August 24, 2025 • 51 mins
In this episode of the My DPC Story Podcast, Dr. Maryal Concepcion interviews Dr. Pouneh Alizadeh, founder of Flourish Gynecology, who shares her inspiring journey transitioning from a hospital-employed OB/GYN to combining locums work with launching her own direct specialty care (DSC) practice. Dr. Alizadeh opens up about the challenges of balancing motherhood, physician burnout, and the drive to practice medicine on her own terms through the Direct Primary Care (DPC) model. The conversation covers the practicalities of starting a DPC/DSC practice, managing finances, setting boundaries, and integrating locums work for stability and flexibility. Dr. Alizadeh offers insights on building a sustainable, patient-focused medical career, highlights the importance of networking and community, and emphasizes the empowerment DPC provides for women physicians. If you’re interested in DPC, locums, direct specialty care, physician entrepreneurship, or women’s health, this episode delivers firsthand advice and encouragement to take control of your career and redefine success in medicine.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:04):
Direct Primary care is aninnovative alternative path to
insurance-driven healthcare.
Typically, a patient pays theirdoctor a low monthly membership
and in return builds a lastingrelationship with their doctor
and has their doctor availableat their fingertip.
Welcome to the My DPC Storypodcast, where each week you
(00:26):
will hear the ever so relatablestories shared by physicians who
have chosen to practice medicinein their individual communities
through the direct primary caremodel.
I'm your host, MarielleConception.
Family, physician, DPC, owner,and former fee for service.
Doctor, I hope you enjoy today'sepisode and come away feeling
inspired about the future ofpatient care direct primary
(00:49):
care.
Dr. Pouneh Alizadeh (00:53):
Starting a DPC practice has been so
influential and important to meas a physician.
It's allowed me to hang myvirtual shingle and practice
medicine on my own terms.
I'm Dr.
PDay of Flourish Gynecology, andthis is my DPC story.
Maryal Concepcion MD (01:10):
Welcome to the podcast, Dr.
Leeza Day.
Dr. Pouneh Alizadeh (01:12):
Thank you so much for having me.
Maryal Concepcion MD (01:14):
I am really, really excited about.
I, I say that at the beginningof every podcast, but legit, I
get excited about every singlephysician I get, the honor to
talk to, and in your case.
The reason I'm so excited isbecause we have just all come
together in, on the nationalfront of things, at the DPC
summit in New Orleans, and thereare people who are specialists,
(01:39):
there are people who are primarycare, there are residents,
medical students, and I was soexcited to have your episode air
on this state in particularbecause I really feel that you,
of all of my physician friendshave just really represented
what it is like to be.
An employed physician, what itis like to be a person who then
(02:03):
chooses to do her own thing, andthen also learned and executed
on a direct primary carebusiness plan.
So again, I'm super excited as Ilegitimately am with every
single guest including you.
I am so excited for you to behere today.
Dr. Pouneh Alizadeh (02:17):
I'm so excited to be on here today.
I don't know if you remember,but when I first met you at the
flexed staff Summit last year, Iwas actually listening to my DPC
story on the flight there.
And then when I met you, I waslike, oh my God, I'm meeting a
celebrity.
I and you were like even betterin person, so
Maryal Concepcion MD (02:38):
you're so sweet and Absolutely.
I do remember that.
It's so funny because I, I'mvery, I think this is why I get
excited is literally just thepeople connection.
It's very visual.
I mean, it's very it's veryvivid for me.
And so I absolutely rememberyou.
You're wearing your black andwhite dress and you were like,
oh my God.
And I'm like.
It's so exciting to meet peoplewho listen to the podcast.
(02:59):
'cause I'm like, my kids listento my voice all the time.
But it's very different to hear,from a physician who's oh no
this episode meant a lot becauseof X, Y, or Z.
And definitely heard a lot aboutthat thankfully at talking to
people in New Orleans also.
Dr. Pouneh Alizadeh (03:13):
So
Maryal Concepcion MD (03:14):
All of that said, I wanna get started
with your journey into medicinebecause you are still one of
those amazing physicians who,takes any delivery that is
coming their way you still usethose skills when you do your
locums work as well as nowyou've added direct primary
care, like I mentioned.
So bring us to Dr.
(03:36):
Ade choosing to become an obgyn.
To start, because I think thatit, it's very much going to help
paint how you had the the acumenand the execution skills to do
what you're doing today.
Dr. Pouneh Alizadeh (03:50):
Yeah.
So when I went to medicalschool, I wasn't sure, what I
wanted to do.
I had shadowed a few emergencymedicine physicians and thought
that might be, something fun todo.
And then as I went throughmedical school, I really loved
physiology.
I really loved hormones.
I loved when I did my OB GYNrotation that we were able to do
(04:15):
a little bit of everything.
So as an ob, GYN, you do alittle clinic, you do a little
preventative care, you dospecialty care, you can do
surgeries, and then of coursethe whole world of obstetrics,
which is incredible in and ofitself.
I still have a picture on myphone from my first delivery as
a medical student, and I hadthese big goofy glasses that
(04:37):
were riding down on my nose.
And my attending took maskingtape and taped them, taped my
glasses to my face.
And I still have this photo, andI cried because the grandma
cried.
And, and anyway, so that was amoment that I was like, I love
obstetrics.
This is something that I want todo.
And I continue to love it.
And as you've noticed, I do, Istill do a little bit of
(04:58):
everything.
So I think what brought me tothe field has those, those same
the same and what motivates mehas continued to motivate me
throughout my career and career,how I revamped my career.
Maryal Concepcion MD (05:11):
And I just think that's amazing though
because I think that that.
When you said, especially thetape part, that when other
people are hearing that they'rethinking about their own,
situation or whatever happenedin medical school or residency
that really impacted themsimilarly to how you were
impacted by the tape.
(05:32):
And I think that's so awesome,especially also you are your
interview is airing after Dr.
Lawrence Reed shared about herdiaper chair story.
So I think that, we all have ourstories and these are the
stories that I think are whatmake my DBC story so relatable.
When you knew that you weregoing to do ob gyn, did you ever
(05:52):
have a time after residencywhere you were, in a place
thinking about, do I continueobstetrics and gynecology?
Do I only focus on one or moreof one than the other?
Dr. Pouneh Alizadeh (06:07):
Yeah, absolutely.
When I graduated from residency,so to give a little bit of
perspective to the listeners, Ihad stayed on with the hospital
system that I had done residencywith and agreed to open up a
practice in a nearby hospital.
So I opened a practice as aresident and I had actually one
of my attendings and two othersincluding Holly, she, which some
(06:29):
of your listeners might know.
So that was a whole differentexperience for me.
But you know, as an OB GYNresidency, it's a lot different
when you take, when you have abig call pool and you have hour
restrictions and largely shiftwork.
And so from an hoursperspective, switching to being
(06:52):
on Q3 Q4 call was a huge, it wasa huge change for me.
And so there were definitelytimes where I'm like, how is
this sustainable?
I love what I do, but I am humanand sleep is kind of important.
And so, but yeah, there isdefinitely times when I was in
(07:14):
this kind of traditional modelthat I thought I just don't know
if I can picture myself at 50continuing to, to work at this
rate.
Maryal Concepcion MD (07:24):
Totally.
And I know that when you said,you know you need sleep one,
it's ironic because the firsttime I met you, you did a talk
about sleep during locum shifts,but also.
I remember, like I, I don'tknow.
I'm dating myself.
I am 43.
I like unabashedly watched anmaniacs and if anybody
(07:44):
understands, Katie, kaboom, thatis a hundred percent me
post-call OB in the hospital.
And I knew when I leftresidency, Marielle was done
with deliveries.
And so I totally get that.
And you and I are also very muchsimilar in that we are moms of
two young kids.
And so I think that that adds acompletely different layer to
(08:06):
when you are awake, that'sdifferent than how capable are
you of being present for yourpatients, for your family
especially for little kids.
So talk to us about.
How you went forward because youdid have little kids in the mix
along your journey to,especially because you were able
(08:30):
to see what was sustainable oryou had a feeling for that.
Whereas I, I don't, I, I don'tthink that that's something
necessarily that we sort of pimpeach other with when we're
thinking about what are we gonnado after residency.
We don't necessarily alwaysthink about what's sustainable
beyond what's financiallysustainable.
Nipple.
Dr. Pouneh Alizadeh (08:48):
Yeah.
So my kiddos, let's see.
I had a kiddo in residency andthen I had a kiddo was pregnant
my fourth year.
So I started my practice with.
Pregnant actually, and anddelivered the first year of
practice.
And I mean, honestly, whoremembers those first two, like
two, two kids under two and ahalf?
(09:09):
It's all just a little bit of ablur.
But over time as I was settlingin into attending life and being
a mother of two, and I also havea stepdaughter who is now a
teenager, so we had a fullhouse.
I really realized that there wasgonna be kind of a fork in the
road of like how I wanted toshow up as a parent and how I
(09:31):
wanted to balance that with mycareer.
And and I'm just gonna put adisclaimer as this is anybody's.
Own choice to what they chooseto do here.
This was just, this is just howI felt about it.
So I knew that either I wasgonna get a nanny plus daycare,
I was gonna get an au pair.
I was going to kind of.
(09:52):
Delegate all the things that Ididn't need to de that maybe I
didn't need to do.
Maybe I didn't need to shuttlekids to and from practice and,
but I'd be there for the games.
Right.
You kind of decide what'simportant for your family,
what's important to you, andthen how does that balance with
what fills your cup at work?
For me, I really just wanted tobe there for everything.
(10:12):
I wanted to drive my kids topractice.
I liked I think we've talkedabout like mundane conversations
though with other parents at, atsporting events and sometimes
it's less than fun.
But for me, I kind of, I kind ofliked that and so I knew I
wanted to be kind of part of thecommunity for my kids.
And so that was a little bit ofa roadblock for me in terms of
(10:34):
staying in the position that Iwas in and how I would continue
to not only be present but bementally there.
Right.
Not be tired, not be checking.
Messages on my phone not puttingout emergencies, kind of like
left and right.
Maryal Concepcion MD (10:53):
And that said, how did you take those
next steps to then make thatsustainability, make that plan a
reality?
Mm-hmm.
Yeah.
So in, so what happenedcareer-wise was I ended up
taking a leadership role in theclinic.
A few of my partners had leftand I was still very motivated
(11:14):
to improve the clinic.
And again, we started it fromscratch.
It was really a wonderfulclinic.
It was thriving and I wanted toelevate it.
And so I had actually reachedout to a coach to see more of
like executive leadershiptraining as a physician.
Like how do I one overcome thefact that I was a resident in
this health system and now I'm aleader?
And yes, I was their resident,but I have good ideas and I can
(11:38):
connect with my staff and withmy patients, and how do I gain
the respect of, ofadministrators?
So in doing that, there was justa lot.
It was the first time wheresomebody had asked me like, what
are the four things that youvalue?
Put them in order by the timeyou're 50.
35 things that you want to dothis or that, like it, what,
(12:00):
what are, give me answers tothese questions.
And maybe we did this in medicalschool, but like the context was
like totally not there.
And so now so I did that and I,I realized what was important to
me.
And I actually had no intentionsof leaving my practice.
I had got up the strength reallyto, to ask for something that I
(12:22):
wanted, right.
So I felt like I was giving Iwas bringing a lot to the table.
I have pleasant personality.
Patients like me as a goodphysician.
I am motivated.
I like all the techie stuff.
I'd help everybody with theirepic.
And so I went and asked for justa little bit of time to.
To accomplish these things.
'cause it's hard to do it whenyou don't have any time.
(12:43):
And I really, this idea of timebecame very finite for me.
And so I knew that I couldn'tcontinue to operate with this
much on the plate, so somethinghad to give.
And so when I asked for it, Iwas told, well, yeah, you're
great.
You're probably better thanmost, but it wouldn't be
equitable to give you more timethan somebody else.
(13:05):
And, and, and I don't know whatit was, but then I was like, I
don't know what came over me,but it was a very fine line in
the sand.
And then I was like, I put mynotice in 10 days later, no idea
what I was going to do.
it's just so kick ass mm-hmm.
You are very much similar to mein that it's I don't necessarily
(13:29):
have a plan, but I can't do thisanymore.
Dr. Pouneh Alizadeh (13:31):
Mm-hmm.
Mm-hmm.
And
Maryal Concepcion MD (13:33):
you, we've figured it out, so.
Mm-hmm.
As scary as that is, I, I,again, am really intentional
about the audience hearing yourstory right after DPC Summit, on
the heels of days of people,drinking the DPC Kool-Aid,
having their come to whoeverthey pray to moment and mm-hmm.
(13:53):
Just saying my gosh, there issomething out there called
Direct primary care.
It is real.
It is happening and this is apossibility for me.
So I'm wondering, especially ifyou can hear, talk about the
conversation you had with your,with your husband, with your
partner, because that is alsosomething that it's like as we
(14:14):
are very capable femalephysicians to say like, I ain't
doing that anymore.
It's another thing to be like,also, I have a family and I
gotta make this work for myfamily too.
So tell us about theconversation that you had in
this moment of well, if treatingyour physicians.
Equitably doesn't mean takingcare of them.
(14:34):
Then this is not for me and thisis not an equitable position for
me to stay in.
What did you and your husbandthen talk about?
Because again, there's lots ofpeople going to their partners
or their family members who aredropping things like, I'm gonna
leave my position pretty soon.
Dr. Pouneh Alizadeh (14:53):
Very interesting because I was very
nervous to tell those around methat I cared about what my plans
were because again, I trained inthe system.
I started practice in thesystem, grew the practice, grew
into a leadership position.
I think I was like on that.
Track, ladder, what, whateveryou wanna call it.
(15:16):
And I also happened to beprimary income for my family, so
I was a little bit nervous onhow that would all shake out.
But I, I can't, I think I toldmy husband first and I said, I
think I'm going to quit my job.
And he goes, oh yeah, abouttime.
I was like, wait, what?
I thought I was holding ittogether really good.
(15:37):
What do you mean about time?
And then I told my mom and shesaid the same thing.
And then I told my brother andhe said the same thing.
And then I told my mother-in-lawwho lives across the country,
and she said the same thing.
So that actually blew me away.
And what it actually reallytaught me is that we are
affecting those around us.
And we.
Our loved ones don't necessarilywanna give us that feedback
(15:59):
because they know our career isso important to us.
My husband has been with me fromthe start, and he wants me to do
what makes me happy.
And I think you all were arespectable career, we're
physicians and sometimes they'reafraid to say things.
And so that, that was a, alittle bit of an eye-opening
moment for me.
Maryal Concepcion MD (16:18):
I think it, I think it's awesome and I,
I think it just makes me thinkabout how sometimes we can't see
past the ends of our noses andwe, we sometimes get into our
own head space so much so thatit's here's a great example.
You didn't even have to sayanything and everyone else was
already confirming yourthoughts, even though you hadn't
said them out loud.
So that's, that's amazing.
And I, I hope that it is alsogiving some people some.
(16:43):
Courage or, just just anotherstory to hear in their head when
it comes to that as aconversation I have yet to have
with my loved ones.
So after you decided to quitdefinitely in the world of ob
gyn there's always going to bethe need for a very well-trained
(17:04):
physician, especially in acutecare and acute deliveries, to
have a job.
And you very much leaned intolocums, and I'm just wondering
if you can tell us about that,because.
It's very different when,especially on ob, like anyone
who's done a rotation in OBknows that the people who run
(17:25):
the OB floor are the OB nurses.
And so when you're going from, Iknow my OB team and residency, I
stayed on as an attending andthen I have to go to different
OB teams all over the country.
I would, I would never make thatdecision myself personally
because I stopped doingdeliveries after residency.
'cause I, that terrifies me.
(17:46):
But for you, what was your, whatwas your thought about doing
locums versus looking for adifferent employed position that
was quote unquote moreequitable?
I'm just saying that so snarly'cause it's ridiculous.
Mm-hmm.
Yeah,
Dr. Pouneh Alizadeh (18:01):
I wanted to make one comment on quitting
your job before I answer thatquestion.
And one thing I just wanna pointout to those that are listening
is that you don't have to waittill the point that you are
burnt out to a crisp to draw theline and change your job.
And so I don't think that I wasnecessarily burnt out.
(18:25):
I just knew that this was notsustainable and I didn't want to
know what would happen to myselfor my family or those around me
if I continued at this pace.
And so, again, for those thatare listening, you don't, you
don't have to push yourself tothe ultimate end before you make
a change.
It is people in otherspecialties and other jobs
(18:47):
careers, they make changes allthe time.
Change is okay and I think.
We're not used to that mindset.
So again um, to answer yourquestion about why I decided to
do locums, I was not ready tocommit to another permanent
position.
I, I also was leaving in Juneand wanted a little bit of a
summer selfishly forth myfamily.
(19:09):
And Dr.
Chen had, she had left I thinkeight months prior to my final.
My final shift.
And she had dabbled a little bitinto locums before, and I was
like, okay, great.
I'll just see what's out there.
And for me, it actually workedout really organically.
And I shared this a little bitwhen I talk about direct
(19:30):
contracting, but I was onLinkedIn and I got a message
from a hospital that, for apermanent position, and I had
said was not interested in apermanent position, but I am
actually free to help yourhospital until they find one.
And they were like, great.
And there you go.
(19:50):
That was the start of it.
And I went there a week, a monthfor, and I still go there two
over two years later.
And so yeah, when you'rethinking about doing locums.
In general outside of even beingan ob, GYN is that you have to
be pretty malleable and you haveto be pretty flexible.
This is not the time where it'slike we do things my way and
(20:12):
only my way.
You have to integrate yourselfthe hospital system, and there
are protocols.
You have to trust the nurses.
And honestly, there is only likeone place maybe that I got a
little bit hazed.
But since then, really every,they're very appreciative.
I go to smaller communities, sothey're just really happy one to
(20:32):
have hope for their physicians.
What I've really noticed inthese small communities is that
especially these nurses look outfor their physicians and they
are really worried about theirwellbeing.
And so they have really acceptedme and.
(20:53):
Like I said before, in general,I'm like pretty pleasant.
Like my med school evaluations,every single one, she's so
pleasant.
So for me it was, it, it wasnice to also feel appreciative.
So all the, all the things thatmy other, my former employer was
like, yeah, you're all thesethings, but it doesn't really
matter.
I'm now, I'm in a position wherepeople appreciated my
personality and they appreciatedmy work ethic and the way I took
(21:16):
care of patients.
Maryal Concepcion MD (21:17):
I can absolutely testify that Dr.
Lee today is not just likepulling your leg.
She is a very pleasant person tobe around.
But I think that's so funnybecause it's, I think that it
just, it makes me think aboutthat pleasant does not mean that
someone can just walk over you.
And I think that that issomething that especially in the
(21:39):
employed.
Positions that, people who havezero medical training and yet
they make gazillions of dollarsoff of the backs of the
physicians who actually see thepatients.
They have the audacity, toperceive that being malleable,
pleasant, flexible hardworkingis that you are an indentured
(22:04):
servant and you get to be toldwhat is okay and what is not
okay.
So, I just I'm, I'm very proudof both of us for making it very
apparent that those two are notequal pleasant and pushover.
I am really grateful that youmentioned you don't have to let
yourself burn to a crisp beforesaying these are my boundaries.
(22:25):
I think especially in themindset of a physician
entrepreneur that that is whathappens all the time.
If your patient is calling forTylenol at two o'clock in the
morning when they can go to the24 hour Walmart, or, if somebody
is, is stepping on boundaries,it's so important to not wait
(22:45):
until it gets so bad.
And yes, like I've definitelybeen there where I'm like, oh my
gosh, how did it get this bad?
I'm never gonna have that happenagain.
I've spoken to my regret oftaking patients acutely to my
practice.
But it's, I think it's a reallygood point for people to listen
to because it also.
It's part of that honoring likeyou said, who are, who am I and
(23:08):
what do I need to besustainable?
That that spirit of us right.
When it comes to the, thesesmall communities, I'm wondering
because there's probably a lotof people in the audience who
have not, probably until beforeDr.
Lawrence Reed talked aboutlocums, have thought about
locums before.
And you were also one of mygo-to people when it comes to
(23:28):
the world of direct contracting,the world of locums.
Because I think that what manyof us are familiar with is the
recruitment emails.
I mean, yesterday I got, okay,I, I love this'cause it says
Sheboygan, so I'm gonna read itjust because it says Sheboygan.
What was it?
Hi Doc fm Green Bay slashSheboygan.
Epic.
EMR, 18 to 20 patients a day,36, patient contact, hours for
(23:54):
profit, interested, reply, stopto opt out.
Those are like our datingmessages that we get and we are
very familiar with those.
But for you you have, you haveyour own crib sheet when it
comes to addressing what jobsyou will and will not take.
So I would love if you couldtalk to us about as you started
(24:14):
working in these smallercommunities, as you started
getting used to being nimble andbeing able to, work with
different teams, how did youthen hone in on that craft so
that you were taking things thatyou wanted to do and not what
was just left out there?
Dr. Pouneh Alizadeh (24:30):
the idea.
Of the scarcity mindset comes upa lot and I think physicians
unfortunately tend to have that.
And, and I don't think it's ofany fault of our own.
It is just that we have been onthe wheel to get here, right?
Like we were in high school, weneed to get into college.
When we're in college, we needto take the MCATs, get into med
(24:51):
school, med school residency geta re be a research fellow, do X,
Y, or Z.
And and a particularly theresidency match, right?
You took what you can get.
And so that has reallytranslated, I think into life
after residency for a lot ofphysicians.
And, and so I think it's really.
(25:12):
Important to shift from that tomore of an abundance, a mindset
of abundance.
And it was pretty quick.
I, I would say initially when Istarted, I was, I maybe
overcommitted because I was alittle bit nervous that there
weren't gonna be availablepositions.
But then once I started doing itfor a couple of months I got to
(25:32):
be a little bit more free in, insaying no really.
And then that, that's anotherimportant thing that I think
physicians need to learn to sayand may be just humans in
general is no.
And just, and, being part ofFlex Med staff and going to
their conferences, there's a lotof good CME there about really
(25:54):
how you navigate theseconversations.
And it's hard to dilute it downto one or two sentences, but
what you, I think if yourlisteners take something away
from this is that you have theskills, okay?
You are taking care of thepatient, they need you.
(26:14):
And so if you view yourself asthe business, as the, as the
service, and you conductyourself in that way, it works
really well.
And you just have to be able tosay, if it's not.
The terms that you agreed to,that you walk away and knowing
that there are gonna be plentyof more opportunities to come.
(26:36):
It might not be in the exacttime that you want.
Right.
But there's a lot of differentways as you're thinking about,
setting up your, your, yourbusiness in providing like
safeguards and layeringstability in, in this type of
work.
Maryal Concepcion MD (26:54):
so true.
The, the, the, the, the way thatwe are put into the, the cold
water of our boiling pot of a, acareer in healthcare, it's like
you literally are so trained toyou don't think about, anything
other than.
(27:14):
You are supposed to get your 16patients seen in the ICU by
rounds at 2:00 PM you aresupposed to do this.
And it, we, we very much don'tthink about is there a different
way we could do this?
Is there a more effective waythat we could do this?
Is there there a more personableway that we could do this?
Instead it's well, I, I can geteveryone's A1C to 7.1 who has
(27:38):
diabetes.
Absolutely.
I I can do that.
Yes, sir.
Thank you.
Have a good day.
Can I have some more girls?
Like it's really, it's reallyfrustrating that, when we are
out of that system, we can see.
The, the personality the, Iwouldn't say personality, but
the the tendencies that we, wehave in training in a very, and
(28:00):
I will say patriarchal society,because that's absolutely what,
your, yours and my generationexperience.
Mm-hmm.
You have the attending and youhave the third year, the second
year, the first year.
Or God forbid if you're inseventh year training for
neurosurgery.
I'm, I wish you well, I couldnever do it that long, but I do
think that it, it is, it is sointeresting and it is so sad
(28:23):
that it is so relatable when itcomes to just the the, the way
that we just did.
We didn't, we didn't have a lotof autonomy.
Yeah, yeah.
That's
Dr. Pouneh Alizadeh (28:34):
so true.
I think when I had initiallyleft my job and I was working
one week a month and I didn'treally do much else, the.
Remainder of the three weekswhich is when I learned sleep is
really important.
'cause that was the first timein a very long time where I
slept every night like eight, ateight to nine hours a night for
(28:55):
three weeks straight.
And I felt like a whole newhuman.
So it's very interesting thatyou say that, that we just kind
of did what we were told andthat really became apparent to
me after I was in this new workschedule where I had three weeks
off.
I was able, it's veryinteresting.
I was able to make, make moredecisions for myself because I
(29:17):
had more freedom of time,whether it was in my personal
life or in my work life.
And what I did find out aboutmyself is I do enjoy, I do enjoy
working, like medicine isstimulating for me.
And so that's how the birth ofmy direct specialty care came in
(29:39):
was really from that downtimewhere I was away from the like
ultra robotic productivity thatI was so used to achieving that
now I had the space to becreative and really find like
what I enjoyed doing.
But I don't get, you don't getthat when you just don't have
(30:00):
the time or freedom or energyreally.
To tap into,
Maryal Concepcion MD (30:05):
tap into those thoughts.
Totally.
And it makes me think about howpeople have said on this podcast
that, DPC is not a walk in thepark.
DPC is, it can be one of thehardest jobs, but it's so much
more rewarding as you're doingthe job versus what we were used
to in fee for service.
And so here, I wanna ask, again,thinking about you as a doctor,
(30:30):
you as a mom, you as a businessowner, you as an entrepreneur I,
I totally get you, when it comesto your brain comes alive, like
you realize what you like andwhat you don't like.
For you, it ended up being doinglocums, along with opening up a
(30:51):
direct specialty care practice.
Tell us about that, because noneof those roles that I mentioned
are easy.
But you have decided to, to adda different way of how you
deliver yourself in the form ofpatients, in the form of being
an expert.
In your field you could havechosen not to.
And so I'm just wondering if youcould tell us about that
(31:12):
decision to add a layer ofdirect specialty care onto your
locums.
Dr. Pouneh Alizadeh (31:17):
Yeah, I think I easily could have done
locums a week, a month and thenhad the remainder of the time
off.
But for me, I started to misslike longitudinal care and
continuity of care and.
I missed having a little bit ofa home base.
When you do locums, you, youdon't really have a hospital
(31:37):
system.
You don't have an EMR.
You don't, you don't have,you're not part of any
community.
So, for the most part, I willsay I've been doing, I've been
going to some sites for a verylong time, and now I feel like a
part of their community.
But for, but in general it, youdon't have that same continuity
of care or even recognition,right?
Sometimes it's nice to be thedoctor in your community or
(32:00):
build your own community.
So, I was doing in that timealso some telemedicine,
perimenopause, menopause care.
I, I am menopause Societycertified practitioner.
And so, I was running into somepeople that I knew kind of
personally had worked with, andthey're like, I would love to
see you.
Had patients reaching out to meon LinkedIn and again, I was
(32:22):
like, I don't really haveanywhere to send.
I can't see you.
So at, at some point I felt likeI was a physician, but I didn't
really have a place to justpractice medicine.
So when I opened flourishGynecology, it was like really
handling my virtual shingle.
And I was able to see patientsold patients that had come to
(32:44):
me, colleagues, nurses that I'verun into.
I was able to be like, yeah,sure, I can see you here.
So yeah, for me it was reallyjust feeling a little bit more
connected to the community thatI was living in and just being
able to practice as a physicianin my own way without.
(33:06):
Ivory tower.
Maryal Concepcion MD (33:09):
I love that.
And I'm just wondering if youcould talk about the, the money
aspect, the finances aspectthere, because you have to
manage your, your moneydifferently when it's not just
oh, did my paycheck come intoday?
I mean, yes, you're gonna getpaid at doing locums, but at the
same time, like you are verymuch a part of how you get paid
(33:31):
in that much more so than wejust show up to work and somehow
we get a magical check.
Dr. Pouneh Alizadeh (33:34):
Mm-hmm.
Maryal Concepcion MD (33:35):
And then adding a direct primary care
business model layer to it.
I'm just wondering, did thathelp in terms of knowing what to
do financially, how to preparefinancially?
How did you, how did youexperience the addition on when
it came to the finances?
(33:56):
And then I'm gonna ask about howthat addition happened when it
came to, when it comes to time.
Dr. Pouneh Alizadeh (34:03):
Yeah, so I think when you branch out and
you're more of a independentcontractor, entrepreneurial
physician finances are a, a bigthing.
I think fortunately doing locumsis, can be financially
lucrative.
It can be unstable if you don'tcreate some stability in it.
(34:25):
And so for me, since I had donethat about a year before I
launched my kinda DPCI had a fewdifferent sites on rotation.
I had.
I had a little bit of anemergency fund.
I kind of had all my ducks inthe row.
The reason I decided to dotelemedicine also was to keep my
(34:46):
overhead low as I kind of dip myfeet in the water.
And I think a quote I always isperfection is an enemy of
progress, right?
So I just wanted to startsomewhere and it seemed like
pretty safe to start overheadwas quite low for kind of an
office only GYN malpractice withwith, your EMR and a few, a few
(35:08):
other things, a Google voice, aa a fact line.
And it's not, it's not terrible.
And so, for me, locums is stillmy primary income.
And I've intentionally grown myDPC slowly.
I don't have any employees.
It's just me.
And like I said, it's more of apassion project for me in terms
(35:31):
of, I just really connectingwith women and providing just
kind of a different type of carethat I don't, I feel like I
can't provide a traditionalsystem.
And, and so again, the locumsallows me to primarily do that.
I do see a time where that canshift but that'll acquire a
(35:51):
little bit more
Maryal Concepcion MD (35:53):
time and effort on my end.
Totally.
And so that perfectly dovetailedinto the time aspect because as
you said, there's only so muchtime in the day and being
intentional about your future sothat it is sustainable.
How did you.
Add your DPC business servicesto, how did you add your
(36:15):
membership services to yourlocums?
Because I think about yourlocums is a defined from this
day to this day, Dr.
Lee Day will be on call at thishospital.
Mm-hmm.
How, how do you work with yourpatients on the mm-hmm.
Outpatient side of things?
Dr. Pouneh Alizadeh (36:30):
Mm-hmm.
Yeah.
So right now I do primarilytelemedicine, GYN and I do pay
fee for service, essentially payby the appointment as opposed to
a membership model.
That might change in the future.
Again, as I think about how I'mgonna grow I also have the
interest in metabolic health andI'm sitting for the obesity med
boards later this year.
(36:50):
And so, that might change alittle bit, but anyway, when I
am I usually travel for locums.
I was going a week up at a time.
Now I'm going more than four tofive days.
I don't schedule appointmentsduring that time.
But I am readily available to mypatients via the portal.
And again, because I know thesepatients really well, for me,
(37:12):
it's really easy to quicklyanswer a question.
It doesn't bother me at all.
And then when I come home orwhen I know that I'm not on call
and I have time, that's notgonna be disrupted, then I
schedule my visits there.
Maryal Concepcion MD (37:27):
That's awesome.
And I will say that especiallyif you did pick up your physical
copy of the toolkit ourmagazines specifically for the
DPC community, or if you haven'tyet, go to my dpc
story.com/magazine and downloadyour copy today.
But when you mentioned portal, Ithink that this is speaking very
much to what we addressed in thebattle of the EHRs that we just
(37:50):
had, but also like from myperspective, when I looked at
what was sustainable for me, Iknew that I did not want to, in
our practice, give more time andspace for texting than I already
have in my regular life.
And so for me, the patientportal was huge.
And I, I say that especially forpeople to think about their own,
(38:12):
like what do they prefer iftexting more?
Is oh my God, I would love that.
Versus me texting more is likemaking me feel so anxious.
Mm-hmm.
Listen to those feelings as you,go forward when it comes to
time.
I wanna ask about the time withyour family, but then you also
(38:32):
wear hats of being a mom andspending time with family, and
then also being medical directorfor a startup called Frame
Health.
So tell us about how.
You continue to be intentionalabout your time, especially like
we're recording this after youguys just got back from a family
vacation.
Dr. Pouneh Alizadeh (38:51):
I noticed that I will fill my time
regardless of what it is.
And my husband's now understoodthat.
And so, so yeah, I think.
I would be lying if I say everytime I get it right.
I mean, I have to do checksevery couple of months, every
quarter, check in with myhusband, check in with myself,
what feel, what, what, is it toomuch that I overdo?
(39:13):
Do I need to downsize mycommitments?
And I've done that.
And I think that's somethingthat I've really learned in this
journey is that there is timeswhere there's opportunities and
you expand and you take'em.
And then it's okay to say, okay,well that opportunity served me
during that time.
It's no longer serving me, andthen I move on.
So I take inventory prettyregularly.
I did, get to a point earlierthis year when I probably
(39:35):
overcommitted and then I,downsized a little bit.
And so, and earlier when Italked about change, like change
is welcomed.
It's, it's okay.
You don't need to get to thepoint where you're.
To a Chris to just reorganize.
And so I would say I reorganizefairly often.
I love digital health and AI andtechnology.
(39:58):
So, this opportunity to be partof frame fertility has been
really awesome for me.
Actually had talked to them along time ago and the timing
wasn't right and so this isanother ode to networking, talk
to people, keep in contactopportunities may arise in the
future.
Maryal Concepcion MD (40:16):
I love that.
And just going back into the DPCside of things, I'm wondering
how did you set your businessmodel up in terms of is your DPC
separate a separate entity thanyour locums versus frame?
Because I think that that alsosomething that people aren't
necessarily like thinking about,but it is good to plan for.
Dr. Pouneh Alizadeh (40:37):
Mm-hmm.
Yeah.
So I have A-P-L-L-C that's kindof owns everything.
And then I have a doing businessas for Flourish GYN and then the
any of the consulting I domedical director at Frame, those
are all just subcontracted workunder my PLLC.
Maryal Concepcion MD (40:58):
Awesome.
And I, I'm very mindful thatthere are people listening
probably for the first time.
And so check with people, the,the network that you just made
at DBC Summit.
Talk with your friends andfamily.
Go to go to themap@mydbcstory.com, but look for
what is appropriate in yourstate.
For example, in California, wecannot be anything but an S Corp
for A-A-A-D-P-C.
(41:18):
So I think make sure that yourlegal cards are all in order as
you go forward.
so I'm wondering if you Couldtalk to us about how you manage
your DPC, because it is, you,you don't have any other staff
right now.
And yes, like you, youmentioned, it's not like you
started with a thousandpatients, 500 patients, 300
patients, but at the same time,you still have people who are
(41:40):
your patients.
Earlier I get a text about can Iget a rabies vaccine with this a
additional diagnosis that Ihave?
And I'm like, my God, I did notthink that today someone was
going to ask me about a rabiesvaccine with other diagnoses on
board.
So it's like we, we never knowwhat the patients are going to
say to us.
So I'm just wondering if youhave any things that you've
(42:03):
taken from your.
DPC is a business model journeythat have either really helped
you maintain being a micropractice and what you think
could help others who are alsothinking of doing something
similar to what you've done.
Dr. Pouneh Alizadeh (42:18):
Mm-hmm.
Yeah.
I think I'm lucky in the sensethat my practice is a little bit
of a niche practice and kind ofnarrow.
But what I also love about mypractice is that when my patient
reaches out and they say, I justwent to Mexico and I have a GI
virus and they put me onantibiotics, now I have a yeast
infection or X, Y or z.
I don't have to say contact yourprimary care, right?
(42:39):
I can handle some of some ofthese other, questions that they
have.
I think it's important as you'regrowing your practice again to
take like inventory.
What's my patient load look likenow?
And is this sustainable for howI want my life to be?
So right now, I, I have enoughdowntime that it's not a big
(43:02):
deal when I get messaged.
But there have been times in thelast two years where I haven't,
where I scheduled myself.
All of a sudden now I'm workingfour and a half days a week
again.
And I really wanna be workingmore like two to three when I'm
not working my locum shift.
So you, you do have to again,take inventory and, and see what
(43:22):
it feels like now and what it'sgonna continue to feel like.
And again, you don't have towait till it's a problem to
address it.
But for me, I, I have alwaysbeen one of those people that
have been on like MyChartmessaging patients back for me.
I just don't, I don't mind it.
I don't mind sitting on a beachand responding to messages,
(43:46):
which is what I did last week onvacation with my family.
Maryal Concepcion MD (43:51):
Love that.
Oh my gosh.
And that's, that's the thing,it's like somebody just asked me
if I could speak to theirresidents about DPC, and it's
this is the type of stuff Ithink about.
I'm like, in what world couldyou have worked, a, a fee for
service, corporate job, likemost of us experienced in
residency on the beach.
You would be so terrified to belike, I don't know if I can get
(44:13):
the time off.
All this stuff that like, youjust get to be free and practice
medicine.
I mean, yes, digitally, safely,but also like you get to
practice on a beach because,especially if you're.
Because you get to call theshots, especially when you're
doing telemedicine, so that'sawesome.
Mm-hmm.
Yeah.
That's awesome.
Yeah.
And
Dr. Pouneh Alizadeh (44:31):
yeah, and I've thought about, as I expand
on having hybrid model and brickand mortar, and so, again, like
DBD if that, that occurs, butagain, like depending on where
you are in your life and yourcareer, you can start small and
kind of add on and expand as youneed.
Maryal Concepcion MD (44:48):
you've given a lot of people a lot of
amazing pieces of advice,especially the part about taking
inventory on their own livesbecause there is no one else
like you out there, and the,everybody has to tailor today
for them and tomorrow is gonnabe potentially very different.
(45:08):
And so, I'm wondering here ifyou give the audience any
resources or recommendationsthat you would have for people
who want to learn more aboutlocums, want to know, because
there is an entire that is anentire world that like, is very,
very foreign.
I'm getting like toes wet in it,understanding it, but it's like
(45:29):
that is something I'd love ifyou could mention resources for
as well as where can people,connect with you going forward.
Dr. Pouneh Alizadeh (45:37):
Yeah, it definitely is a whole mindset
transition as you leave anemployed position.
I'll say it's a hundred percentworth it.
So everybody out there who'slike considering is surround
yourself with people that dothis because you will find a lot
of naysayers, a lot of, I mean,there's been multiple times that
(46:00):
physicians have told me, oh,that's only gonna last so long.
Or You're gonna need X, Y, or Z,you're gonna need the benefits.
But really you can take care ofyourself.
You can be a business owner, youcan give your own benefits.
There is a lot to learn.
You don't have to learn it allat once.
And I really recommend talkingto a ton of different people
(46:21):
because they're all gonna havedifferent experiences.
And if you take, one thing awayfrom each person, that's
amazing.
For me, flex Med Staff is agroup that Dr.
Aaron Morganstein runs and a fewother of our physicians and Dr.
Shen.
And so.
When I went to the first summittwo years ago now, it was an
(46:43):
incredible feeling to be in aroom surrounded by physicians
who are like-minded.
And I just cannot emphasizethis.
More is what I hear so much fromphysicians is that they're
afraid.
But if you are around peoplethat do it, you'll, you'll feel
(47:03):
inspired.
You'll be encouraged.
And then coming back the secondyear and seeing those people.
Do what we said or, change theircareers and just say thank you
so much for changing my life.
Again, I think networking andcommunity is so important.
We've a rise up summit inOctober and that is gonna be a,
(47:25):
a kind of a collab between DPCand Locums.
And again I'll be giving a fewlectures there.
And again, just surroundingyourself with the people who
have done it is, is invaluable.
Maryal Concepcion MD (47:40):
I love that.
And I will say that when I sawyou for the second flexed
summit, that's when you said, Iopened my DPC and I was like, oh
my gosh, tell me more.
And so absolutely this is, thisis why I, I'm really glad you
mentioned those resources Flexedstaff.
Absolutely.
Look them up.
And also the rise Up summit, Ithink it's gonna be a great
CoLab it's totally virtual, but.
(48:02):
It's a, it's another foothold inthe, the rock climbing wall to
physician entrepreneurship.
So, amazing.
Well, we're gonna continue ourconversation over the Patreon
community.
Definitely.
If you are not aware, we have amy DPC story, Patreon.
It helps support the work we'redoing, but Dr.
eDay and I are gonna continuetalking about this, point at
which you decide to leave versuswaiting until you're burn to a
(48:25):
crisp.
And also talking about menopausecare and how menopause can be
addressed differently in thedirect primary care and direct
specialty care space.
So, so thank you so much Dr.
eDay for joining us today.
Thank
Dr. Pouneh Alizadeh (48:37):
you so much for having me.
This has been so fun.
And if anybody wants to chatwith me afterwards, you can find
me on Instagram.
It's Dr.
Aliza Day, OB GYN.
Thank you.
Maryal Concepcion MD (48:49):
Thank you for listening to another episode
of my DBC story.
If you enjoyed it, please leavea five star review on your
favorite podcast platform.
It helps others find the show,have a question about direct
primary care.
Leave me a voicemail.
You might hear it answered in afuture episode.
Follow us on socials at thehandle at my D DPC story and
join DPC didactics our monthlydeep dive into your questions
(49:11):
and challenges.
Links are@mydpcstory.com forexclusive content you won't hear
anywhere else.
Join our Patreon.
Find the link in the show notesor search for my DPC story on
patreon.com for DPC news on thedaily.
Check out DPC news.com.
Until next week, this isMarielle conception.
Direct Primary care is aninnovative alternative path to
insurance-driven healthcare.
Typically, a patient pays theirdoctor a low monthly membership
and in return builds a lastingrelationship with their doctor
and has their doctor availableat their fingertip.
Welcome to the My DPC Storypodcast, where each week you
(00:26):
will hear the ever so relatablestories shared by physicians who
have chosen to practice medicinein their individual communities
through the direct primary caremodel.
I'm your host, MarielleConception.
Family, physician, DPC, owner,and former fee for service.
Doctor, I hope you enjoy today'sepisode and come away feeling
inspired about the future ofpatient care direct primary
(00:49):
care.
Dr. Pouneh Alizadeh (00:53):
Starting a DPC practice has been so
influential and important to meas a physician.
It's allowed me to hang myvirtual shingle and practice
medicine on my own terms.
I'm Dr.
PDay of Flourish Gynecology, andthis is my DPC story.
Maryal Concepcion MD (01:10):
Welcome to the podcast, Dr.
Leeza Day.
Dr. Pouneh Alizadeh (01:12):
Thank you so much for having me.
Maryal Concepcion MD (01:14):
I am really, really excited about.
I, I say that at the beginningof every podcast, but legit, I
get excited about every singlephysician I get, the honor to
talk to, and in your case.
The reason I'm so excited isbecause we have just all come
together in, on the nationalfront of things, at the DPC
summit in New Orleans, and thereare people who are specialists,
(01:39):
there are people who are primarycare, there are residents,
medical students, and I was soexcited to have your episode air
on this state in particularbecause I really feel that you,
of all of my physician friendshave just really represented
what it is like to be.
An employed physician, what itis like to be a person who then
(02:03):
chooses to do her own thing, andthen also learned and executed
on a direct primary carebusiness plan.
So again, I'm super excited as Ilegitimately am with every
single guest including you.
I am so excited for you to behere today.
Dr. Pouneh Alizadeh (02:17):
I'm so excited to be on here today.
I don't know if you remember,but when I first met you at the
flexed staff Summit last year, Iwas actually listening to my DPC
story on the flight there.
And then when I met you, I waslike, oh my God, I'm meeting a
celebrity.
I and you were like even betterin person, so
Maryal Concepcion MD (02:38):
you're so sweet and Absolutely.
I do remember that.
It's so funny because I, I'mvery, I think this is why I get
excited is literally just thepeople connection.
It's very visual.
I mean, it's very it's veryvivid for me.
And so I absolutely rememberyou.
You're wearing your black andwhite dress and you were like,
oh my God.
And I'm like.
It's so exciting to meet peoplewho listen to the podcast.
(02:59):
'cause I'm like, my kids listento my voice all the time.
But it's very different to hear,from a physician who's oh no
this episode meant a lot becauseof X, Y, or Z.
And definitely heard a lot aboutthat thankfully at talking to
people in New Orleans also.
Dr. Pouneh Alizadeh (03:13):
So
Maryal Concepcion MD (03:14):
All of that said, I wanna get started
with your journey into medicinebecause you are still one of
those amazing physicians who,takes any delivery that is
coming their way you still usethose skills when you do your
locums work as well as nowyou've added direct primary
care, like I mentioned.
So bring us to Dr.
(03:36):
Ade choosing to become an obgyn.
To start, because I think thatit, it's very much going to help
paint how you had the the acumenand the execution skills to do
what you're doing today.
Dr. Pouneh Alizadeh (03:50):
Yeah.
So when I went to medicalschool, I wasn't sure, what I
wanted to do.
I had shadowed a few emergencymedicine physicians and thought
that might be, something fun todo.
And then as I went throughmedical school, I really loved
physiology.
I really loved hormones.
I loved when I did my OB GYNrotation that we were able to do
(04:15):
a little bit of everything.
So as an ob, GYN, you do alittle clinic, you do a little
preventative care, you dospecialty care, you can do
surgeries, and then of coursethe whole world of obstetrics,
which is incredible in and ofitself.
I still have a picture on myphone from my first delivery as
a medical student, and I hadthese big goofy glasses that
(04:37):
were riding down on my nose.
And my attending took maskingtape and taped them, taped my
glasses to my face.
And I still have this photo, andI cried because the grandma
cried.
And, and anyway, so that was amoment that I was like, I love
obstetrics.
This is something that I want todo.
And I continue to love it.
And as you've noticed, I do, Istill do a little bit of
(04:58):
everything.
So I think what brought me tothe field has those, those same
the same and what motivates mehas continued to motivate me
throughout my career and career,how I revamped my career.
Maryal Concepcion MD (05:11):
And I just think that's amazing though
because I think that that.
When you said, especially thetape part, that when other
people are hearing that they'rethinking about their own,
situation or whatever happenedin medical school or residency
that really impacted themsimilarly to how you were
impacted by the tape.
(05:32):
And I think that's so awesome,especially also you are your
interview is airing after Dr.
Lawrence Reed shared about herdiaper chair story.
So I think that, we all have ourstories and these are the
stories that I think are whatmake my DBC story so relatable.
When you knew that you weregoing to do ob gyn, did you ever
(05:52):
have a time after residencywhere you were, in a place
thinking about, do I continueobstetrics and gynecology?
Do I only focus on one or moreof one than the other?
Dr. Pouneh Alizadeh (06:07):
Yeah, absolutely.
When I graduated from residency,so to give a little bit of
perspective to the listeners, Ihad stayed on with the hospital
system that I had done residencywith and agreed to open up a
practice in a nearby hospital.
So I opened a practice as aresident and I had actually one
of my attendings and two othersincluding Holly, she, which some
(06:29):
of your listeners might know.
So that was a whole differentexperience for me.
But you know, as an OB GYNresidency, it's a lot different
when you take, when you have abig call pool and you have hour
restrictions and largely shiftwork.
And so from an hoursperspective, switching to being
(06:52):
on Q3 Q4 call was a huge, it wasa huge change for me.
And so there were definitelytimes where I'm like, how is
this sustainable?
I love what I do, but I am humanand sleep is kind of important.
And so, but yeah, there isdefinitely times when I was in
(07:14):
this kind of traditional modelthat I thought I just don't know
if I can picture myself at 50continuing to, to work at this
rate.
Maryal Concepcion MD (07:24):
Totally.
And I know that when you said,you know you need sleep one,
it's ironic because the firsttime I met you, you did a talk
about sleep during locum shifts,but also.
I remember, like I, I don'tknow.
I'm dating myself.
I am 43.
I like unabashedly watched anmaniacs and if anybody
(07:44):
understands, Katie, kaboom, thatis a hundred percent me
post-call OB in the hospital.
And I knew when I leftresidency, Marielle was done
with deliveries.
And so I totally get that.
And you and I are also very muchsimilar in that we are moms of
two young kids.
And so I think that that adds acompletely different layer to
(08:06):
when you are awake, that'sdifferent than how capable are
you of being present for yourpatients, for your family
especially for little kids.
So talk to us about.
How you went forward because youdid have little kids in the mix
along your journey to,especially because you were able
(08:30):
to see what was sustainable oryou had a feeling for that.
Whereas I, I don't, I, I don'tthink that that's something
necessarily that we sort of pimpeach other with when we're
thinking about what are we gonnado after residency.
We don't necessarily alwaysthink about what's sustainable
beyond what's financiallysustainable.
Nipple.
Dr. Pouneh Alizadeh (08:48):
Yeah.
So my kiddos, let's see.
I had a kiddo in residency andthen I had a kiddo was pregnant
my fourth year.
So I started my practice with.
Pregnant actually, and anddelivered the first year of
practice.
And I mean, honestly, whoremembers those first two, like
two, two kids under two and ahalf?
(09:09):
It's all just a little bit of ablur.
But over time as I was settlingin into attending life and being
a mother of two, and I also havea stepdaughter who is now a
teenager, so we had a fullhouse.
I really realized that there wasgonna be kind of a fork in the
road of like how I wanted toshow up as a parent and how I
(09:31):
wanted to balance that with mycareer.
And and I'm just gonna put adisclaimer as this is anybody's.
Own choice to what they chooseto do here.
This was just, this is just howI felt about it.
So I knew that either I wasgonna get a nanny plus daycare,
I was gonna get an au pair.
I was going to kind of.
(09:52):
Delegate all the things that Ididn't need to de that maybe I
didn't need to do.
Maybe I didn't need to shuttlekids to and from practice and,
but I'd be there for the games.
Right.
You kind of decide what'simportant for your family,
what's important to you, andthen how does that balance with
what fills your cup at work?
For me, I really just wanted tobe there for everything.
(10:12):
I wanted to drive my kids topractice.
I liked I think we've talkedabout like mundane conversations
though with other parents at, atsporting events and sometimes
it's less than fun.
But for me, I kind of, I kind ofliked that and so I knew I
wanted to be kind of part of thecommunity for my kids.
And so that was a little bit ofa roadblock for me in terms of
(10:34):
staying in the position that Iwas in and how I would continue
to not only be present but bementally there.
Right.
Not be tired, not be checking.
Messages on my phone not puttingout emergencies, kind of like
left and right.
Maryal Concepcion MD (10:53):
And that said, how did you take those
next steps to then make thatsustainability, make that plan a
reality?
Mm-hmm.
Yeah.
So in, so what happenedcareer-wise was I ended up
taking a leadership role in theclinic.
A few of my partners had leftand I was still very motivated
(11:14):
to improve the clinic.
And again, we started it fromscratch.
It was really a wonderfulclinic.
It was thriving and I wanted toelevate it.
And so I had actually reachedout to a coach to see more of
like executive leadershiptraining as a physician.
Like how do I one overcome thefact that I was a resident in
this health system and now I'm aleader?
And yes, I was their resident,but I have good ideas and I can
(11:38):
connect with my staff and withmy patients, and how do I gain
the respect of, ofadministrators?
So in doing that, there was justa lot.
It was the first time wheresomebody had asked me like, what
are the four things that youvalue?
Put them in order by the timeyou're 50.
35 things that you want to dothis or that, like it, what,
(12:00):
what are, give me answers tothese questions.
And maybe we did this in medicalschool, but like the context was
like totally not there.
And so now so I did that and I,I realized what was important to
me.
And I actually had no intentionsof leaving my practice.
I had got up the strength reallyto, to ask for something that I
(12:22):
wanted, right.
So I felt like I was giving Iwas bringing a lot to the table.
I have pleasant personality.
Patients like me as a goodphysician.
I am motivated.
I like all the techie stuff.
I'd help everybody with theirepic.
And so I went and asked for justa little bit of time to.
To accomplish these things.
'cause it's hard to do it whenyou don't have any time.
(12:43):
And I really, this idea of timebecame very finite for me.
And so I knew that I couldn'tcontinue to operate with this
much on the plate, so somethinghad to give.
And so when I asked for it, Iwas told, well, yeah, you're
great.
You're probably better thanmost, but it wouldn't be
equitable to give you more timethan somebody else.
(13:05):
And, and, and I don't know whatit was, but then I was like, I
don't know what came over me,but it was a very fine line in
the sand.
And then I was like, I put mynotice in 10 days later, no idea
what I was going to do.
it's just so kick ass mm-hmm.
You are very much similar to mein that it's I don't necessarily
(13:29):
have a plan, but I can't do thisanymore.
Dr. Pouneh Alizadeh (13:31):
Mm-hmm.
Mm-hmm.
And
Maryal Concepcion MD (13:33):
you, we've figured it out, so.
Mm-hmm.
As scary as that is, I, I,again, am really intentional
about the audience hearing yourstory right after DPC Summit, on
the heels of days of people,drinking the DPC Kool-Aid,
having their come to whoeverthey pray to moment and mm-hmm.
(13:53):
Just saying my gosh, there issomething out there called
Direct primary care.
It is real.
It is happening and this is apossibility for me.
So I'm wondering, especially ifyou can hear, talk about the
conversation you had with your,with your husband, with your
partner, because that is alsosomething that it's like as we
(14:14):
are very capable femalephysicians to say like, I ain't
doing that anymore.
It's another thing to be like,also, I have a family and I
gotta make this work for myfamily too.
So tell us about theconversation that you had in
this moment of well, if treatingyour physicians.
Equitably doesn't mean takingcare of them.
(14:34):
Then this is not for me and thisis not an equitable position for
me to stay in.
What did you and your husbandthen talk about?
Because again, there's lots ofpeople going to their partners
or their family members who aredropping things like, I'm gonna
leave my position pretty soon.
Dr. Pouneh Alizadeh (14:53):
Very interesting because I was very
nervous to tell those around methat I cared about what my plans
were because again, I trained inthe system.
I started practice in thesystem, grew the practice, grew
into a leadership position.
I think I was like on that.
Track, ladder, what, whateveryou wanna call it.
(15:16):
And I also happened to beprimary income for my family, so
I was a little bit nervous onhow that would all shake out.
But I, I can't, I think I toldmy husband first and I said, I
think I'm going to quit my job.
And he goes, oh yeah, abouttime.
I was like, wait, what?
I thought I was holding ittogether really good.
(15:37):
What do you mean about time?
And then I told my mom and shesaid the same thing.
And then I told my brother andhe said the same thing.
And then I told my mother-in-lawwho lives across the country,
and she said the same thing.
So that actually blew me away.
And what it actually reallytaught me is that we are
affecting those around us.
And we.
Our loved ones don't necessarilywanna give us that feedback
(15:59):
because they know our career isso important to us.
My husband has been with me fromthe start, and he wants me to do
what makes me happy.
And I think you all were arespectable career, we're
physicians and sometimes they'reafraid to say things.
And so that, that was a, alittle bit of an eye-opening
moment for me.
Maryal Concepcion MD (16:18):
I think it, I think it's awesome and I,
I think it just makes me thinkabout how sometimes we can't see
past the ends of our noses andwe, we sometimes get into our
own head space so much so thatit's here's a great example.
You didn't even have to sayanything and everyone else was
already confirming yourthoughts, even though you hadn't
said them out loud.
So that's, that's amazing.
And I, I hope that it is alsogiving some people some.
(16:43):
Courage or, just just anotherstory to hear in their head when
it comes to that as aconversation I have yet to have
with my loved ones.
So after you decided to quitdefinitely in the world of ob
gyn there's always going to bethe need for a very well-trained
(17:04):
physician, especially in acutecare and acute deliveries, to
have a job.
And you very much leaned intolocums, and I'm just wondering
if you can tell us about that,because.
It's very different when,especially on ob, like anyone
who's done a rotation in OBknows that the people who run
(17:25):
the OB floor are the OB nurses.
And so when you're going from, Iknow my OB team and residency, I
stayed on as an attending andthen I have to go to different
OB teams all over the country.
I would, I would never make thatdecision myself personally
because I stopped doingdeliveries after residency.
'cause I, that terrifies me.
(17:46):
But for you, what was your, whatwas your thought about doing
locums versus looking for adifferent employed position that
was quote unquote moreequitable?
I'm just saying that so snarly'cause it's ridiculous.
Mm-hmm.
Yeah,
Dr. Pouneh Alizadeh (18:01):
I wanted to make one comment on quitting
your job before I answer thatquestion.
And one thing I just wanna pointout to those that are listening
is that you don't have to waittill the point that you are
burnt out to a crisp to draw theline and change your job.
And so I don't think that I wasnecessarily burnt out.
(18:25):
I just knew that this was notsustainable and I didn't want to
know what would happen to myselfor my family or those around me
if I continued at this pace.
And so, again, for those thatare listening, you don't, you
don't have to push yourself tothe ultimate end before you make
a change.
It is people in otherspecialties and other jobs
(18:47):
careers, they make changes allthe time.
Change is okay and I think.
We're not used to that mindset.
So again um, to answer yourquestion about why I decided to
do locums, I was not ready tocommit to another permanent
position.
I, I also was leaving in Juneand wanted a little bit of a
summer selfishly forth myfamily.
(19:09):
And Dr.
Chen had, she had left I thinkeight months prior to my final.
My final shift.
And she had dabbled a little bitinto locums before, and I was
like, okay, great.
I'll just see what's out there.
And for me, it actually workedout really organically.
And I shared this a little bitwhen I talk about direct
(19:30):
contracting, but I was onLinkedIn and I got a message
from a hospital that, for apermanent position, and I had
said was not interested in apermanent position, but I am
actually free to help yourhospital until they find one.
And they were like, great.
And there you go.
(19:50):
That was the start of it.
And I went there a week, a monthfor, and I still go there two
over two years later.
And so yeah, when you'rethinking about doing locums.
In general outside of even beingan ob, GYN is that you have to
be pretty malleable and you haveto be pretty flexible.
This is not the time where it'slike we do things my way and
(20:12):
only my way.
You have to integrate yourselfthe hospital system, and there
are protocols.
You have to trust the nurses.
And honestly, there is only likeone place maybe that I got a
little bit hazed.
But since then, really every,they're very appreciative.
I go to smaller communities, sothey're just really happy one to
(20:32):
have hope for their physicians.
What I've really noticed inthese small communities is that
especially these nurses look outfor their physicians and they
are really worried about theirwellbeing.
And so they have really acceptedme and.
(20:53):
Like I said before, in general,I'm like pretty pleasant.
Like my med school evaluations,every single one, she's so
pleasant.
So for me it was, it, it wasnice to also feel appreciative.
So all the, all the things thatmy other, my former employer was
like, yeah, you're all thesethings, but it doesn't really
matter.
I'm now, I'm in a position wherepeople appreciated my
personality and they appreciatedmy work ethic and the way I took
(21:16):
care of patients.
Maryal Concepcion MD (21:17):
I can absolutely testify that Dr.
Lee today is not just likepulling your leg.
She is a very pleasant person tobe around.
But I think that's so funnybecause it's, I think that it
just, it makes me think aboutthat pleasant does not mean that
someone can just walk over you.
And I think that that issomething that especially in the
(21:39):
employed.
Positions that, people who havezero medical training and yet
they make gazillions of dollarsoff of the backs of the
physicians who actually see thepatients.
They have the audacity, toperceive that being malleable,
pleasant, flexible hardworkingis that you are an indentured
(22:04):
servant and you get to be toldwhat is okay and what is not
okay.
So, I just I'm, I'm very proudof both of us for making it very
apparent that those two are notequal pleasant and pushover.
I am really grateful that youmentioned you don't have to let
yourself burn to a crisp beforesaying these are my boundaries.
(22:25):
I think especially in themindset of a physician
entrepreneur that that is whathappens all the time.
If your patient is calling forTylenol at two o'clock in the
morning when they can go to the24 hour Walmart, or, if somebody
is, is stepping on boundaries,it's so important to not wait
(22:45):
until it gets so bad.
And yes, like I've definitelybeen there where I'm like, oh my
gosh, how did it get this bad?
I'm never gonna have that happenagain.
I've spoken to my regret oftaking patients acutely to my
practice.
But it's, I think it's a reallygood point for people to listen
to because it also.
It's part of that honoring likeyou said, who are, who am I and
(23:08):
what do I need to besustainable?
That that spirit of us right.
When it comes to the, thesesmall communities, I'm wondering
because there's probably a lotof people in the audience who
have not, probably until beforeDr.
Lawrence Reed talked aboutlocums, have thought about
locums before.
And you were also one of mygo-to people when it comes to
(23:28):
the world of direct contracting,the world of locums.
Because I think that what manyof us are familiar with is the
recruitment emails.
I mean, yesterday I got, okay,I, I love this'cause it says
Sheboygan, so I'm gonna read itjust because it says Sheboygan.
What was it?
Hi Doc fm Green Bay slashSheboygan.
Epic.
EMR, 18 to 20 patients a day,36, patient contact, hours for
(23:54):
profit, interested, reply, stopto opt out.
Those are like our datingmessages that we get and we are
very familiar with those.
But for you you have, you haveyour own crib sheet when it
comes to addressing what jobsyou will and will not take.
So I would love if you couldtalk to us about as you started
(24:14):
working in these smallercommunities, as you started
getting used to being nimble andbeing able to, work with
different teams, how did youthen hone in on that craft so
that you were taking things thatyou wanted to do and not what
was just left out there?
Dr. Pouneh Alizadeh (24:30):
the idea.
Of the scarcity mindset comes upa lot and I think physicians
unfortunately tend to have that.
And, and I don't think it's ofany fault of our own.
It is just that we have been onthe wheel to get here, right?
Like we were in high school, weneed to get into college.
When we're in college, we needto take the MCATs, get into med
(24:51):
school, med school residency geta re be a research fellow, do X,
Y, or Z.
And and a particularly theresidency match, right?
You took what you can get.
And so that has reallytranslated, I think into life
after residency for a lot ofphysicians.
And, and so I think it's really.
(25:12):
Important to shift from that tomore of an abundance, a mindset
of abundance.
And it was pretty quick.
I, I would say initially when Istarted, I was, I maybe
overcommitted because I was alittle bit nervous that there
weren't gonna be availablepositions.
But then once I started doing itfor a couple of months I got to
(25:32):
be a little bit more free in, insaying no really.
And then that, that's anotherimportant thing that I think
physicians need to learn to sayand may be just humans in
general is no.
And just, and, being part ofFlex Med staff and going to
their conferences, there's a lotof good CME there about really
(25:54):
how you navigate theseconversations.
And it's hard to dilute it downto one or two sentences, but
what you, I think if yourlisteners take something away
from this is that you have theskills, okay?
You are taking care of thepatient, they need you.
(26:14):
And so if you view yourself asthe business, as the, as the
service, and you conductyourself in that way, it works
really well.
And you just have to be able tosay, if it's not.
The terms that you agreed to,that you walk away and knowing
that there are gonna be plentyof more opportunities to come.
(26:36):
It might not be in the exacttime that you want.
Right.
But there's a lot of differentways as you're thinking about,
setting up your, your, yourbusiness in providing like
safeguards and layeringstability in, in this type of
work.
Maryal Concepcion MD (26:54):
so true.
The, the, the, the, the way thatwe are put into the, the cold
water of our boiling pot of a, acareer in healthcare, it's like
you literally are so trained toyou don't think about, anything
other than.
(27:14):
You are supposed to get your 16patients seen in the ICU by
rounds at 2:00 PM you aresupposed to do this.
And it, we, we very much don'tthink about is there a different
way we could do this?
Is there a more effective waythat we could do this?
Is there there a more personableway that we could do this?
Instead it's well, I, I can geteveryone's A1C to 7.1 who has
(27:38):
diabetes.
Absolutely.
I I can do that.
Yes, sir.
Thank you.
Have a good day.
Can I have some more girls?
Like it's really, it's reallyfrustrating that, when we are
out of that system, we can see.
The, the personality the, Iwouldn't say personality, but
the the tendencies that we, wehave in training in a very, and
(28:00):
I will say patriarchal society,because that's absolutely what,
your, yours and my generationexperience.
Mm-hmm.
You have the attending and youhave the third year, the second
year, the first year.
Or God forbid if you're inseventh year training for
neurosurgery.
I'm, I wish you well, I couldnever do it that long, but I do
think that it, it is, it is sointeresting and it is so sad
(28:23):
that it is so relatable when itcomes to just the the, the way
that we just did.
We didn't, we didn't have a lotof autonomy.
Yeah, yeah.
That's
Dr. Pouneh Alizadeh (28:34):
so true.
I think when I had initiallyleft my job and I was working
one week a month and I didn'treally do much else, the.
Remainder of the three weekswhich is when I learned sleep is
really important.
'cause that was the first timein a very long time where I
slept every night like eight, ateight to nine hours a night for
(28:55):
three weeks straight.
And I felt like a whole newhuman.
So it's very interesting thatyou say that, that we just kind
of did what we were told andthat really became apparent to
me after I was in this new workschedule where I had three weeks
off.
I was able, it's veryinteresting.
I was able to make, make moredecisions for myself because I
(29:17):
had more freedom of time,whether it was in my personal
life or in my work life.
And what I did find out aboutmyself is I do enjoy, I do enjoy
working, like medicine isstimulating for me.
And so that's how the birth ofmy direct specialty care came in
(29:39):
was really from that downtimewhere I was away from the like
ultra robotic productivity thatI was so used to achieving that
now I had the space to becreative and really find like
what I enjoyed doing.
But I don't get, you don't getthat when you just don't have
(30:00):
the time or freedom or energyreally.
To tap into,
Maryal Concepcion MD (30:05):
tap into those thoughts.
Totally.
And it makes me think about howpeople have said on this podcast
that, DPC is not a walk in thepark.
DPC is, it can be one of thehardest jobs, but it's so much
more rewarding as you're doingthe job versus what we were used
to in fee for service.
And so here, I wanna ask, again,thinking about you as a doctor,
(30:30):
you as a mom, you as a businessowner, you as an entrepreneur I,
I totally get you, when it comesto your brain comes alive, like
you realize what you like andwhat you don't like.
For you, it ended up being doinglocums, along with opening up a
(30:51):
direct specialty care practice.
Tell us about that, because noneof those roles that I mentioned
are easy.
But you have decided to, to adda different way of how you
deliver yourself in the form ofpatients, in the form of being
an expert.
In your field you could havechosen not to.
And so I'm just wondering if youcould tell us about that
(31:12):
decision to add a layer ofdirect specialty care onto your
locums.
Dr. Pouneh Alizadeh (31:17):
Yeah, I think I easily could have done
locums a week, a month and thenhad the remainder of the time
off.
But for me, I started to misslike longitudinal care and
continuity of care and.
I missed having a little bit ofa home base.
When you do locums, you, youdon't really have a hospital
(31:37):
system.
You don't have an EMR.
You don't, you don't have,you're not part of any
community.
So, for the most part, I willsay I've been doing, I've been
going to some sites for a verylong time, and now I feel like a
part of their community.
But for, but in general it, youdon't have that same continuity
of care or even recognition,right?
Sometimes it's nice to be thedoctor in your community or
(32:00):
build your own community.
So, I was doing in that timealso some telemedicine,
perimenopause, menopause care.
I, I am menopause Societycertified practitioner.
And so, I was running into somepeople that I knew kind of
personally had worked with, andthey're like, I would love to
see you.
Had patients reaching out to meon LinkedIn and again, I was
(32:22):
like, I don't really haveanywhere to send.
I can't see you.
So at, at some point I felt likeI was a physician, but I didn't
really have a place to justpractice medicine.
So when I opened flourishGynecology, it was like really
handling my virtual shingle.
And I was able to see patientsold patients that had come to
(32:44):
me, colleagues, nurses that I'verun into.
I was able to be like, yeah,sure, I can see you here.
So yeah, for me it was reallyjust feeling a little bit more
connected to the community thatI was living in and just being
able to practice as a physicianin my own way without.
(33:06):
Ivory tower.
Maryal Concepcion MD (33:09):
I love that.
And I'm just wondering if youcould talk about the, the money
aspect, the finances aspectthere, because you have to
manage your, your moneydifferently when it's not just
oh, did my paycheck come intoday?
I mean, yes, you're gonna getpaid at doing locums, but at the
same time, like you are verymuch a part of how you get paid
(33:31):
in that much more so than wejust show up to work and somehow
we get a magical check.
Dr. Pouneh Alizadeh (33:34):
Mm-hmm.
Maryal Concepcion MD (33:35):
And then adding a direct primary care
business model layer to it.
I'm just wondering, did thathelp in terms of knowing what to
do financially, how to preparefinancially?
How did you, how did youexperience the addition on when
it came to the finances?
(33:56):
And then I'm gonna ask about howthat addition happened when it
came to, when it comes to time.
Dr. Pouneh Alizadeh (34:03):
Yeah, so I think when you branch out and
you're more of a independentcontractor, entrepreneurial
physician finances are a, a bigthing.
I think fortunately doing locumsis, can be financially
lucrative.
It can be unstable if you don'tcreate some stability in it.
(34:25):
And so for me, since I had donethat about a year before I
launched my kinda DPCI had a fewdifferent sites on rotation.
I had.
I had a little bit of anemergency fund.
I kind of had all my ducks inthe row.
The reason I decided to dotelemedicine also was to keep my
(34:46):
overhead low as I kind of dip myfeet in the water.
And I think a quote I always isperfection is an enemy of
progress, right?
So I just wanted to startsomewhere and it seemed like
pretty safe to start overheadwas quite low for kind of an
office only GYN malpractice withwith, your EMR and a few, a few
(35:08):
other things, a Google voice, aa a fact line.
And it's not, it's not terrible.
And so, for me, locums is stillmy primary income.
And I've intentionally grown myDPC slowly.
I don't have any employees.
It's just me.
And like I said, it's more of apassion project for me in terms
(35:31):
of, I just really connectingwith women and providing just
kind of a different type of carethat I don't, I feel like I
can't provide a traditionalsystem.
And, and so again, the locumsallows me to primarily do that.
I do see a time where that canshift but that'll acquire a
(35:51):
little bit more
Maryal Concepcion MD (35:53):
time and effort on my end.
Totally.
And so that perfectly dovetailedinto the time aspect because as
you said, there's only so muchtime in the day and being
intentional about your future sothat it is sustainable.
How did you.
Add your DPC business servicesto, how did you add your
(36:15):
membership services to yourlocums?
Because I think about yourlocums is a defined from this
day to this day, Dr.
Lee Day will be on call at thishospital.
Mm-hmm.
How, how do you work with yourpatients on the mm-hmm.
Outpatient side of things?
Dr. Pouneh Alizadeh (36:30):
Mm-hmm.
Yeah.
So right now I do primarilytelemedicine, GYN and I do pay
fee for service, essentially payby the appointment as opposed to
a membership model.
That might change in the future.
Again, as I think about how I'mgonna grow I also have the
interest in metabolic health andI'm sitting for the obesity med
boards later this year.
(36:50):
And so, that might change alittle bit, but anyway, when I
am I usually travel for locums.
I was going a week up at a time.
Now I'm going more than four tofive days.
I don't schedule appointmentsduring that time.
But I am readily available to mypatients via the portal.
And again, because I know thesepatients really well, for me,
(37:12):
it's really easy to quicklyanswer a question.
It doesn't bother me at all.
And then when I come home orwhen I know that I'm not on call
and I have time, that's notgonna be disrupted, then I
schedule my visits there.
Maryal Concepcion MD (37:27):
That's awesome.
And I will say that especiallyif you did pick up your physical
copy of the toolkit ourmagazines specifically for the
DPC community, or if you haven'tyet, go to my dpc
story.com/magazine and downloadyour copy today.
But when you mentioned portal, Ithink that this is speaking very
much to what we addressed in thebattle of the EHRs that we just
(37:50):
had, but also like from myperspective, when I looked at
what was sustainable for me, Iknew that I did not want to, in
our practice, give more time andspace for texting than I already
have in my regular life.
And so for me, the patientportal was huge.
And I, I say that especially forpeople to think about their own,
(38:12):
like what do they prefer iftexting more?
Is oh my God, I would love that.
Versus me texting more is likemaking me feel so anxious.
Mm-hmm.
Listen to those feelings as you,go forward when it comes to
time.
I wanna ask about the time withyour family, but then you also
(38:32):
wear hats of being a mom andspending time with family, and
then also being medical directorfor a startup called Frame
Health.
So tell us about how.
You continue to be intentionalabout your time, especially like
we're recording this after youguys just got back from a family
vacation.
Dr. Pouneh Alizadeh (38:51):
I noticed that I will fill my time
regardless of what it is.
And my husband's now understoodthat.
And so, so yeah, I think.
I would be lying if I say everytime I get it right.
I mean, I have to do checksevery couple of months, every
quarter, check in with myhusband, check in with myself,
what feel, what, what, is it toomuch that I overdo?
(39:13):
Do I need to downsize mycommitments?
And I've done that.
And I think that's somethingthat I've really learned in this
journey is that there is timeswhere there's opportunities and
you expand and you take'em.
And then it's okay to say, okay,well that opportunity served me
during that time.
It's no longer serving me, andthen I move on.
So I take inventory prettyregularly.
I did, get to a point earlierthis year when I probably
(39:35):
overcommitted and then I,downsized a little bit.
And so, and earlier when Italked about change, like change
is welcomed.
It's, it's okay.
You don't need to get to thepoint where you're.
To a Chris to just reorganize.
And so I would say I reorganizefairly often.
I love digital health and AI andtechnology.
(39:58):
So, this opportunity to be partof frame fertility has been
really awesome for me.
Actually had talked to them along time ago and the timing
wasn't right and so this isanother ode to networking, talk
to people, keep in contactopportunities may arise in the
future.
Maryal Concepcion MD (40:16):
I love that.
And just going back into the DPCside of things, I'm wondering
how did you set your businessmodel up in terms of is your DPC
separate a separate entity thanyour locums versus frame?
Because I think that that alsosomething that people aren't
necessarily like thinking about,but it is good to plan for.
Dr. Pouneh Alizadeh (40:37):
Mm-hmm.
Yeah.
So I have A-P-L-L-C that's kindof owns everything.
And then I have a doing businessas for Flourish GYN and then the
any of the consulting I domedical director at Frame, those
are all just subcontracted workunder my PLLC.
Maryal Concepcion MD (40:58):
Awesome.
And I, I'm very mindful thatthere are people listening
probably for the first time.
And so check with people, the,the network that you just made
at DBC Summit.
Talk with your friends andfamily.
Go to go to themap@mydbcstory.com, but look for
what is appropriate in yourstate.
For example, in California, wecannot be anything but an S Corp
for A-A-A-D-P-C.
(41:18):
So I think make sure that yourlegal cards are all in order as
you go forward.
so I'm wondering if you Couldtalk to us about how you manage
your DPC, because it is, you,you don't have any other staff
right now.
And yes, like you, youmentioned, it's not like you
started with a thousandpatients, 500 patients, 300
patients, but at the same time,you still have people who are
(41:40):
your patients.
Earlier I get a text about can Iget a rabies vaccine with this a
additional diagnosis that Ihave?
And I'm like, my God, I did notthink that today someone was
going to ask me about a rabiesvaccine with other diagnoses on
board.
So it's like we, we never knowwhat the patients are going to
say to us.
So I'm just wondering if youhave any things that you've
(42:03):
taken from your.
DPC is a business model journeythat have either really helped
you maintain being a micropractice and what you think
could help others who are alsothinking of doing something
similar to what you've done.
Dr. Pouneh Alizadeh (42:18):
Mm-hmm.
Yeah.
I think I'm lucky in the sensethat my practice is a little bit
of a niche practice and kind ofnarrow.
But what I also love about mypractice is that when my patient
reaches out and they say, I justwent to Mexico and I have a GI
virus and they put me onantibiotics, now I have a yeast
infection or X, Y or z.
I don't have to say contact yourprimary care, right?
(42:39):
I can handle some of some ofthese other, questions that they
have.
I think it's important as you'regrowing your practice again to
take like inventory.
What's my patient load look likenow?
And is this sustainable for howI want my life to be?
So right now, I, I have enoughdowntime that it's not a big
(43:02):
deal when I get messaged.
But there have been times in thelast two years where I haven't,
where I scheduled myself.
All of a sudden now I'm workingfour and a half days a week
again.
And I really wanna be workingmore like two to three when I'm
not working my locum shift.
So you, you do have to again,take inventory and, and see what
(43:22):
it feels like now and what it'sgonna continue to feel like.
And again, you don't have towait till it's a problem to
address it.
But for me, I, I have alwaysbeen one of those people that
have been on like MyChartmessaging patients back for me.
I just don't, I don't mind it.
I don't mind sitting on a beachand responding to messages,
(43:46):
which is what I did last week onvacation with my family.
Maryal Concepcion MD (43:51):
Love that.
Oh my gosh.
And that's, that's the thing,it's like somebody just asked me
if I could speak to theirresidents about DPC, and it's
this is the type of stuff Ithink about.
I'm like, in what world couldyou have worked, a, a fee for
service, corporate job, likemost of us experienced in
residency on the beach.
You would be so terrified to belike, I don't know if I can get
(44:13):
the time off.
All this stuff that like, youjust get to be free and practice
medicine.
I mean, yes, digitally, safely,but also like you get to
practice on a beach because,especially if you're.
Because you get to call theshots, especially when you're
doing telemedicine, so that'sawesome.
Mm-hmm.
Yeah.
That's awesome.
Yeah.
And
Dr. Pouneh Alizadeh (44:31):
yeah, and I've thought about, as I expand
on having hybrid model and brickand mortar, and so, again, like
DBD if that, that occurs, butagain, like depending on where
you are in your life and yourcareer, you can start small and
kind of add on and expand as youneed.
Maryal Concepcion MD (44:48):
you've given a lot of people a lot of
amazing pieces of advice,especially the part about taking
inventory on their own livesbecause there is no one else
like you out there, and the,everybody has to tailor today
for them and tomorrow is gonnabe potentially very different.
(45:08):
And so, I'm wondering here ifyou give the audience any
resources or recommendationsthat you would have for people
who want to learn more aboutlocums, want to know, because
there is an entire that is anentire world that like, is very,
very foreign.
I'm getting like toes wet in it,understanding it, but it's like
(45:29):
that is something I'd love ifyou could mention resources for
as well as where can people,connect with you going forward.
Dr. Pouneh Alizadeh (45:37):
Yeah, it definitely is a whole mindset
transition as you leave anemployed position.
I'll say it's a hundred percentworth it.
So everybody out there who'slike considering is surround
yourself with people that dothis because you will find a lot
of naysayers, a lot of, I mean,there's been multiple times that
(46:00):
physicians have told me, oh,that's only gonna last so long.
Or You're gonna need X, Y, or Z,you're gonna need the benefits.
But really you can take care ofyourself.
You can be a business owner, youcan give your own benefits.
There is a lot to learn.
You don't have to learn it allat once.
And I really recommend talkingto a ton of different people
(46:21):
because they're all gonna havedifferent experiences.
And if you take, one thing awayfrom each person, that's
amazing.
For me, flex Med Staff is agroup that Dr.
Aaron Morganstein runs and a fewother of our physicians and Dr.
Shen.
And so.
When I went to the first summittwo years ago now, it was an
(46:43):
incredible feeling to be in aroom surrounded by physicians
who are like-minded.
And I just cannot emphasizethis.
More is what I hear so much fromphysicians is that they're
afraid.
But if you are around peoplethat do it, you'll, you'll feel
(47:03):
inspired.
You'll be encouraged.
And then coming back the secondyear and seeing those people.
Do what we said or, change theircareers and just say thank you
so much for changing my life.
Again, I think networking andcommunity is so important.
We've a rise up summit inOctober and that is gonna be a,
(47:25):
a kind of a collab between DPCand Locums.
And again I'll be giving a fewlectures there.
And again, just surroundingyourself with the people who
have done it is, is invaluable.
Maryal Concepcion MD (47:40):
I love that.
And I will say that when I sawyou for the second flexed
summit, that's when you said, Iopened my DPC and I was like, oh
my gosh, tell me more.
And so absolutely this is, thisis why I, I'm really glad you
mentioned those resources Flexedstaff.
Absolutely.
Look them up.
And also the rise Up summit, Ithink it's gonna be a great
CoLab it's totally virtual, but.
(48:02):
It's a, it's another foothold inthe, the rock climbing wall to
physician entrepreneurship.
So, amazing.
Well, we're gonna continue ourconversation over the Patreon
community.
Definitely.
If you are not aware, we have amy DPC story, Patreon.
It helps support the work we'redoing, but Dr.
eDay and I are gonna continuetalking about this, point at
which you decide to leave versuswaiting until you're burn to a
(48:25):
crisp.
And also talking about menopausecare and how menopause can be
addressed differently in thedirect primary care and direct
specialty care space.
So, so thank you so much Dr.
eDay for joining us today.
Thank
Dr. Pouneh Alizadeh (48:37):
you so much for having me.
This has been so fun.
And if anybody wants to chatwith me afterwards, you can find
me on Instagram.
It's Dr.
Aliza Day, OB GYN.
Thank you.
Maryal Concepcion MD (48:49):
Thank you for listening to another episode
of my DBC story.
If you enjoyed it, please leavea five star review on your
favorite podcast platform.
It helps others find the show,have a question about direct
primary care.
Leave me a voicemail.
You might hear it answered in afuture episode.
Follow us on socials at thehandle at my D DPC story and
join DPC didactics our monthlydeep dive into your questions
(49:11):
and challenges.
Links are@mydpcstory.com forexclusive content you won't hear
anywhere else.
Join our Patreon.
Find the link in the show notesor search for my DPC story on
patreon.com for DPC news on thedaily.
Check out DPC news.com.
Until next week, this isMarielle conception.
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