August 31, 2025 • 43 mins
In this episode of the My DPC Story Podcast, Dr. Maryal Concepcion hosts Dr. Holly Shen and Dr. Aaron Morganstein to discuss physician entrepreneurship and the power of collaboration in Direct Primary Care (DPC), locum tenens, and direct contracting. The trio introduces the upcoming Rise Up Physician Summit—a virtual event designed to empower physicians with tools and education to take control of their medical careers, improve financial independence, and explore non-traditional clinical paths. Listeners will hear real stories about leaving traditional employment, gaining professional and personal autonomy, building supportive physician communities, and balancing clinical work with passion projects. The episode covers actionable advice for both new and experienced doctors considering DPC, locums, or direct contracting, while highlighting the crucial role of mentorship and peer support in navigating alternative career models in medicine. Register for the summit at flexmedstaff.com/RiseUp to access transformative content and connect with a community reimagining modern medical practice. Early Bird Registration ends 9/15/25.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Maryal Concepcion MD (00:04):
Direct Primary care is an innovative
alternative path toinsurance-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 fingertips.
Welcome to the my DPC storypodcast, where each week.
(00:26):
You will hear the ever sorelatable stories shared by
physicians who have chosen topractice medicine in their
individual communities throughthe direct primary care model.
I'm your host, Marielleconception family physician,
DPC, owner, and former fee forService.
Doctor, I hope you enjoy today'sepisode and come away feeling
inspired about the future ofpatient care direct Primary
(00:49):
care.
I'm so excited.
I know I said this at thebeginning of Dr.
Day's episode, but I am soexcited because today's topic is
really.
Hitting at the fact thatphysician entrepreneurship is
why people listen to my DPCstory.
Why Peoples Choose DPC.
Because physicianentrepreneurship represents so
(01:10):
much, it represents thereclamation of our ability as
physicians to really work forand with our patients and not
for and with the insurancecompanies and the DPC case.
But we are going to extend themindset of DPC to also talking
about how does one expand theirphysician entrepreneurship
(01:30):
skills and knowledge into thelocum tenant space, as well as
direct contracting.
And so you've been hearing onthe podcast ways to do side gigs
from Dr.
Naomi La Lawrence Reed who.
This is a, jumping to the end ofthe episode is going to be one
of our presenters at the summitthat we're going to be talking
about Rise up.
But also you just heard from Dr.
(01:52):
PDay who referenced Dr.
Shen, who you'll hear today, andDr.
Morganstein who you'll heartoday as well.
And we are really going to betalking about the importance of
physician entrepreneurship toreally take our profession into
our own hands no matter whatspecialty, surgical or
non-surgical, and the ability totake that profession and combine
(02:15):
it with how we craft the rest ofour lives, so I am so excited.
Thank you so much, Dr.
Shen and Dr.
Morganstein for joining metoday.
Aaron Morganstein MD (02:22):
Hey, great to see you.
Maryal Concepcion MD (02:23):
So.
Rise up.
This is a, a new summit.
And for the, the audience it'sDPC summit season in the summer
and the three of us have beencollaborating with the rest of
the team at Flexed staff abouthow we can empower DPC
physicians as well as our otherphysician colleagues in locums,
in direct contracting, and alsopeople who are like, I don't
(02:45):
know what there is out there,but I know that there's gotta be
something different.
And we've created the summitcalled Rise Up.
What is the importance ofcollaborating together as
physicians in different spaces?
Yet we're all con, we're allcoming together around physician
entrepreneurship.
Holly Shen MD (03:01):
Well, I can start with that.
So I, I never envisioned even adesire to be a physician
entrepreneur.
That was never something thatwas a part of my life plan for
myself as a physician.
I always considered myself to bea part of a group or a part of a
practice, or a part of, thetraditional practice of medicine
(03:21):
and how it has been and how wekind of worked thought of in
residency and taught that thingsran.
But actually living it was awhole different story.
And thinking about actuallybecoming a physician
entrepreneur was.
Incredibly daunting andoverwhelming.
That was something that I couldnot see myself doing and
(03:42):
probably held myself back frommaking these steps a really long
time ago.
I probably would've taken thesesooner had I had the
collaboration.
And, and truthfully thecollaboration that I found
certainly across specialties asI was making my way into
becoming a a one woman,O-B-G-Y-N, critical access,
physician, entrepreneur, was, Ifound Erin.
(04:03):
I found Erin because Erin wasalready trying to collaborate
with other physicians acrossspecialties to provide education
in how to be successful in thisspace.
And I basically wanted to draghis experience, expertise and
his, like, nauseating ability tojust provide the wonderful
(04:24):
education that we actually couldnever figure out how Aaron could
do this.
How he could just always haveall this energy and power to
pull people together and teachand with, just.
The best of intentions, and Ipulled him into my space.
I pulled him into my group thatI had created for my specialty
to work this way, because weneeded to take every little bit
of knowledge that he hadexperienced over, I'm, correct
(04:47):
me if I'm wrong, Aaron, but likea decade of working this way.
You did a long time ago.
You did it a while ago.
You pulled away a while ago, andyou have learned these lessons
along the way, and you've beencompiling every little tidbit
and then sharing with us.
So we were able to take that andshare it across our specialty.
So as much as it wasn't so much,across the specialty, I actually
took it from across the ties andshared it into my specialty and
(05:10):
my group.
Aaron Morganstein MD (05:10):
I think that the concerning thing I see
in medicine is the number ofphysicians that are leaving
medicine.
And the way that I look at itand the way that I can help keep
physicians in medicine is byadvocating for physicians to
create non-traditional clinicalcareers.
So in my opinion, there's threeways to do that.
(05:33):
There is the DPC model, whichyou're an expert at.
There is the direct contractingwhere you go direct to a
facility, a healthcare facility,and you negotiate a contract and
you get paid directly throughthem.
And the third model is thetraditional locums model where
you go through a middleman or anagency with.
The rise of physicians leavingmedicine.
(05:55):
I think we have to do everythingwe can to keep physicians in
medicine, and I think that theway that you empower physicians
to stay in clinical medicine isthrough education.
And I think that not only isflex med staff.com, the number
one priority being education.
I think this upcoming summit,the Rise Up Physician Summit is
(06:17):
the event to start to empowerphysicians through education, to
be that independent physicianthat, that entrepreneur that you
want to be to create your ownclinical career.
And we provide you those tools.
And I think collaborating withexperts from the locums
industry, the direct contractingand the DPC is gonna be a
(06:39):
tremendous event going forward.
Maryal Concepcion MD (06:40):
Amen.
And I will say that for those ofyou who are like me and are
like, okay, just give me whereto sign up flexed staff.com/r
I-S-E-U-P for flexedstaff.com/riseup.
That's where you go to register.
And I will say absolutely that Ia hundred percent love what you
(07:00):
guys are saying and what youguys are highlighting, which is
so important for all physiciansand soon to be physicians to
know, because this is wherephysicians are teaching
physicians.
This is where physicians aretaking back the narrative.
And this is where physicians notonly are providing education
like you guys are saying, butalso the mentorship through just
like Holly, showed like you weredoing this, Erin before.
(07:23):
Holly started this and it, it'sliterally the power of seeing
that this is possible is just sogame changing when we're so done
with the regular way of being anemployed indentured servant.
So amen to that.
Flex Med staff.com/riseup.
Early bird tickets are still onsale, so just make sure that you
(07:46):
go, today it's only$199 and itis an entirely virtual summit.
But with that, I wanna jump intoa little bit of your guys'
backstories Holly mentioned thecommunity that you had created
but you also, went out and, andfound Erin like you described.
Dr.
Aliza Day also mentioned thatyou were her mentor and you
continue to be, but what wasgoing on that you decided to
(08:08):
choose this path?
And then Erin, same question foryou, because surgical
specialties, this is somethingthat a lot of physicians and
residents are saying.
Like, I, I can't do anything butbe an employed physician because
I am a surgical specialist ifyou're a physician out there
listening and you're like, but Ilove hospital medicine.
I don't know how to do hospitalmedicine unless I take a
(08:31):
contract with the hospital.
The content that is going to beridiculously beautiful in this
rise up summit is going to provethat you do not have to do an
employed role.
So, Ali, I'll, I'll turn it backto you.
And then Erin, if you can answeralso like what brought you into
this movement because thepassion definitely people hear
(08:53):
that it's already there,
Holly Shen MD (08:54):
So first I'll just clarify that.
By the way, Aaron has beenworking with Flex Med staff for
several years before I joinedto, I just, this became such a
passion for both of us together,and he had such a fantastic
foundation already laid for FlexMed staff.
So I was stepping into somethingthat was already it was already
such a beautiful framed positivelight what we were just taking
(09:15):
to expand and especially into myspace.
But for me personally, I woke upone day, I literally woke up one
day.
I, I can tell you it was.
A day in May.
I can't tell you exactly whichday it was.
Several years ago I woke up andI knew I couldn't do another
day.
In the situation of work that Iwas in, I had tried the private
(09:36):
practice route with the promisesof, become a partner.
All you have to do is put yourhead down, be productive, you'll
be offered a partnership role.
And then, quickly learned of thelack of transparency and the
private equity takeovers and theunrealistic expectations with no
balance.
So.
For me, the first step outtathat was, okay, if I, if I can't
(09:58):
do private practice, I thinkI'll probably go into an
employed role.
I'll just show up and be adoctor.
Just show up and be a doctor.
I just gotta go to work and domy job and then come home
because somebody else runs allthe other stuff.
So in in coming into that model,I found there wasn't very much
different.
The same unrealisticexpectations, the same broken
promises, the same poorboundaries, the same poor work
(10:22):
life balance.
Everything was translating intoexactly the experience that I
had had prior.
So, when I had that wake up.
Day in May, I really didn't knowexactly what else was out there,
but I knew something else betterbe I needed something else out
there.
So Erin and I are kind of alikein the way that we kind of just
took the jump now and figurethings out later approach that
(10:46):
does not work well for everyone.
Some people really need tounderstand and plan each step,
and that is something that I amso happy to be a part of.
Being able to build those toolsand those stepping stones for
people who need that and can'tjust jump and, figure things out
later.
So when I jumped it was reallyan unseen path before me.
(11:07):
I did a little dabbling of, ofworking independently in this
way, in that way.
But, in making a lot of mistakesand trying to work independently
as a locums physician as, and Ididn't even know what
independent contracting was backthen.
That's when I came across Aaronand Hi and Corin.
Corin Ra is his, as is anotherone of our Flex Med staff
partners.
(11:28):
They were making some amazingvideos teaching other physicians
with literally nothing buteducation in mind.
How to be independent, how to,how to learn the game, how to
understand how to work as alocums physician through the
agencies, but also understandthe backside of agency knowhow,
(11:49):
what the recruiters were doing,how to be ahead, how to make
sure you got what you needed.
Literally, the how to for how towork with a locums agency was
first what I was learning fromthem.
And then the direct contractingcame in, which I had never even
postulated in my mind.
So.
That made me actually, it mademe angry.
It made me angry at the industryand I said, no.
(12:11):
Well, if I don't need them, Ican do this on my own.
Let me learn how to do this onmy own.
And through the tools thatFlexed staff was already putting
out, what, two to three yearsago, I was able to take those
tools, build on them in my ownexperiences.
Become a successful independentphysician contractor.
(12:33):
Now, I don't utilize locumsagencies because they anger me,
but I, but if I did, Iunderstand how to work from the
backside.
I understand the rules and whattheir, how to protect myself and
advocate for myself in thoseroles.
So for me, it was literally justkind of a jump figure stuff out.
But along the way, coming acrossa fantastic collaborative
(12:55):
community of physicians thatwere already starting to band
together.
Now, what I did with that was Isaid, well, where's OB in this?
Because OB has a huge need forlocums coverage for independent
contractor coverage.
There are such a shortage of us,and with rural and critical
access, literally falling apartas we speak, physicians need to
(13:17):
be able to put, and this is myfavorite statement, boots on the
ground.
So boots on the ground, ob bootson the ground where patients
need care is something that notonly benefits the patients,
obviously hugely, and thehospital systems hugely, but it
benefits us as physicians to beable to take control of the way
that we work and work on our ownterms.
So we get back a huge degree ofsatisfaction.
(13:39):
We get back.
Working on our own terms, ourflexibility hopefully some
financial flexibility as welland making things work better
for ourselves.
We also get back a huge amountof satisfaction for caring for
patients that otherwise may nothave had that care.
So it is incredibly justfulfilling to step back into
medicine without the corporatepart, without the employer part,
(14:02):
without the 10,000 emails ofrequirements from your
corporation and just providecare for patients.
So I took that and built agroup.
We are now almost at.
At 1600, 1600 OB GYN physicianswho are female actually.
'cause this is the OB LocumsWomen Physicians Group.
So these are female docs who areeither currently working or
(14:25):
interested in working as anindependent contractor,
physician, or as a locumsphysician.
And we are literally funnelingthe expertise that we're pulling
together from flexed staff intothe OB Locums Women's Physicians
Group every day and every day weget thank hugs.
We are leaps and bounds ahead ofadvocating for ourselves and for
(14:45):
making things better for bothourselves and our patients.
Aaron Morganstein MD (14:48):
can't articulate it sometimes as well
as how they can, but I want topoint this out.
I think that if we're going to.
Change our careers, improve ourlives, and to help other
physicians.
I think we need to pass theeducation we learn forward.
Okay.
And what you're gonna see at theupcoming physician, the Rise Up
Physician Summit, you're gonnasee speakers that have been
(15:11):
helped by other physicians inthe past, and they're excited
about helping others like you inthe future.
So as far as my life, Igraduated residency and one week
later I started a locums gigbefore I started my full-time
opportunity.
I learned a lot about theagencies through that, and it
(15:31):
started to make me think, couldI become a surgical list or a
part-time surgeon?
I went and did my traditionaltwo year employment gig.
It was a good opportunity.
I really enjoyed the people Iworked for, but I knew it wasn't
for me.
And so for me, I had to learn.
How to potentially go out thereon my own and become a surgeon
(15:54):
on a part-time basis.
Now, I say the word part-time,but I also do about two weeks
on, two weeks off.
And what I think Holly kind oftouched on is that not
everyone's like us in the sensethat I believe in the motto,
quit today, plan for your futuretomorrow.
And so that's exactly what Idid.
I quit my job because I knew itwasn't for me.
I knew there was no way I couldmentally, physically stay in
(16:15):
medicine if I continued on thetrajectory I was on.
So I quit and the next day Istarted making phone calls.
I started making phone calls,locums agencies.
I started making phone calls assurgical, as programs that are
out there.
And I started to call hospitalsdirectly and I started to learn
more on my own.
And I wanted to share thatinformation with other people
because Holly knows this well.
(16:36):
And those who have attendedother flexed staff events know I
would not be in medicine now ifit wasn't for the life that I
was able to create for myself.
For me.
The traditional employment modelwas not for me because it was
becoming routine, hectic andcrazy, and they were only
expecting to do more.
(16:56):
Work more, see more patients,cover more call, work more
weekends.
And for me, that wasn't gonnawork'cause it wasn't gonna make
me happy.
Even if they paid me better, itwas not gonna make me happy.
I hate using the word burnout orthe word, the words moral
injury.
I really do.
Because one of the reasons why Ithink I personally was not gonna
(17:18):
enjoy the employment, thetraditional employment model,
was that I was gonna get boredand mentally insane treating all
these patients and dealing withall these issues.
And so for me.
Rather than getting bored inthis industry, I'm able to
create a clinical lifestyle thatallows me to stay in medicine,
but also gives me the time offto enjoy family, friends, and
(17:41):
also do many of my side hustles,which I know that this podcast
has interviewed other experts inthe side hustle arenas.
Maryal Concepcion MD (17:50):
I'm sure that some of you in the audience
are also losing your minds too,because think of the
possibilities when you areempowered to go wherever the
heck you want with your career.
Erin was like, oh dang, I wishyou would've told me you're
coming to Maine for your familyreunion.
'cause I would've met up withyou and we could have gone
boating on my new boat.
Holly does interior design'causeshe can, on the side of her side
(18:11):
gig.
So like, when you think abouteverything that you're hearing
already, how do you answer, howcan I do ob but I am family
medicine and I wanna do DPC, butI don't know how to do ob.
You could literally do OBthrough a locums gig or through
direct contracting while you runyour DPC.
Dr.
Corrine Rao, who you guysmentioned, she is a hospitalist.
(18:34):
She does internal medicine andballroom dancing, and then she
also has a DPC now.
So guys, like literally, this iswhere collaborating together and
expanding your educationalknowledge beyond what we even
hear at the DPC summit is soempowering to our futures.
And also that when we do thesethings, then we are the mentors
for the next generation.
(18:54):
So literally, this is how theexcitement level is and how the
endless possibilities are incoming together to create this
rise up summit.
It's amazing,
Holly Shen MD (19:03):
in understanding what you get from.
Reshaping the way that you workin medicine, you, you really
don't even imagine.
You can't even imagine the levelof just open doors that come
with this.
If you think about how you workin a traditionally employed
contract, most of us weren'tallowed to do side gig
consulting.
Maybe you have a passion for it,like I did quality and safety.
(19:27):
I was doing quality safety,corporate high reliability.
I would, I had spent yearsperfecting an entire knowledge
set in this.
However, I was not allowed toconsult in it outside of my own
corporation, which, it was kindof really, really maddening to
me.
I also love to do legal reviewsand peer reviews and external
reviews.
Those were things that I was notallowed to do and if I was
(19:49):
allowed to do it, I had tobasically turn over a like
percentage of any money that Imade and had to be approved for
it to be done.
Absolutely ridiculous.
Controlling what a physician cando with their medical license,
absolutely ludicrous.
Happens in no other type ofwork.
No other type of profession dowe allow this so.
I didn't realize once I left, Ikind of had a plan for, okay,
(20:11):
actually I'm gonna delve into myquality and safety role.
I wanted time to be full-timequality and safety, and then
just do clinical shifts on theside.
That's kind of what I thought Iwas gonna end up doing in my,
wake up and jump out and figuresomething out face.
And I did.
I did do some of that, but Idecided in the process, I
actually fell back in love withclinical medicine and hospital
(20:36):
OB care on my own terms.
So I realized when I wasn'tbeing forced to cover call, when
I was being, when I was coveringcall at an hourly rate that I
had decided was fair andrewarding for me, and I was
making decisions solely based onnothing but the best interest of
the patient.
No time.
I don't have clinic in themorning, I'm not, all these
things, I'm not being forced todo this by a corporation.
(20:58):
I fell back in love with myclinical work and I actually
shifted back away from myquality and safety plan back
into clinical ob floor medicineand focused myself in a place
I'd never thought I'd be, whichis critical access, and I fell
in love with it.
So, new passion, you find newpassions when you have this
flexibility open up.
The other is you find ways tosneak back in which you really
(21:19):
thought you loved.
So now I do a really decentamount of legal consulting and
quality and safety work on myown terms as I decide, and I
fill it in.
So sometimes if I take a monthoff because I want a month off
of clinical work, I do legalwork and I do that in that
timeframe, you can literally.
Mold and construct the way thatyou use your medical degree to
(21:41):
work, whether it's clinical ornonclinical.
Once you have that flexibilityand freedom, we're not allowed
to do that otherwise.
So you don't even allow yourmind to go there.
So that's one thing that peopleneed to realize.
The doors just open up into anentire new world of ways to use
your experience in medicine andreally the options and
opportunities are endless.
Aaron Morganstein MD (22:01):
for those physicians that might be
considering attending this eventfor educational purposes, for
DPC or about locums or directcontracting, I think that I
hear, and I know that you guyshear this as well, I'm thinking
about doing this.
It's on my two year plan.
Well, you know what?
Just stop hesitating about itand get the material now.
(22:23):
Learn it and, and dive right in.
You don't have to wait two yearsuntil you are officially burned
out.
Maybe we just start, you knowthat process now.
I want people to recognize thatif you're employed by a private
practice or some private equitygroup or a hospital-based system
you don't like, I want you to bereminded that there's plenty of
(22:43):
healthcare facilities throughoutthis country, and you may think
poorly upon the facility thatyou're at or the healthcare
system you're stuck within, butthere are plenty of decent ones
out there and there's patientpopulations that would love to
have you treat them.
And so I think some of this isthat there are gonna be people
that wanna work locally, but Ithink that if you truly want to
be a direct contractor doinglocums type work, or you wanna
(23:06):
look work through agencies,there's a ton of hospitals out
there looking for yourprofessional services.
And for those physicians thatare concerned about having time
off, you'll be able to achievetime off.
You won't just have a three dayweekend.
You'll have an arrangement whereyou might have two weeks off.
Not just two weeks off once ayear.
You might have that three, sixtimes a year.
(23:28):
The other thing I wanna stressto these folks, and I hear this
commonly, and I feel like thetwo women here on this podcast
can probably speak more freelyabout this, is that I commonly
hear from physicians, well Ican't do that.
I got a husband, I got a wife, Igot kids.
Well, you know what?
You can still create yourlifestyle that you're looking
(23:49):
for your, the career you'relooking for in medicine, even if
you have those, those entitiesto worry about.
And I'll tell you this.
I thought about going into thismany years ago, and I remember
meeting an orthopedic surgeonand that orthopedic surgeon had
two, two teenage boys, and had abeautiful house, I can't
remember, maybe in Virginia,okay?
He was flying to Massachusettsto take 15 days straight of
(24:13):
work.
Straight call, And I said tohim, I go, don't you miss your
family and your wife?
He said to me, he goes,actually, they see me more now
than they ever saw me before.
So I think that if you work withus, you take home that education
we provide to you, there areways, there are avenues out
there to create a lifestyle inmedicine that really allows you
(24:37):
to stay in medicine while alsotaking advantage of all these
other things, spending more timewith your family, having more
time off.
And you know what the greatthing is, guys, is that some of
us who are flying to other areasof the country, we're helping
doctors in those communitiestake more time off and we're
lessening their burnout bytaking extra days a call or
taking on extra patient poppopulation or maybe doing
(24:59):
elective surgeries for them.
We're helping them out and we'rehelping out their families as
well.
Holly Shen MD (25:04):
I could do a whole podcast with Marielle on
the ways that my family haschanged positively since I left
for this lifestyle in medicine.
It could literally do a wholeseparate podcast on that.
Maryal Concepcion MD (25:15):
I love that.
And that's not could we'll doit.
That's not in this episode.
It will, it will be forthcoming.
It will be forthcoming.
So let's talk about how thecollaboration is manifesting
when it comes to content.
It's going to be four amazingdays in October.
And one thing that I really,really want to highlight and
that I love is that.
(25:36):
Something that like speaks somuch to my heart is that when
you register, you also getaccess to the content if you
can't make it live on the actualdays.
However, we are also going to betalking about why it's so
important if you can't attend toattend Lifetime.
Aaron Morganstein MD (25:50):
Each day is designated to a a specific
entity, okay?
So one day is for DPC, and wehave about seven hours of
terrific content coming at youfrom multiple different speakers
who are experts in the DPCarena.
In addition, on a second day,we're gonna have experts.
That are experts in the locumsagencies.
Working with locums agencies isa full day.
(26:13):
Once again, another seven hoursof content.
Okay?
And this is pure education.
And if you log in with us live,you're gonna be able to join the
chat box where you're gonna haveexperts all over, all throughout
the country answering yourquestions throughout the
lectures.
Okay?
The third day, another sevenhours of lectures, and this is
gonna be about directcontracting.
So this is gonna be educationalcontent for those that are
(26:35):
trying to go direct.
So these are people that aretrying to connect directly with
hospitals, get paid directly,negotiate directly with
hospitals, and trying to cut outthe traditional middleman.
So an entity you may, might beable to be your own boss and
live the, or live out a lifethat's more flexible and really,
truly have that autonomy.
Now the fourth day I'm reallyexcited about, it's not totally
(26:56):
set in stone, but it's gonna bea full day.
Somewhere between four to fivehours of just q and a sessions.
And we're gonna have experts,that are gonna be answering
questions about DPC workingthrough locums agencies or going
direct.
And so basically what I'm sayinghere is you're gonna have three
days full of educationalcontent.
(27:17):
You can join our chat box liveand answer your questions
throughout.
And then on that fourth day,October 26th, that Sunday, it's
gonna be totally live q and a.
And we'll have experts loggingin throughout the country,
experts in DPC, locums anddirect contracting, answering
all your specific questions youhave about entering these
(27:38):
arenas.
One of the reasons why we'recollaborating is because we
think that there's DPC doctorsthat may be trying to get into
DBC and may not have the income.
So this is a great opportunity.
Holly Shen MD (27:48):
The RiseUP Summit actually is going to be a
compilation of topics that areincredibly valuable to people
who are either early in the gameor thinking about going into
this.
Line of work, or have been doingit a bit, but haven't quite
gotten to where they wanna be.
And we have taken the topicsthat we hear about every day.
So on our pages, on our socialmedia groups when someone
(28:10):
approaches me in person at mysite, because it happens like
every day tell me how to dothis.
How do I do this?
What would I do if I was this?
How do I do this?
So, some of the things that youcan look forward to on the
Locums through agencies days,one of the most important topics
is understanding the locums gamein general.
So we're gonna hit that frompayment structures, from from
(28:31):
being able to set expectationsand boundaries with locums
agencies, from understandingwhat a confirmation letter
means.
What a PSA or professionalservices agreement means.
All the things, all thebuzzwords that come up in
working with locum staragencies, we're going to cover
in one way, shape, or form.
And a lot of it overlaps.
So you get a lot of justrecurring and solidifying
(28:52):
information for you, educationfor you to take away.
So you're gonna understand howto get started or how to more
effectively work with locumsagencies and to advocate for
yourself.
Because as much as we would loveto say agencies are advocating
for us, it's us that areadvocating for us, and that's
most important.
Direct contracting is one of mypassions because I feel like
it's the thing that has workedbest for me working
(29:13):
independently.
I love to learn how to take outthe middleman because I don't
like sharing my paycheck.
I'm working, I'm taking therisk.
I want the, the, the financialbenefits.
So we're going to have youunderstand the differences
between if you're working as aW2 or 10 99 and working directly
with, which could'cause it'spossible as a direct contractor.
(29:35):
How you prepare to work as adirect contractor, how you
negotiate conversations with,with hospitals and facilities,
if you're trying to findopportunities how to deal with
stark law and fair market valueand how that applies to when
we're direct contracting.
Because again, that's a rulethat doesn't apply when you're
working via agencies.
There are so many nuances andwhen you're working with a, an
(29:56):
agency versus, versus workingdirectly, it is just a whole
different ball game.
It is night and day and you haveto understand the nuances to be
able to do it both effectivelyand, and legally as well, which
is really important.
You know why some of us choosenot to use agencies anymore and
only work direct?
And one of mine that I'll bepresenting is, kind of how to be
(30:16):
a one person physician business,how to run yourself as a one
person physician business.
All these are super important.
Now, when we get to the, thefourth day, I think this is
where people take away some ofthe most.
'cause we're laying thefoundation, we're giving you
tools.
It's literally a, a gettingstarted guide for locums are, or
independent contract work.
(30:36):
We've done all the work for youbecause we've learned, we've
aired, we've, we've made thiscompilation of education for
you.
But day four is gonna be one ofthe coolest days because You'll
get to plug questions into thechat box.
We'll be able to pull thosequestions and we'll be able to
address them from our personalexperiences.
And everybody's got a little bitof a different spin on some of
(30:57):
these approaches.
So there's so much to learn fromthese experts, whether they're
in the chat box or whetherthey're on the pan panel sitting
in front of you.
You're gonna be able to take andlearn from the wins and also
from our mistakes, so you avoidthem.
So it's literally not only a howto but a how not to, and it is
just the absolute end all and beall the Bible for how to work as
(31:21):
an independent physician.
Maryal Concepcion MD (31:23):
And I think that, especially when
you're talking about the how notto that is some of the most
priceless information that youcan have when you are a person,
especially like the three of us.
Like just quit and then thinklater what, what you're gonna do
to solve the, that job doesn'texist anymore.
How can I create a new onesituation?
And I'd wanna point out here,especially because this is my
DPT story, a lot of you arecoming on this podcast to listen
(31:45):
about direct primary care.
So the direct primary care focusday is not going to disappoint
at all.
I'm so excited.
We're gonna have representationfrom all over the country.
Urban rural.
I'm so excited for our speakersbecause we're really looking at
the topics that direct primarycare physicians are really
wanting to know more about.
And yes, that includes, how tostart A DPC, but it also
(32:07):
includes how to market and growyour DPC, how to collaborate
with other physicians, how tomaintain your, your skills.
Like I was mentioning, if youwanna do OB and c-sections and
deliveries as a family medicinedoctor, colonoscopies, amen.
You can do that.
But this is a way to startputting the pieces together to
build that dream career.
Dr.
Stephanie Phillips, who has beenon the podcast before serving
(32:29):
the poorest regional Georgiawith her DPC model, is going to
be talking about rural medicinein DPC.
And so there's so many examplesof how A DPC physician can not
only just, get empowered withthe DPC space, but then follow
that up and be empowered withthe more collaborative space of.
(32:50):
How could I expand my DPC?
By doing things like locums ordoing things like direct
contracting and where especiallyI think the number one thing
that I hear as to how thiscollaboration can really help is
if you are stressed financially.
If you are maybe not the personwho's like, I can't just quit
and then figure it out becauseI'm the primary care breadwinner
(33:11):
or whatever, or I'm the primarybreadwinner.
Whatever your situation is, ifyour finances are not where you
would like them to be, but youwant your finances to be robust
and and dictated by you anddictated by the, the jobs you
decide you take, whether it belocums that is literally within
your geographic area or acrossthe country, the, I, I love that
(33:32):
story that Erin shared about theorthopedic surgeon actually
spending more time with theirfamily.
But the finances, when you freeyourself of the worry of, I am
not good enough to, to be hiredby I don't know how to, all of
these fears that we've beenmentioning, when you're able to
financially have the, theability to you when you're able
(33:54):
to have the ability to craftyour financial future, and then
that opens the doors to whateveryou wanna do.
I, I, I love all of theseexamples of people who are doing
locums and direct contractingand DPC, like, we don't have to
limit to just one of theseavenues.
Holly Shen MD (34:09):
I'm glad you brought up the financial
perspective because I, I am andwas that person who was the
breadwinner.
I'm, I'm blessed to have a, aspouse who is able to be at home
with our children and beresponsible for our children.
But that also means that there'sno other significant income
coming in.
And I am the one, and per myprior work experiences, I was
(34:31):
always stuck in that salary box.
You, you make this much salaryand that's, you're a W2 employee
and that's, that's essentiallywhat you have to work with.
But what I found when I left wasthat I had absolute freedom in
my financial.
Abilities.
I could take, I could work asmany hours or as few hours as I
wanted, but if I needed to makemore money to go on a nice
vacation or to pay a medicalbill or to whatever, I could
(34:53):
literally pick up extra shifts.
I now in this current role, and,and I truthfully, I work, I
probably work 10, anywherebetween 10 and 15 days a month
of, of work.
And that's 24 hour shifts.
They're not in-house, but they,they're working.
So in that time, I now make, Iwould say I make almost three
(35:15):
times as much as I made as anemployed physician with way more
time off, complete flexflexibility and control, and the
ability to pick up more or lesswhenever I want.
So now I have the ability towork more and make more if I
want to, and feel rewarded inthat way or take that time back,
but.
Take it as an ability to be ableto if you're the breadwinner and
(35:37):
you feel kind of crunched andcrushed, is the ability to
expand.
I now have a fantasticretirement plan I never did
before.
I was not able to invest.
I am now able to take time andactually travel and afford the
trips, which is great, but itactually puts it in your hands
and lets you be in charge ofyour own professional financial
destiny instead of living in asalary box.
Aaron Morganstein MD (35:57):
I think that there's a lot of, a lot of
a lot physicians can gain bysharing stories, and I'm a huge
advocate of that, and I thinkthat's what your podcast does
well, is share stories andexperiences.
I want folks to know that ifthey're attending the.
The Rise Up Physician Summit orpurchasing it so that they can
watch the recordings later.
I want them to know that theselectures okay, are 30 minutes
(36:19):
long.
And each day is literally likeits own Masterclass it's like a
master course in DBCA Master'scourse in working through
agencies.
It's a mastery course in directcontracting.
And the reason why we have ourlectures or our speakers only
speaking for 30 minutes at atime is because we want to make
it a very impactful 30 minutesfor you.
(36:39):
They're gonna go through thematerial fast, it's gonna be
dense and to be gonna beextremely high yield for these
folks.
And so I just want them to knowthat we've designed the
curriculum so literally they canget as much material as possible
all throughout each day.
Holly Shen MD (36:55):
Another benefit of having these recordings and
being able to kind of listen tothem in your own time, if you do
need to purchase and listenlater, that's, that's great.
Lots of people listen in theircars.
Or when they're traveling orwhenever they have free time,
it's fantastic.
But not only will you hear theinformation and be able to hear
it again and again when you needto, you can refer back to it.
But another thing is you'regoing to hear different spins on
(37:15):
the same information.
You're gonna hear each physicianor each presenter's different
take on why they chose, an anLLC or an S corp, or why they,
how they approached a facilitywhen wanting a direct contract.
So understanding the basicknowledge and hearing it
repetitively to be able to kindof let it sink in and let it,
(37:37):
kind of become a real option foryou is one thing.
But hearing success stories,hearing these, and these are all
our speakers, are physicians whohave, talk the talk and walk the
walk.
They are not people who are justteaching, they are people who
have been there, done that andbeen successful.
So when you hear more and moresuccess stories and more spins
on how to be able to approachthe same topic or the same, hang
(38:01):
up or roadblock that you have,you're gonna find something that
will work for you.
You're gonna find somebody'sapproach that sounds like, okay,
I could actually do that.
So that repetition and havingthese recordings for later is an
invaluable tool.
Aaron Morganstein MD (38:13):
I guarantee you will learn
something new.
And this is why I know thisbecause we've hosted several
events at Flex Med staff and I'malways learning new things from
people like Holly and otherphysicians that speak.
It's tremendous for me andempowering to me when I continue
to learn new things at each oneof our events.
So I want folks to know outthere that if you're a beginner
(38:33):
level, you're interested in theidea of DPC or locums or direct
contracting, or you've been atfor several years, there's
something at this event for you.
Holly Shen MD (38:43):
And also don't forget, and this is, this is an
important thing.
This is a very nebulous topic.
This is a new and evolving waythat physicians work.
There is not one way to be, itis not black and white.
The market changes, theapproaches change, the needs
change.
Every day, every week, everyyear.
(39:04):
So at Flex Med staff, we alwayshave a finger on the pulse.
Our physician leads always havea finger on the pulse to be able
to say what is changing in themarket?
How do we need to change ourstrategies, our approach to be
able to better advocate forourselves and for our physician
community.
So just understand this is anever evolving and adapting
field.
(39:24):
It's not.
Once you learn it, you know it,it is that you need to
understand how fluid andchanging the topics that we're
gonna talk about are.
And when we present, generallyannually, sometimes a little bit
more frequently than that,especially beginner topics,
we've incorporated what is newsince the last time we have
spoken, what has changed?
What have we learned?
We've come across this.
(39:46):
We are always with an ear to theground, to what is changing in
independent physician work.
Maryal Concepcion MD (39:50):
Where you're gonna go is flexed
staff.com/riseup and early birdtickets are on sale through
September 15th.
The tickets are$199 the datesare October 23rd to 26th.
If you are not available toattend live, just as we've
mentioned here you will haveaccess to the recordings
afterwards and as long as yousign up before the event goes
(40:12):
live, before rise up startsyou're able to access the
content for six months after thesummit goes live.
So, thank you guys so much forjoining us today and proving
that medicine is truly strongerwhen we, as physicians take back
control together and rise up.
Thank you for listening toanother episode of my DBC story.
(40:35):
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
and challenges.
Links are@mydpcstory.com forexclusive content you won't hear
(40:59):
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 an innovative
alternative path toinsurance-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 fingertips.
Welcome to the my DPC storypodcast, where each week.
(00:26):
You will hear the ever sorelatable stories shared by
physicians who have chosen topractice medicine in their
individual communities throughthe direct primary care model.
I'm your host, Marielleconception family physician,
DPC, owner, and former fee forService.
Doctor, I hope you enjoy today'sepisode and come away feeling
inspired about the future ofpatient care direct Primary
(00:49):
care.
I'm so excited.
I know I said this at thebeginning of Dr.
Day's episode, but I am soexcited because today's topic is
really.
Hitting at the fact thatphysician entrepreneurship is
why people listen to my DPCstory.
Why Peoples Choose DPC.
Because physicianentrepreneurship represents so
(01:10):
much, it represents thereclamation of our ability as
physicians to really work forand with our patients and not
for and with the insurancecompanies and the DPC case.
But we are going to extend themindset of DPC to also talking
about how does one expand theirphysician entrepreneurship
(01:30):
skills and knowledge into thelocum tenant space, as well as
direct contracting.
And so you've been hearing onthe podcast ways to do side gigs
from Dr.
Naomi La Lawrence Reed who.
This is a, jumping to the end ofthe episode is going to be one
of our presenters at the summitthat we're going to be talking
about Rise up.
But also you just heard from Dr.
(01:52):
PDay who referenced Dr.
Shen, who you'll hear today, andDr.
Morganstein who you'll heartoday as well.
And we are really going to betalking about the importance of
physician entrepreneurship toreally take our profession into
our own hands no matter whatspecialty, surgical or
non-surgical, and the ability totake that profession and combine
(02:15):
it with how we craft the rest ofour lives, so I am so excited.
Thank you so much, Dr.
Shen and Dr.
Morganstein for joining metoday.
Aaron Morganstein MD (02:22):
Hey, great to see you.
Maryal Concepcion MD (02:23):
So.
Rise up.
This is a, a new summit.
And for the, the audience it'sDPC summit season in the summer
and the three of us have beencollaborating with the rest of
the team at Flexed staff abouthow we can empower DPC
physicians as well as our otherphysician colleagues in locums,
in direct contracting, and alsopeople who are like, I don't
(02:45):
know what there is out there,but I know that there's gotta be
something different.
And we've created the summitcalled Rise Up.
What is the importance ofcollaborating together as
physicians in different spaces?
Yet we're all con, we're allcoming together around physician
entrepreneurship.
Holly Shen MD (03:01):
Well, I can start with that.
So I, I never envisioned even adesire to be a physician
entrepreneur.
That was never something thatwas a part of my life plan for
myself as a physician.
I always considered myself to bea part of a group or a part of a
practice, or a part of, thetraditional practice of medicine
(03:21):
and how it has been and how wekind of worked thought of in
residency and taught that thingsran.
But actually living it was awhole different story.
And thinking about actuallybecoming a physician
entrepreneur was.
Incredibly daunting andoverwhelming.
That was something that I couldnot see myself doing and
(03:42):
probably held myself back frommaking these steps a really long
time ago.
I probably would've taken thesesooner had I had the
collaboration.
And, and truthfully thecollaboration that I found
certainly across specialties asI was making my way into
becoming a a one woman,O-B-G-Y-N, critical access,
physician, entrepreneur, was, Ifound Erin.
(04:03):
I found Erin because Erin wasalready trying to collaborate
with other physicians acrossspecialties to provide education
in how to be successful in thisspace.
And I basically wanted to draghis experience, expertise and
his, like, nauseating ability tojust provide the wonderful
(04:24):
education that we actually couldnever figure out how Aaron could
do this.
How he could just always haveall this energy and power to
pull people together and teachand with, just.
The best of intentions, and Ipulled him into my space.
I pulled him into my group thatI had created for my specialty
to work this way, because weneeded to take every little bit
of knowledge that he hadexperienced over, I'm, correct
(04:47):
me if I'm wrong, Aaron, but likea decade of working this way.
You did a long time ago.
You did it a while ago.
You pulled away a while ago, andyou have learned these lessons
along the way, and you've beencompiling every little tidbit
and then sharing with us.
So we were able to take that andshare it across our specialty.
So as much as it wasn't so much,across the specialty, I actually
took it from across the ties andshared it into my specialty and
(05:10):
my group.
Aaron Morganstein MD (05:10):
I think that the concerning thing I see
in medicine is the number ofphysicians that are leaving
medicine.
And the way that I look at itand the way that I can help keep
physicians in medicine is byadvocating for physicians to
create non-traditional clinicalcareers.
So in my opinion, there's threeways to do that.
(05:33):
There is the DPC model, whichyou're an expert at.
There is the direct contractingwhere you go direct to a
facility, a healthcare facility,and you negotiate a contract and
you get paid directly throughthem.
And the third model is thetraditional locums model where
you go through a middleman or anagency with.
The rise of physicians leavingmedicine.
(05:55):
I think we have to do everythingwe can to keep physicians in
medicine, and I think that theway that you empower physicians
to stay in clinical medicine isthrough education.
And I think that not only isflex med staff.com, the number
one priority being education.
I think this upcoming summit,the Rise Up Physician Summit is
(06:17):
the event to start to empowerphysicians through education, to
be that independent physicianthat, that entrepreneur that you
want to be to create your ownclinical career.
And we provide you those tools.
And I think collaborating withexperts from the locums
industry, the direct contractingand the DPC is gonna be a
(06:39):
tremendous event going forward.
Maryal Concepcion MD (06:40):
Amen.
And I will say that for those ofyou who are like me and are
like, okay, just give me whereto sign up flexed staff.com/r
I-S-E-U-P for flexedstaff.com/riseup.
That's where you go to register.
And I will say absolutely that Ia hundred percent love what you
(07:00):
guys are saying and what youguys are highlighting, which is
so important for all physiciansand soon to be physicians to
know, because this is wherephysicians are teaching
physicians.
This is where physicians aretaking back the narrative.
And this is where physicians notonly are providing education
like you guys are saying, butalso the mentorship through just
like Holly, showed like you weredoing this, Erin before.
(07:23):
Holly started this and it, it'sliterally the power of seeing
that this is possible is just sogame changing when we're so done
with the regular way of being anemployed indentured servant.
So amen to that.
Flex Med staff.com/riseup.
Early bird tickets are still onsale, so just make sure that you
(07:46):
go, today it's only$199 and itis an entirely virtual summit.
But with that, I wanna jump intoa little bit of your guys'
backstories Holly mentioned thecommunity that you had created
but you also, went out and, andfound Erin like you described.
Dr.
Aliza Day also mentioned thatyou were her mentor and you
continue to be, but what wasgoing on that you decided to
(08:08):
choose this path?
And then Erin, same question foryou, because surgical
specialties, this is somethingthat a lot of physicians and
residents are saying.
Like, I, I can't do anything butbe an employed physician because
I am a surgical specialist ifyou're a physician out there
listening and you're like, but Ilove hospital medicine.
I don't know how to do hospitalmedicine unless I take a
(08:31):
contract with the hospital.
The content that is going to beridiculously beautiful in this
rise up summit is going to provethat you do not have to do an
employed role.
So, Ali, I'll, I'll turn it backto you.
And then Erin, if you can answeralso like what brought you into
this movement because thepassion definitely people hear
(08:53):
that it's already there,
Holly Shen MD (08:54):
So first I'll just clarify that.
By the way, Aaron has beenworking with Flex Med staff for
several years before I joinedto, I just, this became such a
passion for both of us together,and he had such a fantastic
foundation already laid for FlexMed staff.
So I was stepping into somethingthat was already it was already
such a beautiful framed positivelight what we were just taking
(09:15):
to expand and especially into myspace.
But for me personally, I woke upone day, I literally woke up one
day.
I, I can tell you it was.
A day in May.
I can't tell you exactly whichday it was.
Several years ago I woke up andI knew I couldn't do another
day.
In the situation of work that Iwas in, I had tried the private
(09:36):
practice route with the promisesof, become a partner.
All you have to do is put yourhead down, be productive, you'll
be offered a partnership role.
And then, quickly learned of thelack of transparency and the
private equity takeovers and theunrealistic expectations with no
balance.
So.
For me, the first step outtathat was, okay, if I, if I can't
(09:58):
do private practice, I thinkI'll probably go into an
employed role.
I'll just show up and be adoctor.
Just show up and be a doctor.
I just gotta go to work and domy job and then come home
because somebody else runs allthe other stuff.
So in in coming into that model,I found there wasn't very much
different.
The same unrealisticexpectations, the same broken
promises, the same poorboundaries, the same poor work
(10:22):
life balance.
Everything was translating intoexactly the experience that I
had had prior.
So, when I had that wake up.
Day in May, I really didn't knowexactly what else was out there,
but I knew something else betterbe I needed something else out
there.
So Erin and I are kind of alikein the way that we kind of just
took the jump now and figurethings out later approach that
(10:46):
does not work well for everyone.
Some people really need tounderstand and plan each step,
and that is something that I amso happy to be a part of.
Being able to build those toolsand those stepping stones for
people who need that and can'tjust jump and, figure things out
later.
So when I jumped it was reallyan unseen path before me.
(11:07):
I did a little dabbling of, ofworking independently in this
way, in that way.
But, in making a lot of mistakesand trying to work independently
as a locums physician as, and Ididn't even know what
independent contracting was backthen.
That's when I came across Aaronand Hi and Corin.
Corin Ra is his, as is anotherone of our Flex Med staff
partners.
(11:28):
They were making some amazingvideos teaching other physicians
with literally nothing buteducation in mind.
How to be independent, how to,how to learn the game, how to
understand how to work as alocums physician through the
agencies, but also understandthe backside of agency knowhow,
(11:49):
what the recruiters were doing,how to be ahead, how to make
sure you got what you needed.
Literally, the how to for how towork with a locums agency was
first what I was learning fromthem.
And then the direct contractingcame in, which I had never even
postulated in my mind.
So.
That made me actually, it mademe angry.
It made me angry at the industryand I said, no.
(12:11):
Well, if I don't need them, Ican do this on my own.
Let me learn how to do this onmy own.
And through the tools thatFlexed staff was already putting
out, what, two to three yearsago, I was able to take those
tools, build on them in my ownexperiences.
Become a successful independentphysician contractor.
(12:33):
Now, I don't utilize locumsagencies because they anger me,
but I, but if I did, Iunderstand how to work from the
backside.
I understand the rules and whattheir, how to protect myself and
advocate for myself in thoseroles.
So for me, it was literally justkind of a jump figure stuff out.
But along the way, coming acrossa fantastic collaborative
(12:55):
community of physicians thatwere already starting to band
together.
Now, what I did with that was Isaid, well, where's OB in this?
Because OB has a huge need forlocums coverage for independent
contractor coverage.
There are such a shortage of us,and with rural and critical
access, literally falling apartas we speak, physicians need to
(13:17):
be able to put, and this is myfavorite statement, boots on the
ground.
So boots on the ground, ob bootson the ground where patients
need care is something that notonly benefits the patients,
obviously hugely, and thehospital systems hugely, but it
benefits us as physicians to beable to take control of the way
that we work and work on our ownterms.
So we get back a huge degree ofsatisfaction.
(13:39):
We get back.
Working on our own terms, ourflexibility hopefully some
financial flexibility as welland making things work better
for ourselves.
We also get back a huge amountof satisfaction for caring for
patients that otherwise may nothave had that care.
So it is incredibly justfulfilling to step back into
medicine without the corporatepart, without the employer part,
(14:02):
without the 10,000 emails ofrequirements from your
corporation and just providecare for patients.
So I took that and built agroup.
We are now almost at.
At 1600, 1600 OB GYN physicianswho are female actually.
'cause this is the OB LocumsWomen Physicians Group.
So these are female docs who areeither currently working or
(14:25):
interested in working as anindependent contractor,
physician, or as a locumsphysician.
And we are literally funnelingthe expertise that we're pulling
together from flexed staff intothe OB Locums Women's Physicians
Group every day and every day weget thank hugs.
We are leaps and bounds ahead ofadvocating for ourselves and for
(14:45):
making things better for bothourselves and our patients.
Aaron Morganstein MD (14:48):
can't articulate it sometimes as well
as how they can, but I want topoint this out.
I think that if we're going to.
Change our careers, improve ourlives, and to help other
physicians.
I think we need to pass theeducation we learn forward.
Okay.
And what you're gonna see at theupcoming physician, the Rise Up
Physician Summit, you're gonnasee speakers that have been
(15:11):
helped by other physicians inthe past, and they're excited
about helping others like you inthe future.
So as far as my life, Igraduated residency and one week
later I started a locums gigbefore I started my full-time
opportunity.
I learned a lot about theagencies through that, and it
(15:31):
started to make me think, couldI become a surgical list or a
part-time surgeon?
I went and did my traditionaltwo year employment gig.
It was a good opportunity.
I really enjoyed the people Iworked for, but I knew it wasn't
for me.
And so for me, I had to learn.
How to potentially go out thereon my own and become a surgeon
(15:54):
on a part-time basis.
Now, I say the word part-time,but I also do about two weeks
on, two weeks off.
And what I think Holly kind oftouched on is that not
everyone's like us in the sensethat I believe in the motto,
quit today, plan for your futuretomorrow.
And so that's exactly what Idid.
I quit my job because I knew itwasn't for me.
I knew there was no way I couldmentally, physically stay in
(16:15):
medicine if I continued on thetrajectory I was on.
So I quit and the next day Istarted making phone calls.
I started making phone calls,locums agencies.
I started making phone calls assurgical, as programs that are
out there.
And I started to call hospitalsdirectly and I started to learn
more on my own.
And I wanted to share thatinformation with other people
because Holly knows this well.
(16:36):
And those who have attendedother flexed staff events know I
would not be in medicine now ifit wasn't for the life that I
was able to create for myself.
For me.
The traditional employment modelwas not for me because it was
becoming routine, hectic andcrazy, and they were only
expecting to do more.
(16:56):
Work more, see more patients,cover more call, work more
weekends.
And for me, that wasn't gonnawork'cause it wasn't gonna make
me happy.
Even if they paid me better, itwas not gonna make me happy.
I hate using the word burnout orthe word, the words moral
injury.
I really do.
Because one of the reasons why Ithink I personally was not gonna
(17:18):
enjoy the employment, thetraditional employment model,
was that I was gonna get boredand mentally insane treating all
these patients and dealing withall these issues.
And so for me.
Rather than getting bored inthis industry, I'm able to
create a clinical lifestyle thatallows me to stay in medicine,
but also gives me the time offto enjoy family, friends, and
(17:41):
also do many of my side hustles,which I know that this podcast
has interviewed other experts inthe side hustle arenas.
Maryal Concepcion MD (17:50):
I'm sure that some of you in the audience
are also losing your minds too,because think of the
possibilities when you areempowered to go wherever the
heck you want with your career.
Erin was like, oh dang, I wishyou would've told me you're
coming to Maine for your familyreunion.
'cause I would've met up withyou and we could have gone
boating on my new boat.
Holly does interior design'causeshe can, on the side of her side
(18:11):
gig.
So like, when you think abouteverything that you're hearing
already, how do you answer, howcan I do ob but I am family
medicine and I wanna do DPC, butI don't know how to do ob.
You could literally do OBthrough a locums gig or through
direct contracting while you runyour DPC.
Dr.
Corrine Rao, who you guysmentioned, she is a hospitalist.
(18:34):
She does internal medicine andballroom dancing, and then she
also has a DPC now.
So guys, like literally, this iswhere collaborating together and
expanding your educationalknowledge beyond what we even
hear at the DPC summit is soempowering to our futures.
And also that when we do thesethings, then we are the mentors
for the next generation.
(18:54):
So literally, this is how theexcitement level is and how the
endless possibilities are incoming together to create this
rise up summit.
It's amazing,
Holly Shen MD (19:03):
in understanding what you get from.
Reshaping the way that you workin medicine, you, you really
don't even imagine.
You can't even imagine the levelof just open doors that come
with this.
If you think about how you workin a traditionally employed
contract, most of us weren'tallowed to do side gig
consulting.
Maybe you have a passion for it,like I did quality and safety.
(19:27):
I was doing quality safety,corporate high reliability.
I would, I had spent yearsperfecting an entire knowledge
set in this.
However, I was not allowed toconsult in it outside of my own
corporation, which, it was kindof really, really maddening to
me.
I also love to do legal reviewsand peer reviews and external
reviews.
Those were things that I was notallowed to do and if I was
(19:49):
allowed to do it, I had tobasically turn over a like
percentage of any money that Imade and had to be approved for
it to be done.
Absolutely ridiculous.
Controlling what a physician cando with their medical license,
absolutely ludicrous.
Happens in no other type ofwork.
No other type of profession dowe allow this so.
I didn't realize once I left, Ikind of had a plan for, okay,
(20:11):
actually I'm gonna delve into myquality and safety role.
I wanted time to be full-timequality and safety, and then
just do clinical shifts on theside.
That's kind of what I thought Iwas gonna end up doing in my,
wake up and jump out and figuresomething out face.
And I did.
I did do some of that, but Idecided in the process, I
actually fell back in love withclinical medicine and hospital
(20:36):
OB care on my own terms.
So I realized when I wasn'tbeing forced to cover call, when
I was being, when I was coveringcall at an hourly rate that I
had decided was fair andrewarding for me, and I was
making decisions solely based onnothing but the best interest of
the patient.
No time.
I don't have clinic in themorning, I'm not, all these
things, I'm not being forced todo this by a corporation.
(20:58):
I fell back in love with myclinical work and I actually
shifted back away from myquality and safety plan back
into clinical ob floor medicineand focused myself in a place
I'd never thought I'd be, whichis critical access, and I fell
in love with it.
So, new passion, you find newpassions when you have this
flexibility open up.
The other is you find ways tosneak back in which you really
(21:19):
thought you loved.
So now I do a really decentamount of legal consulting and
quality and safety work on myown terms as I decide, and I
fill it in.
So sometimes if I take a monthoff because I want a month off
of clinical work, I do legalwork and I do that in that
timeframe, you can literally.
Mold and construct the way thatyou use your medical degree to
(21:41):
work, whether it's clinical ornonclinical.
Once you have that flexibilityand freedom, we're not allowed
to do that otherwise.
So you don't even allow yourmind to go there.
So that's one thing that peopleneed to realize.
The doors just open up into anentire new world of ways to use
your experience in medicine andreally the options and
opportunities are endless.
Aaron Morganstein MD (22:01):
for those physicians that might be
considering attending this eventfor educational purposes, for
DPC or about locums or directcontracting, I think that I
hear, and I know that you guyshear this as well, I'm thinking
about doing this.
It's on my two year plan.
Well, you know what?
Just stop hesitating about itand get the material now.
(22:23):
Learn it and, and dive right in.
You don't have to wait two yearsuntil you are officially burned
out.
Maybe we just start, you knowthat process now.
I want people to recognize thatif you're employed by a private
practice or some private equitygroup or a hospital-based system
you don't like, I want you to bereminded that there's plenty of
(22:43):
healthcare facilities throughoutthis country, and you may think
poorly upon the facility thatyou're at or the healthcare
system you're stuck within, butthere are plenty of decent ones
out there and there's patientpopulations that would love to
have you treat them.
And so I think some of this isthat there are gonna be people
that wanna work locally, but Ithink that if you truly want to
be a direct contractor doinglocums type work, or you wanna
(23:06):
look work through agencies,there's a ton of hospitals out
there looking for yourprofessional services.
And for those physicians thatare concerned about having time
off, you'll be able to achievetime off.
You won't just have a three dayweekend.
You'll have an arrangement whereyou might have two weeks off.
Not just two weeks off once ayear.
You might have that three, sixtimes a year.
(23:28):
The other thing I wanna stressto these folks, and I hear this
commonly, and I feel like thetwo women here on this podcast
can probably speak more freelyabout this, is that I commonly
hear from physicians, well Ican't do that.
I got a husband, I got a wife, Igot kids.
Well, you know what?
You can still create yourlifestyle that you're looking
(23:49):
for your, the career you'relooking for in medicine, even if
you have those, those entitiesto worry about.
And I'll tell you this.
I thought about going into thismany years ago, and I remember
meeting an orthopedic surgeonand that orthopedic surgeon had
two, two teenage boys, and had abeautiful house, I can't
remember, maybe in Virginia,okay?
He was flying to Massachusettsto take 15 days straight of
(24:13):
work.
Straight call, And I said tohim, I go, don't you miss your
family and your wife?
He said to me, he goes,actually, they see me more now
than they ever saw me before.
So I think that if you work withus, you take home that education
we provide to you, there areways, there are avenues out
there to create a lifestyle inmedicine that really allows you
(24:37):
to stay in medicine while alsotaking advantage of all these
other things, spending more timewith your family, having more
time off.
And you know what the greatthing is, guys, is that some of
us who are flying to other areasof the country, we're helping
doctors in those communitiestake more time off and we're
lessening their burnout bytaking extra days a call or
taking on extra patient poppopulation or maybe doing
(24:59):
elective surgeries for them.
We're helping them out and we'rehelping out their families as
well.
Holly Shen MD (25:04):
I could do a whole podcast with Marielle on
the ways that my family haschanged positively since I left
for this lifestyle in medicine.
It could literally do a wholeseparate podcast on that.
Maryal Concepcion MD (25:15):
I love that.
And that's not could we'll doit.
That's not in this episode.
It will, it will be forthcoming.
It will be forthcoming.
So let's talk about how thecollaboration is manifesting
when it comes to content.
It's going to be four amazingdays in October.
And one thing that I really,really want to highlight and
that I love is that.
(25:36):
Something that like speaks somuch to my heart is that when
you register, you also getaccess to the content if you
can't make it live on the actualdays.
However, we are also going to betalking about why it's so
important if you can't attend toattend Lifetime.
Aaron Morganstein MD (25:50):
Each day is designated to a a specific
entity, okay?
So one day is for DPC, and wehave about seven hours of
terrific content coming at youfrom multiple different speakers
who are experts in the DPCarena.
In addition, on a second day,we're gonna have experts.
That are experts in the locumsagencies.
Working with locums agencies isa full day.
(26:13):
Once again, another seven hoursof content.
Okay?
And this is pure education.
And if you log in with us live,you're gonna be able to join the
chat box where you're gonna haveexperts all over, all throughout
the country answering yourquestions throughout the
lectures.
Okay?
The third day, another sevenhours of lectures, and this is
gonna be about directcontracting.
So this is gonna be educationalcontent for those that are
(26:35):
trying to go direct.
So these are people that aretrying to connect directly with
hospitals, get paid directly,negotiate directly with
hospitals, and trying to cut outthe traditional middleman.
So an entity you may, might beable to be your own boss and
live the, or live out a lifethat's more flexible and really,
truly have that autonomy.
Now the fourth day I'm reallyexcited about, it's not totally
(26:56):
set in stone, but it's gonna bea full day.
Somewhere between four to fivehours of just q and a sessions.
And we're gonna have experts,that are gonna be answering
questions about DPC workingthrough locums agencies or going
direct.
And so basically what I'm sayinghere is you're gonna have three
days full of educationalcontent.
(27:17):
You can join our chat box liveand answer your questions
throughout.
And then on that fourth day,October 26th, that Sunday, it's
gonna be totally live q and a.
And we'll have experts loggingin throughout the country,
experts in DPC, locums anddirect contracting, answering
all your specific questions youhave about entering these
(27:38):
arenas.
One of the reasons why we'recollaborating is because we
think that there's DPC doctorsthat may be trying to get into
DBC and may not have the income.
So this is a great opportunity.
Holly Shen MD (27:48):
The RiseUP Summit actually is going to be a
compilation of topics that areincredibly valuable to people
who are either early in the gameor thinking about going into
this.
Line of work, or have been doingit a bit, but haven't quite
gotten to where they wanna be.
And we have taken the topicsthat we hear about every day.
So on our pages, on our socialmedia groups when someone
(28:10):
approaches me in person at mysite, because it happens like
every day tell me how to dothis.
How do I do this?
What would I do if I was this?
How do I do this?
So, some of the things that youcan look forward to on the
Locums through agencies days,one of the most important topics
is understanding the locums gamein general.
So we're gonna hit that frompayment structures, from from
(28:31):
being able to set expectationsand boundaries with locums
agencies, from understandingwhat a confirmation letter
means.
What a PSA or professionalservices agreement means.
All the things, all thebuzzwords that come up in
working with locum staragencies, we're going to cover
in one way, shape, or form.
And a lot of it overlaps.
So you get a lot of justrecurring and solidifying
(28:52):
information for you, educationfor you to take away.
So you're gonna understand howto get started or how to more
effectively work with locumsagencies and to advocate for
yourself.
Because as much as we would loveto say agencies are advocating
for us, it's us that areadvocating for us, and that's
most important.
Direct contracting is one of mypassions because I feel like
it's the thing that has workedbest for me working
(29:13):
independently.
I love to learn how to take outthe middleman because I don't
like sharing my paycheck.
I'm working, I'm taking therisk.
I want the, the, the financialbenefits.
So we're going to have youunderstand the differences
between if you're working as aW2 or 10 99 and working directly
with, which could'cause it'spossible as a direct contractor.
(29:35):
How you prepare to work as adirect contractor, how you
negotiate conversations with,with hospitals and facilities,
if you're trying to findopportunities how to deal with
stark law and fair market valueand how that applies to when
we're direct contracting.
Because again, that's a rulethat doesn't apply when you're
working via agencies.
There are so many nuances andwhen you're working with a, an
(29:56):
agency versus, versus workingdirectly, it is just a whole
different ball game.
It is night and day and you haveto understand the nuances to be
able to do it both effectivelyand, and legally as well, which
is really important.
You know why some of us choosenot to use agencies anymore and
only work direct?
And one of mine that I'll bepresenting is, kind of how to be
(30:16):
a one person physician business,how to run yourself as a one
person physician business.
All these are super important.
Now, when we get to the, thefourth day, I think this is
where people take away some ofthe most.
'cause we're laying thefoundation, we're giving you
tools.
It's literally a, a gettingstarted guide for locums are, or
independent contract work.
(30:36):
We've done all the work for youbecause we've learned, we've
aired, we've, we've made thiscompilation of education for
you.
But day four is gonna be one ofthe coolest days because You'll
get to plug questions into thechat box.
We'll be able to pull thosequestions and we'll be able to
address them from our personalexperiences.
And everybody's got a little bitof a different spin on some of
(30:57):
these approaches.
So there's so much to learn fromthese experts, whether they're
in the chat box or whetherthey're on the pan panel sitting
in front of you.
You're gonna be able to take andlearn from the wins and also
from our mistakes, so you avoidthem.
So it's literally not only a howto but a how not to, and it is
just the absolute end all and beall the Bible for how to work as
(31:21):
an independent physician.
Maryal Concepcion MD (31:23):
And I think that, especially when
you're talking about the how notto that is some of the most
priceless information that youcan have when you are a person,
especially like the three of us.
Like just quit and then thinklater what, what you're gonna do
to solve the, that job doesn'texist anymore.
How can I create a new onesituation?
And I'd wanna point out here,especially because this is my
DPT story, a lot of you arecoming on this podcast to listen
(31:45):
about direct primary care.
So the direct primary care focusday is not going to disappoint
at all.
I'm so excited.
We're gonna have representationfrom all over the country.
Urban rural.
I'm so excited for our speakersbecause we're really looking at
the topics that direct primarycare physicians are really
wanting to know more about.
And yes, that includes, how tostart A DPC, but it also
(32:07):
includes how to market and growyour DPC, how to collaborate
with other physicians, how tomaintain your, your skills.
Like I was mentioning, if youwanna do OB and c-sections and
deliveries as a family medicinedoctor, colonoscopies, amen.
You can do that.
But this is a way to startputting the pieces together to
build that dream career.
Dr.
Stephanie Phillips, who has beenon the podcast before serving
(32:29):
the poorest regional Georgiawith her DPC model, is going to
be talking about rural medicinein DPC.
And so there's so many examplesof how A DPC physician can not
only just, get empowered withthe DPC space, but then follow
that up and be empowered withthe more collaborative space of.
(32:50):
How could I expand my DPC?
By doing things like locums ordoing things like direct
contracting and where especiallyI think the number one thing
that I hear as to how thiscollaboration can really help is
if you are stressed financially.
If you are maybe not the personwho's like, I can't just quit
and then figure it out becauseI'm the primary care breadwinner
(33:11):
or whatever, or I'm the primarybreadwinner.
Whatever your situation is, ifyour finances are not where you
would like them to be, but youwant your finances to be robust
and and dictated by you anddictated by the, the jobs you
decide you take, whether it belocums that is literally within
your geographic area or acrossthe country, the, I, I love that
(33:32):
story that Erin shared about theorthopedic surgeon actually
spending more time with theirfamily.
But the finances, when you freeyourself of the worry of, I am
not good enough to, to be hiredby I don't know how to, all of
these fears that we've beenmentioning, when you're able to
financially have the, theability to you when you're able
(33:54):
to have the ability to craftyour financial future, and then
that opens the doors to whateveryou wanna do.
I, I, I love all of theseexamples of people who are doing
locums and direct contractingand DPC, like, we don't have to
limit to just one of theseavenues.
Holly Shen MD (34:09):
I'm glad you brought up the financial
perspective because I, I am andwas that person who was the
breadwinner.
I'm, I'm blessed to have a, aspouse who is able to be at home
with our children and beresponsible for our children.
But that also means that there'sno other significant income
coming in.
And I am the one, and per myprior work experiences, I was
(34:31):
always stuck in that salary box.
You, you make this much salaryand that's, you're a W2 employee
and that's, that's essentiallywhat you have to work with.
But what I found when I left wasthat I had absolute freedom in
my financial.
Abilities.
I could take, I could work asmany hours or as few hours as I
wanted, but if I needed to makemore money to go on a nice
vacation or to pay a medicalbill or to whatever, I could
(34:53):
literally pick up extra shifts.
I now in this current role, and,and I truthfully, I work, I
probably work 10, anywherebetween 10 and 15 days a month
of, of work.
And that's 24 hour shifts.
They're not in-house, but they,they're working.
So in that time, I now make, Iwould say I make almost three
(35:15):
times as much as I made as anemployed physician with way more
time off, complete flexflexibility and control, and the
ability to pick up more or lesswhenever I want.
So now I have the ability towork more and make more if I
want to, and feel rewarded inthat way or take that time back,
but.
Take it as an ability to be ableto if you're the breadwinner and
(35:37):
you feel kind of crunched andcrushed, is the ability to
expand.
I now have a fantasticretirement plan I never did
before.
I was not able to invest.
I am now able to take time andactually travel and afford the
trips, which is great, but itactually puts it in your hands
and lets you be in charge ofyour own professional financial
destiny instead of living in asalary box.
Aaron Morganstein MD (35:57):
I think that there's a lot of, a lot of
a lot physicians can gain bysharing stories, and I'm a huge
advocate of that, and I thinkthat's what your podcast does
well, is share stories andexperiences.
I want folks to know that ifthey're attending the.
The Rise Up Physician Summit orpurchasing it so that they can
watch the recordings later.
I want them to know that theselectures okay, are 30 minutes
(36:19):
long.
And each day is literally likeits own Masterclass it's like a
master course in DBCA Master'scourse in working through
agencies.
It's a mastery course in directcontracting.
And the reason why we have ourlectures or our speakers only
speaking for 30 minutes at atime is because we want to make
it a very impactful 30 minutesfor you.
(36:39):
They're gonna go through thematerial fast, it's gonna be
dense and to be gonna beextremely high yield for these
folks.
And so I just want them to knowthat we've designed the
curriculum so literally they canget as much material as possible
all throughout each day.
Holly Shen MD (36:55):
Another benefit of having these recordings and
being able to kind of listen tothem in your own time, if you do
need to purchase and listenlater, that's, that's great.
Lots of people listen in theircars.
Or when they're traveling orwhenever they have free time,
it's fantastic.
But not only will you hear theinformation and be able to hear
it again and again when you needto, you can refer back to it.
But another thing is you'regoing to hear different spins on
(37:15):
the same information.
You're gonna hear each physicianor each presenter's different
take on why they chose, an anLLC or an S corp, or why they,
how they approached a facilitywhen wanting a direct contract.
So understanding the basicknowledge and hearing it
repetitively to be able to kindof let it sink in and let it,
(37:37):
kind of become a real option foryou is one thing.
But hearing success stories,hearing these, and these are all
our speakers, are physicians whohave, talk the talk and walk the
walk.
They are not people who are justteaching, they are people who
have been there, done that andbeen successful.
So when you hear more and moresuccess stories and more spins
on how to be able to approachthe same topic or the same, hang
(38:01):
up or roadblock that you have,you're gonna find something that
will work for you.
You're gonna find somebody'sapproach that sounds like, okay,
I could actually do that.
So that repetition and havingthese recordings for later is an
invaluable tool.
Aaron Morganstein MD (38:13):
I guarantee you will learn
something new.
And this is why I know thisbecause we've hosted several
events at Flex Med staff and I'malways learning new things from
people like Holly and otherphysicians that speak.
It's tremendous for me andempowering to me when I continue
to learn new things at each oneof our events.
So I want folks to know outthere that if you're a beginner
(38:33):
level, you're interested in theidea of DPC or locums or direct
contracting, or you've been atfor several years, there's
something at this event for you.
Holly Shen MD (38:43):
And also don't forget, and this is, this is an
important thing.
This is a very nebulous topic.
This is a new and evolving waythat physicians work.
There is not one way to be, itis not black and white.
The market changes, theapproaches change, the needs
change.
Every day, every week, everyyear.
(39:04):
So at Flex Med staff, we alwayshave a finger on the pulse.
Our physician leads always havea finger on the pulse to be able
to say what is changing in themarket?
How do we need to change ourstrategies, our approach to be
able to better advocate forourselves and for our physician
community.
So just understand this is anever evolving and adapting
field.
(39:24):
It's not.
Once you learn it, you know it,it is that you need to
understand how fluid andchanging the topics that we're
gonna talk about are.
And when we present, generallyannually, sometimes a little bit
more frequently than that,especially beginner topics,
we've incorporated what is newsince the last time we have
spoken, what has changed?
What have we learned?
We've come across this.
(39:46):
We are always with an ear to theground, to what is changing in
independent physician work.
Maryal Concepcion MD (39:50):
Where you're gonna go is flexed
staff.com/riseup and early birdtickets are on sale through
September 15th.
The tickets are$199 the datesare October 23rd to 26th.
If you are not available toattend live, just as we've
mentioned here you will haveaccess to the recordings
afterwards and as long as yousign up before the event goes
(40:12):
live, before rise up startsyou're able to access the
content for six months after thesummit goes live.
So, thank you guys so much forjoining us today and proving
that medicine is truly strongerwhen we, as physicians take back
control together and rise up.
Thank you for listening toanother episode of my DBC story.
(40:35):
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
and challenges.
Links are@mydpcstory.com forexclusive content you won't hear
(40:59):
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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