February 20, 2025 • 43 mins
In this episode, Wayne Lowry sits down with Joe Wilson to break down what’s wrong with American healthcare and how direct primary care (DPC) offers a better way. They discuss the difference between coverage and care, how DPC benefits employers and small clinics, and what it takes to grow a successful DPC practice. Joe shares personal stories, lessons learned, and a powerful testimonial about how DPC is changing lives—both for patients and healthcare providers. Tune in for an insightful look at the future of healthcare!
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Wayne LowryAnd there we are! We're live with Wilson, let's do this. You got coffee in your system?
(00:06):
Joe WilsonWell, I'm actually trying the new Blackberry Dr. Pepper this evening for the first time. So, I'm going to give it...
Wayne LowryWow.
Joe WilsonI mean, it's honestly not that bad. It's a good refreshing flavor. It's not endorsing. But I would say if you're into alternative sodas, just like alternative healthcare, Blackberry Dr. Pepper.
(00:27):
Wayne LowryYeah, I think that's good. I'm glad we're going to start off our first podcast with a plug for a soda company.
Joe WilsonYeah.
Wayne LowryNothing says the state of American healthcare like carbonated, caffeinated, sugar-infused sodas.
Joe WilsonThat's right.
Wayne LowryAll right.
(00:56):
Wayne LowryWelcome and hello to everybody watching or listening to the number one DPC related podcast in the world. We're number one, Joe. And I don't know if you knew that, but we are the number one podcast directly, specifically targeting DPCs in the world.
Joe WilsonCongratulations.
(01:16):
Wayne LowryYeah, well, thank you. Thank you. It's been a battle to get to this point, but here we are.
Joe WilsonYeah.
Wayne LowrySo today, as my guest, is Joe Wilson. Joe Wilson is a lifelong friend of mine. At least it seems like lifelong. We've known each other for like five years.
Joe WilsonYeah, sorry. You have to mind the train in the background right now. Can you hear it?
(01:41):
Wayne LowryIs that a train? Is that a metaphor for American health care right now? Is it about to run off the rails?
Joe WilsonNo, it's leaving the station. That's what's happening.
Wayne LowryThat must be the DPC we're talking about.
Joe WilsonYeah, that's right. All aboard.
Wayne LowryWell, nothing like the train to interrupt the kickoff of a podcast.
Wayne LowrySo, Joe Wilson, you are with Frontier Direct Care. We've known each other for years. We're not going to... you know, put a veil over the fact that we've known each other.
(02:11):
Wayne LowryWe've worked alongside each other in DPC. When I sat down and decided to start the best DPC podcast, I said, the first person I want to have on the podcast is one of my best friends, Joe Wilson, a pioneer, a warrior, a fighter…He was always there advancing DPC. And I said, we got to have Joe as the first guest. So, Joe, welcome to the podcast.
(02:41):
Joe WilsonYeah, thanks for having me.
Wayne LowryYeah. So, Joe, tell me about your day. Now this is 9: 35 PM that we're recording this podcast. Like what happened? We were supposed to do this at like seven o'clock this morning.
Joe WilsonWell, that's a good question. It's a long story that I'll make short, but it involves a washing machine, you know the town of Corpus Christi, Texas, and probably forgetting that I had somebody flying in for an in-person meeting today.
(03:09):
Joe WilsonThat was two hours long. And then realizing at about nine o'clock this morning, oh, I can't work remote. I need to be back in Harlingen. So, that’s how it started. And then I just got done delivering that washing machine over to Alamo, Texas. And so here I am now diving back through the office for a podcast with you.
Wayne LowryWow, you know what I feel honored. So, let me get this straight so you were going to work remotely and then said you became a…was a dishwasher you said? Dishwasher? Oh, washing machine—laundry machine. So you installed that today instead?
(03:46):
Joe WilsonNo, I just had to drop it off. That was it.
Wayne LowryJust had to drop it off. Okay. Well, I'm glad you made time for this pod.
Wayne LowrySo, Joe, we're going to talk a little bit about American health care. And just to dive right in, from your position and the state of things, what are you seeing that is wrong with American health care? And I mean, frankly, why is it so terrible, Joe?
(04:13):
Joe WilsonThat's a loaded question for sure. I think—
Wayne LowryI wanted to start easy with you, Joe.
Joe WilsonYeah, some low hanging fruit. You know, it's a big, loaded question. I think, the thing I see from even an administrative side, watching that transition over the last couple of weeks. And even as we think through what we see on the commercial side with private businesses is a lot of times where people are attacking the coverage aspect, right? So, they're angry or they're upset at Blue Cross or United or these big carriers or they're angry at the hospital.
(04:54):
Joe WilsonAnd really, I mean, unfortunately, you have to tell everybody like…It's your choices, right? And so it's an education and an understanding of actually how you procure care. And a lot of people are still over here fighting the coverage side of things and not actually addressing the care side of things.
Joe WilsonI think the administration's moving in a better direction towards some of the care delivery pieces, but still a long way to go when the oversized bear in the room seems to be insurance carriers. And that seems to be what gets addressed first. So that's probably the biggest thing I see is wrong with it.
(05:33):
Joe WilsonI think we're in some ways, attacking the wrong thing first. And it really has to be that patient education, consumerism, to make sure that they understand how to engage healthcare and what to use it for and how to use it.
Joe WilsonAnd that would change a lot of what's going on.
Wayne LowrySo for those that are listening that may not quite understand the difference between coverage and care, I mean, most people, at least in the traditional sense, they take their insurance card, they go the doctor, they use that insurance card with that doctor, they get the prescriptions with that card, they get the labs with that card. That magic card takes care of all their problems. So, when we talk about the difference between coverage and care, how would you describe those differences and kind of lay it out in layman's terms?
(06:25):
Joe WilsonYeah, I mean, I think, you know, ultimately we look at a large insurance carrier or we think about an insurance network is kind of maybe a familiar term. You get in-network or out-of-network coverages. And if it's in-network, that means that there's probably been a contract contract between let's say an insurance carrier like UnitedHealthcare and that provider, their own personal business that might be you know Wayne Lowry's medical clinic, right? And so UnitedHealthcare—
(06:55):
Wayne LowryI would not—I would not go there.
Joe WilsonYeah, so UnitedHealthcare comes in, does a contract with you, and then ultimately there's some you know rates that are associated with your services that you can send your claims to UnitedHealthcare when members come in with that insurance card, and they will reimburse you with money from those employers that those people work for from those health funds, right?
(07:22):
Joe WilsonWhether those are premiums that United has kept, and are doling out or if it's simply money from their medical claims accounts.
Joe WilsonSo when that coverage, that's just simply saying that there's a vehicle or a method or a platform that is available for you to pay for your medical services. That's what insurance is doing. They're giving you the platform to process payments on, in what seems like and may have been for a long time a more efficient manner, right, than maybe just going out there and trying to figure it out on your own.
(08:01):
Joe WilsonAnd then more so though when you look over at care, it's actually those people that own those businesses that pay that lease and have those machines and employ that staff that put hands on you and actually administer procedure or care or give you a shot or prescribe a medicine.
Joe WilsonThat's the difference. And you can actually go buy that care and not have to actually go and do the network, right? The network kind of gives you an overarching, easy-to-use method, but it's not always the most affordable method. And so, it's good to have insurance. It's also great to go and procure care and make sure you're getting the highest value for your dollar.
(08:46):
Wayne LowrySo when you're talking about the highest value of care, obviously, you know, we're familiar with the direct primary care model. What would you say is some of the real benefits of direct primary care over the traditional health care model?
Joe WilsonI think, you know, the real benefits of direct primary care is it's extremely versatile. And so, you know, whether you're in a fully insured, you know, typical insurance program that a lot of small businesses have where they just simply pay premiums to their insurance carrier and then that money is gone, whether you use it or not. Whether you're in that program or you're in a self-funded, you know, fully customized insurance program that your employer has put together. Either way, DPC has a very powerful role in both.
(09:37):
Joe WilsonWhen you look at fully insured, one of the coolest things I like to think about is you know Obviously, let's just make up some fake numbers here, but like somebody's paying a $500 premium for their insurance package. Maybe they've got a $5,000 deductible. you know, some… maybe it's a higher out of pocket, like an $8,000 out of pocket. It's pretty inexpensive plan given the current market where it's at now.
(10:03):
Joe WilsonBut in order for them to go up and have maybe what would be like $0 copays and $1,000 deductible and really low drug copays as well, that top plan on that, you know, renewal that you're going to get, it's probably going to be like $1,200 per person per month, right? And the cheapest plan might be $400 per person per month.
(10:26):
Joe WilsonAnd the big difference between that being your out-of-pocket exposure and the co-pays or the amount of money that would be charged for you to get care for the first time, right? And so a lot of times those more expensive plans, it's cheaper. The co-pays are $10 or free for primary care, but they're going to cost you $1,200 a month. You can go and get that lower fully insured plan that might be maybe $400 or $500 a month, add direct primary care. And I know out there there's several DPCs ranging from $60 a month to $120 a month seems to be kinda around the threshold…
(11:02):
Joe WilsonAnd so you can stack that in there. And now for roughly, you know, $550 or $600, you've got a plan that—with DPC and a low premium insurance plan has—is driving a similar value to the top plan on the list that would have effectively cost you like $1,200.
Joe WilsonSo you can really take...something where, you know, you want to give your employees better benefits, you can do that by still giving them an affordable, inexpensive insurance plan, but then tacking on DPC. And now that thing is working like the Rolls Royce of insurance plans.
(11:38):
Joe WilsonThe same thing you see when you move into the self-funded space is the best thing I see there is that–and you're familiar with this, right, you stand up front and you tell, i don't know, a couple hundred employees like, “hey, here's what we're doing today…” And two minutes later, probably, you know, almost forgotten all of it. And they don't have any clue what we were supposed to be doing today. And they're coming back to you and saying, “Hey boss, can you tell us again what the plan was?”
(12:09):
Wayne LowryNo, they were coming back complaining about the snacks you offered in the presentation. That's what they were doing.
Joe WilsonProbably so. And so, that's what happens out there; a lot of times we have really creative advisors in the insurance space. You have really specialized and intentional people in the human resources space or benefit administration space. You've got very innovative vendors in the market that have everything from virtual care to mail order drugs, to international sourcing, to 340(b) to 501(r); all these programs that can really help alleviate the risk from your plan and save you a ton of money and get your people better care faster.
(12:49):
Joe WilsonThat's all available and you can spend all year building a very cool plan for that. But the problem is when you just let that plan go out to the open network and it's—you're telling that to your employees then they walk out and walk into the nearest hospital. Nobody at that hospital knows what your plan is. The only thing they're gonna recognize, for the most part, is you got it from Blue Cross or United or Aetna or Cigna or whoever that might be. And that's where they're gonna send their claims.
(13:17):
Joe WilsonWhen you have direct primary care, those plans can be communicated with your providers. And so, that first experience that your employee has, now all those cost containment features and great plan design things you did to really enhance the benefits, can be communicated not just at open enrollment, but at every single patient encounter.
(13:37):
Joe WilsonAnd so, we're eliminating a massive amount of medical waste in that and just making sure that people are able to get in, see their provider, understand the options that are available to them for downstream referral use, whether that's a direct contract or a pharmacy program or a wellness program, or even an occupational health program, they're able to be coached through that with their dedicated primary care provider. And that solves a ton of the cost issues just by not allowing or not setting up an ecosystem where everything you're doing is falling on deaf ears every day.
(14:16):
Wayne LowrySo, Joe, you're talking about a comprehensive approach to solving the problem of coverage and care. What about these small DPCs and small clinics that—I mean—we've seen, you know, there's thousands of them across the United States. And every day since I've launched this directory, BestDPC.com, we have...almost every day, we've got a new clinic.
(14:46):
Wayne LowryAnd it's fascinating when I'm looking at their story and seeing, you know, several of them may have two, three hundred members, they may be one provider, two providers, and a single clinic, how can they engage in this overall process when they're such a small site?
Wayne LowryLike what can they do to help employer groups, whether they're small, medium or large, to provide DPC to those employees and how will it benefit those small employers in those situations?
(15:20):
Joe WilsonYeah. I mean, I think, you know…
Joe WilsonYou were a part of Frontier's journey for a lot of seasons there. And so, you watched it happen too. We started out like every other mom and pop DPC out there. We had a little bit bigger vision. We knew we wanted to scale and we wanted to be able to grow to be multiple locations because Dr. Pete, our founder, wanted to be able to invite the residents that he was teaching. He wanted to be able to invite them into a direct primary care model.
(15:54):
Joe WilsonAnd he just simply saw that the risk for those residents to come out, hang up a shingle and go out there and start doing business, the delta was just too wide for any of them to really jump across it. And so, he knew he had to kind of do it himself and then create the bridge to bring other providers and physicians into this model.
(16:15):
Joe WilsonAnd so, you know, I think the biggest thing we did first was we created that vision, right? You got to know where you want to go. And, you know, one thing I recommend for that is the book, “Traction”. I think we're—you know, we made you read it, Wayne, when you joined the team for a season there.
Wayne LowryYeah.
Joe WilsonAnd it was like, this is what—
Wayne LowryI have—Well, and not only that, Joe, I'll tell you. I've taken that with me in every other little startup or venture since leaving Frontier because it is such a great tool.
(16:44):
Joe WilsonYeah, and it's simple, right? And so, but at least having that, you know, because I think the second part is, one, you got to have a game plan and then two, with that game plan, it should tell you exactly what kind of team you need to build. And so, you know, thinking through—yeah, there's “Traction”, Gino Wickman, the author there…buy it on paperback. You can do the audio book, you will need some of the resources in it.
(17:06):
Joe WilsonSo, I don't recommend the audiobook by itself. But there's a ton of online resources as well.That was foundational to us starting our business and as we built a team, I think that's second part is you gotta have a game plan, you gotta have a team to execute that game plan. You know, sometimes it's a combination of you wear a lot of hats when you start that first DPC.
(17:32):
Joe WilsonAnd so, you're the head of marketing, the head of HR—all those things. And as you're hiring and growing and scaling and doing sales and trying to work with brokers and learn insurance, like it is a lot to undertake.
Wayne LowryI wanna 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?
(17:59):
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 surprising medical bills or a physician ready to build a thriving membership-based practice, we’ve got the tools and resources you need.
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 primary care is the future of medicine. That’s BestDPC.com. Because great healthcare should be simple, affordable—and built around you.
(18:35):
Joe WilsonThe first thing I think about, when people are going to start working with employer groups as a direct primary care, is they need to understand what they're getting into. And one, it's got a lot of upside in that you get to have one decision maker in a lot of ways. And we'll make this seem very simple, but it's not.
(18:56):
Joe WilsonBut maybe you talk to one person and you have one or two meetings and you gain 50 new lives for your practice, right, and that sounds pretty awesome.
Joe WilsonAnd trust me, when you look at your membership thing, and it bumps up, 50 new people just registered for your DPC and you've been floating along for you know eight months with like 100 members, you're like, “Oh my gosh, we have found the magic sauce. Here we go.”
(19:20):
Joe WilsonBut with that, comes a lot of things. There's a massive process to open enrollment, to communicating what the benefits are, to having those materials, marketing and all those things ready to educate those new members about that DPC, really having a great consultant or broker or advisor, whoever you're kind of working with there, making sure they understand how to operate a plan that has DPC in it, because it's not the same. I mean, it can feel very similar, but there's a lot of ways that you can make it challenging and there's a lot of ways that you can make it very efficient.
(20:00):
Joe WilsonAnd so, you know, understanding that, thinking through that, giving yourself enough time to—that's a big one—I think early on we got into the rat race of like, “Hey, they want to sign up.” “Ok, we'll see you on Monday,” right? And not actually going over and educating the patient.
Joe WilsonAnd so on the backside, we would have employees who, you know, the business owner didn't know how to talk about DPC, the broker didn't know how to talk about DPC, and they're the ones that did the open enrollment. And now, you've got 15 people walking in your door saying, “I'm here to see the doctor.”
(20:28):
Joe WilsonAnd so, they made a great decision, but are they going to back it up two or three years from now when it comes time for renewal? Or is it something that's just going to be cut out?
Joe WilsonAnd you're going, “we do that by appointment.” And now, they're all frustrated because nobody told them it was by appointment only, right? And so, you've got to just make sure you're really methodically walking through that checklist.
Joe WilsonAnd then I think the second part, you know—or another addition to that, is don't get out of your skis. And that can be a big challenge that, you know, you're maybe a one or two provider practice, you're trying to keep your patient panel at 600 people or so, and all of a sudden, you get an opportunity, maybe a great broker comes through and says, “Look, I got a 300 person group. Do you want them?”
(21:07):
Joe WilsonAnd you say, “Yes.” And you take them on and you realize half your business is now contingent on one person making a decision if they want to keep using you. And in addition, if that one person is a city leader or a church leader, there's a lot of reality that they might not be there in two or three years because those are kind of some transient jobs that we often see.
(21:37):
Wayne LowryIt's hard when you're—I mean, at any capacity, you might say to put all your eggs in one basket. So either, you know, as you scale, as you're examining your capacity, and whether or not you want to take on, you know, business clients into your practice,
Wayne Lowryone of the things—like you mentioned—you got to know your capacity and know if you're really willing to put that many eggs in that basket. ‘Cause who knows what could happen? You lose that one client, then all of a sudden you're back at square one.
(22:07):
Wayne LowryAnd as you could probably state, better than I can, there's a chance you will lose some existing customers because you have to shift your focus. And all of a sudden, those one-on-one interactions that you were so freely giving to your patients become harder to harder to do. Wayne Lowry And now, your new partner in the business or a mid-level that's taken part of your load or whatever your case is, is all of a sudden the face that this one patient is now seeing instead of your face. And so, there's a lot of challenges and opportunities in some of that.
(22:48):
Wayne LowrySo, I guess, if you were to sum up or wrap up this section of thought, what would be the number one caution you would give to any DPC? What would be that one little piece of advice going through what you've gone through to any small DPCs that are looking to expand on that?
(23:09):
Joe WilsonYeah, I mean, I think ultimately, finding a mentor in the space is key. And so, you know, whether that's talking to a DPC down the road, that's maybe a season or two ahead of you and just asking like, “Hey, how does your patient agreement look? What kind of contract did you put together? What were some pitfalls or some heartaches that you went through? How do you even judge or think through a sales cycle?”, right?
(23:35):
Joe WilsonAnd, “When do these sales even happen?” That's a big part of it and I think just finding that mentor that can look around the corner for you, you can ask questions of, it's great. I mean, we've done it a lot when we were growing up.
Joe WilsonI remember—a big shout out to our friends at first primary care—like just up the road in Houston, they were a couple seasons ahead of us and they had a great website and they had a great like sales funnel and they had members coming in they were getting you know two, three, four—twenty a day at sometimes, right? Just retail members finding them on facebook, signing up. And I thought, “That's incredible.”
(24:09):
Joe WilsonAnd talking to Jay Medley up there, he just said, “Hey, man, we want the whole movement to grow.” And so, you open up the playbook and said, “Here's the vendors we use for our tech stack, here's the things we put together, here's how we drive some membership.”
Joe WilsonAnd so there's a lot of people in the DPC community that are very willing to share how they got to where they are or things they wish they wouldn't have done. And it helps us not pay the dumb tax, what we call it.
(24:34):
Joe WilsonSo, you know, don't pay the dumb tax. Find a mentor. That'll take you a long way.
Wayne LowryWell, I appreciate the discussion on kind of the overarching movements, the problems, the solutions in DPC, but I want to take a little bit time now to talk a little bit about Frontier Direct Care directly and specifically just looking at your involvement there, what you've seen, and you know talk a little bit about that experience.
(25:01):
Wayne LowryA couple things that come to mind, Joe, you know some kids when they grow up, they want to be firefighters. Some kids, they want to work for NASA. You said, I want to change healthcare, right? You were that five-year-old boy that said, I want to change healthcare for America.
(25:23):
Joe WilsonYeah.
Wayne LowrySo,
Joe WilsonLet him be driving a NASCAR, maybe. Like, I was all end into, like, let's be the next Dale Earnhardt here. Like, checkers or wreckers?
Wayne LowrySo, what you're saying is you didn't exactly think you were going to get into healthcare. So, Joe, what drew you to direct primary care? Why did Joe Wilson give up the NASCAR and go into direct primary care?
(25:49):
Joe WilsonWell, first, we're going to look at this thing called the budget, and I don't have a couple million bucks, so we don't have a race card team.
Wayne LowryOkay.
Joe WilsonBut then we'll get to the next part.
Wayne LowryYeah.
Joe WilsonYou know, what drew me to it, honestly, was, you know, I'd done 20 years of nonprofit outreach ministry with high school kids and things like that. And, you Dr. Pete was my committee chair for the organization I worked for, Young Life.
(26:11):
Joe WilsonAnd Bibb, our CEO, was my finance chair. And so they would help me raise money and spend money, basically. And so it really was just this kind of unique time as as we went through the pandemic and that kind of gave us all a chance to kind of look at this idea
Joe Wilsonand do we want to, you know, kick something off like this and see if Dr. Pete wants to grow to have two or three clinics and invite other the providers in. So that was an interesting conversation.
(26:39):
Joe Wilsonat an interesting time when we were kind of shut down with ministry stuff in the high schools. And I just knew that I had, you know, an opportunity. One, I had been volunteering with Culture of Life. I think you're familiar with them.
Wayne LowryOh, yeah.
Joe WilsonSo, if you don't know, Wayne, I live in the same town. We're, actually, we live in the same neighborhood.
Wayne LowryHe's actually sitting right here next to me. No, I'm just kidding.
(27:01):
Joe WilsonI'm like 10 minutes away. But anyway, Culture of Life is a really cool ministry that Dr. Robinson has. And so I was able to sit on kind of the board of directors there for a season and help with some of the marketing stuff and solve this drastic need for those that have been marginalized to have access to health care.
Joe WilsonAnd when COVID hit, we realized the whole fee for service world out there had nothing on virtual. Like they couldn't bill or code for it. They didn't know how to access it. It wasn't a part of their electronic health records. Like, so everybody trying to get diabetic medicine and things like that couldn't get in. So we stood up on a virtual platform, went to the news media and did that.
(27:41):
Joe WilsonAnd I saw the impact it had just like that. And yeah. really to watch people come in and thank you for just treating them as a human and looking them in the eyes and being able to, you know, care for them with compassion and give them the things that they needed was very basic, but very life giving. And so when Dr. Pete was like,
(28:02):
Joe Wilson“Hey, would you help me with this mission of restoring healthcare care and bringing it back to what it should have been in direct primary care?” And he was totally selling me on like the old school dock with a bag walking house to house at that time, because that's kind of what he was doing.
Joe WilsonI thought, well, that's fascinating. And so began to help out, had a little bit of a knack for raising money. And so kind of used that skillset with Bibb and Dr. Pete to begin talking to investors to gather up enough capital to open up, you know, two or three locations and invite a couple of doctors in and try and sell in, actually individual members at that point, you know, through Facebook or whatever into those locations.
(28:40):
Joe WilsonSo that's how we got started. And then, yeah, I don't know how much further you want me to go.
Wayne LowryYeah.
Wayne LowryWell, you know, so I'm thinking, some of the kind of interesting stories we talked about: how many hats, you kind of mentioned in passing, how many hats someone might wear when they're starting a DPC. So Joe, here's a little trivia.
Wayne LowryCan you tell me how many hats you've wore?
(29:04):
Joe WilsonOh, gosh. Officially, I've worn three now. So I started out as the chief operating officer.
Joe Wilsonand you're counting this now.
Wayne LowryI'm going count.
Joe WilsonAnd then after a while, like we knew that we wanted to bring somebody else for that role. And so I moved over to the chief growth officer, which was a little bit more ambiguous. And so I could do more things like product development, sales, all that kind of stuff.
(29:27):
Wayne LowryYep.
Wayne LowryAnd that's when we shot rubber bands at each other from across the hall.
Joe WilsonYeah.
Joe WilsonAnd then now that we've kind of stepped into a really pretty well-developed product and we've got a whole lot of team members in specific roles, I've kind of moved over as like an executive vice president. And so mainly focus on the public sector and sales, in with government services and things like that.
(29:57):
Joe WilsonAnd so we look at, you know, new cities and locations and school districts and try to see if we can go and serve communities that are looking to solve access issues and then partner with those communities and their brokers and advisors to build direct primary care centric plans and either employ another direct primary care out there and help connect them if it's not in our market or if it's something we can serve, build a clinic and staff it and start doing DPC in a new community.
(30:25):
Wayne LowryNow, I counted three official titles, but I also remember you being the guy that built the desks that we used out of ParticleBoard.
Wayne LowryIs that not also one of your jobs, Joe?
Joe WilsonIt was. I was a furniture maker for a season for the new office furniture when we moved in here. And then my favorite,
(30:46):
Wayne LowryYou ran the HVAC system.
Joe WilsonMy favorite was wearing the HR hat when I got to hire you know primary care providers and I knew hardly anything about actual medicine, right? Like and knew kind of how to build a team and was like trusting them, but what's fascinating, I'm sure they were kind of like, this is the least medically inclined treatment I've ever had.
(31:10):
Joe WilsonBut thankfully Dr. Pete was there to ask the medical questions. I was there to ask the fun questions like, you know, “If you had to improve Domino's pizza delivery, how would you do it?” And then they would answer and I'd be like, “That's a great answer.” And then we'd move on. So,
Wayne LowryYou wouldn't. You would tell them that was a terrible answer. Stay in your lane, doc. That's what you'd say.
Wayne LowryLet’s take a quick break to talk about ScalebySEO.com
(31:31):
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(31:58):
Wayne LowryBe visible. Get found. Grow your practice. Don’t leave growth to chance. Visit ScalebySEO.com today and let’s get your clinic in front of the right people.
Wayne LowryAll right, Joe. So tell us. So when I was working at Frontier, we had about, I don't know, 14 people on staff. We were in an old parts store.
(32:23):
Wayne LowryThe AC didn't work. There were no doors. There were no doors, except for there were some sliding doors for the HR department, I think.
Wayne LowryThat was about it. But the rest of us, we hear every phone call. Tell me things have been improved.
Joe WilsonThey've improved a lot. We're starting to, I think we've got well over 100 employees now. I'm going to mess up on the actual number. I feel like it's around 130, 140 folks are joining the team, rapidly expanding in some new markets. So that's really exciting.
(32:58):
Joe WilsonBut yeah, it's gotten a lot better. You know, those days and and where we were all, you know, hey, I'm HR one minute, then I'm going to go do open enrollment the next minute, then I'm going to be sales, and then I'm going to do some marketing, and then I'm going to do graphic design, and I'm going to work on some kind of tech process to help out Steven with the, you know, EHR stuff.
Joe WilsonLike, it's just… It was crazy, you know, and it still is a lot of fun to dive into those projects. But now everybody's really got a good team behind them. What used to be hats became people and then those people became departments, right? And so that's kind of cool to watch.
(33:35):
Wayne LowryYeah.
Joe WilsonIt's just, if somebody, you know, we hired one person that came in as a part-time graphic designer and now they're you know standing in member services and really doing a great job and moved over into concierge and referrals.
Joe WilsonAnd so to watch the development of those people and our team as they've grown up inside this company has been really special and really freeing just to see like your vision and dream that you shared with your friends and poured into so many people as you brought them into the team and like take shape. And now they're pushing that same mission forward.
(34:12):
Wayne LowryThat's awesome, Joe. So what is, I guess one of the last questions I had was if you could, and with one word, just say one word, and that one word would fix healthcare.
Wayne LowryWhat would that word be, Joe?
(34:34):
Wayne LowryTrust. Nice. Can you elaborate on that now?
Joe WilsonHmm. Trust.
Joe WilsonYou just asked for one word.
Wayne LowryI know what I asked.
Joe WilsonTrust. Trust to me is so much of the answer in everything we do in healthcare. One, I love all the AI stuff. Trust me, it makes life a lot easier. But the reality is I still need a relationship at the end of the day and I still want to talk to somebody.
(35:06):
Joe WilsonI still need physical touch and somebody to, you know, help me when I'm hurting and to, you know, administer healing. Like that's a powerful thing. I think that like we've been created for that person to, and for that purpose to engage one another. And so I think trust represents the relationship.
Joe WilsonI think trust also represents transparency. And like, you know, you and I have talked about this a lot in business, like looking at your partners and saying like, “Hey, this is the bottom line. Here's the budget. Here's where the money's going.”
(35:38):
Joe WilsonYou know, sure, we all got to make a living. Sure, there has to be margins in there. And if you're doing a great job and get paid well for it, like no problem with that kind of mentality.
Joe WilsonBut at the end of the day, if I can't ask a question and get a clear answer, or you're trying to confuse me with language, I can't understand, it erodes that trust. And if you're stripping out relationships and confusing with language, we're eroding trust and transparency.
(36:04):
Joe WilsonI think the other thing is, you know, even as we talk about, like, in the business side of it, where we've got consultants working with purchasers and vendors in that space, you and I have had to deal with this a lot. And there's a lot of people in these relationships and you can't always trust all of them, do what's in the best interest of everybody or the plan or the member.
(36:31):
Joe WilsonBut, you know, there are a lot of people with really great integrity in the industry. And so finding those that you can trust and assembling that team and working with those people, even though you might not be on the same team, you sit on the same side of the table in an attitude of trust. And so, yeah, trust is it.
Wayne LowryAwesome, Joe.
Wayne LowryJoe, so before we completely wrap up today, I do want to ask you one thing. You've been in the battle, you might say, and you have seen some great success stories with DPC.
(37:01):
Wayne LowryCould you share just maybe a story of a patient who received something that changed their life or a provider that came out of the traditional healthcare system to find a better way with DPC and it changed their life? What is some inspiring, life-changing story that you've witnessed that for those that may be on the edge and considering joining this DPC movement, what's a real-life testimonial that you would think worthy of to share?
(37:35):
Joe WilsonI mean, there's lots and I don't want to discredit the good things that happen in standard old hospital ER rooms every week too, and every day as well, and people's lives are saved and impacted.
Joe WilsonBut I think what really inspires me the most is the quality of life of the providers, right? I think that's what's overlooked is we're looking for a patient story. Those happen in fee-for-service hospitals, you know, it doesn't matter, like people's lives get impacted in a positive way through sound medicine.
(38:06):
Joe WilsonAnd so, Awesome. But we have a provider and she's incredible. And she came over and joined the team and she worked with us for, gosh, probably like six months.
Joe WilsonAnd then we asked her to come and speak at a dinner that we were hosting as we were recruiting some new nurse practitioners and physician associates with us.
(38:33):
Joe WilsonAnd we asked her to stand up. We didn't prep her in any way. We just said, “Hey, just stand up, just share from the heart. Like you seem to enjoy this.” And she's like, “No, I really do. It's been incredible.” And she stands up and she begins to weep, right?
Joe WilsonAnd, you look at this grown woman who has children and a family and a spouse, and she goes, “I can't believe that all of my career, I did it that way.”
(38:59):
Joe Wilson“And we would go on family vacations and I would bill and code and chart in the hotel, in the bedroom while my family was on the beach. And I tell them, "I'll catch you all at dinner.””
Joe Wilson“And I would spend the first two days of my vacation catching up and the last two days of my five day vacation, like winding up. And so and then every night I would come home, catch the window to put my kids to bed and then jump back on and build a code and chart.”
(39:26):
Joe Wilson“And I'd wake up early and do it again. And now, when I moved over into direct primary care and working with Frontier, like I don't do that at all. I'm able to go home and be with my family. When we go on vacation, I have time to be with them. And I am here to tell all of you that are interested in this, there is a much better way for you and your life and your family, and you can still make great money doing it. Like this is the future of that.” And then she started sharing about her patients and it was like icing on the cake.
(39:57):
Joe WilsonBut I think to change the quality of life and providers, like that's the mission in a lot of ways, because healthy providers are going to produce healthy members and that's going to help fix the healthcare issue.
Joe WilsonBut if we're burning out our providers, like, how can they even tackle what's going on in the lives of the members they're serving?
Wayne LowryThanks Joe for sharing that story. I think that is a powerful message, especially for any providers considering getting into the DPC space. And so Joe, I want to thank you for your time this evening. Do you have any parting words? You want to pitch any products? You selling anything?
(40:35):
Joe WilsonNo, I mean…
Wayne LowryYou want people to send their data so you can review it and see if you can save them money?
Joe WilsonYeah, that's a bear.
Joe WilsonYeah, I think my advice or my parting word would be, go for it. I think, you know, assemble a team, get out there, decide if you want to work with employers or not. You don't have to work with giant ones or really big ones.
(41:05):
Joe WilsonWe spend a lot of time working with small ones and doing the 10 person group and the 20 person group and the 5 person group. And that was a really sweet season of life for us.
Joe WilsonYou know, now it's 5 and 7 and 10,000 at a time. And those are massive projects. And it's very different.
(41:27):
Joe WilsonBut, you know, whatever excites your vision for growing DPC in that movement, you know, go after it and look around the community. There's a lot of folks that want to help.
Joe WilsonI mean, there's great vendors out there, there's great partners in this this industry, whether it's people like NextEra or the DPC Coalition or Health Rosetta or Free Market Medical Association or people at Hint, whatever, Spruce, like they're all looking in this way to educate and form so they can continue to stack providers in this movement that's going to change healthcare for so many.
(42:07):
Joe WilsonAnd so, yeah, join it. Get involved. Ask questions. You're not in it alone. Like there's a lot of people that want to help out.
Wayne LowryThank you, Joe Wilson. To find Joe Wilson, you can follow him on LinkedIn. Also, you can find Joe at FrontierDirectCare.com is their website. And Joe, fantastic job. Thank you so much.
(42:30):
Wayne LowryThis is the Best DPC Podcast. We want to thank you for your time. We hope you enjoyed the listen, and we'll see you again really soon. This is the pod.
Wayne LowryBye-bye.
Wayne LowryAnd there we are! We're live with Wilson, let's do this. You got coffee in your system?
(00:06):
Joe WilsonWell, I'm actually trying the new Blackberry Dr. Pepper this evening for the first time. So, I'm going to give it...
Wayne LowryWow.
Joe WilsonI mean, it's honestly not that bad. It's a good refreshing flavor. It's not endorsing. But I would say if you're into alternative sodas, just like alternative healthcare, Blackberry Dr. Pepper.
(00:27):
Wayne LowryYeah, I think that's good. I'm glad we're going to start off our first podcast with a plug for a soda company.
Joe WilsonYeah.
Wayne LowryNothing says the state of American healthcare like carbonated, caffeinated, sugar-infused sodas.
Joe WilsonThat's right.
Wayne LowryAll right.
(00:56):
Wayne LowryWelcome and hello to everybody watching or listening to the number one DPC related podcast in the world. We're number one, Joe. And I don't know if you knew that, but we are the number one podcast directly, specifically targeting DPCs in the world.
Joe WilsonCongratulations.
(01:16):
Wayne LowryYeah, well, thank you. Thank you. It's been a battle to get to this point, but here we are.
Joe WilsonYeah.
Wayne LowrySo today, as my guest, is Joe Wilson. Joe Wilson is a lifelong friend of mine. At least it seems like lifelong. We've known each other for like five years.
Joe WilsonYeah, sorry. You have to mind the train in the background right now. Can you hear it?
(01:41):
Wayne LowryIs that a train? Is that a metaphor for American health care right now? Is it about to run off the rails?
Joe WilsonNo, it's leaving the station. That's what's happening.
Wayne LowryThat must be the DPC we're talking about.
Joe WilsonYeah, that's right. All aboard.
Wayne LowryWell, nothing like the train to interrupt the kickoff of a podcast.
Wayne LowrySo, Joe Wilson, you are with Frontier Direct Care. We've known each other for years. We're not going to... you know, put a veil over the fact that we've known each other.
(02:11):
Wayne LowryWe've worked alongside each other in DPC. When I sat down and decided to start the best DPC podcast, I said, the first person I want to have on the podcast is one of my best friends, Joe Wilson, a pioneer, a warrior, a fighter…He was always there advancing DPC. And I said, we got to have Joe as the first guest. So, Joe, welcome to the podcast.
(02:41):
Joe WilsonYeah, thanks for having me.
Wayne LowryYeah. So, Joe, tell me about your day. Now this is 9: 35 PM that we're recording this podcast. Like what happened? We were supposed to do this at like seven o'clock this morning.
Joe WilsonWell, that's a good question. It's a long story that I'll make short, but it involves a washing machine, you know the town of Corpus Christi, Texas, and probably forgetting that I had somebody flying in for an in-person meeting today.
(03:09):
Joe WilsonThat was two hours long. And then realizing at about nine o'clock this morning, oh, I can't work remote. I need to be back in Harlingen. So, that’s how it started. And then I just got done delivering that washing machine over to Alamo, Texas. And so here I am now diving back through the office for a podcast with you.
Wayne LowryWow, you know what I feel honored. So, let me get this straight so you were going to work remotely and then said you became a…was a dishwasher you said? Dishwasher? Oh, washing machine—laundry machine. So you installed that today instead?
(03:46):
Joe WilsonNo, I just had to drop it off. That was it.
Wayne LowryJust had to drop it off. Okay. Well, I'm glad you made time for this pod.
Wayne LowrySo, Joe, we're going to talk a little bit about American health care. And just to dive right in, from your position and the state of things, what are you seeing that is wrong with American health care? And I mean, frankly, why is it so terrible, Joe?
(04:13):
Joe WilsonThat's a loaded question for sure. I think—
Wayne LowryI wanted to start easy with you, Joe.
Joe WilsonYeah, some low hanging fruit. You know, it's a big, loaded question. I think, the thing I see from even an administrative side, watching that transition over the last couple of weeks. And even as we think through what we see on the commercial side with private businesses is a lot of times where people are attacking the coverage aspect, right? So, they're angry or they're upset at Blue Cross or United or these big carriers or they're angry at the hospital.
(04:54):
Joe WilsonAnd really, I mean, unfortunately, you have to tell everybody like…It's your choices, right? And so it's an education and an understanding of actually how you procure care. And a lot of people are still over here fighting the coverage side of things and not actually addressing the care side of things.
Joe WilsonI think the administration's moving in a better direction towards some of the care delivery pieces, but still a long way to go when the oversized bear in the room seems to be insurance carriers. And that seems to be what gets addressed first. So that's probably the biggest thing I see is wrong with it.
(05:33):
Joe WilsonI think we're in some ways, attacking the wrong thing first. And it really has to be that patient education, consumerism, to make sure that they understand how to engage healthcare and what to use it for and how to use it.
Joe WilsonAnd that would change a lot of what's going on.
Wayne LowrySo for those that are listening that may not quite understand the difference between coverage and care, I mean, most people, at least in the traditional sense, they take their insurance card, they go the doctor, they use that insurance card with that doctor, they get the prescriptions with that card, they get the labs with that card. That magic card takes care of all their problems. So, when we talk about the difference between coverage and care, how would you describe those differences and kind of lay it out in layman's terms?
(06:25):
Joe WilsonYeah, I mean, I think, you know, ultimately we look at a large insurance carrier or we think about an insurance network is kind of maybe a familiar term. You get in-network or out-of-network coverages. And if it's in-network, that means that there's probably been a contract contract between let's say an insurance carrier like UnitedHealthcare and that provider, their own personal business that might be you know Wayne Lowry's medical clinic, right? And so UnitedHealthcare—
(06:55):
Wayne LowryI would not—I would not go there.
Joe WilsonYeah, so UnitedHealthcare comes in, does a contract with you, and then ultimately there's some you know rates that are associated with your services that you can send your claims to UnitedHealthcare when members come in with that insurance card, and they will reimburse you with money from those employers that those people work for from those health funds, right?
(07:22):
Joe WilsonWhether those are premiums that United has kept, and are doling out or if it's simply money from their medical claims accounts.
Joe WilsonSo when that coverage, that's just simply saying that there's a vehicle or a method or a platform that is available for you to pay for your medical services. That's what insurance is doing. They're giving you the platform to process payments on, in what seems like and may have been for a long time a more efficient manner, right, than maybe just going out there and trying to figure it out on your own.
(08:01):
Joe WilsonAnd then more so though when you look over at care, it's actually those people that own those businesses that pay that lease and have those machines and employ that staff that put hands on you and actually administer procedure or care or give you a shot or prescribe a medicine.
Joe WilsonThat's the difference. And you can actually go buy that care and not have to actually go and do the network, right? The network kind of gives you an overarching, easy-to-use method, but it's not always the most affordable method. And so, it's good to have insurance. It's also great to go and procure care and make sure you're getting the highest value for your dollar.
(08:46):
Wayne LowrySo when you're talking about the highest value of care, obviously, you know, we're familiar with the direct primary care model. What would you say is some of the real benefits of direct primary care over the traditional health care model?
Joe WilsonI think, you know, the real benefits of direct primary care is it's extremely versatile. And so, you know, whether you're in a fully insured, you know, typical insurance program that a lot of small businesses have where they just simply pay premiums to their insurance carrier and then that money is gone, whether you use it or not. Whether you're in that program or you're in a self-funded, you know, fully customized insurance program that your employer has put together. Either way, DPC has a very powerful role in both.
(09:37):
Joe WilsonWhen you look at fully insured, one of the coolest things I like to think about is you know Obviously, let's just make up some fake numbers here, but like somebody's paying a $500 premium for their insurance package. Maybe they've got a $5,000 deductible. you know, some… maybe it's a higher out of pocket, like an $8,000 out of pocket. It's pretty inexpensive plan given the current market where it's at now.
(10:03):
Joe WilsonBut in order for them to go up and have maybe what would be like $0 copays and $1,000 deductible and really low drug copays as well, that top plan on that, you know, renewal that you're going to get, it's probably going to be like $1,200 per person per month, right? And the cheapest plan might be $400 per person per month.
(10:26):
Joe WilsonAnd the big difference between that being your out-of-pocket exposure and the co-pays or the amount of money that would be charged for you to get care for the first time, right? And so a lot of times those more expensive plans, it's cheaper. The co-pays are $10 or free for primary care, but they're going to cost you $1,200 a month. You can go and get that lower fully insured plan that might be maybe $400 or $500 a month, add direct primary care. And I know out there there's several DPCs ranging from $60 a month to $120 a month seems to be kinda around the threshold…
(11:02):
Joe WilsonAnd so you can stack that in there. And now for roughly, you know, $550 or $600, you've got a plan that—with DPC and a low premium insurance plan has—is driving a similar value to the top plan on the list that would have effectively cost you like $1,200.
Joe WilsonSo you can really take...something where, you know, you want to give your employees better benefits, you can do that by still giving them an affordable, inexpensive insurance plan, but then tacking on DPC. And now that thing is working like the Rolls Royce of insurance plans.
(11:38):
Joe WilsonThe same thing you see when you move into the self-funded space is the best thing I see there is that–and you're familiar with this, right, you stand up front and you tell, i don't know, a couple hundred employees like, “hey, here's what we're doing today…” And two minutes later, probably, you know, almost forgotten all of it. And they don't have any clue what we were supposed to be doing today. And they're coming back to you and saying, “Hey boss, can you tell us again what the plan was?”
(12:09):
Wayne LowryNo, they were coming back complaining about the snacks you offered in the presentation. That's what they were doing.
Joe WilsonProbably so. And so, that's what happens out there; a lot of times we have really creative advisors in the insurance space. You have really specialized and intentional people in the human resources space or benefit administration space. You've got very innovative vendors in the market that have everything from virtual care to mail order drugs, to international sourcing, to 340(b) to 501(r); all these programs that can really help alleviate the risk from your plan and save you a ton of money and get your people better care faster.
(12:49):
Joe WilsonThat's all available and you can spend all year building a very cool plan for that. But the problem is when you just let that plan go out to the open network and it's—you're telling that to your employees then they walk out and walk into the nearest hospital. Nobody at that hospital knows what your plan is. The only thing they're gonna recognize, for the most part, is you got it from Blue Cross or United or Aetna or Cigna or whoever that might be. And that's where they're gonna send their claims.
(13:17):
Joe WilsonWhen you have direct primary care, those plans can be communicated with your providers. And so, that first experience that your employee has, now all those cost containment features and great plan design things you did to really enhance the benefits, can be communicated not just at open enrollment, but at every single patient encounter.
(13:37):
Joe WilsonAnd so, we're eliminating a massive amount of medical waste in that and just making sure that people are able to get in, see their provider, understand the options that are available to them for downstream referral use, whether that's a direct contract or a pharmacy program or a wellness program, or even an occupational health program, they're able to be coached through that with their dedicated primary care provider. And that solves a ton of the cost issues just by not allowing or not setting up an ecosystem where everything you're doing is falling on deaf ears every day.
(14:16):
Wayne LowrySo, Joe, you're talking about a comprehensive approach to solving the problem of coverage and care. What about these small DPCs and small clinics that—I mean—we've seen, you know, there's thousands of them across the United States. And every day since I've launched this directory, BestDPC.com, we have...almost every day, we've got a new clinic.
(14:46):
Wayne LowryAnd it's fascinating when I'm looking at their story and seeing, you know, several of them may have two, three hundred members, they may be one provider, two providers, and a single clinic, how can they engage in this overall process when they're such a small site?
Wayne LowryLike what can they do to help employer groups, whether they're small, medium or large, to provide DPC to those employees and how will it benefit those small employers in those situations?
(15:20):
Joe WilsonYeah. I mean, I think, you know…
Joe WilsonYou were a part of Frontier's journey for a lot of seasons there. And so, you watched it happen too. We started out like every other mom and pop DPC out there. We had a little bit bigger vision. We knew we wanted to scale and we wanted to be able to grow to be multiple locations because Dr. Pete, our founder, wanted to be able to invite the residents that he was teaching. He wanted to be able to invite them into a direct primary care model.
(15:54):
Joe WilsonAnd he just simply saw that the risk for those residents to come out, hang up a shingle and go out there and start doing business, the delta was just too wide for any of them to really jump across it. And so, he knew he had to kind of do it himself and then create the bridge to bring other providers and physicians into this model.
(16:15):
Joe WilsonAnd so, you know, I think the biggest thing we did first was we created that vision, right? You got to know where you want to go. And, you know, one thing I recommend for that is the book, “Traction”. I think we're—you know, we made you read it, Wayne, when you joined the team for a season there.
Wayne LowryYeah.
Joe WilsonAnd it was like, this is what—
Wayne LowryI have—Well, and not only that, Joe, I'll tell you. I've taken that with me in every other little startup or venture since leaving Frontier because it is such a great tool.
(16:44):
Joe WilsonYeah, and it's simple, right? And so, but at least having that, you know, because I think the second part is, one, you got to have a game plan and then two, with that game plan, it should tell you exactly what kind of team you need to build. And so, you know, thinking through—yeah, there's “Traction”, Gino Wickman, the author there…buy it on paperback. You can do the audio book, you will need some of the resources in it.
(17:06):
Joe WilsonSo, I don't recommend the audiobook by itself. But there's a ton of online resources as well.That was foundational to us starting our business and as we built a team, I think that's second part is you gotta have a game plan, you gotta have a team to execute that game plan. You know, sometimes it's a combination of you wear a lot of hats when you start that first DPC.
(17:32):
Joe WilsonAnd so, you're the head of marketing, the head of HR—all those things. And as you're hiring and growing and scaling and doing sales and trying to work with brokers and learn insurance, like it is a lot to undertake.
Wayne LowryI wanna 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?
(17:59):
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 surprising medical bills or a physician ready to build a thriving membership-based practice, we’ve got the tools and resources you need.
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 primary care is the future of medicine. That’s BestDPC.com. Because great healthcare should be simple, affordable—and built around you.
(18:35):
Joe WilsonThe first thing I think about, when people are going to start working with employer groups as a direct primary care, is they need to understand what they're getting into. And one, it's got a lot of upside in that you get to have one decision maker in a lot of ways. And we'll make this seem very simple, but it's not.
(18:56):
Joe WilsonBut maybe you talk to one person and you have one or two meetings and you gain 50 new lives for your practice, right, and that sounds pretty awesome.
Joe WilsonAnd trust me, when you look at your membership thing, and it bumps up, 50 new people just registered for your DPC and you've been floating along for you know eight months with like 100 members, you're like, “Oh my gosh, we have found the magic sauce. Here we go.”
(19:20):
Joe WilsonBut with that, comes a lot of things. There's a massive process to open enrollment, to communicating what the benefits are, to having those materials, marketing and all those things ready to educate those new members about that DPC, really having a great consultant or broker or advisor, whoever you're kind of working with there, making sure they understand how to operate a plan that has DPC in it, because it's not the same. I mean, it can feel very similar, but there's a lot of ways that you can make it challenging and there's a lot of ways that you can make it very efficient.
(20:00):
Joe WilsonAnd so, you know, understanding that, thinking through that, giving yourself enough time to—that's a big one—I think early on we got into the rat race of like, “Hey, they want to sign up.” “Ok, we'll see you on Monday,” right? And not actually going over and educating the patient.
Joe WilsonAnd so on the backside, we would have employees who, you know, the business owner didn't know how to talk about DPC, the broker didn't know how to talk about DPC, and they're the ones that did the open enrollment. And now, you've got 15 people walking in your door saying, “I'm here to see the doctor.”
(20:28):
Joe WilsonAnd so, they made a great decision, but are they going to back it up two or three years from now when it comes time for renewal? Or is it something that's just going to be cut out?
Joe WilsonAnd you're going, “we do that by appointment.” And now, they're all frustrated because nobody told them it was by appointment only, right? And so, you've got to just make sure you're really methodically walking through that checklist.
Joe WilsonAnd then I think the second part, you know—or another addition to that, is don't get out of your skis. And that can be a big challenge that, you know, you're maybe a one or two provider practice, you're trying to keep your patient panel at 600 people or so, and all of a sudden, you get an opportunity, maybe a great broker comes through and says, “Look, I got a 300 person group. Do you want them?”
(21:07):
Joe WilsonAnd you say, “Yes.” And you take them on and you realize half your business is now contingent on one person making a decision if they want to keep using you. And in addition, if that one person is a city leader or a church leader, there's a lot of reality that they might not be there in two or three years because those are kind of some transient jobs that we often see.
(21:37):
Wayne LowryIt's hard when you're—I mean, at any capacity, you might say to put all your eggs in one basket. So either, you know, as you scale, as you're examining your capacity, and whether or not you want to take on, you know, business clients into your practice,
Wayne Lowryone of the things—like you mentioned—you got to know your capacity and know if you're really willing to put that many eggs in that basket. ‘Cause who knows what could happen? You lose that one client, then all of a sudden you're back at square one.
(22:07):
Wayne LowryAnd as you could probably state, better than I can, there's a chance you will lose some existing customers because you have to shift your focus. And all of a sudden, those one-on-one interactions that you were so freely giving to your patients become harder to harder to do. Wayne Lowry And now, your new partner in the business or a mid-level that's taken part of your load or whatever your case is, is all of a sudden the face that this one patient is now seeing instead of your face. And so, there's a lot of challenges and opportunities in some of that.
(22:48):
Wayne LowrySo, I guess, if you were to sum up or wrap up this section of thought, what would be the number one caution you would give to any DPC? What would be that one little piece of advice going through what you've gone through to any small DPCs that are looking to expand on that?
(23:09):
Joe WilsonYeah, I mean, I think ultimately, finding a mentor in the space is key. And so, you know, whether that's talking to a DPC down the road, that's maybe a season or two ahead of you and just asking like, “Hey, how does your patient agreement look? What kind of contract did you put together? What were some pitfalls or some heartaches that you went through? How do you even judge or think through a sales cycle?”, right?
(23:35):
Joe WilsonAnd, “When do these sales even happen?” That's a big part of it and I think just finding that mentor that can look around the corner for you, you can ask questions of, it's great. I mean, we've done it a lot when we were growing up.
Joe WilsonI remember—a big shout out to our friends at first primary care—like just up the road in Houston, they were a couple seasons ahead of us and they had a great website and they had a great like sales funnel and they had members coming in they were getting you know two, three, four—twenty a day at sometimes, right? Just retail members finding them on facebook, signing up. And I thought, “That's incredible.”
(24:09):
Joe WilsonAnd talking to Jay Medley up there, he just said, “Hey, man, we want the whole movement to grow.” And so, you open up the playbook and said, “Here's the vendors we use for our tech stack, here's the things we put together, here's how we drive some membership.”
Joe WilsonAnd so there's a lot of people in the DPC community that are very willing to share how they got to where they are or things they wish they wouldn't have done. And it helps us not pay the dumb tax, what we call it.
(24:34):
Joe WilsonSo, you know, don't pay the dumb tax. Find a mentor. That'll take you a long way.
Wayne LowryWell, I appreciate the discussion on kind of the overarching movements, the problems, the solutions in DPC, but I want to take a little bit time now to talk a little bit about Frontier Direct Care directly and specifically just looking at your involvement there, what you've seen, and you know talk a little bit about that experience.
(25:01):
Wayne LowryA couple things that come to mind, Joe, you know some kids when they grow up, they want to be firefighters. Some kids, they want to work for NASA. You said, I want to change healthcare, right? You were that five-year-old boy that said, I want to change healthcare for America.
(25:23):
Joe WilsonYeah.
Wayne LowrySo,
Joe WilsonLet him be driving a NASCAR, maybe. Like, I was all end into, like, let's be the next Dale Earnhardt here. Like, checkers or wreckers?
Wayne LowrySo, what you're saying is you didn't exactly think you were going to get into healthcare. So, Joe, what drew you to direct primary care? Why did Joe Wilson give up the NASCAR and go into direct primary care?
(25:49):
Joe WilsonWell, first, we're going to look at this thing called the budget, and I don't have a couple million bucks, so we don't have a race card team.
Wayne LowryOkay.
Joe WilsonBut then we'll get to the next part.
Wayne LowryYeah.
Joe WilsonYou know, what drew me to it, honestly, was, you know, I'd done 20 years of nonprofit outreach ministry with high school kids and things like that. And, you Dr. Pete was my committee chair for the organization I worked for, Young Life.
(26:11):
Joe WilsonAnd Bibb, our CEO, was my finance chair. And so they would help me raise money and spend money, basically. And so it really was just this kind of unique time as as we went through the pandemic and that kind of gave us all a chance to kind of look at this idea
Joe Wilsonand do we want to, you know, kick something off like this and see if Dr. Pete wants to grow to have two or three clinics and invite other the providers in. So that was an interesting conversation.
(26:39):
Joe Wilsonat an interesting time when we were kind of shut down with ministry stuff in the high schools. And I just knew that I had, you know, an opportunity. One, I had been volunteering with Culture of Life. I think you're familiar with them.
Wayne LowryOh, yeah.
Joe WilsonSo, if you don't know, Wayne, I live in the same town. We're, actually, we live in the same neighborhood.
Wayne LowryHe's actually sitting right here next to me. No, I'm just kidding.
(27:01):
Joe WilsonI'm like 10 minutes away. But anyway, Culture of Life is a really cool ministry that Dr. Robinson has. And so I was able to sit on kind of the board of directors there for a season and help with some of the marketing stuff and solve this drastic need for those that have been marginalized to have access to health care.
Joe WilsonAnd when COVID hit, we realized the whole fee for service world out there had nothing on virtual. Like they couldn't bill or code for it. They didn't know how to access it. It wasn't a part of their electronic health records. Like, so everybody trying to get diabetic medicine and things like that couldn't get in. So we stood up on a virtual platform, went to the news media and did that.
(27:41):
Joe WilsonAnd I saw the impact it had just like that. And yeah. really to watch people come in and thank you for just treating them as a human and looking them in the eyes and being able to, you know, care for them with compassion and give them the things that they needed was very basic, but very life giving. And so when Dr. Pete was like,
(28:02):
Joe Wilson“Hey, would you help me with this mission of restoring healthcare care and bringing it back to what it should have been in direct primary care?” And he was totally selling me on like the old school dock with a bag walking house to house at that time, because that's kind of what he was doing.
Joe WilsonI thought, well, that's fascinating. And so began to help out, had a little bit of a knack for raising money. And so kind of used that skillset with Bibb and Dr. Pete to begin talking to investors to gather up enough capital to open up, you know, two or three locations and invite a couple of doctors in and try and sell in, actually individual members at that point, you know, through Facebook or whatever into those locations.
(28:40):
Joe WilsonSo that's how we got started. And then, yeah, I don't know how much further you want me to go.
Wayne LowryYeah.
Wayne LowryWell, you know, so I'm thinking, some of the kind of interesting stories we talked about: how many hats, you kind of mentioned in passing, how many hats someone might wear when they're starting a DPC. So Joe, here's a little trivia.
Wayne LowryCan you tell me how many hats you've wore?
(29:04):
Joe WilsonOh, gosh. Officially, I've worn three now. So I started out as the chief operating officer.
Joe Wilsonand you're counting this now.
Wayne LowryI'm going count.
Joe WilsonAnd then after a while, like we knew that we wanted to bring somebody else for that role. And so I moved over to the chief growth officer, which was a little bit more ambiguous. And so I could do more things like product development, sales, all that kind of stuff.
(29:27):
Wayne LowryYep.
Wayne LowryAnd that's when we shot rubber bands at each other from across the hall.
Joe WilsonYeah.
Joe WilsonAnd then now that we've kind of stepped into a really pretty well-developed product and we've got a whole lot of team members in specific roles, I've kind of moved over as like an executive vice president. And so mainly focus on the public sector and sales, in with government services and things like that.
(29:57):
Joe WilsonAnd so we look at, you know, new cities and locations and school districts and try to see if we can go and serve communities that are looking to solve access issues and then partner with those communities and their brokers and advisors to build direct primary care centric plans and either employ another direct primary care out there and help connect them if it's not in our market or if it's something we can serve, build a clinic and staff it and start doing DPC in a new community.
(30:25):
Wayne LowryNow, I counted three official titles, but I also remember you being the guy that built the desks that we used out of ParticleBoard.
Wayne LowryIs that not also one of your jobs, Joe?
Joe WilsonIt was. I was a furniture maker for a season for the new office furniture when we moved in here. And then my favorite,
(30:46):
Wayne LowryYou ran the HVAC system.
Joe WilsonMy favorite was wearing the HR hat when I got to hire you know primary care providers and I knew hardly anything about actual medicine, right? Like and knew kind of how to build a team and was like trusting them, but what's fascinating, I'm sure they were kind of like, this is the least medically inclined treatment I've ever had.
(31:10):
Joe WilsonBut thankfully Dr. Pete was there to ask the medical questions. I was there to ask the fun questions like, you know, “If you had to improve Domino's pizza delivery, how would you do it?” And then they would answer and I'd be like, “That's a great answer.” And then we'd move on. So,
Wayne LowryYou wouldn't. You would tell them that was a terrible answer. Stay in your lane, doc. That's what you'd say.
Wayne LowryLet’s take a quick break to talk about ScalebySEO.com
(31:31):
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Wayne LowryWe help DPC clinics get seen where people are searching. So, you are not just waiting for word of mouth referrals.
Wayne LowryWith the right SEO strategy, your practice becomes the obvious choice when people are looking for better healthcare options. If you’re not showing up where they’re searching, you’re missing out.
(31:58):
Wayne LowryBe visible. Get found. Grow your practice. Don’t leave growth to chance. Visit ScalebySEO.com today and let’s get your clinic in front of the right people.
Wayne LowryAll right, Joe. So tell us. So when I was working at Frontier, we had about, I don't know, 14 people on staff. We were in an old parts store.
(32:23):
Wayne LowryThe AC didn't work. There were no doors. There were no doors, except for there were some sliding doors for the HR department, I think.
Wayne LowryThat was about it. But the rest of us, we hear every phone call. Tell me things have been improved.
Joe WilsonThey've improved a lot. We're starting to, I think we've got well over 100 employees now. I'm going to mess up on the actual number. I feel like it's around 130, 140 folks are joining the team, rapidly expanding in some new markets. So that's really exciting.
(32:58):
Joe WilsonBut yeah, it's gotten a lot better. You know, those days and and where we were all, you know, hey, I'm HR one minute, then I'm going to go do open enrollment the next minute, then I'm going to be sales, and then I'm going to do some marketing, and then I'm going to do graphic design, and I'm going to work on some kind of tech process to help out Steven with the, you know, EHR stuff.
Joe WilsonLike, it's just… It was crazy, you know, and it still is a lot of fun to dive into those projects. But now everybody's really got a good team behind them. What used to be hats became people and then those people became departments, right? And so that's kind of cool to watch.
(33:35):
Wayne LowryYeah.
Joe WilsonIt's just, if somebody, you know, we hired one person that came in as a part-time graphic designer and now they're you know standing in member services and really doing a great job and moved over into concierge and referrals.
Joe WilsonAnd so to watch the development of those people and our team as they've grown up inside this company has been really special and really freeing just to see like your vision and dream that you shared with your friends and poured into so many people as you brought them into the team and like take shape. And now they're pushing that same mission forward.
(34:12):
Wayne LowryThat's awesome, Joe. So what is, I guess one of the last questions I had was if you could, and with one word, just say one word, and that one word would fix healthcare.
Wayne LowryWhat would that word be, Joe?
(34:34):
Wayne LowryTrust. Nice. Can you elaborate on that now?
Joe WilsonHmm. Trust.
Joe WilsonYou just asked for one word.
Wayne LowryI know what I asked.
Joe WilsonTrust. Trust to me is so much of the answer in everything we do in healthcare. One, I love all the AI stuff. Trust me, it makes life a lot easier. But the reality is I still need a relationship at the end of the day and I still want to talk to somebody.
(35:06):
Joe WilsonI still need physical touch and somebody to, you know, help me when I'm hurting and to, you know, administer healing. Like that's a powerful thing. I think that like we've been created for that person to, and for that purpose to engage one another. And so I think trust represents the relationship.
Joe WilsonI think trust also represents transparency. And like, you know, you and I have talked about this a lot in business, like looking at your partners and saying like, “Hey, this is the bottom line. Here's the budget. Here's where the money's going.”
(35:38):
Joe WilsonYou know, sure, we all got to make a living. Sure, there has to be margins in there. And if you're doing a great job and get paid well for it, like no problem with that kind of mentality.
Joe WilsonBut at the end of the day, if I can't ask a question and get a clear answer, or you're trying to confuse me with language, I can't understand, it erodes that trust. And if you're stripping out relationships and confusing with language, we're eroding trust and transparency.
(36:04):
Joe WilsonI think the other thing is, you know, even as we talk about, like, in the business side of it, where we've got consultants working with purchasers and vendors in that space, you and I have had to deal with this a lot. And there's a lot of people in these relationships and you can't always trust all of them, do what's in the best interest of everybody or the plan or the member.
(36:31):
Joe WilsonBut, you know, there are a lot of people with really great integrity in the industry. And so finding those that you can trust and assembling that team and working with those people, even though you might not be on the same team, you sit on the same side of the table in an attitude of trust. And so, yeah, trust is it.
Wayne LowryAwesome, Joe.
Wayne LowryJoe, so before we completely wrap up today, I do want to ask you one thing. You've been in the battle, you might say, and you have seen some great success stories with DPC.
(37:01):
Wayne LowryCould you share just maybe a story of a patient who received something that changed their life or a provider that came out of the traditional healthcare system to find a better way with DPC and it changed their life? What is some inspiring, life-changing story that you've witnessed that for those that may be on the edge and considering joining this DPC movement, what's a real-life testimonial that you would think worthy of to share?
(37:35):
Joe WilsonI mean, there's lots and I don't want to discredit the good things that happen in standard old hospital ER rooms every week too, and every day as well, and people's lives are saved and impacted.
Joe WilsonBut I think what really inspires me the most is the quality of life of the providers, right? I think that's what's overlooked is we're looking for a patient story. Those happen in fee-for-service hospitals, you know, it doesn't matter, like people's lives get impacted in a positive way through sound medicine.
(38:06):
Joe WilsonAnd so, Awesome. But we have a provider and she's incredible. And she came over and joined the team and she worked with us for, gosh, probably like six months.
Joe WilsonAnd then we asked her to come and speak at a dinner that we were hosting as we were recruiting some new nurse practitioners and physician associates with us.
(38:33):
Joe WilsonAnd we asked her to stand up. We didn't prep her in any way. We just said, “Hey, just stand up, just share from the heart. Like you seem to enjoy this.” And she's like, “No, I really do. It's been incredible.” And she stands up and she begins to weep, right?
Joe WilsonAnd, you look at this grown woman who has children and a family and a spouse, and she goes, “I can't believe that all of my career, I did it that way.”
(38:59):
Joe Wilson“And we would go on family vacations and I would bill and code and chart in the hotel, in the bedroom while my family was on the beach. And I tell them, "I'll catch you all at dinner.””
Joe Wilson“And I would spend the first two days of my vacation catching up and the last two days of my five day vacation, like winding up. And so and then every night I would come home, catch the window to put my kids to bed and then jump back on and build a code and chart.”
(39:26):
Joe Wilson“And I'd wake up early and do it again. And now, when I moved over into direct primary care and working with Frontier, like I don't do that at all. I'm able to go home and be with my family. When we go on vacation, I have time to be with them. And I am here to tell all of you that are interested in this, there is a much better way for you and your life and your family, and you can still make great money doing it. Like this is the future of that.” And then she started sharing about her patients and it was like icing on the cake.
(39:57):
Joe WilsonBut I think to change the quality of life and providers, like that's the mission in a lot of ways, because healthy providers are going to produce healthy members and that's going to help fix the healthcare issue.
Joe WilsonBut if we're burning out our providers, like, how can they even tackle what's going on in the lives of the members they're serving?
Wayne LowryThanks Joe for sharing that story. I think that is a powerful message, especially for any providers considering getting into the DPC space. And so Joe, I want to thank you for your time this evening. Do you have any parting words? You want to pitch any products? You selling anything?
(40:35):
Joe WilsonNo, I mean…
Wayne LowryYou want people to send their data so you can review it and see if you can save them money?
Joe WilsonYeah, that's a bear.
Joe WilsonYeah, I think my advice or my parting word would be, go for it. I think, you know, assemble a team, get out there, decide if you want to work with employers or not. You don't have to work with giant ones or really big ones.
(41:05):
Joe WilsonWe spend a lot of time working with small ones and doing the 10 person group and the 20 person group and the 5 person group. And that was a really sweet season of life for us.
Joe WilsonYou know, now it's 5 and 7 and 10,000 at a time. And those are massive projects. And it's very different.
(41:27):
Joe WilsonBut, you know, whatever excites your vision for growing DPC in that movement, you know, go after it and look around the community. There's a lot of folks that want to help.
Joe WilsonI mean, there's great vendors out there, there's great partners in this this industry, whether it's people like NextEra or the DPC Coalition or Health Rosetta or Free Market Medical Association or people at Hint, whatever, Spruce, like they're all looking in this way to educate and form so they can continue to stack providers in this movement that's going to change healthcare for so many.
(42:07):
Joe WilsonAnd so, yeah, join it. Get involved. Ask questions. You're not in it alone. Like there's a lot of people that want to help out.
Wayne LowryThank you, Joe Wilson. To find Joe Wilson, you can follow him on LinkedIn. Also, you can find Joe at FrontierDirectCare.com is their website. And Joe, fantastic job. Thank you so much.
(42:30):
Wayne LowryThis is the Best DPC Podcast. We want to thank you for your time. We hope you enjoyed the listen, and we'll see you again really soon. This is the pod.
Wayne LowryBye-bye.
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