle medicine. It's something that we. Especially as physicians tend to not necessarily nurture as much as as we can in terms of living a Stressless life. Just again, because medicine is freaking stressful sometimes, I, I just, before our call, I was venting to another doctor who is in the system. I used to be in that our local, corporation refuses to take referrals from our clinic now because we're out of network. And I'm like if a patient is found to have breast cancer you can, you can go ahead and, tell the newspapers and tell your legislators about that. Like they denied you access to an image because they said we're out of network. And I'm like, but you're in network and you're the one ordering the imaging. So it's like the, the job, the stress it can come not even just from our patients, but just when we're trying to do the right thing for our patients. Definitely, I've definitely hit those obstacles over time, like getting denied certain things. 'cause I'm opted out of Medicare and I know you've talked about that. Having to call, make calls, having to wait months for something to get cleared again, it's, there's definitely been obstacles and I think there's a system trying to go against us, but there's also pretty loud physicians and even non-physicians in the community who are very pro DBC. So that's encouraging. Yeah. And I, I will say that I cannot agree with you more in that. There's so many people, it's a huge reason that the model is growing. It's physicians love DPC, patients love DPC. People who don't even, know that they can become a DPC member are still like, oh, but like you could actually just get cash, price albuterol or whatever over here. That's, so yes, absolutely., That is definitely helping the tailwind of DPC grow Mm-hmm. Definitely. In terms of California in particular when you think of practicing in this state that we're in versus another, do you find any particular pros or cons about our state in particular for those who are listening and thinking like, I'm from California, or I'd like to practice in California. Anything that you have as a thought of any thoughts that you have on practicing DPC specifically in California? I dunno if it's a California specific issue. But I think it definitely matters where you decide to practice in terms of access to other physicians and how quickly you'll grow, right? So we're in a very insurance heavy area where we live. And I would say that that probably caused me to grow slow at the beginning because people weren't really willing to, to pay for a DPC membership plus insurance. Now it's a bit different because patients will experience insurance based care and then they will switch their insurance plans to something high deductible and then join our practice. So I think that that's more of an obstacle I face because. I'm in South Orange County specifically, whereas colleagues in, Redlands or San Luis Obispo or where you're at, I think there's a lot less competition from those types of places or insurance-based systems. Yeah, so I don't know that it's California specific. The only other thing I will mention is that we're, I think, one of five states that does issue the penalty for not having insurance. And I know you've been working on that because it just doesn't make sense to be so proactive about your health and have a direct primary care membership and then be dinged. So I'm really hoping that that changes in the near future because I think that would be a huge win for DPC and for, for patients. I can't agree with you again, more. I, I think that this is where the, the reason I continue to maintain my a FP membership and the reason why I, I do things like work with public health is because advocacy for showing people that like, yes, there's what you've been doing, and then there's also ways that you can actually make this the standard of US healthcare. And to do that. If we are not at the table as the physicians who are doing this model, people don't understand what the heck we're doing because they're not representing it properly. Yeah. And I, I mean, I would love to get involved. I'm not sure if you started to get involved in policy after your, you kind of, your panel filled up and you were able to slow down a bit. But that's something I definitely hope to get involved in. I, I mean, I did my master's in public health and it was in, health administration and leadership and I want to somehow use that and I think that this would be a great way to do it. I just, when your plate is so full, it's hard. But that's what I'm hoping that DPC will help with. Once, I'm sure once you kind of get to that, your study panel, you get more time to do other things. Yeah. And for me, I will say that I think that. For my journey. It's always been balancing the two together in tandem. And so, and even this podcast, I would consider in the realm of advocacy. So my panel is intentionally smaller because I am so passionate and also so pissed off at the corporation, what they did to us that I'm just like, I will until my last breath be, be proselytizing what we are doing. And even to the point of just tomorrow actually after, after we do this interview something that is like. Oh my God. How is this not already a law In our state? It's not a law that if measles protection rates go down, or if measles vaccination rates go down at public schools, under the, the, the safety net number the, the herd protection number that. That public schools aren't supposed to let the public know or let their families know. I'm like, how is that not a law? So I'm literally speaking on the assembly floor to a committee tomorrow that like, this should be policy because measles is coming. It's a coming. And it like, it's just I never would've, I never would've had the time to drive to Sacramento to do this had I had an eight to five job where I had to request time off. And so for me, like advocacy has been a very, very it's been a defining part of what DPC is for me. Again, I go back to my journey started when I was gonna be fired at 28 weeks pregnant because. I wasn't seeing enough people and they wanted more of my money. I wish it would've been a different journey than threatening to take my access to an ob. But you know what? That's the, the cards, dealt it and it has fueled my fire. And so this is just the way I respond to that. But you do not have to be present on an assembly floor to make a difference. The fact that you are doing DPC is making a difference, period. So like for you and for everybody else, never freaking forget that because you are advocating by literally leaving the system and being a doctor in DPC. I just respect you so much for your work and hopefully someday soon I can join you. I will save you a seat. Amazing, amazing. Well, thank you so much Dr. And sorry for joining us today. I'm so excited for everybody to hear your journey and learn more about Harbor DC thank you so much for having me. I was really honored to be asked to be on your podcast and have a great, great uh, time tomorrow. Thanks for doing your work.

Maryal Concepcion 1:05:03

Thanks for being here for this episode of my DPC story. Whether you stumbled across DPC for the first time today, or you've been in practice for years, these stories are here for you, wherever you are in your DPC journey. And that's exactly, have a start here. page@mydpcstory.com is built now. It meets you where you are new to DPC and learning the fundamentals. There's a path for that already practicing or in the planning stages and looking for practical tools. There's a path for that too. Ready to go deeper. That's covered. Head to the start herePage@mydpcstory.com and find your starting point. If you have a question or challenge you want to hear addressed on the show, go to the contactPage@mydpcstory.com and leave me a voice message. And if this episode moved you, please leave a five star review on Apple Podcasts. It's one of the best ways to help other physicians find these stories when they need them the most. For commercial free episodes and extended conversations, check out our Patreon. There's a free tier and a paid tier, and both help keep the show going. Follow us. On socials at my DPC story and find everything from episodes free resources, the DPC Toolkit Magazine, and more@mydpcstory.com. My DPC story is created and hosted by me Maryal Concepcion A huge thank you to the team that makes this show possible. Chief Growth Officer, Keira Hanselman, head of Marketing and Strategy, Nathalia Highland and Chief Operational Officer Alexander Gobble We are all in your corner. Until next time, this is Maryal Concepcion