The DPC NP
The DPC NP Podcast is a biweekly audio program that offers valuable insights and firsthand experiences pertaining to the management of a Direct Primary Care clinic owned by nurse practitioners and physician assistants. Esteemed guests will articulate and elucidate their individual journeys in navigating the complexities inherent in establishing and operating a Direct Primary Care practice.
Feel free to email me with any questions you might have about DPC!
aprice@faithfamilymedical.com
The DPC NP
Launching a Direct Primary Care Practice Inside an Aesthetics Clinic: Verlisha Goins' vision
What happens when a nurse practitioner refuses to accept the limitations of traditional healthcare? Verlisha Goins is about to find out as she prepares to add direct primary care services to her thriving aesthetics practice in Columbia, South Carolina.
After becoming a nurse in 2012, inspired by her own experience with compassionate nursing care during her daughter's birth and NICU stay, Verlisha worked her way through various healthcare settings before opening Sophisticated Wellness and Aesthetics in 2022. What started as an IV hydration clinic has evolved into a comprehensive aesthetic practice offering everything from medical weight management to Botox and facials.
Now standing at the threshold of her next big move, Verlisha shares the real story behind her decision to incorporate DPC—including the self-doubt that kept her from launching sooner. "I kept saying I wasn't ready," she admits, crediting mentor Penni Vachon, APRN with providing the accountability she needed to finally set a launch date. With 19 patients already on her waitlist, Verlisha is positioned to quickly reach her six-month goal of 50 members.
The conversation explores practical considerations for practitioners considering similar hybrid models: pricing structures ($99/month for adults, $59/month for children), marketing strategies focused on community engagement rather than paid advertising, and the innovative cross-promotion of services that offers DPC members significant discounts on aesthetic treatments.
Perhaps most compelling is Verlisha's vision for healthcare delivery that refuses to be confined by traditional boundaries. "I want to position my clinic to be the go-to and the leading premier wellness clinic for health, wellness and beauty," she explains, rejecting advice to "niche down" in favor of comprehensive care that meets multiple patient needs in one location.
Whether you're contemplating opening your own practice, considering adding new service lines, or simply looking for inspiration to move past self-imposed limitations, this conversation offers valuable insights from someone who's taking the leap right now. Connect with us on social media to continue the conversation about innovative practice models and the future of healthcare delivery.
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Welcome to Season 2 of the DPCNP Podcast. I'm Amanda Price and I'm thrilled to be back, bringing you even more insights, strategies and success stories from nurse practitioners and physician assistants leading the way in direct primary care. This season, we'll dive deeper into real-world experiences, innovative practice models and the latest updates in the DPC movement. Whether you're just exploring DPC or already running your own practice, this podcast is here to support and inspire you. Let's get started.
Speaker 2:Hey everybody, welcome to the next podcast episode of the DPC NP. I am interviewing today Verleisha Goins from Columbia, south Carolina. She is the founder, director and CEO of Sophisticated Wellness and Aesthetics. Verleisha, I am so glad to have you on the show.
Speaker 3:Hey Amanda, Thank you so much for having me. I really appreciate it.
Speaker 2:Well, you're welcome. I'm looking forward to hearing all about your clinic, because you're making some pretty significant changes in the near future, and so that is very exciting, and I think it'll be very helpful for those who are just about to do the same thing or they're in their mind and headspace thinking maybe I should do this, but I'm not sure. So you will literally be right there ahead of them and maybe can give them some good advice or some tips on how you progress through your process. So let's go all the way back to when did you become a nurse and how did that all come about?
Speaker 3:So I became a nurse in 2012, a little bit older, not fresh out of high school my daughter was born and I had such a positive experience during her childbirth in the hospital, and I remember that the only people I remembered were my nurses. My daughter was born five weeks early and so she spent three weeks in the NICU and my nurses were so accommodating to me, so much that I was able to stay in my hospital room for three weeks because they advocated for me, and I just remember thinking I want to make people feel how they made me feel. So that's why I became a nurse. My first major was computer science. Totally hated it. Where I grew up at that was a very popular field. So the school I went to, columbus State University, my first major was computer science, but I got rid of that really quickly and soon after having my daughter I was 20 years old and I went to nursing school Awesome, and so how many years did you work as a nurse until you decided to?
Speaker 3:become a nurse practitioner Three and a half years before I became a nurse practitioner. So I worked in the hospital, the same unit, for the whole time. During my rotation in my MSN program I had to go PRN, so I did go to the float pool for a little while, but most of my experience was in med-surg and then I became a nurse practitioner in 2016. Did you?
Speaker 3:go to the same school as you did when you got your RN degree, graduated from South University on campus in Columbia, south Carolina. For my BSN and my MSN, and then for my DNP, I went to Wilkes University.
Speaker 2:And how long had you been a nurse practitioner when you went back for your doctorate?
Speaker 3:I got my doctorate in 2020. So four years.
Speaker 2:Oh, right, there before I finished?
Speaker 3:Yeah, definitely we actually. They pushed back our graduation a year later because of COVID, so I finished in 2020, but I didn't walk until 2021.
Speaker 2:So you weren't able to take your certification exam until then.
Speaker 3:Oh no, I mean for my DMP, for my MSN. I finished in 2015 and I passed my boards in 2016.
Speaker 2:So did you work for another provider for a few years before you opened up your own practice?
Speaker 3:Yes, many years. So I worked a few different jobs. I worked in rural health was my first job out of school. Working at a federally qualified health center got some loan reimbursement. I worked there until I was close to having my second daughter and it was such a far drive back and forth that I had to let that go. And then I worked in internal medicine for a little while. I also did some house call visits and assisted living facilities and long-term care facility type work. And then I worked at doctor's care for a little while in urgent care as well. Then I opened my own practice with my own IV hydration business with two business partners, but that didn't work out initially, so we parted ways and a few months later I was open in a brick and mortar doing my own thing with sophisticated wellness and aesthetics. And what year was that? I opened in 2022. We started our business 2021 of like June, and that ended maybe in April of 2022. And then I was open in October of 2022, by myself.
Speaker 2:That was originally just an IV hydration clinic.
Speaker 3:Yes, with my partners. That's all we did. Yes, okay.
Speaker 2:And then, when you switched over to being a solo practitioner, what other services were you offering other than IV hydration?
Speaker 3:IV therapy, medical, managed weight loss and then Botox is what I opened offering and then we've expanded since then, so I bought a hydrafacial and I have an esthetician here that does facials. We also offer chemical pills and microneedling and body contouring with lipodissolve. So a lot of aesthetic treatments and just skincare treatments to help people feel good and look good too.
Speaker 2:When did you learn how to give Botox?
Speaker 3:In 2019,? I believe, yeah, and I. So I'm learning this about myself. It took me a while to start doing it. I learned how to do Botox before I actually opened my own clinic and had a clinic with my partners, because that was something I wanted to incorporate. So when I first opened here, even when I opened my own clinic, I was kind of hesitant about bringing it on, and so I'm learning that about myself is that I may have a little bit of doubt here and there, but I do eventually get it done. So I'm proud of myself for that and I'm killing it now. I'm not shy to do Botox now at all.
Speaker 2:Yeah, because you really can't ruin their face, I mean after three months it's out of their system.
Speaker 3:Well, yeah, it's not permanent, so that's a good thing. But people are very like particular. I mean it's your phase, so it makes me worried and I still get you know with placement and things. I'm very upfront and open with people about what can happen so that if it does happen they don't beat me up too much. They already know it could possibly happen, so I make it a little worse than what it will probably be just to kind of protect myself. Yes, I do the same thing.
Speaker 2:When I went back and learned how to do Botox and dermal fillers, after I got done with the certification and everything, I got really nervous about the dermal filler. So I had decided from the get go, I'm like I don't think I'm ever going to do this, so I only had done the Botox. So I've been doing Botox, you know, for 10 years, which I'm not at all nervous about that. But there are people that are like I wish you could give me some lip filler and I'm like sorry, yeah.
Speaker 3:So I do offer filler and I will say I understand, because I, even now I've done so many different trainings for filler even one on ones and I just still don't feel 100% confident. So I offer lip filler I'm not shy for that. I do that pretty well. But when it gets to doing filler in the face, I think my only issue is that I want to treat the whole problem. And people come in and they're like oh, I want my nasolabial folds to look better, or I want you know this, and I know they need more than just one syringe, and so that makes it kind of hard to treat.
Speaker 2:so I really don't even market it, but I have, I do offer it why don't you tell the listeners what program you went to go get your education in Botox and dermal fillers? Because I think that there are going to be some nurse practitioners that are listening that will be interested in knowing how do they even learn how to do it?
Speaker 3:Initially I went through like a bigger company called AMET. I did their basic and advanced course and I will say it was okay but for a beginner like maybe for talks I felt comfortable doing talks but absolutely not filler. Even after the advanced course you just don't get enough hands on with the instructor because there's so many other people in your class. And then after that I did cosmetic medical training which they come to you and they come in your clinic and it can be just you or you can split it. I split it with another provider. We went to her clinic to offer it. They came and taught both of us. We recruited our own models and we got more hands-on experience that way and we kind of split the cost and it was very affordable.
Speaker 3:And then I did some one-on-one training with a local. Well, she's in North Carolina, in Concord, essendon Aesthetics. I did some filler training with her one-on-one and also with Mary at Smiley Aesthetics in Nashville. I did some one-on-one with her as well. And then I have an awesome nurse practitioner right here in Columbia who is very open to like me, shadowing her and helping me just get more confident. Her name's Amy Loper. She's really sweet. So I think that you should seek out injectors whose work you like and who aligns with what you like and just reach out to them to see if you could get training with them. But I would recommend doing a certification course initially. But I just don't think it will be enough to jump out there and just start injecting.
Speaker 2:Yes, I totally agree with that, which is probably why I'm not comfortable with dermal fillers, because I went through the American Academy of Facial Aesthetics and it was online written information that you had to read and then you take a little short test after each course and then then we had to go and do demonstrations on models that we supply, just like you did, and so I only had one person that I'd given Botox to, and I had one person that I had done dermal fillers to, and that was only lip. I didn't do any nasolabial folds, like I didn't even know where to put it up here. They call that level two, and I just knew I wasn't gonna do it, so I never even moved to level two.
Speaker 3:Yeah, it's very pricey. I still need more training. I plan to maybe do one training or conference this year because I do enjoy it making people feel pretty and just helping them with their skin. I will say that I want to do more like bio stimulators, so them with their skin. I will say that I want to do more like bio stimulators, so maybe like PRF. More training on radius I'm not filler to me is like maybe down the road for people. I don't think it should be the first line of treatment. So I think skin good, skincare, some PRF, so we'll see. We'll see where I go with that.
Speaker 2:So it's very interesting because you basically have this aesthetics clinic and IV hydration, but you're wanting to incorporate DPC, and so this is my first interview where I have someone that is just about to open their DPC clinic. They haven't quite opened it, but I'm interested to know how did you even find out about DPC, and what made you want to do a complete addition onto your wellness and aesthetics clinic?
Speaker 3:I'm glad to hear that I'm the first. That's exciting. So the crazy thing is I've done DPC and worked in DPC and not even known it before I heard about it through the elite MP group is how I found out about it.
Speaker 3:But my last job as a nurse practitioner was with a company I won't say the name of the company, but it was basically B2B. So I worked for a company that their client was a pharmaceutical company. Well, one of their clients and I just so happened to apply for this job. I worked at this clinic. I helped open this clinic and I didn't even know that I was doing this like helping open the clinic, but it was their first clinic here like that. So they already service Aflac and then they also service the County of Lexington here and then they opened a new clinic which I was the first provider there and it was for a pharmaceutical company. Well, the client pays them, they have a contract. The client pays them and we see all of their employees and their employees' family members. At the time I didn't know that was DPC, because essentially that's what it is, because they don't utilize any insurance, they get free care. They came in the clinic. I would see maybe two to five patients a day, but they came in for whatever it is they needed to be seen for we seen them. We didn't bill them, they left. They were happy.
Speaker 3:At the time I didn't know what it was, and then I got more into the elite nurse practitioner group. I'd done many of his classes, even the dpc course that he put out not too long ago, and that's when it started like a light bulb went off, like wait a minute, this is exactly what my job was doing they. They were just not doing it for individuals, it was for a company. So that's really how I heard about it through ELEMP, and I love primary care it's majority of what I've done as a nurse practitioner but I hate the thought of insurance and so when I figured out that it was something that I could do working for myself I pretty much do primary care with my weight loss patients and I just don't get paid for it. So it just was a no brainer for me to add it on to my practice and make a difference in the patients I already see and get some new ones.
Speaker 2:So we had talked earlier, before we started the podcast, that you already had some people on a waiting list. What did it look like for you to decide that you're going to do DPC and then how are you going to market to your current aesthetic patients, or how are you going to market to your community to let them know, hey, we are incorporating this family practice side of our wellness and aesthetics clinic.
Speaker 3:Okay. So through the elite NP group I met Penny, Penny Vachon, who is actually up the road from me, about two hours away in Charleston, and she was just very personable. She had her own group and she invited me to the group. So I joined that group and ever since then, anytime I reached out to her, she was very receptive. She always answered questions. She never felt bothered. She gave me her personal cell phone number and I text her and I was like can I come shadow you? And she said absolutely. And I went last April to shadow her and I was just very it was amazing. And then to see that she had grown her practice over the last what six years to having other MPs working with her. And she just told me like you're gonna start in June. What are you? What are you waiting for?
Speaker 1:and.
Speaker 3:I was like I just don't feel ready. And June came and I didn't start because I thought I didn't, I wasn't ready. So I said, okay, I'll launch in October. And October came and went and I still didn't launch because I just felt like, oh, I need an exam table with stirrups, oh, I need this. Just, you know, all this stuff I felt like I needed in my you. Like you got everything. You need all you need.
Speaker 3:So the dpc launchpad happened and, oh my gosh, that was like the icing on the cake and I said I can do this like just listening to all of you you know, talk about your stories and how you got started and how thriving your practices are. I met someone at the dpc launchpad who had just opened in april when I was supposed to open, and she told me she had 400 patients. Then I was like, oh my gosh, like I could have had 400 patients by now. Like, what am I doing? So that was just it for me. I decided that I'm going to stop being in my own way and what helped was just putting that wait list out. I knew that it was going to make me do what I was supposed to do. Plus, penny said, if I didn't launch, she was going to come here and kick my tail. Personally, I definitely didn't want that. So I'm launching May 1st and I'm just going to go with it Like. I got my paperwork done, it's done. I have no excuses, yeah.
Speaker 2:Penny's right. Like you really only need a stethoscope, I mean, you probably need an otoscope. You know which I have?
Speaker 3:Yeah, Okay so you've got toys right Bam table. It just doesn't have stirrups like I have. So it was just excuses, I guess.
Speaker 2:You know, I think sometimes it gets comfortable saying, oh, I need one more thing. I need one more thing than to take that giant leap into are people going to trust me, Are people going to buy into me, Are people going to support me in this endeavor? But you were able to surround yourself with other providers and Penny she has been a huge support system to even me she really is.
Speaker 2:I consider her such a good friend now. I have enjoyed getting to know her and just seeing how she treats us as fellow nurse practitioners and how she treats her patients and everything. So, yeah, she's a wealth of knowledge too. Yeah, I think the key takeaway there is find you a person that is that person that A will hold you accountable, because if she wasn't there telling you, yes, you're going to start and you're going to do it on this day, I believe in you and I know that you'll be successful. You may not see it yet because you're still have the curtains over your eyes, but I already know because I've been where you are, and so if you just find that person, that colleague that is in your area, then that is what's going to launch you into the success of a DPC clinic. So that's really cool that she is your person, lucky you.
Speaker 2:If you're listening. Thank you, penny. I'll be sure and text her when this goes out and say hey, this whole podcast is a shout out to you, so make sure you listen to it.
Speaker 3:He's been so amazing Even to connecting me with her collaborating physician. She's just been really, really nice and you know everybody's not nice and she doesn't expect anything in return.
Speaker 2:Exactly yes. Okay, so let's move on to do. You have people on a waiting list who have already committed that, once you start on May 1st, that they are going to sign up? What other kinds of marketing do you plan on doing to gain more patients and what is your goal? How many patients do you hope to achieve in, let's say, six months from now?
Speaker 3:Our yearly goal is 100. So I would say 50 within the next six months. And as far as marketing, I will say that my marketing strategies currently are more community driven. So I don't really run any ads and I don't plan to do that for my DPC practice either. Most of my patients I have a panel of maybe like 700 people, but I don't know like maybe 400 of them are active and they mostly come from word of mouth free marketing through social media, and I host events at least two or three times a year and they're usually free. I don't charge for them.
Speaker 3:So those are things that I plan to continue doing and I want to make a little commercial for my DPC program. I think that would be really nice and I still plan to use social media because it's free and I really do get a lot of people in through social media, a lot of every time we check a patient, a new patient in, we always ask how'd you hear about us? And it's either a current referral through a patient we already see, or they say Instagram or TikTok or something of that nature. So I do plan to use that because it's absolutely free and so I think it's been very helpful for my current business. I know that direct primary care is a little bit different, but my marketing will speak to those people who, and then my current patients.
Speaker 3:So we've already sent out newsletters through my email because I do email campaigns every week. We have one going out tomorrow just reminding them that there's one week left to sign up for the waiting list. So the wait list basically their enrollment fee is being waived if they join our wait list before we launch. That was the benefit of joining the wait list early Now. After that they'll have to pay an enrollment fee. It's just a one-time enrollment fee and then in South Carolina we bill in arrears, so they won't be billed until the month after they.
Speaker 2:There are certain states that make you bill at the end instead of at the beginning. I really don't know what Tennessee does. Actually, our EMR bills patients on every five days, so depending on when they signed up is when they get billed. You use Atlas. Yes, what are you doing? I use.
Speaker 3:Charm. I use that for my booking system I mean my charting system, because it's integrated with LabCorp and it's very inexpensive. But then I also have a booking system that I use which will do my membership billing for me. And what is that company? I'm very it's Boulevard. I'm so like all about aesthetics and it was just very pretty for me. So I had and it has so many other perks too, like membership packages. We can do loyalty points, a reward system, so it fits because I offer aesthetics too. So I really, really like it.
Speaker 2:I've never heard of Boulevard, so it will be appropriate for your DPC practice as well.
Speaker 3:Yes, because it has the recurring member. Are you saying for the membership payments or what do you mean? Yes for? The membership payments yes, and I can run reports and things like that. Oh, that's great.
Speaker 2:And charm will be how you chart on your patients.
Speaker 3:Yeah, and communicate with them as well, because it has like a client facing, you know, text communication offering, and then I'm able to scan documents directly into the chart, I'm able to fax through there. So it just, it's just easy because everything's right there in one place. So I really like that about charmm and it's really inexpensive. How much is inexpensive? So you don't even pay until you get past 50 people. So once you get past 50, then I think it's like 200 for the practice.
Speaker 2:Well cause, I'm the only provider. Do you plan on hiring a?
Speaker 3:medical assistant. I do have a medical assistant. She just started last week. Her first day was Monday, no-transcript. The right choice with hiring her. She's been amazing, so I'm excited. She's excited about primary care, so it just makes everything so much easier.
Speaker 2:It is so nice to hire somebody that is willing to be multi, versatile and do the things that you need. I am so thankful for my medical assistant because my office manager only works a few days a week, so there's two days out of the week that she's not there, and my office manager is also my front office person that answers the phone and stuff. So when she's not there, my medical assistant answers the phone and does all that stuff. So it really is nice to find someone that doesn't mind when the job description has gray areas and you're just like, can you do this?
Speaker 2:Like, will you do that? And then they'll also take it upon themselves to do things that you didn't know you needed. But after it's done, you're like oh that's so helpful.
Speaker 3:Yeah, definitely needed brochures, because people ask me all the time and I just ran out and I never made more. But she did that and we just got them printed, picked them up yesterday. They're here. We have a pop-up event on Thursday that we're going to, so we do have our direct primary care information to let those people know about. We're going to a college, which is really good, so we made our pricing simple.
Speaker 3:For DPC it's like if you're an adult, you pay this price. If you're a kid six and older you pay this price, and if you're in college without an enrolled parent, you pay the kid price as long as they're under 23. So it's really like straightforward, no fluff or anything. Just because I didn't want to be confused myself, well, that's a good segue, because I was going to ask you what your pricing was and how did you come up with it. So I checked around in my area and there were prices as low as like $60 a month and as high as like 150 a month.
Speaker 3:So I'm kind of in the middle. My pricing is 99 a month for adults and then 59 for kids and that's for six and older. Simply because my first job I worked in Peds for two and a half years. I won't have immunizations or anything like that on hand because I just it's too expensive, they'll expire and I just didn't wanna deal with that. So I will be like highly recommending that they still have a primary care or a pediatrician, but in the event that they need to be seen for a sick visit like I'm all for that and willing to do those things, or even a wellness visit I won't have immunizations on hand.
Speaker 2:You had mentioned to me that you were going to offer discounts for your aesthetics to your DPC patients. So you're going to have other patients that will come in just for the aesthetic stuff that will not sign up for DPC. So what kind of discounts have you come up with? That is going to be enticing for people to sign up for DPC.
Speaker 3:Oh, so the IV for one. The IV therapy like their pricing is basically cut in half because they're already paying their DPC membership fee monthly. I usually charge anywhere from for a basic infusion, 85 with no fluids, for 500, 125 for a liter. My highest basic IV therapy that's not like NAD or something is 210. So they'll get that for 99. Because we have a membership it's called the IV League and it's for IV hydration. They save $60 a month by joining up for the membership because it's a recurring payment. So they have to agree to be on that for three months at least and then it just comes out automatically every month. But the people who are on DPC get an even better discount. So I think it just it's more enticing like make them want to join, especially if they, even if they have insurance, like some people, have to wait. I have patients that come here and they have. They complain about waiting weeks to get in with their primary care provider, so that won't be an issue here.
Speaker 2:No, it will not, honey. You will have same day appointments. I mean I have almost 500 patients and I still have same day appointments.
Speaker 3:Yes, we'll do same day or next day appointments, like guaranteed.
Speaker 2:And a lot of people that you'll find don't necessarily want to come in If they have a sinus infection or they have a urinary tract infection or they have poison ivy or something that's so simple. They know what. They have a sinus infection or they have a urinary tract infection or they have poison IV or something that's so simple. They know what they have. They're going to want to just text you and just say, hey, we call me in the antibiotic or whatever.
Speaker 2:And don't think that I'm hating on that, because I'm not, if I can just call you in something because you know what you have. Like people are pretty smart, they know their bodies right and so I respect that. So you'll find that there'll be a lot of days that'll go by that you will not have any patients that are coming into the practice because they don't technically need to leave work and come and be seen. But I think that's the value of DPC for people and definitely a good marketing ploy is that, hey, I'm not going to require that you come in every single time something is wrong with you, like I would if I took your insurance, because the only way I would make any money is if I build your insurance and you have to be present in this place in order for me to do that Right exactly.
Speaker 3:Now, if you want to come in great, come on, but you don't have to.
Speaker 2:So you've already got 19 people, which is almost halfway there to your six month goal. So I have a sneaking suspicion that you're going to have 100 patients way before a year. So have you thought about what is it going to look like after you've done the 100? And your waiting list keeps growing, because I can tell you I can tell you from being the compassionate nurse personality that you probably have and I have and all these other nurses have when you start seeing people that want you and you think you've met your max, it's going to eat at you every day that there's these people over here on the list that you're not letting in. So what are you going to do about that? How are you going to handle that?
Speaker 3:I mean, there is a number that I have in mind that I probably would be comfortable. I just like kind of did the math that I will be comfortable bringing on another nurse practitioner. I don't want to overwhelm myself but I think once I get to about 300 to 350 people that I would hire another, another provider.
Speaker 2:Okay, so 100 is a goal, but that's not the limit of which you plan on maxing out.
Speaker 3:No, that's my goal for the first year, oh okay.
Speaker 2:So when is your long-term goal? Like you said, 300,. You'd probably hire a new nurse practitioner. So, when do you want to get to 300?
Speaker 3:I mean, as soon as possible, but I just don't know what to expect. You know, a lot of people are always, when I tell them what I'm doing, they're like, oh, are you going to take insurance? That's like the first thing people say. So I really think that it's going to be on me to be able to articulate and explain to them why what I'm offering is much better than what they could get with insurance. So I'm working on that part and I think that once people see the benefit, that's when I will like be busy, busy. I completely agree with that. I'm working on that.
Speaker 2:I think DPC is still so new even though there are providers out there who have been in DPC for over five years and some of them almost 10 years, so it's been around for a little while but it is still so new that I don't think patients understand how valuable it is and why you don't really need insurance. So definitely articulating and just explaining these things in your Facebook posts and Instagram and things like that, where you plan on networking with people, is going to be key to helping them understand why insurance is not the holy grail of healthcare.
Speaker 3:And when you said networking, I do. I have a patient of mine who comes to me now and she does like insurance and so I asked her like is there a plan that I can recommend to my patients, because people always have this question too Well, what if I need to go to the emergency room? Or what if I get cancer? So if there's a plan that they can just like a supplemental plan for people who don't have insurance? She said that she knew that she has someone who has that. So we're going to meet for lunch and kind of just talk about it to see how I could offer that as a benefit to my patients too, like they sign up with her just to feel some type of comfort with that, because obviously DPC is not insurance, so we can't help that. You know we are not an emergency room, but I want them to feel comfortable as well and confident that even though I'm their primary, they could still be seen at the emergency room and not have to worry about this crazy bill.
Speaker 2:So I think it is good to network in that capacity because if you just get to know your local insurance agents, they are helping people get insurance. But they also have a number of patients that, A don't qualify for insurance or, B that when they finally get their quote back for the insurance, the premiums are just too high. They cannot financially handle that. So you want to have an insurance agent in your back pocket that is going to say, hey, I'm sorry, I couldn't help you out, I'm sorry that this is going to be too expensive. But there is another way for you to obtain health care and it's going to go see my friend Verlicia up the road that you'll just pay a monthly membership fee and then you'll at least have primary care. And then, in vice versa, you can help that agent out by sending DPC patients that are looking for just catastrophic plans because they want to keep you as their primary care but they are concerned in case of that emergency healthcare visit that they might need is having coverage for that.
Speaker 3:So those are some of the things that were scaring me in the first place, but now I'll figure it out as I go is my mindset for?
Speaker 2:that Did you have to change your malpractice?
Speaker 3:insurance. So, interesting enough, this that was always on my malpractice insurance. My insurance has been I mean, to me it's been expensive, but when I look at other people's it's not very expensive Primary care has always been on there. I always like there's things on my insurance that I don't even do now, like laser, because I knew I wanted to eventually bring on a laser device. So I put like dermatology all of that is on my malpractice because I knew I wanted it to be like a one-stop location for health, wellness and beauty. So I just kind of prepared for that and when I was part-time I was paying half of what I pay now for my malpractice insurance.
Speaker 2:Tell me what your insurance company is that you're using oh, cmnf.
Speaker 3:Don't ask me what that stands for, because I don't know.
Speaker 2:I was using CMNF.
Speaker 3:Yes, I used to have pro liability, but they didn't cover something I can't remember, so I switched to CMNF because they said they cover whatever is within my scope of practice.
Speaker 2:My husband was an insurance broker before he opened up the camp and so he does my insurance renewals every year for me and he just got a quote from Baxter that was so cheap. There was a reason that we didn't go with them and I can't remember what it was. I think they were doing a 1 million million to $3 million aggregate instead of a $1 million to $6 million. So I think that's why we stayed with CMNF, because I have the same insurance as you do, but Baxter was super cheap. So maybe when you're up for renewal you can at least get a quote from Baxter and see if they can give you a better price.
Speaker 3:One to six as well for the aggregate.
Speaker 2:That matters, right, I think the one million is for one occurrence and this is me like assuming, because I'm not an insurance person and I never bothered to ask Mark, but I think it's one million for one incident and 6 million total incidents. Well, in my opinion, I've been a nurse practitioner 21 years. I have owned my own practice for 18. I've never had to pay out one red dime of anything for anybody. So why do I need 6 million?
Speaker 2:But he was like oh, but you know when you're married to an insurance guy, like all they talk about is having insurance for this and that and the other, so I have more insurance than you could possibly imagine.
Speaker 3:Well, yeah, I don't think I'll keep that, but mine isn't really that bad. It's like for 4600 a year. Oh no, that's not bad at all, that's good. I think it depends on where you are to like your area, because I've seen people that pay a lot more using CMNF and we do the same things. So I just think it's where you are geographically located as well.
Speaker 2:Yeah, I totally agree with that. So how big a space are you in as far as your clinic size, and are you going to need to move to another space when you start gaining all these patients?
Speaker 3:So that was another one of those things where I was like this place isn't big enough, I need more rooms, and you know who told me to stop One of my own patients. So I have a 1200 square feet space. I have three exam rooms Well, two exam rooms, because my esthetician uses one room for her services and then I have a exam chair in one treatment room and then an exam table in the other treatment room. So I utilize both of those spaces. And then I have an IV open lounge area where people who want to infuse as a group go, and if I just have one patient, they go there too. But if they want a private room, then I do that in the back room.
Speaker 3:So, yes and no, I have enough space, but I want more space because you know when you think about I have enough space, but I want more space because you know when you think about I have an employee now who's going to be here with me all the time, so I just it's the little things like I want to. We need a break room, we need another restroom and I am currently looking at a location. I actually was filling out the application before I call, so I'm hoping that that works out because it's it's bigger than where I am now. It has a lot more treatment rooms, there's three bathrooms, there's a reception area set up more like a doctor's office, which is what I want, but kind of in between a med spa feel and a doctor's office.
Speaker 3:So I want like a luxury doctor's office, like how my space is now. It's really inviting and people don't feel like they're at the doctor, but they trust me and my clinical expertise too, because I'm very like serious but also I have like a really good personality. So so it all works out together and I want my space to be just very comfy, inviting, pretty like I'm all about aesthetics I told you that. So, yeah, I think I need a bigger space and I'm actually in the market for one right now. My lease is up here in August, so it's all like kind of working out great because there's a doctor's office in the space that I want to lease and they move out June 30th, so it will be like a smooth transition if I do get that space. Oh, that would be wonderful.
Speaker 2:I hope you get that. I do too. So when you move to your bigger space, do you plan on hiring a front office staff or do you plan on hiring an office manager or someone like?
Speaker 3:that I absolutely do need an office manager. I just don't see it in the budget right now. But I will need a second staff member to do a receptionist job per se, because my medical assistant is actually acting as a receptionist and medical assistant. So she checks our patients in, checks them out, she also rooms them, does their vital signs, and then I told you she voluntarily works as a marketer too. So I definitely will. That will be priority. I want my employees to stay, so I don't want to overwork her.
Speaker 3:So the plan is to bring on one more staff member that could be my receptionist and actually at the space that I told you I wanted to lease they are already a doctor's office and one of the ladies there. When I was going to look at it it was outside of their business hours, but she introduced me to someone who works there currently. She's a patient care tech, but she's also just finished esthetician school and she can't find a job because everybody wants her to have experience. So my thought process was that she could be my receptionist at the front desk and then, if we get busy or our clientele builds up pretty quickly, we could move her to the back some days to do other services so she can get her feet wet. So I just was kind of thinking of that. That's not guaranteed, but just kind of thinking of ways to help other people while also helping myself too.
Speaker 2:Oh, I love that and to find someone that wants to move up in the company creates longevity and employee retention, so that's a good yes. So when you have your memberships, there are times when their credit cards don't process and you're going to have to call them and say, oh, your membership didn't process, so are you going to do that, or are you going to ask your nurse to do that? How?
Speaker 3:do you?
Speaker 3:plan on that I don't plan on doing that. I plan on having my medical assistant because she calls. So what she did and when I put the job posting out, just to be fair, I list the that this person would be our medical concierge and medical assistant, so basically doing two jobs. And we're not like I'm not super busy, like we saw 12 people Monday, so it's not overly crazy, but she does do two jobs. So now she calls my patients and kind of confirms their appointments. She books their appointment we confirmed two days before by phone, even though our system asked them with automated text. We kind of want to talk to them and have them confirm it so we can know that they're actually coming. So she would be like I would have her do that.
Speaker 3:Yeah, I don't want to be really uncomfortable talking about money with my patients still, even though I'm like cash pay and so what helps me is putting all the pricing out, like I'm so price transparency is I'm all about it, because I don't want anyone to have to ask me like, how much does this cost? Because I don't like to talk about it. So all of my pricing is on my website and my booking site and then there'll be times where somebody will ask me for something like, or ask me to do something, and I'm like, oh, yeah, I can do that, but we don't have anything in place for that. Yeah, I can do that, but we don't have anything in place for that. So I'm like, I'm just like we don't. We don't offer that right now or something, just to kind of avoid trying to come up with a price. Off the top of my head, I let that go.
Speaker 3:But primary care is something I do right now for free. So, yeah, that's not fun either, but I don't want to be the one to talk to them about their bill not being paid. And then in my contract it does say that I think after five days or something I can't remember exactly what the attorney put in there, but after five days that they will have to pay, like I think $25 or something, and I'll be honest, I probably won't even I know this sounds bad, but that probably won't be something that will be strictly enforced, because I know things happen. But as long as they get it paid once we call them, because we'll call them after my system tells me like the next day when they're overdue on their membership payment, and so we would just go.
Speaker 3:I mean, I guess we could give them a few days and give them a call like hey, we noticed that your payment and it tries every day to take the payment my system. I found that out recently with one of my weight loss patients that it tried to every single day and it just kept failing. So I reached out to her because it's her FSA. Come to find out she needed a letter of medical necessity. So we got that done and everything was fine.
Speaker 2:But so things like that might happen. What is the?
Speaker 3:$25 for Like a late fee if they don't, if their membership doesn't go through and they don't remit. I think she put like five days or something in the contract. The attorney when I was reading through it.
Speaker 3:What attorney did you use and how did you pick that attorney? I use a local attorney here, like Jolly Law Group, to do all. They did all of my forms and paperwork and they're in South Carolina and they're like specialized in healthcare and things like that. I've been using them for a while but I don't. I just use them when I need them, basically because that can be very pricey.
Speaker 2:Yes, I have found chat GPT to be very helpful for my forms.
Speaker 3:It's really good. I agree, especially for forms, that you don't need to reinvent the wheel for I think that chat GPT is good and then you go through and like kind of proofread and make sure it's right, cause I've used chat GPT for a lot of forms too.
Speaker 2:Yes, In fact, atlas MD has patient forms and HIPAA privacy forms and stuff that are already created within their EMR, and we had listened to the attorney that came to DPC Launchpad who suggested that sometimes attorneys that are working for your EMR may not necessarily have all your best interests in mind and they leave there's gaps in your contracts and all these things. So my office manager decided to basically put our entire contract into chat GPT and ask chat GPT, do you feel like this is a good contract? And chat GPT read it in 10 seconds and said this is a great contract. So I was fine with that. I'm sure it's great.
Speaker 3:I'm sure it's great, like and just in all honesty, one of my patients was here getting an IV and her friend is an attorney and she was on speakerphone with her and I kind of discussed the price that one particular attorney was charging that I didn't use and she was like what, you better put that thing in chat GPT. And she was an attorney and she said that that's what attorneys are doing and I'm like okay. So she asked me what do you need? And I told her she put it in chat GPT and she sent it to me via email and she was like there, you go Use that. And I was like, well, nice. So you know, I guess it just depends on. I'm not saying don't have legal help when you need to, when first opening, but you know it's expensive.
Speaker 2:Yes, Well, why don't we, since we're about to close up with our interview, tell me what does the future look like for sophisticated wellness and aesthetics? In the next five years, I guess? What do you see as the end game for sophisticated wellness, or do you feel like it's always going to be growing and doing new things?
Speaker 3:Oh, that is great. That's a great question. So I'm in a mentorship program right now through Goldman Sachs and we are actually working on our plan of action, and so I would like to position my clinic to be the go-to and the leading premier wellness clinic for health, wellness and beauty. That is my vision for this place. I don't want to just only offer, you know, direct primary care, but I want it to be a place where people can go for their wellness needs, their beauty needs, their aesthetic needs, for Botox, iv therapy, all of the things, even a sauna laser. Just, I have a really big vision for it. Obviously, I'm going to need a really big team, because I can't do it all by myself. So the goal is to build a team of other providers and exhilarate staff to help me build my practice to be what I envision it to be. I think that that's possible. Many times I've gotten oh, you need to niche down. Like you know, people aren't going to want to go somewhere where you offer everything, and I just don't find that to be true, cause if that were true, they wouldn't go see their primary care provider, for who knows a lot about you know. So we, that's just how I I am I've never found in nursing.
Speaker 3:I remember when I graduated nursing school I said I never want to work in ortho and that was my first job out of nursing school and I absolutely loved it. I worked on an ortho med surgery unit Loved it. Never want I don't want to work in peds. Finished NP school. My first job in rural health. They had me seeing the kids peds on the walk-in clinic side. I would see 38 to 40 patients a day, loved it. I haven't found a job in nursing that I hate. So I don't think I have to limit myself to just primary care or just aesthetics. I think that if I have a team we can provide all of it for our patients who come in here and they don't have to go anywhere else.
Speaker 2:That's great and I wish you all the best. I know that you're going to be successful. I can already tell that you just have the charisma, you have the personality and you definitely have surrounded yourself with positive people to make it happen for yourself. So I'm excited. This is going to be. This is going to be a great adventure, and I hope that I'll see you at the DPC Launchpad next year and then you can tell me all about it, because then you will have been up and running for like eight months by then.
Speaker 3:I'm excited. I'm waiting for you guys to drop the details on the cruise for DPC Launchpad.
Speaker 2:Well, we're still working on those details.
Speaker 3:Wherever it is, I'll be there. Hopefully I can share my success story of reaching my goal of 150 patients in the first six months, because you said it'll be eight months from now and maybe even surpass it. But I'm going to keep it 50 for six months and 100 for the first year, and I think I can do that for sure.
Speaker 2:Oh, I have no doubt that you can. So best of luck to you, and if you ever need anything, do not hesitate to reach out to me as well. Oh, thank you so much. I appreciate it. You're welcome. Have a great day you too. Bye, bye. Thank you so much for joining us today on the DPCNP. We hope you found our conversation insightful and informational. If you enjoyed today's episode, please consider subscribing to our podcast so that you do not miss an update, and don't forget to leave us a review. Your feedback means the world to us and it helps others discover our show. We love hearing from our listeners and it helps others discover our show. We love hearing from our listeners. Feel free to connect on our social media, share your thoughts, your suggestions and even topic ideas for future episodes. As we wrap up today, we are so grateful that you chose to spend a part of your life with us. Until next time, take care. This is Amanda Price signing off. See you on the next episode.