May 21, 2025 • 37 mins
In this episode, Wayne Lowry talks with Dr. Cynthia Villacis of Health Connections DPC about reclaiming the heart of medicine through Direct Primary Care. Dr. Villacis dives into her transformation from overworked community health physician to empowered small business owner delivering personalized care. She shares how she balances patient needs, runs her practice solo, manages immigration medical exams, and navigates GLP-1 therapy in lifestyle medicine. Whether you're a fellow physician or curious patient, this episode is packed with practical advice, inspiration, and a deep commitment to compassionate care.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Wayne LowryIs that you're getting rid of all of that pesky admin.
(00:03):
Cynthia VillacisWell, no, I wouldn't say that it's more a question if you get to decide how you are going to do the admin and how you are going to structure your day. There are so many fewer levels than an employee practice. It's not that it goes away.
(00:30):
Wayne LowryHello everybody and welcome to the Best DPC podcast. The world's #1 show, covering all things direct primary care. I am your host Wayne Lowry, and today I am very honored to have with us Doctor Cynthia Villacis who is joining us today to talk about her experience in direct primary care.
Wayne LowryWe've got a lot of exciting topics in store. She has been serving in DPC for going on, I guess, seven years, eight years founded her DPC practice in 2017, Health Connections DPC to deliver more accessible patient-first care, that is direct primary care for you.
(01:10):
Wayne LowryShe's an expert on immigration medical exams, lifestyle medicine for obesity management. We're gonna talk about GLP therapy and all sorts of things. So I am excited and let's jump in. So welcome, Cynthia to the podcast.
Cynthia VillacisThank you. Great to be here.
Wayne LowrySo what are you doing today? What? What is your daily routine look like there in Florence, KY?
(01:34):
Cynthia VillacisWell, one of the things about my practice is it's really kind of splits. I have some people that I do like direct primary care stuff with and I also do immigration medical exams,
Cynthia VillacisAnd then since I am a direct primary care practice, I am not employed, so I have to take care of all those admin things that you have to do to run a practice and have a business because you know we are small businesses.
(01:59):
Wayne LowrySo let's talk a little bit about what brought you into medicine to start with. So I understand you graduated and earned your MD became an MD in 99. Tell us about that experience.
Cynthia VillacisYeah. Well, I went to Med school at Wright State up in Dayton, OH, and then I went to residency at Saint Elizabeth in Northern Kentucky here. And that was another three years as far as her family practice residency. So, I mean, it's pretty intense. I mean, that was back in the day before work hour restrictions.
(02:31):
Cynthia VillacisWe still had a relatively traditional curriculum of the first two years being the hardcore sciences and then the next two years after that being the clinical rotations, but yeah.
Cynthia VillacisThat was when I had my son. The fall of my fourth year of Med school. So I did third year Med school pregnant, you know, sleeping on the bunk bed at right pad on the top because I was the lowest on the totem pole.
(02:58):
Cynthia VillacisSo, that was always fun.
Wayne LowrySo they put you at the top even as pregnant?
Cynthia VillacisYeah, yes, yes. And I struggled with that too much. And then I was in the infusion room on a cot.
Wayne LowryAre you serious?
Wayne LowryWow. Yeah. That. Yeah. Yeah. OK. Yeah, yeah. There's so many things that run through my head, and none of them are good. So I'm gonna move on. So what made you decide to get into DPC from a more traditional setting?
Cynthia VillacisYeah. Things changed.
(03:22):
Cynthia VillacisYeah, no problem.
Cynthia VillacisYeah, well, I spent most of my time after residency working in the community health centers in the Greater Cincinnati area and…
Wayne LowryTell us. Tell us what is a community health center?
(03:43):
Cynthia VillacisYeah, community health centers are set up to help folks that either don't have insurance or are underinsured or who have Medicare/Medicaid access care so they receive funding to help as far as with that.
Cynthia VillacisBut it is hard because they get reimbursed the same amount. At least they used to. Haven't been there in, you know, 7-8 years for somebody who was coming in with an ear infection and somebody who's coming in with diabetes and hypertension and heart failure and depression.
(04:19):
Cynthia VillacisAnd I was always struggling with not feeling like I had enough time to do the teaching, you know, with my patients and always felt like I was running behind. I didn't just feel like I was running behind. I was running behind.
Wayne LowryHow much time? So how much time on average were you able to spend with a patient in that setting?
Cynthia VillacisWell, I was usually scheduled in 15 minute increments, but that also included time to document everything, time to place orders, time to return phone calls from other patients and get everything wrapped up.
(04:52):
Cynthia VillacisAnd of course that didn't happen because when you get figure out all the other things, taking them out, that if I were to run on time, I would have had to be doing in the patient room maybe 10 minutes if that, which you know if you've got like 4 problems that doesn't leave you. Yeah, you don't so basically.
Wayne LowryYeah, you don't have time to deal with many of them.
(05:14):
Cynthia VillacisI was always running behind and I was trying to figure out ways to make myself go faster and they tried to figure out ways to make me go faster and I just never really felt like I could provide the kind of care that I wanted to in that setting and I thought it was just because as a community health center, right? So I'm looking around and I'm talking to other people and I'm like, oh, wait, it's not just me.
Cynthia VillacisIt is the way medicine, corporate medicine, is structured these days, so I was brainstorming what I could do differently. You know, everything from Google glasses to different kind of scheduling or scribing or whatever. And I wasn't getting place with any of that. And I was reading a medical economics magazine actually when I was on vacation, which kind of tells you how stressed I was, if I was doing that for fun.
(06:01):
Cynthia VillacisBut anyways, I was reading about that and I had it upon the idea of DPC and when I got back I kind of Googled DPC near me and I found one person that was about an hour and a half south of me.
Cynthia VillacisI went and visited her practice and went down to a conference with my husband a couple months later and came back and was like, “OK, I want to do this.” You know, this seems like it would allow me to provide the kind of care that I want to and that I think patients deserve. So it could be a win-win.
(06:31):
Wayne LowryYeah.
Wayne LowrySo 2017, so you went to a conference. Where was the conference?
Cynthia VillacisIt was in Texas. It was the Doctor's for Patient Care conference that Lee Gross had helped put together. So yeah, that was really pivotal.
Wayne LowryOK.
Wayne LowrySo, well, it's gotta be great if it was in Texas, so I can't argue with that. So you found yourself kind of finding hitting your head against the wall, not being able to provide the kind of care that you were expecting.
(06:59):
Wayne LowryFast forward. You decide to own your own, you know, open up your own DPC. I do want to talk a little bit about what it's like to run a business because I love talking about small business.
Wayne LowryBut before that, staying on that same thread of patient care. What have you taken from your past experience and applied into your practice?
(07:27):
Cynthia VillacisWow. So I mean, there were things that I had done as far as when I was in the community health center to try to help with people with diabetes. We had a dietician and the stuff with the diabetes prevention project trying to help with patient education and help with that, so I took that knowledge and brought that forward.
(07:51):
Wayne LowryWell, I guess what I was kind of leading towards was you're talking about having like 5 minutes, 10 minutes at most to talk with the patient. Yeah. How is that patient experience now in what you're doing with DPC?
Cynthia VillacisGot you. OK. Sorry. That's the wrong direction with that.
Cynthia VillacisSo yeah, so in terms of at this point in time, I am able to schedule an hour for new patients and 1/2 hour for follow-ups and patients can come back and see me when they need to or when they want to and they're really not limited by oh, are they sick enough to need to pay the copay to come in.
(08:27):
Cynthia VillacisYou know it's more guided by what, what their needs are. We can do telehealth visits. So if I've got somebody who is trying to do a follow up on like a mental health issue or a diabetes issue where it's more of a talking than a hands on kind of thing, those work really well for telehealth and patients can have the convenience of not having to drive to the office. Yeah, so.
(08:53):
Wayne LowryThat's so how much of your would you say the percentage of your patient follow-ups are strictly either telehealth or on a phone call or a text message or some sort of digital communication versus another in person appointment? Cause I can tell you from my experience.
Wayne LowryMy experience in healthcare is typically I'm going to go see my provider, I'm going to get, you know, the once over and then I'm hoping that my DPC doctor will just text me what I need to know so that I can go back to working. I like to work. I don't know. I'm weird that way.
(09:27):
Wayne LowryI want to take a quick break to talk about BestDPC.com. Are you a doctor looking to break free from the headaches of insurance and take control of your practice? Or maybe you're an employer searching for an affordable healthcare solution that actually works?
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(09:59):
Wayne LowryFind the Best DPC doctors near you. Get expert advice and take the first step towards a better healthcare visit BestDPC.com today and see why direct primary care is the future of medicine. That's BestDPC.com because great healthcare should be simple, affordable and built around you.
Wayne LowryIn person, every time for their follow up or how often are you, you know, using some of the technology platforms to expedite and help them with their care.
(10:30):
Cynthia VillacisIt honestly really depends on the patient and what their preference is and what the problem is they have going on. I use a patient portal pretty frequently for asynchronous communication.
Cynthia VillacisSometimes that will then end up having me call the person back to, you know, turn into a telehealth to get more detail about what's going on, obviously there's some limitations to that, but patients know that.
(10:54):
Cynthia VillacisSo if we're trying to follow up like on a blood pressure, sometimes patients have, you know, machines and we are comfortable with how their machines are working and they may be checking the blood pressure at home and then communicating those numbers towards me but obviously there's a limit that I can't redouble check it as far as you know in the office.
Cynthia VillacisSo I mean It's honestly, it's a mixture. I do more in person than I do tella, but that's based more on patient preference to be honest.
(11:21):
Wayne LowryI was gonna say, is that more based on where you're located or is it based on your patient panel makeup, how would you say— what would you say are the biggest factors? Because I guess it depends really on your target patient bin.
Cynthia VillacisYeah, I mean it honestly, it does depend on the demographics some. But it really just depends on the patient. I mean there's some people that really want to come in, they want you to see you and they feel more comfortable being here and talk to me face to face than having a camera.
(11:59):
Cynthia VillacisThere are other people like there was a guy I was talking with yesterday and I had seen him the previous week for a problem and I was wanting to touch base with him, you know? So I could go over how the problem had gone over the weekend, how he was doing now and was able to do a telehealth visit as far as in the mornings so he didn't have to leave work or come in and that worked.
Cynthia VillacisThat worked great. You know, so it was able to let him stay at work and also come consult with me about how he was doing about the problem that we already discussed.
(12:28):
Wayne LowryGotcha. So you talked about your patient portal, we talked a little bit about tech, but as a small business owner, you know you're either a solo opener or do you have other providers as a part of your practice?
Cynthia VillacisI don't have any providers, I'm the only prescriber. I do have two staff people that work for me. That's more because of the immigration medical exam part. The amount of documentation and help as far as that I want with that.
(12:52):
Wayne LowryOK.
Cynthia VillacisWhen I started out, though, I didn't have any, it was just me, myself, and I. And that was a lot of hats to wear. I remember my medical assistant from the community health center gave me an old medical assistant textbook that she had as a parting gift because, you know, there are many things as an employee that you don't do right?
(13:23):
Cynthia VillacisSo it's like everything from getting shots and drawing blood and actually being the one doing the EKG. Had I done those things before? yes, had I done those things in the last several years? no, you know.
Wayne LowryNo, that's that's fair to say and you know I kind of joke. So I'm blessed. I have a PA that's my primary care provider. But we also have a supervising MD that we're close with and will look at our charts and check more complicated or more, I would say more complicated but you understand, he's looking at different things but I won't let him anywhere near my veins.
(14:07):
Wayne LowryI will tell you that right now, like he's not going to draw my blood. We've got some of the I know the two. One is an RN and the other one is an MA and both of them if I'm coming in for labs like move out of the way, Doc. I want one of them.
Cynthia VillacisAbsolutely. I mean, they're the ones that are used to doing it more. You know, I mean. Yeah.
(14:29):
Wayne LowryAnd so, so being the solo practice, you've had to wear all the hats. So with tech and and the reason I bring that up is I'm thinking about it from a tech perspective.
Cynthia VillacisStep up the game.
Wayne LowryYou know, obviously there's tools and platforms that you've probably found to be helpful as a solopreneur, maybe some other DPC practices are looking at looking at their tech stack and thinking what do they need to do to kind of help their practice from a marketing perspective or for a scribing perspective or sending out referrals or any of those things so?
(15:05):
Wayne LowryIf you don't mind, share your tech stack. What are you finding helpful and what are you using?
Cynthia VillacisYeah. So Servo is my AHR, as far as that I use. So, I've had that for a number of years now. And I know people I—that was a big question when I was starting. “Which system should I use? What should I go with?” and I mean…I keep saying well you use what makes sense to your brain. And I was like, “What?”
(15:31):
Cynthia Villacis“There has to be a best system,” and I'm like, “OK, maybe there really isn't a best system,” but…
Wayne LowryHave you seen 1DPC? You've seen 1DPC.
Cynthia VillacisYeah. So I mean, I like Servo and it—
Wayne LowryEverybody's different.
Cynthia VillacisYeah, absolutely—has a bidirectional interface with my lab. So, that makes it really easy as far as for us to send…
Cynthia VillacisYou know, orders, you know, over somebody isn't getting their blood drawn in my office and then getting the results back. It comes in the chart really easily. So that's nice. And has the portal. It has the TeleHealth stuff. You know, in there has E prescribing, you know, in there it has the scheduling part in there and then it also has…
(16:10):
Cynthia VillacisYou know, the ability to do billing stuff. I don't bill insurance. I think there is a way to have an interface with something else, but that's not something that I do so…
Wayne LowryYeah. What about your patient communication? What are you using for some of the other tools?
Cynthia VillacisYeah. So I am in a transition phase right now. So I am kind of in the onboarding process of a version of a Go High Level. I don't know if you've heard of it at all?
(16:42):
Wayne LowryYeah, yeah, GHL.
Cynthia VillacisYeah. So I'm kind of, I'm working on that. I got it updated and got my website live over the weekend as far as through that, so that was huge.
Cynthia VillacisAnd it looks like it's really going to be a really good platform. I'm not going to be doing scheduling there because, you know, Servo has that, but for communication and e-mail, phone calls, leads, sending out forms—Servo does have the ability to do some forms. But…
(17:14):
Cynthia VillacisI'm not in love with the form kind of thing.
Cynthia VillacisYeah. So it looks like it's a really nice, nice platform. And I know it's able way more than I know how to do with it so far, so stay tuned.
Wayne LowryWell, that's awesome. I have not. I did not know that Go High level had a platform that would be good for DPC, so maybe that's something we'll put in the show notes. Maybe if there's a link to that tool, we can share at the end.
(17:45):
Cynthia VillacisYes.
Wayne LowryWhat about…are you a Google stack or a Microsoft stack?
Wayne LowryOr a Zuho?
Cynthia VillacisI use Google, yeah.
Wayne LowrySo, OK, good. We can be friends.
Wayne LowryI have people that love that, that clunky old Microsoft, but I'm not one of them. So all right, well, let's get into a little bit about the type of work that you do day in, day out. We've already discussed a little bit about it. So I want to kind of dive into the immigration medical exam.
(18:23):
Wayne LowryAs I mentioned to you before the show started, I live in South Texas.
Wayne LowryYou know immigration, our relationship with Mexico's crucial to the economy down here and we're seeing individuals outside and of any political party or political view of the day. We see people that are suffering and…
(18:48):
Wayne Lowryneed access to care and you know from a medical perspective, obviously you've got some experience in that world. And I thought it'd be kind of nice for you to discuss a little bit about your experience doing immigration medical exams, what's unique and different than a typical, you know, DPC patient, you might say.
(19:12):
Cynthia VillacisYeah. So as far as the immigration medical exam, that is a form of physical exam that anybody who is looking at trying to get the permanent residency or have an adjustment status done has to turn in with that application. So they have to turn in their immigration medical exam form along with their adjustment of status 485.
(19:36):
Cynthia VillacisSo the purpose of it is to make sure that folks don't have anything that's going to make them be a danger to themselves or others as they're going through the process. So there is taking the patient's history, there's certain vaccines they have to get. There's certain blood tests they have to get, have to sometimes have to look at old records depending on what's going on.
Cynthia VillacisIt's a process. It usually takes about a week. I do have some of those patients who stay on the other side and do decide to become DPC patients. And I have other people that just, you know, see me for the exam and I'm able to help them along the way.
(20:11):
Wayne LowrySo what? You know, when you're going through that, what are some of the nuance differences as far as language barriers? What are you finding as far as those things go?
Cynthia VillacisWell, I mean, I have people that come from several hours away sometimes to come see me because I do speak Spanish and my staff speak Spanish and that's very intentional because it really is…
(20:36):
Cynthia VillacisI think people can do and get a much better exam done and feel much more comfortable if they're able to do it in their mother tongue, right? I lived in Ecuador for a year between high school and college. One of my assistants is from Puerto Rico, the other one is from Venezuela. So everybody can speak in both languages comfortably and quite fluently.
(21:00):
Cynthia VillacisThat's how I have that set up. I also use an interpreter service online as far as for people when they speak other languages just because I think it is important to have that communication. And I know when I started out, I used family members more frequently. I didn't have the interpreting things set up and the family member would sgn that they were being the interpreter.
(21:23):
Cynthia VillacisBut I don't think that was really best medical practice because you don't know what the other person is saying. You know what I'm saying? And then you're expecting them to listen.
Cynthia VillacisNot just with their, you know, spousal hat, but with the interpreter hat. And there's a lot of filtering that I think just naturally happens, even if people have best intentions, you know? And for this purpose, I really wanna make sure the patient is able to give the accurate information and understands the process themselves.
(21:59):
Wayne LowrySo what are you seeing as far as trends go? Is there really a big drop off as far as people that you're seeing or is it still pretty consistent, pretty steady?
Cynthia VillacisThere was a big surge in December, January, February, maybe the first part of March. And then there has been a drop off some since then. It really kind of depends on what people are…
(22:32):
Cynthia VillacisWhat their status is in terms of how their applications are going, whether they're wanting to go ahead and proceed with that, or they're wanting to wait a little bit. There's a lot of variation in terms of what the lawyers are advising as far as how they proceed.
Wayne LowryGotcha. So a lot of things are up in the air is what you're saying?
Cynthia VillacisIt is. There have been a lot of people that have been really stressed about all the changes that have gone on. I mean, I've had folks that have been here completely legally and have their green cards—I mean, this is back in, like February, right? And had their green cards—not green cards. I'm mistaking their permanent authorization cards.
(23:11):
Cynthia VillacisWhere they're working legally, asking me if they should go to work because they were scared to go to work.
Wayne LowryGotcha.
Cynthia VillacisYou know, I've had people come in who have had family members that were being deported. I've had other people come in and they've, you know, been in the states for a very long time and…
(23:32):
Cynthia VillacisYou know that at that point in their life where they're like, “Yeah, no, we need to get this paperwork done so I can be legal.” Other people that come over on fiance visas or that are sponsored through their different employers who are now qualifying to do that. Other people came over on vacation and you know to visit their boyfriend and they got married inside they wanted to stay.
(23:54):
Wayne LowrySo it's it's. Yeah, they're coming in all you know, all backgrounds. And again like, like we say from a medical perspective it's just a person who needs care.
Wayne LowryAnd so commend you on your efforts to provide you know, quality medical care and and try to assist those that you can in your practice.
(24:18):
Wayne LowrySo another item that we wanted to talk about today before we wrap up here in a little bit is GLP-1’s. So you know it wasn't long ago that you could not open up Facebook or Google or TikTok and not get tons of ads about all of the GLP-1 options that you had and all of a sudden it got quiet. You know why it got quiet all of a sudden?
(24:48):
Cynthia VillacisWell, I think it had to do with regulations around compounding.
Cynthia VillacisI think that’s the biggest thing.
Wayne LowryYou mean when it went from like $300.00 a month to $1500 a month that may have a little bit impact?
Cynthia VillacisYeah.
Cynthia VillacisYeah, I mean it, there are different ways that people can get it and it can be more cost effective than like $1500. And there are some people that do have, you know, decent coverage as far as their employer.
(25:13):
Cynthia VillacisEspecially if somebody has diabetes, in addition to the other health issues that would be indicated for it, but there are some programs now as far as like through like LillyDirect where the physicians can send the prescription and they can get it like Lily for the moon jars. It has some vials that people can get if they're willing to drop inject.
(25:36):
Cynthia VillacisAs opposed to having it then and obviously you know, if you're talking about something that doesn't need the technology of a pen that can be in a little vial and the syringe and needle, obviously that's going to be, yeah, cheaper. And that's from a non alternative source you know, but yeah.
Wayne LowrySo tell me about that. How? What is that as far as the price point today? What are you seeing for that for patients? So is that actually a decent option right now?
(26:02):
Cynthia VillacisStill expensive, but it's as far as with the LillyDirect program. That's like the Mujra or or is that bounce that's running about $500 a month still expensive, but it's not 15?
Wayne LowryRight.
Cynthia VillacisSo that's for the prescription as opposed to you know any lab work or doctor visit. That's just you know them buying the medication but…
(26:24):
Wayne LowrySo tell me a little bit about your weight loss or weight management program. What are you, what are you doing with your patients? I understand you do a lot of lifestyle medicine and nutritional coaching. Obviously GLP-1 can be a part of that equation. So what is kind of a typical service that you're providing? What are you looking at in this case?
(26:49):
Cynthia VillacisLike it's the first thing I would look at as far as what the person's motivation is and what they're trying to achieve, you know? I mean, sometimes weight loss is part of that. Sometimes weight loss isn't part of that. You know, I mean, sometimes people need to address, you know, the sleep or the stress or, you know, all those other things that affect our health before…
(27:11):
Wayne LowryWe're not supposed to have stress, and we're supposed to sleep?
Cynthia VillacisYeah, well, those things really do kind of affect the people's ability to lose weight also, you know, so if somebody is really stressed that their cortisol levels are going to be up, if somebody has sleep apnea that's not being treated, you know it's going to contribute to their hypertension..
Cynthia VillacisIt's going to make it harder for them to lose weight, you know, so trying to make sure to take a look at the whole person and see what's going on with them and not not just focusing on the weight, the weight is, you know, that's your gravitational pull. It's a number.
(27:49):
Wayne LowryGot you.
Cynthia VillacisYou know, I've seen people who are, you know, 160 lbs and are really healthy and 160 lbs and they're really sick, you know, in the same thing, you know, if somebody's 200 lbs sometimes they can actually be pretty healthy. You know, they can be running their blood runner and the blood sugars can be fine and their cholesterol can be fine and metabolically. They're actually doing really good. There's just more gravitational pull on them.
(28:10):
Cynthia VillacisAnd I've had other people who are in very bad metabolic shape who have that same gravitational pull, you know, so it's trying to look at the person's overall health and what can we do to help with that.
Wayne LowrySo how often is a typical coaching session work for you?
Cynthia VillacisI have done that differently at different points in time at this point in time, I don't have it as something separate. It's more of a technique that I use and roll into talking with patients about what they're doing for their health, helping them set goals as well as looking at what mind shift things are affecting their ability to make progress to their goals, whatever their goals are.
(28:55):
Wayne LowrySo what would you recommend to a guy like me mid 40s? Should I just stop eating altogether? Should I burn 1000 calories a day? Like come on, Doc, help me out.
Wayne LowryEat more protein?
Cynthia VillacisYeah, well, stop eating all together. Would be a problem. And that's, you know, one of the reasons that makes it so hard because you can't cold Turkey eating. You know, it's a question of making healthy choices. And your body does tell you when it needs to eat.
(29:27):
Cynthia VillacisAnd the the food, the way the food is made these days, you know, in terms of the stuff that's processed is generally isn't the most healthy and it is, if you're, you know, eating out or buying things that are out there made in a way to get you to buy more, you know, so they've got that sugar and fat, it's all mixed mixed in and it tastes good, but it's really not good for you.
(29:48):
Cynthia VillacisAnd can make it harder for people to meet their health goal, no matter what it is. So I just kind of…
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(30:15):
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(30:38):
Cynthia VillacisDecreasing the amount of eating out, decrease the amount of processed food they're eating. Sometimes people with candy oh, they're not eating enough protein and they do need to eat more. Sometimes they need to drink more fluids. Sometimes it's a question of looking at, making sure that they're getting enough fruits and vegetables. You know, as far as in their diet.
Cynthia VillacisYou know, we talked about eating a rainbow of things, and that's to help people get the different vitamins and micronutrients and stuff like that that they need for it to be healthy. Now, when you add on a GLP-1, that helps with the mind chatter a lot.
(31:12):
Cynthia VillacisHelps as far as the appetite, people tend to have smaller portions, tend not to have the cravings for it and allows people to make more conscious choices as well about what they're doing, what they're not eating. Personally, I've taken a GLP-1 and I never realized how much mind chatter I had.
(31:35):
Cynthia VillacisUntil I took it and then I realized I wasn't thinking about food. Food was there and I was using it to…help nor with my body. Right. But it wasn't the urging or the cravings. You know, it wasn't. I want this. It was like, OK, it's time to eat. What am I going to eat to help make myself healthier?
Wayne LowryRight, you start to see it more as a fuel source and not a way to pass the time.
(32:00):
Wayne LowryOr to eat— Cynthia Villacis Oh yeah.
Wayne LowryEat your anxiety or eat your stress.
Cynthia VillacisOh yeah. I mean, I had definitely done work as far as with the stress stuff. You know, I've been, I've not just done coaching with people. I've been on the other side of getting coached on the other side of, you know, talking to a counselor. And those things are very helpful. And I think as people are making any kind of a journey to get healthier.
(32:21):
Cynthia VillacisGoing through that sort of process can help them a lot.
Wayne LowryAwesome. Well, thank you for your work in that space as well. A lot of patients can lean on your knowledge and your skill set to help them with their weight management, their diabetes management and you know that intentional care we talked about the time you can spend with the patients to really get to the root of the problem, get to the root of their issue and not just take care of the surface things as a testament to what you're doing in DPC.
(32:53):
Wayne LowryLet's just say you're talking to a new DPC provider, someone who's just jumping into the fray. What are some of the immediate, you know, some of the things that you would advise them to do maybe from day one? Thinking about your practice? What's something you wish someone would have told you and what could you share with them?
(33:19):
Cynthia VillacisUM, well, OK, so I guess to find other people that you can talk with.
Cynthia VillacisTo support you in the process, you know preferably other either private practice owners or DPC Doc’s that will understand what you're going through because it's a totally different base being an employed position and having your own business, you know.
(33:43):
Wayne LowryIt, and if there was only a DPC directory where you could find other DPC doctors and providers, right?
Cynthia VillacisAbsolutely, absolutely.
Wayne LowrySo, so community, it's about having a tribe, having a community. What about work life balance? How would you encourage a DPC provider coming in to live a life with work life balance?
(34:13):
Cynthia VillacisHonestly, I think that is something I have probably always struggled with and probably still struggle with to some extent because honestly I like what I do now. So before I struggled with it because I didn't have a choice and I felt trapped and I was stuck in the system and working busily for hours.
Cynthia VillacisAt this point in time, I do sometimes have problems saying not self off, but that's because I'm always trying to figure out ways to change things and make them better and take care of the patients as a different motivation. But make sure to figure out things that you can do that will support yourself and your family and don't just let the business take over everything because for those of us that have that tendency.
(34:57):
Cynthia VillacisBut surround yourself with the time—to be intentional about the time that you're setting aside for yourself and your family, because at the end of the day, you know when you go home, it's your family.
Cynthia VillacisThat's there as far as for you and we'll be with you as far as going forward. You know, your kids are not going to find another mom. Your husband's, hopefully, not gonna find another wife. Your mom isn't going to find another daughter. Your sister's still your sister. If everything else were to go away, your family is what's there.
(35:27):
Wayne LowryYeah.
Wayne LowryThat's true. That's a great, great spot to end your family still there. So I wanna thank you. Before we close it out, though, how can people find you?
Cynthia VillacisYeah. So my handle is Health Connections, DPC.
Cynthia VillacisWhich is really long, but this thing I try to get that short—Oh, that'd be another advice. Don't go for something as long as that. Takes a really long time to type. But Health Connections, DPC and I'm on Facebook and Instagram, I have a YouTube channel. And if you are in the Greater Cincinnati area, please.
(36:06):
Cynthia VillacisLook me up.
Cynthia VillacisAnd we can get together and talk.
Wayne LowryAwesome. Well, thank you. That's a wrap for today's episode. Make sure you find Doctor Cynthia and you connect with her in one of the social media platforms and do her a big solid and go and like her Facebook page. Share it. You know, all of those things can help even from afar.
(36:31):
Wayne LowryMaybe you don't drive to Florence, KY. But you can give her some encouragement online, so that's a wrap for today's show. Thank you for sharing your experience. And I want to thank all the listeners today for joining in and being a part of this program. We covered some really cool topics.
Wayne LowryAnd if you were interested in the things we talked about, please make a comment on the comments here on the YouTube channel, share, like, let the world know how much you care about direct primary care and until next time, your health matters so demand the best with direct primary care. Bye bye.
Wayne LowryIs that you're getting rid of all of that pesky admin.
(00:03):
Cynthia VillacisWell, no, I wouldn't say that it's more a question if you get to decide how you are going to do the admin and how you are going to structure your day. There are so many fewer levels than an employee practice. It's not that it goes away.
(00:30):
Wayne LowryHello everybody and welcome to the Best DPC podcast. The world's #1 show, covering all things direct primary care. I am your host Wayne Lowry, and today I am very honored to have with us Doctor Cynthia Villacis who is joining us today to talk about her experience in direct primary care.
Wayne LowryWe've got a lot of exciting topics in store. She has been serving in DPC for going on, I guess, seven years, eight years founded her DPC practice in 2017, Health Connections DPC to deliver more accessible patient-first care, that is direct primary care for you.
(01:10):
Wayne LowryShe's an expert on immigration medical exams, lifestyle medicine for obesity management. We're gonna talk about GLP therapy and all sorts of things. So I am excited and let's jump in. So welcome, Cynthia to the podcast.
Cynthia VillacisThank you. Great to be here.
Wayne LowrySo what are you doing today? What? What is your daily routine look like there in Florence, KY?
(01:34):
Cynthia VillacisWell, one of the things about my practice is it's really kind of splits. I have some people that I do like direct primary care stuff with and I also do immigration medical exams,
Cynthia VillacisAnd then since I am a direct primary care practice, I am not employed, so I have to take care of all those admin things that you have to do to run a practice and have a business because you know we are small businesses.
(01:59):
Wayne LowrySo let's talk a little bit about what brought you into medicine to start with. So I understand you graduated and earned your MD became an MD in 99. Tell us about that experience.
Cynthia VillacisYeah. Well, I went to Med school at Wright State up in Dayton, OH, and then I went to residency at Saint Elizabeth in Northern Kentucky here. And that was another three years as far as her family practice residency. So, I mean, it's pretty intense. I mean, that was back in the day before work hour restrictions.
(02:31):
Cynthia VillacisWe still had a relatively traditional curriculum of the first two years being the hardcore sciences and then the next two years after that being the clinical rotations, but yeah.
Cynthia VillacisThat was when I had my son. The fall of my fourth year of Med school. So I did third year Med school pregnant, you know, sleeping on the bunk bed at right pad on the top because I was the lowest on the totem pole.
(02:58):
Cynthia VillacisSo, that was always fun.
Wayne LowrySo they put you at the top even as pregnant?
Cynthia VillacisYeah, yes, yes. And I struggled with that too much. And then I was in the infusion room on a cot.
Wayne LowryAre you serious?
Wayne LowryWow. Yeah. That. Yeah. Yeah. OK. Yeah, yeah. There's so many things that run through my head, and none of them are good. So I'm gonna move on. So what made you decide to get into DPC from a more traditional setting?
Cynthia VillacisYeah. Things changed.
(03:22):
Cynthia VillacisYeah, no problem.
Cynthia VillacisYeah, well, I spent most of my time after residency working in the community health centers in the Greater Cincinnati area and…
Wayne LowryTell us. Tell us what is a community health center?
(03:43):
Cynthia VillacisYeah, community health centers are set up to help folks that either don't have insurance or are underinsured or who have Medicare/Medicaid access care so they receive funding to help as far as with that.
Cynthia VillacisBut it is hard because they get reimbursed the same amount. At least they used to. Haven't been there in, you know, 7-8 years for somebody who was coming in with an ear infection and somebody who's coming in with diabetes and hypertension and heart failure and depression.
(04:19):
Cynthia VillacisAnd I was always struggling with not feeling like I had enough time to do the teaching, you know, with my patients and always felt like I was running behind. I didn't just feel like I was running behind. I was running behind.
Wayne LowryHow much time? So how much time on average were you able to spend with a patient in that setting?
Cynthia VillacisWell, I was usually scheduled in 15 minute increments, but that also included time to document everything, time to place orders, time to return phone calls from other patients and get everything wrapped up.
(04:52):
Cynthia VillacisAnd of course that didn't happen because when you get figure out all the other things, taking them out, that if I were to run on time, I would have had to be doing in the patient room maybe 10 minutes if that, which you know if you've got like 4 problems that doesn't leave you. Yeah, you don't so basically.
Wayne LowryYeah, you don't have time to deal with many of them.
(05:14):
Cynthia VillacisI was always running behind and I was trying to figure out ways to make myself go faster and they tried to figure out ways to make me go faster and I just never really felt like I could provide the kind of care that I wanted to in that setting and I thought it was just because as a community health center, right? So I'm looking around and I'm talking to other people and I'm like, oh, wait, it's not just me.
Cynthia VillacisIt is the way medicine, corporate medicine, is structured these days, so I was brainstorming what I could do differently. You know, everything from Google glasses to different kind of scheduling or scribing or whatever. And I wasn't getting place with any of that. And I was reading a medical economics magazine actually when I was on vacation, which kind of tells you how stressed I was, if I was doing that for fun.
(06:01):
Cynthia VillacisBut anyways, I was reading about that and I had it upon the idea of DPC and when I got back I kind of Googled DPC near me and I found one person that was about an hour and a half south of me.
Cynthia VillacisI went and visited her practice and went down to a conference with my husband a couple months later and came back and was like, “OK, I want to do this.” You know, this seems like it would allow me to provide the kind of care that I want to and that I think patients deserve. So it could be a win-win.
(06:31):
Wayne LowryYeah.
Wayne LowrySo 2017, so you went to a conference. Where was the conference?
Cynthia VillacisIt was in Texas. It was the Doctor's for Patient Care conference that Lee Gross had helped put together. So yeah, that was really pivotal.
Wayne LowryOK.
Wayne LowrySo, well, it's gotta be great if it was in Texas, so I can't argue with that. So you found yourself kind of finding hitting your head against the wall, not being able to provide the kind of care that you were expecting.
(06:59):
Wayne LowryFast forward. You decide to own your own, you know, open up your own DPC. I do want to talk a little bit about what it's like to run a business because I love talking about small business.
Wayne LowryBut before that, staying on that same thread of patient care. What have you taken from your past experience and applied into your practice?
(07:27):
Cynthia VillacisWow. So I mean, there were things that I had done as far as when I was in the community health center to try to help with people with diabetes. We had a dietician and the stuff with the diabetes prevention project trying to help with patient education and help with that, so I took that knowledge and brought that forward.
(07:51):
Wayne LowryWell, I guess what I was kind of leading towards was you're talking about having like 5 minutes, 10 minutes at most to talk with the patient. Yeah. How is that patient experience now in what you're doing with DPC?
Cynthia VillacisGot you. OK. Sorry. That's the wrong direction with that.
Cynthia VillacisSo yeah, so in terms of at this point in time, I am able to schedule an hour for new patients and 1/2 hour for follow-ups and patients can come back and see me when they need to or when they want to and they're really not limited by oh, are they sick enough to need to pay the copay to come in.
(08:27):
Cynthia VillacisYou know it's more guided by what, what their needs are. We can do telehealth visits. So if I've got somebody who is trying to do a follow up on like a mental health issue or a diabetes issue where it's more of a talking than a hands on kind of thing, those work really well for telehealth and patients can have the convenience of not having to drive to the office. Yeah, so.
(08:53):
Wayne LowryThat's so how much of your would you say the percentage of your patient follow-ups are strictly either telehealth or on a phone call or a text message or some sort of digital communication versus another in person appointment? Cause I can tell you from my experience.
Wayne LowryMy experience in healthcare is typically I'm going to go see my provider, I'm going to get, you know, the once over and then I'm hoping that my DPC doctor will just text me what I need to know so that I can go back to working. I like to work. I don't know. I'm weird that way.
(09:27):
Wayne LowryI want to take a quick break to talk about BestDPC.com. Are you a doctor looking to break free from the headaches of insurance and take control of your practice? Or maybe you're an employer searching for an affordable healthcare solution that actually works?
Wayne LowryAt BestDPC.com we cut through the noise and connect you with the country's best direct primary care clinics. Whether you're a patient tired of surprise medical bills or A physician ready to build a thriving membership based practice. We've got the tools and resources you need.
(09:59):
Wayne LowryFind the Best DPC doctors near you. Get expert advice and take the first step towards a better healthcare visit BestDPC.com today and see why direct primary care is the future of medicine. That's BestDPC.com because great healthcare should be simple, affordable and built around you.
Wayne LowryIn person, every time for their follow up or how often are you, you know, using some of the technology platforms to expedite and help them with their care.
(10:30):
Cynthia VillacisIt honestly really depends on the patient and what their preference is and what the problem is they have going on. I use a patient portal pretty frequently for asynchronous communication.
Cynthia VillacisSometimes that will then end up having me call the person back to, you know, turn into a telehealth to get more detail about what's going on, obviously there's some limitations to that, but patients know that.
(10:54):
Cynthia VillacisSo if we're trying to follow up like on a blood pressure, sometimes patients have, you know, machines and we are comfortable with how their machines are working and they may be checking the blood pressure at home and then communicating those numbers towards me but obviously there's a limit that I can't redouble check it as far as you know in the office.
Cynthia VillacisSo I mean It's honestly, it's a mixture. I do more in person than I do tella, but that's based more on patient preference to be honest.
(11:21):
Wayne LowryI was gonna say, is that more based on where you're located or is it based on your patient panel makeup, how would you say— what would you say are the biggest factors? Because I guess it depends really on your target patient bin.
Cynthia VillacisYeah, I mean it honestly, it does depend on the demographics some. But it really just depends on the patient. I mean there's some people that really want to come in, they want you to see you and they feel more comfortable being here and talk to me face to face than having a camera.
(11:59):
Cynthia VillacisThere are other people like there was a guy I was talking with yesterday and I had seen him the previous week for a problem and I was wanting to touch base with him, you know? So I could go over how the problem had gone over the weekend, how he was doing now and was able to do a telehealth visit as far as in the mornings so he didn't have to leave work or come in and that worked.
Cynthia VillacisThat worked great. You know, so it was able to let him stay at work and also come consult with me about how he was doing about the problem that we already discussed.
(12:28):
Wayne LowryGotcha. So you talked about your patient portal, we talked a little bit about tech, but as a small business owner, you know you're either a solo opener or do you have other providers as a part of your practice?
Cynthia VillacisI don't have any providers, I'm the only prescriber. I do have two staff people that work for me. That's more because of the immigration medical exam part. The amount of documentation and help as far as that I want with that.
(12:52):
Wayne LowryOK.
Cynthia VillacisWhen I started out, though, I didn't have any, it was just me, myself, and I. And that was a lot of hats to wear. I remember my medical assistant from the community health center gave me an old medical assistant textbook that she had as a parting gift because, you know, there are many things as an employee that you don't do right?
(13:23):
Cynthia VillacisSo it's like everything from getting shots and drawing blood and actually being the one doing the EKG. Had I done those things before? yes, had I done those things in the last several years? no, you know.
Wayne LowryNo, that's that's fair to say and you know I kind of joke. So I'm blessed. I have a PA that's my primary care provider. But we also have a supervising MD that we're close with and will look at our charts and check more complicated or more, I would say more complicated but you understand, he's looking at different things but I won't let him anywhere near my veins.
(14:07):
Wayne LowryI will tell you that right now, like he's not going to draw my blood. We've got some of the I know the two. One is an RN and the other one is an MA and both of them if I'm coming in for labs like move out of the way, Doc. I want one of them.
Cynthia VillacisAbsolutely. I mean, they're the ones that are used to doing it more. You know, I mean. Yeah.
(14:29):
Wayne LowryAnd so, so being the solo practice, you've had to wear all the hats. So with tech and and the reason I bring that up is I'm thinking about it from a tech perspective.
Cynthia VillacisStep up the game.
Wayne LowryYou know, obviously there's tools and platforms that you've probably found to be helpful as a solopreneur, maybe some other DPC practices are looking at looking at their tech stack and thinking what do they need to do to kind of help their practice from a marketing perspective or for a scribing perspective or sending out referrals or any of those things so?
(15:05):
Wayne LowryIf you don't mind, share your tech stack. What are you finding helpful and what are you using?
Cynthia VillacisYeah. So Servo is my AHR, as far as that I use. So, I've had that for a number of years now. And I know people I—that was a big question when I was starting. “Which system should I use? What should I go with?” and I mean…I keep saying well you use what makes sense to your brain. And I was like, “What?”
(15:31):
Cynthia Villacis“There has to be a best system,” and I'm like, “OK, maybe there really isn't a best system,” but…
Wayne LowryHave you seen 1DPC? You've seen 1DPC.
Cynthia VillacisYeah. So I mean, I like Servo and it—
Wayne LowryEverybody's different.
Cynthia VillacisYeah, absolutely—has a bidirectional interface with my lab. So, that makes it really easy as far as for us to send…
Cynthia VillacisYou know, orders, you know, over somebody isn't getting their blood drawn in my office and then getting the results back. It comes in the chart really easily. So that's nice. And has the portal. It has the TeleHealth stuff. You know, in there has E prescribing, you know, in there it has the scheduling part in there and then it also has…
(16:10):
Cynthia VillacisYou know, the ability to do billing stuff. I don't bill insurance. I think there is a way to have an interface with something else, but that's not something that I do so…
Wayne LowryYeah. What about your patient communication? What are you using for some of the other tools?
Cynthia VillacisYeah. So I am in a transition phase right now. So I am kind of in the onboarding process of a version of a Go High Level. I don't know if you've heard of it at all?
(16:42):
Wayne LowryYeah, yeah, GHL.
Cynthia VillacisYeah. So I'm kind of, I'm working on that. I got it updated and got my website live over the weekend as far as through that, so that was huge.
Cynthia VillacisAnd it looks like it's really going to be a really good platform. I'm not going to be doing scheduling there because, you know, Servo has that, but for communication and e-mail, phone calls, leads, sending out forms—Servo does have the ability to do some forms. But…
(17:14):
Cynthia VillacisI'm not in love with the form kind of thing.
Cynthia VillacisYeah. So it looks like it's a really nice, nice platform. And I know it's able way more than I know how to do with it so far, so stay tuned.
Wayne LowryWell, that's awesome. I have not. I did not know that Go High level had a platform that would be good for DPC, so maybe that's something we'll put in the show notes. Maybe if there's a link to that tool, we can share at the end.
(17:45):
Cynthia VillacisYes.
Wayne LowryWhat about…are you a Google stack or a Microsoft stack?
Wayne LowryOr a Zuho?
Cynthia VillacisI use Google, yeah.
Wayne LowrySo, OK, good. We can be friends.
Wayne LowryI have people that love that, that clunky old Microsoft, but I'm not one of them. So all right, well, let's get into a little bit about the type of work that you do day in, day out. We've already discussed a little bit about it. So I want to kind of dive into the immigration medical exam.
(18:23):
Wayne LowryAs I mentioned to you before the show started, I live in South Texas.
Wayne LowryYou know immigration, our relationship with Mexico's crucial to the economy down here and we're seeing individuals outside and of any political party or political view of the day. We see people that are suffering and…
(18:48):
Wayne Lowryneed access to care and you know from a medical perspective, obviously you've got some experience in that world. And I thought it'd be kind of nice for you to discuss a little bit about your experience doing immigration medical exams, what's unique and different than a typical, you know, DPC patient, you might say.
(19:12):
Cynthia VillacisYeah. So as far as the immigration medical exam, that is a form of physical exam that anybody who is looking at trying to get the permanent residency or have an adjustment status done has to turn in with that application. So they have to turn in their immigration medical exam form along with their adjustment of status 485.
(19:36):
Cynthia VillacisSo the purpose of it is to make sure that folks don't have anything that's going to make them be a danger to themselves or others as they're going through the process. So there is taking the patient's history, there's certain vaccines they have to get. There's certain blood tests they have to get, have to sometimes have to look at old records depending on what's going on.
Cynthia VillacisIt's a process. It usually takes about a week. I do have some of those patients who stay on the other side and do decide to become DPC patients. And I have other people that just, you know, see me for the exam and I'm able to help them along the way.
(20:11):
Wayne LowrySo what? You know, when you're going through that, what are some of the nuance differences as far as language barriers? What are you finding as far as those things go?
Cynthia VillacisWell, I mean, I have people that come from several hours away sometimes to come see me because I do speak Spanish and my staff speak Spanish and that's very intentional because it really is…
(20:36):
Cynthia VillacisI think people can do and get a much better exam done and feel much more comfortable if they're able to do it in their mother tongue, right? I lived in Ecuador for a year between high school and college. One of my assistants is from Puerto Rico, the other one is from Venezuela. So everybody can speak in both languages comfortably and quite fluently.
(21:00):
Cynthia VillacisThat's how I have that set up. I also use an interpreter service online as far as for people when they speak other languages just because I think it is important to have that communication. And I know when I started out, I used family members more frequently. I didn't have the interpreting things set up and the family member would sgn that they were being the interpreter.
(21:23):
Cynthia VillacisBut I don't think that was really best medical practice because you don't know what the other person is saying. You know what I'm saying? And then you're expecting them to listen.
Cynthia VillacisNot just with their, you know, spousal hat, but with the interpreter hat. And there's a lot of filtering that I think just naturally happens, even if people have best intentions, you know? And for this purpose, I really wanna make sure the patient is able to give the accurate information and understands the process themselves.
(21:59):
Wayne LowrySo what are you seeing as far as trends go? Is there really a big drop off as far as people that you're seeing or is it still pretty consistent, pretty steady?
Cynthia VillacisThere was a big surge in December, January, February, maybe the first part of March. And then there has been a drop off some since then. It really kind of depends on what people are…
(22:32):
Cynthia VillacisWhat their status is in terms of how their applications are going, whether they're wanting to go ahead and proceed with that, or they're wanting to wait a little bit. There's a lot of variation in terms of what the lawyers are advising as far as how they proceed.
Wayne LowryGotcha. So a lot of things are up in the air is what you're saying?
Cynthia VillacisIt is. There have been a lot of people that have been really stressed about all the changes that have gone on. I mean, I've had folks that have been here completely legally and have their green cards—I mean, this is back in, like February, right? And had their green cards—not green cards. I'm mistaking their permanent authorization cards.
(23:11):
Cynthia VillacisWhere they're working legally, asking me if they should go to work because they were scared to go to work.
Wayne LowryGotcha.
Cynthia VillacisYou know, I've had people come in who have had family members that were being deported. I've had other people come in and they've, you know, been in the states for a very long time and…
(23:32):
Cynthia VillacisYou know that at that point in their life where they're like, “Yeah, no, we need to get this paperwork done so I can be legal.” Other people that come over on fiance visas or that are sponsored through their different employers who are now qualifying to do that. Other people came over on vacation and you know to visit their boyfriend and they got married inside they wanted to stay.
(23:54):
Wayne LowrySo it's it's. Yeah, they're coming in all you know, all backgrounds. And again like, like we say from a medical perspective it's just a person who needs care.
Wayne LowryAnd so commend you on your efforts to provide you know, quality medical care and and try to assist those that you can in your practice.
(24:18):
Wayne LowrySo another item that we wanted to talk about today before we wrap up here in a little bit is GLP-1’s. So you know it wasn't long ago that you could not open up Facebook or Google or TikTok and not get tons of ads about all of the GLP-1 options that you had and all of a sudden it got quiet. You know why it got quiet all of a sudden?
(24:48):
Cynthia VillacisWell, I think it had to do with regulations around compounding.
Cynthia VillacisI think that’s the biggest thing.
Wayne LowryYou mean when it went from like $300.00 a month to $1500 a month that may have a little bit impact?
Cynthia VillacisYeah.
Cynthia VillacisYeah, I mean it, there are different ways that people can get it and it can be more cost effective than like $1500. And there are some people that do have, you know, decent coverage as far as their employer.
(25:13):
Cynthia VillacisEspecially if somebody has diabetes, in addition to the other health issues that would be indicated for it, but there are some programs now as far as like through like LillyDirect where the physicians can send the prescription and they can get it like Lily for the moon jars. It has some vials that people can get if they're willing to drop inject.
(25:36):
Cynthia VillacisAs opposed to having it then and obviously you know, if you're talking about something that doesn't need the technology of a pen that can be in a little vial and the syringe and needle, obviously that's going to be, yeah, cheaper. And that's from a non alternative source you know, but yeah.
Wayne LowrySo tell me about that. How? What is that as far as the price point today? What are you seeing for that for patients? So is that actually a decent option right now?
(26:02):
Cynthia VillacisStill expensive, but it's as far as with the LillyDirect program. That's like the Mujra or or is that bounce that's running about $500 a month still expensive, but it's not 15?
Wayne LowryRight.
Cynthia VillacisSo that's for the prescription as opposed to you know any lab work or doctor visit. That's just you know them buying the medication but…
(26:24):
Wayne LowrySo tell me a little bit about your weight loss or weight management program. What are you, what are you doing with your patients? I understand you do a lot of lifestyle medicine and nutritional coaching. Obviously GLP-1 can be a part of that equation. So what is kind of a typical service that you're providing? What are you looking at in this case?
(26:49):
Cynthia VillacisLike it's the first thing I would look at as far as what the person's motivation is and what they're trying to achieve, you know? I mean, sometimes weight loss is part of that. Sometimes weight loss isn't part of that. You know, I mean, sometimes people need to address, you know, the sleep or the stress or, you know, all those other things that affect our health before…
(27:11):
Wayne LowryWe're not supposed to have stress, and we're supposed to sleep?
Cynthia VillacisYeah, well, those things really do kind of affect the people's ability to lose weight also, you know, so if somebody is really stressed that their cortisol levels are going to be up, if somebody has sleep apnea that's not being treated, you know it's going to contribute to their hypertension..
Cynthia VillacisIt's going to make it harder for them to lose weight, you know, so trying to make sure to take a look at the whole person and see what's going on with them and not not just focusing on the weight, the weight is, you know, that's your gravitational pull. It's a number.
(27:49):
Wayne LowryGot you.
Cynthia VillacisYou know, I've seen people who are, you know, 160 lbs and are really healthy and 160 lbs and they're really sick, you know, in the same thing, you know, if somebody's 200 lbs sometimes they can actually be pretty healthy. You know, they can be running their blood runner and the blood sugars can be fine and their cholesterol can be fine and metabolically. They're actually doing really good. There's just more gravitational pull on them.
(28:10):
Cynthia VillacisAnd I've had other people who are in very bad metabolic shape who have that same gravitational pull, you know, so it's trying to look at the person's overall health and what can we do to help with that.
Wayne LowrySo how often is a typical coaching session work for you?
Cynthia VillacisI have done that differently at different points in time at this point in time, I don't have it as something separate. It's more of a technique that I use and roll into talking with patients about what they're doing for their health, helping them set goals as well as looking at what mind shift things are affecting their ability to make progress to their goals, whatever their goals are.
(28:55):
Wayne LowrySo what would you recommend to a guy like me mid 40s? Should I just stop eating altogether? Should I burn 1000 calories a day? Like come on, Doc, help me out.
Wayne LowryEat more protein?
Cynthia VillacisYeah, well, stop eating all together. Would be a problem. And that's, you know, one of the reasons that makes it so hard because you can't cold Turkey eating. You know, it's a question of making healthy choices. And your body does tell you when it needs to eat.
(29:27):
Cynthia VillacisAnd the the food, the way the food is made these days, you know, in terms of the stuff that's processed is generally isn't the most healthy and it is, if you're, you know, eating out or buying things that are out there made in a way to get you to buy more, you know, so they've got that sugar and fat, it's all mixed mixed in and it tastes good, but it's really not good for you.
(29:48):
Cynthia VillacisAnd can make it harder for people to meet their health goal, no matter what it is. So I just kind of…
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(30:15):
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(30:38):
Cynthia VillacisDecreasing the amount of eating out, decrease the amount of processed food they're eating. Sometimes people with candy oh, they're not eating enough protein and they do need to eat more. Sometimes they need to drink more fluids. Sometimes it's a question of looking at, making sure that they're getting enough fruits and vegetables. You know, as far as in their diet.
Cynthia VillacisYou know, we talked about eating a rainbow of things, and that's to help people get the different vitamins and micronutrients and stuff like that that they need for it to be healthy. Now, when you add on a GLP-1, that helps with the mind chatter a lot.
(31:12):
Cynthia VillacisHelps as far as the appetite, people tend to have smaller portions, tend not to have the cravings for it and allows people to make more conscious choices as well about what they're doing, what they're not eating. Personally, I've taken a GLP-1 and I never realized how much mind chatter I had.
(31:35):
Cynthia VillacisUntil I took it and then I realized I wasn't thinking about food. Food was there and I was using it to…help nor with my body. Right. But it wasn't the urging or the cravings. You know, it wasn't. I want this. It was like, OK, it's time to eat. What am I going to eat to help make myself healthier?
Wayne LowryRight, you start to see it more as a fuel source and not a way to pass the time.
(32:00):
Wayne LowryOr to eat— Cynthia Villacis Oh yeah.
Wayne LowryEat your anxiety or eat your stress.
Cynthia VillacisOh yeah. I mean, I had definitely done work as far as with the stress stuff. You know, I've been, I've not just done coaching with people. I've been on the other side of getting coached on the other side of, you know, talking to a counselor. And those things are very helpful. And I think as people are making any kind of a journey to get healthier.
(32:21):
Cynthia VillacisGoing through that sort of process can help them a lot.
Wayne LowryAwesome. Well, thank you for your work in that space as well. A lot of patients can lean on your knowledge and your skill set to help them with their weight management, their diabetes management and you know that intentional care we talked about the time you can spend with the patients to really get to the root of the problem, get to the root of their issue and not just take care of the surface things as a testament to what you're doing in DPC.
(32:53):
Wayne LowryLet's just say you're talking to a new DPC provider, someone who's just jumping into the fray. What are some of the immediate, you know, some of the things that you would advise them to do maybe from day one? Thinking about your practice? What's something you wish someone would have told you and what could you share with them?
(33:19):
Cynthia VillacisUM, well, OK, so I guess to find other people that you can talk with.
Cynthia VillacisTo support you in the process, you know preferably other either private practice owners or DPC Doc’s that will understand what you're going through because it's a totally different base being an employed position and having your own business, you know.
(33:43):
Wayne LowryIt, and if there was only a DPC directory where you could find other DPC doctors and providers, right?
Cynthia VillacisAbsolutely, absolutely.
Wayne LowrySo, so community, it's about having a tribe, having a community. What about work life balance? How would you encourage a DPC provider coming in to live a life with work life balance?
(34:13):
Cynthia VillacisHonestly, I think that is something I have probably always struggled with and probably still struggle with to some extent because honestly I like what I do now. So before I struggled with it because I didn't have a choice and I felt trapped and I was stuck in the system and working busily for hours.
Cynthia VillacisAt this point in time, I do sometimes have problems saying not self off, but that's because I'm always trying to figure out ways to change things and make them better and take care of the patients as a different motivation. But make sure to figure out things that you can do that will support yourself and your family and don't just let the business take over everything because for those of us that have that tendency.
(34:57):
Cynthia VillacisBut surround yourself with the time—to be intentional about the time that you're setting aside for yourself and your family, because at the end of the day, you know when you go home, it's your family.
Cynthia VillacisThat's there as far as for you and we'll be with you as far as going forward. You know, your kids are not going to find another mom. Your husband's, hopefully, not gonna find another wife. Your mom isn't going to find another daughter. Your sister's still your sister. If everything else were to go away, your family is what's there.
(35:27):
Wayne LowryYeah.
Wayne LowryThat's true. That's a great, great spot to end your family still there. So I wanna thank you. Before we close it out, though, how can people find you?
Cynthia VillacisYeah. So my handle is Health Connections, DPC.
Cynthia VillacisWhich is really long, but this thing I try to get that short—Oh, that'd be another advice. Don't go for something as long as that. Takes a really long time to type. But Health Connections, DPC and I'm on Facebook and Instagram, I have a YouTube channel. And if you are in the Greater Cincinnati area, please.
(36:06):
Cynthia VillacisLook me up.
Cynthia VillacisAnd we can get together and talk.
Wayne LowryAwesome. Well, thank you. That's a wrap for today's episode. Make sure you find Doctor Cynthia and you connect with her in one of the social media platforms and do her a big solid and go and like her Facebook page. Share it. You know, all of those things can help even from afar.
(36:31):
Wayne LowryMaybe you don't drive to Florence, KY. But you can give her some encouragement online, so that's a wrap for today's show. Thank you for sharing your experience. And I want to thank all the listeners today for joining in and being a part of this program. We covered some really cool topics.
Wayne LowryAnd if you were interested in the things we talked about, please make a comment on the comments here on the YouTube channel, share, like, let the world know how much you care about direct primary care and until next time, your health matters so demand the best with direct primary care. Bye bye.
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