December 7, 2025 • 34 mins
Today Dr. Emily Holt, a Direct Primary Care (DPC) physician based in New Orleans, shares her inspiring journey from working in federally qualified health centers (FQHCs) and university clinics to opening her own DPC practice amidst a rapidly changing healthcare landscape. The discussion dives deep into the effects of the "one big beautiful bill," the challenges facing marginalized communities following recent legislative changes, and innovative ways DPC physicians in Louisiana are collaborating to fill healthcare gaps. The episode also highlights the power of community-driven solutions, nonprofit partnerships, and coalition-building among DPC practitioners to improve access to affordable, relationship-based care. Whether you’re a physician, patient, or healthcare advocate, this episode offers firsthand insight into DPC, healthcare advocacy, and the current realities for patients and providers in New Orleans and beyond. Recorded July 2025.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Maryal Concepcion (00:47):
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.
(01:08):
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
(01:31):
care.
Dr.
Emily Holt is joining me todayand she opened in October and it
is so exciting to be here in NewOrleans.
This is like one of the thingsthat is the highlight of today
to be able to meet you and talkwith you, but also in this town
where you have.
(01:52):
Lived and worked for many yearsin different roles.
I would love if you could sharewith the audience.
Especially because we are at atime now where they quote, big,
beautiful Bill has passed and itis now affecting communities
like this lovely community thatyou live in and you work in.
So can you tell us a little bitabout what roles have you been
(02:13):
in throughout the years thatyou've been in
Dr. Emily Holt (02:16):
New Orleans?
Sure.
Well, first of all.
Thank you for reaching out tome.
I'm totally fangirling overhere.
And it it, if it wasn't forthings like your podcast, I
would not have my own clinic.
So thank you for what you'vedone for the movement.
So yeah, I started in, I, when Igraduated my residency in New
(02:37):
York City, I moved to NewOrleans with my two sons at the
time, and my husband and Istarted working for a fairly
qualified health center.
And I fell in love with thatpopulation, honestly, that that
population of people who werevery hardworking and needed
healthcare and that clinic wastheir safety net.
(02:58):
Really?
Dr. Maryal Concepcion (02:59):
Yeah.
Dr. Emily Holt (02:59):
And I knew that I wanted to be that doctor for
people for the rest of my life.
When I had my third baby, Iactually left that FQHC while I
was on maternity leave.
Wow.
Because.
I could just tell that there's,you know, before I, I quit, I
was waking up at 4:00 AM to, tofinish charting and, you know,
(03:23):
after having been up severaltimes, breastfeeding the other,
one of the other ones.
And at night I just, it was notsustainable.
Mm-hmm.
Um, And I was probably seeingbetween 22 and 26 patients a day
at the FQHC.
I really enjoyed the patients,but New Orleans is a pretty poor
(03:45):
city in the, in, insocioeconomic status.
And so a lot of patients werecoming from backgrounds of very,
very meager means.
And as many people who work atFQHCs can I probably identify
with I would spend a lot of my15 to 20 minutes with a patient
Googling or looking onWalmart's.
(04:07):
$4 list mm-hmm.
To help them figure out whichtwo of their six medications
they were gonna purchase thatmonth.
Yeah.
And so it felt a lot, like Iwasn't helping many people, but
at the same time I knew howimportant it was to be there.
Mm-hmm.
And have places like that, FQHC.
(04:28):
So, it really hurt to leave, butI also knew that.
I could not, it was notsustainable for me, my family,
my mental health, my physicalhealth.
And so I, and I left to go to ajob that had a much better work
life balance.
I was at the Tulane UniversityCampus Health Center for six
years and.
(04:48):
I really enjoyed that job.
I really enjoyed the patientpopulation there.
Mm-hmm.
It, I, I realized that if Ihadn't even known what
adolescent medicine was, I mighthave decided to do a fellowship
at some point.
It was, it was just a funpopulation to work with
especially as a mom.
Mm-hmm.
I felt like all those students,those kids, those young adults
(05:11):
were my kids.
Yeah.
And, and I really enjoyed.
Having a little bit more time tospend with them.
Mm-hmm.
And it, it occurred to me thatso many students who came to
college actually had very littleeducation about them themselves,
their bodies, their health.
And so this felt like a reallyfun opportunity to spend the
(05:34):
time with them and educate them.
So.
Yeah, that's, that's what it,and then I, I left to start my
practice, so after that, sothat's pretty much, that's
pretty much it.
As a doctor, it, as prior tomedical school, when I, I went
to me, I went to undergrad atTulane University and I did a
master's in public health.
(05:54):
There.
I worked in between those twoedu educations as an emergency
medical technician for the cityof New Orleans full-time.
I chose night shifts because youwere guaranteed at least one
gunshot wound per night.
Dr. Maryal Concepcion (06:10):
Oh my gosh.
And
Dr. Emily Holt (06:11):
I loved those adrenaline rushes.
Wow.
I actually thought I wanted tobe an emergency room doctor and
you know, I, growing up I didn'tknow any doctors.
Yeah.
There's nobody in my family isreally in medicine, and so
that's why I became an EMT.
I wanted to know what it waslike.
Sure.
And I thought for sure I wasgonna go into er'cause it was
(06:32):
just way too fun.
All the trauma, not knowing whatwas, what you were gonna get
called to next.
This was back when we treatedCHF exacerbations with IV pushes
of lasik.
Oh man.
And I, I just seem to remember,I mean, I wasn't a paramedic, I
was the emergency medicaltechnician, so I didn't have the
(06:54):
same skill level, but.
I, I remember we, when we codedpatients, the back then the
paramedics would push drugsthrough the endotracheal tube.
And you know, I learned so muchand it was fun.
Talk about dopamine rushes.
But actually I happened to beworking full time when Hurricane
(07:14):
Katrina hit the city of NewOrleans and that experience.
You know, I could talk for anhour about it, but the nutshell
was I was stranded with mypatients.
They split, there were about 86of us working for the city's new
Orleans EMS, which at the timewas called New Orleans Health
(07:34):
Department.
And they gathered us togetherthe day of the storm and they
said, okay, this is it.
This is the big one.
This is the storm we've all beenexpecting.
It's gonna be a direct hit, acategory, four or five, a direct
hit on the city, and we expectthe city to be destroyed, and we
expect communication towers togo down and it's too late for
(07:57):
people to evacuate.
Yeah.
And the Superdome, which isnormally used as a, a oh, what's
it called, A shelter.
Last resort is not going to beused as a shelter.
So people will have nowhere togo.
And so we know they're gonnaneed help.
So we're splitting you up intosmall groups and we're posting
you throughout the city Wow.
(08:17):
So that you can provide medicalcare.
And I wound up at the Superdome.
And so long story short, this,we got to the dome with all of
our equipment as the, after thelevees broke and as the water
started to rise.
We were stranded there with sixfeet of water surrounding the
(08:38):
dome with the thousands ofpeople who had come to the dome
because they expected it to be ashelter.
Wow.
And it took three days for fema,the government to show up with
helicopters.
And in that time, I had nochoice but to get to know my
patients.
Yeah.
All we did was triage.
(08:59):
I mean, we.
We, we took patients, the oneswho needed to go first, and we
didn't know what was coming.
'cause it's true, allcommunications were down.
Geez.
So we didn't know.
We didn't know if we shouldexpect a boat or a helicopter.
But we took the patients who weknew needed to go out first and
put'em in a, essentially a pile.
We tagged dead patients.
(09:20):
We, we separated the ones whocould hang on a little longer.
And I, I mean.
Being in such an environment ofjust desperate humanity and I
was in it with my patients.
Yeah.
I didn't have any food or watereither.
(09:41):
Yeah.
Made me realize how importantrelationships were with the
people I cared for.
Yeah.
And how much I wanted to knowwhat had happened to them.
Yeah.
What was happening to them.
And so those long-termrelationships were something I
had never considered and it mademe completely changed my
(10:01):
trajectory in medicine.
And I, I, from then on, Idecided I wanna be a primary
care doctor.
I wanna get to know thesepeople.
And I want to live my life withthem alongside them.
Yeah.
I don't wanna treat'em and treat'em is how he would call it in
the emergency room.
Dr. Maryal Concepcion (10:17):
Totally.
Dr. Emily Holt (10:18):
And that is.
Dr. Maryal Concepcion (10:19):
For the listeners, that is literally a
pervasive term or a phrase, andthat is so realistic, but it
also absolutely speaks to theperson you are that you know,
you are so mission driven toeven become a physician, a
primary care physician versus anER physician, or you know,
somebody who is going to takecare of people only in the acute
stage.
(10:41):
Here we are now.
Fast forwarding to 2025, thisquote unquote, big, beautiful
bill has passed.
And like I mentioned in thebeginning, we're already to see,
we're already seeing the, thefallout of what happens when
healthcare is not a human right.
When human rights are not ahuman right.
(11:02):
Depending on the color of yourskin, your orientation, your,
you know, whatever it is.
There's so much divisivenessright now.
It's really, really achallenging time.
And earlier we had aconversation about what happens
(11:29):
when a clinic that is.
Taking care of the patients whoyou, you know, the, the, the
avatar of the patient who youused to care for.
The person who goes to the FQHCclinic when their care is being
threatened because of funding,because of government funding
can no longer be used for fillin the blank, you know, ism
(11:51):
right now that is going on.
What.
What are you hearing from peoplein the community who are also
with that same mission that youhad choosing primary care?
What are they asking you inorder to help these patients?
The same as you wanted to helpyour patients when you became a
doctor?
Dr. Emily Holt (12:11):
Yeah, I mean, you know, I think it's a
difficult time right now inmedicine because.
Politics seems to have creepedin, in such a way that I've
never seen it before.
Hmm.
You know, literally today afederal judge blocked the Trump
administration's.
It, I don't remember if it wasan executive order or I think it
(12:34):
was or it was, maybe it was apart of the big beautiful bill
that said that plannedParenthood could not take
Medicaid funding.
You know, that's been a reallybig issue in the deep South
because it's very hard for womenin Louisiana to get good
healthcare.
(12:54):
Full stop.
I think we have one of thehighest maternal mortality rates
in the United States, and Ithink Mississippi might be
number one on that list, andwe're number two, but.
And then to break it downfurther black maternal mortality
is by far the worst, and it's eextremely divided.
(13:17):
It's, it's, it's a much biggerjump in terms of how bad it is
mm-hmm.
Than it is for other, for whitewomen.
So when it comes to like, it, itkind of depends on what you're
talking about.
Mm-hmm.
Because it feels like there's.
Different interests.
Mm-hmm.
And physicians, they aren'tnecessarily all aligned.
(13:37):
Yeah, sure.
I mean, I'll just be totallyhonest with you.
I'm a member of the LouisianaAcademy of Family Physicians a
proud member of the LouisianaAcademy of Family Physicians.
We really don't, and I'm on thelegislative advocacy committee
and we really don't talk aboutthe bills that.
Are impacting women's health.
Dr. Maryal Concepcion (13:59):
Yeah.
Dr. Emily Holt (14:00):
We didn't even discuss the fact that Louisiana
made Mery stone and misoprostolcontrolled substances in October
of 2024.
We were the first state to doit.
That's not even something thatLouisiana Academy of Family
Physicians is.
Is vocal about.
And frankly it's because they,I'm sure it's because, I don't
(14:22):
know.
'cause no one tells mespecifically, but they don't
feel they have the support.
Wow.
And so it's, when you ask aquestion like that, it's
honestly hard to answer.
'cause some physicians are outthere saying, you know, how can
we support the patients who are.
No longer gonna qualify forfederally qualified health
(14:43):
centers because they'reundocumented.
Yeah.
Because of the big, beautifulbill that was specifically put
in there to try to stopundocumented patients from
getting healthcare.
Mm-hmm.
How are we gonna serve thosepatients?
Federally qualified healthcenters locally are very
concerned about that.
Mm-hmm.
They are going to lose fundingand they can't make up the gap.
(15:07):
Also gender affirming care.
They, there is one federallyqualified health center that is
still providing it andeveryone's kind of got their
eyes on them and wondering Sure.
Are they gonna be able tocontinue?
Yeah.
Because there are even wholeuniversity systems in other
states that have stopped theirgender affirming care programs.
(15:29):
Mm-hmm.
So it's a very fluid situationand large.
Populations of people'shealthcare
Dr. Maryal Concepcion (15:36):
are at risk.
Absolutely.
And you know, I, I think abouthow there are probably listeners
who are saying things that Idefinitely hear in California,
like, oh, but that's not gonnaaffect me and.
That's absolutely not true,because as we see, you know, if,
if people are no longer workingat jobs, it affects the, you
(15:56):
know, the supply chain.
If people are no longer withaccess to healthcare, where are
they gonna go to the emergencyroom?
And so when you actually have anemergency, you might be one of
how many if that hospitalremains open.
Because if the Medicaid andMedi-Cal reimbursements are
enough that they will stay open.
Who knows?
So.
The complacency and the, youknow, the thoughts of like,
(16:20):
that's not going to happen tome.
When you, when you see thathappening, but you also see
people in the community who aretrying to look to the future and
look with, with that, with thosetypes of situations happening,
how to prepare to offer an an, apathway for people to, to
(16:41):
access.
Care, access, healthcare, notinsurance.
What are the conversations thatare going on in Louisiana?
Dr. Emily Holt (16:50):
Well, if you, you're not gonna have the
government funding like we wereused to having, and that's
pretty clear that that's goingaway.
Who can fill the gaps and how?
And so just today we, I had aconversation with an FQHC
locally about you know.
(17:10):
Should we look for grants?
Should we look for benefactors?
Should we, and, and you and Iwere talking about, you know,
should we, should I make aprogram for some people who are
able to, to pay more, almostlike that Robinhood mm-hmm.
Model that you mentioned so thatother people who can't afford it
can pick it up.
I have lots of service industryworkers.
(17:32):
Mm-hmm.
And who are members of my d, myDPC.
Just today I had to join andthey, they told me they each
make six, about$16 an hour.
They applied for Medicaid andthey were told they don't
qualify.
They don't, they don't, theymake too much, but they would
have to pay$400 a month if theywanted a marketplace plan.
And they certainly can't affordthat.
(17:53):
Yeah.
And so, you know, the struggleis where, where am I gonna spend
my time?
Mm-hmm.
How, how am I gonna defend,divide my time?
And while also trying to growand run a business and reminding
myself that I can't, I can'tsave everybody.
Yep.
And it's, it sounds so trite,but it's something that I've
(18:18):
struggled with from since I wasan emergency medical technician.
Yeah.
And so protecting myself is alsopart of this equation.
Mm-hmm.
My practice isn't even really.
Profitable right now.
I'm, and so, you're asking themillion dollar question.
Mm-hmm.
And a lot of people are puttingtheir heads together to try to
(18:40):
figure out how can we fill thisgap.
I am a little scared that I knowwe're not gonna fill it for
everybody.
Mm-hmm.
And there's gonna be a lot ofsuffering.
Yeah.
Yeah.
Dr. Maryal Concepcion (18:51):
And all of what you are saying is so
true and it's so.
Painful at the same time becauseit is so true.
And in my opinion, it is totallyavoidable because especially
physicians like you and myselfhave been saying, you know, we
have to uncouple insurance fromprimary care for a very long
(19:11):
time.
There are thousands of doctorssaying that, but yet at levels
of bureaucracy that are at, youknow, in different
organizations, different levelsof the state, government, et
cetera, that is not the defaultyou know, thought process of how
do you do any healthcare withoutinsurance is not it's not the
default.
It is definitely being morefamiliar because people are
(19:33):
having to be creative.
But I think that yes, it is themillion dollar question because
if we could fix everythingtomorrow that would be
fantastic.
Unfortunately, too long, in myopinion, we have left this
pipeline of medical students andresidents to the, the wolves of
corporate medicine.
And like I was there in termsof, I was an employee, I didn't
(19:57):
know how to do anything else.
But when those are the onlythings that are presented to
you, you, you're only taughtcodes in residency and you're
only taught the insurancesystem.
It leaves, it, it's almost likea, a learned helplessness and.
When people like you and I arecoming to the table to have
conversations to try to fixthings definitely you've, you've
(20:19):
even taken a big, you've takenalready a big step in being a
part of a safety net.
Tell us about your affiliationwith Bija Clinic.
Dr. Emily Holt (20:27):
Yes, I'm really excited about this.
So, Dr.
Byron Jasper, who is a DPCphysician in Baton Rouge, and he
somehow figured out how to alsostart a nonprofit Baja.
And he brought me on literallyas recently as a couple weeks
ago as an affiliate to his DPC.
(20:49):
And what, what I understand andwhat I, the MOU that I signed
said is that I, as an affiliatecan benefit from programs that
are accessible to his nonprofit.
Mm-hmm.
Like for example, i'm nowconnected with the public health
department, so I now have rapidpoint of care, h, hiv mm-hmm.
(21:12):
Syphilis and Hepatitis C teststhat I've, I can make available
to anybody.
And I also have access to his isit three 40 B pharmacy?
Mm-hmm.
Pricing.
Now the FQHCs in town also usethis pharmacy.
It's called Aveda.
And as I understand it, thelarger the pot or the larger the
(21:36):
nonprofit, the lower the pricesget Sure.
For the three 40 B pharmacy.
And so if currently I actuallydon't know if, if Dr.
Jasper has other affiliates.
I think he does.
I think he has three otheraffiliates.
Okay.
But you know, as long as all ofus are still quite young in our
businesses and we don't have.
(21:56):
Thousands of patients like the,these FQHCs do.
The, the three 40 B pricingisn't gonna look exactly like it
would for an FQHC, but the morewe grow together, the better the
prices get, essentially for ourpatients at the pharmacy.
And the more we're able to helpother patients mm-hmm.
(22:17):
Who are in need.
Yeah.
And so that's one of certainlyBaja is mission driven.
Absolutely.
And, I really respect that andit's what I, what was, what I
was drawn to when Dr.
Jasper was talking to me aboutit.
And so one of the things that hecan do with Baja is any sort of
donations to Baja or the themoney that comes from the three
(22:39):
40 B pharmacy can be used anddistributed to affiliates for
things like paying formemberships for patients who
can't afford the, the, themembership fee.
Which is really exciting.
Yeah.
Dr. Maryal Concepcion (22:52):
And I, I think it's, I, I love that we're
talking about this.
I love that we're together justbrainstorming as a movement, how
to fill in these gaps, becausethey're gonna get larger and
larger, especially for thecommunities who are in the most
need.
And that doesn't matter whatyour, what state you're in, it's
literally going to happen toevery community, urban, rural,
et cetera.
(23:13):
So I'm wondering in terms ofwhen you were mentioning, you
talked with an FQHC, what are,do they understand what DPC is
or what is the conversation interms of you educating them
about what DPC is?
Because I think this is helpfulfor people who are.
We're on one side of the, thecommunity.
(23:33):
We're always talking DPC, andthere's clearly other people in
the, you know, and not the DBCcommunity yet who are speaking,
but we only know how to doinsurance.
So how are you speaking and howare you educating people who are
not always in the DPC space,like yourself and myself?
Sure.
Well, I
Dr. Emily Holt (23:54):
first they feel out what they do know.
Mm-hmm.
Because it's really.
I guess it's not astonishingbecause this was me maybe four
or five years ago.
I didn't know what DPC was.
I didn't have a clue that waseven something that could be
possible.
Sure.
And then with the FQHC, it'sclear that they know very little
(24:14):
about the model.
And they're so entrenched inthe, you know, of course,'cause
they have to be, how to pay forhealthcare using government
funding.
And obviously also commercialhealth plans.
And so they are very entrenchedin the mechanics of using
insurance and government plansto pay for healthcare.
(24:35):
Yeah.
So, you know, as my husbandnoted, there were 12 people at
the table in our Zoom call andprobably 11 of them did not
practice patient clinicalmedicine.
Yeah.
They were administrators andthat, and that's not a.
Knock on them at all.
Like that's the system that theyhad to set up in order to
(24:55):
service thousands and thousandsof patients.
And thank goodness for them.
Yeah.
Because otherwise those patientswouldn't get any care.
Dr. Maryal Concepcion (25:04):
Yeah.
Dr. Emily Holt (25:05):
But it's a very, very different model mm-hmm.
Than DPC.
And so they, you know, theystart asking out just extremely
basic questions like how do youeven get patients?
How do you market to them?
How do they know you exist?
You know, what do they do?
What do you do after hours?
And it's like exactly the samequestions that I asked.
(25:25):
Yeah.
When I started mulling this overin my head and I'm like, wait,
what is this beast?
Dr. Maryal Concepcion (25:31):
I've never seen this before.
Yeah, it totally, and you know,it, it's so interesting'cause
that's exactly what I wasthinking when you were saying
that just now is like, wow,where did those questions sound?
Where do they, how come Itsounds familiar.
And I have also have been inthis place of like, oh, like.
This is a real thing.
I remember going to my firstsummit only because somebody
(25:52):
told me to, and I had zero ideawhat DVC actually was.
And so this is fascinating.
And I I, it, it's exciting toothat more people are, it's
unfortunate that they're beingforced to look into another way,
but it's like, what a time to beinnovative.
And going back to how youmentioned creative ways to
offer.
(26:13):
Your DPC offerings to differentpeople in the community.
I'm wondering, are you guyscoming together as you know, the
region within Louisiana to havemore of these conversations?
Louisiana's a state.
Where are you guys in terms ofwho in the DPC community in
Louisiana is coming to the tableto try and brainstorm with
(26:34):
people who are not yet in theDPC space?
Dr. Emily Holt (26:37):
Yes.
So that's actually also been areally exciting.
Sort of recent movement in, inLouisiana, there's a handful of
DPCs, many of whom have beenopen for over, I would say six
or eight years mm-hmm.
Who are coming together andforming a coalition.
Dr. Maryal Concepcion (26:55):
Mm-hmm.
Dr. Emily Holt (26:56):
We've already kind of all met for dinner
together and had a good time inBaton Rouge and met each other
in person.
I don't necessarily know thateverybody wants to be part of a
coalition.
Sure.
Everyone's in different placesin their practice and their
lives right now, but there'sdefinitely a handful of people
who are, are looking to start aLouisiana coalition.
(27:18):
Mm-hmm.
And getting that movement goingwith the networking.
I met a handful, you know, theDPC summit 2025 was in New
Orleans this past weekend.
Yeah.
And, and I, and I met a coupledoc private practice doctors who
were from Metairie, who was asub, that's a suburb of New
Orleans.
And they were dp, DPC, curious.
And so we're sort of envelopingthem Yeah.
(27:40):
Under our wing at the same time.
And I don't really, I don't knowwhere it's going, but just
having.
The fellowship in the firstplace has been really, really
fantastic.
I've learned so much from theLouisiana doctors who came
before me, and it has been sucha privilege to, to speak to them
and work with them and learnfrom them.
(28:02):
And I just, it makes me want topay it forward.
Yeah.
That's awesome.
And I
think
Dr. Maryal Concepcion (28:05):
that that is, that is literally getting
at, you know, what we enjoy withour patients, having a
relationship with them when wehave a relationship amongst our
own community.
That's so powerful because then,you know, even just by talking
out about something like, youknow, oh man, I'm really
struggling with accessinglidocaine or whatever it is, you
(28:26):
don't know.
Just same as as when I talk onthe podcast and then somebody
randomly will say like, oh, Iheard that and it made me move
to this different state and opena DBC.
Like, we never know who we'regonna meet or talk to, but when
it comes to.
Working together with all of ourdifferent experiences, I think
that there is always going to bepower in community and coming
(28:48):
together to move forwardtogether for the community.
So I think that's fantastic thatyou guys are, you know, even
looking at how do we worktogether.
And I I will say that this issomething that J Keith said the
DBC coalition echoed thisweekend is that even though now
the HSA legislation has passedthe Primary Care Enhancement
Act, this is where the workreally happens because as more
(29:11):
people are going to be impactedby losing healthcare, as more
physicians are going to bereplaced by non-physician
providers, as more access pointsphysically are going to close,
and more people are going tolook into DPC because of
whatever reason, includingnecessity.
This is where we have to speakup, in my opinion to make sure
(29:34):
we do not rebuild a system thatwe are have just left.
Dr. Emily Holt (29:38):
Mm-hmm.
Yes, absolutely.
And then to speak a little bitmore to that in terms of the
physician empowerment andleadership.
Being as important as it is inthis day and age, I am one of
the they're called clusterleaders of the reproductive
health access projects.
So I'm one of the colu leadersin Louisiana.
(29:59):
Given that it's a, a veryrestrictive state for women's
rights, it's actually quite apropo to call us a cluster.
But we, we are currently in theprocess of setting up.
A group.
Mm-hmm.
Sort of, I don't wanna call it aproject, but a meet and greet
almost with the emergencymedicine, reproductive health
(30:20):
access project.
Because as physicians indifferent specialties and people
who care about, in thisparticular circumstance, it's
gonna be women's health or humanrights when it comes to those
who menstruate.
Or bear children.
Mm-hmm.
You know, we have got to reachout to whoever we can to help
(30:43):
each other.
Mm-hmm.
And that's not something I'veever seen before.
And I am, I consider myselfsomebody who's really been in
the advocacy space for a longtime.
And so maybe that's a, a silverlining.
You know, family medicines andemergency family medicine
doctors and emergency medicinedoctors coming together to
(31:06):
strategize.
Absolutely.
'cause we need all hands on deckright
Dr. Maryal Concepcion (31:09):
now.
Dr. Emily Holt (31:09):
Yep,
Dr. Maryal Concepcion (31:09):
a hundred percent.
And I will say here that ifadvocating for our profession,
advocating for our patients,advocating for human rights,
access to healthcare, all of thethings, if that.
If that, you know, really makesyou fired up as you're hearing
this, I definitely would saytalk to your, you know, your
colleague in DPC.
(31:30):
See how, if they've advocated,where have they gone?
Local Chamber of Commerce, citycouncil, state, federal where,
because I will say that ingeneral, whether it be local or
whether it be federal, I, I willsay that one of the things to
keep in mind is that.
DPC has always been bipartisanand it remains so in this.
(31:54):
Time of extreme divisiveness andwhere we can advocate is
literally telling about howwe're delivering care to
patients, not how we'redelivering care with religious
beliefs or politicalaffiliation, but literally this
is the access and quality ofcare that I can deliver to my
patient that I have arelationship with over time.
(32:15):
And that is.
Quite powerful.
And so I say that because evenbefore we started recording,
that was a concern that I washearing is that how do you
advocate if, you know, medicallywe don't all agree, we're not
talking about how we can cometogether, put our heads together
to.
Ensure ways of people accessinghealthcare and not health
(32:37):
insurance.
thank you so much.
It, It's so wonderful and justfulfilling to know that there is
a doctor out there like you whohas literally followed her work
and her mission and making surethat they tie together at all
times.
So thank you so much for whatyou do and I'm so excited for
everyone to hear this.
(32:58):
Thank you.
Thank you.
You as well.
I really appreciate you.
Thanks for tuning in to My DPCStory.
If this episode inspired you,please leave a five star review
on Apple Podcasts.
It helps more physicians findthese stories when they need
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If you're new to DPC, you'rejust beginning your journey.
Head to the Start Here age@mydpcstory.com.
(33:19):
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(33:41):
paid tier that helps support theshow.
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mydpcstory.com.
Until next time, this is MaryalConcepcion.
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.
(01:08):
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
(01:31):
care.
Dr.
Emily Holt is joining me todayand she opened in October and it
is so exciting to be here in NewOrleans.
This is like one of the thingsthat is the highlight of today
to be able to meet you and talkwith you, but also in this town
where you have.
(01:52):
Lived and worked for many yearsin different roles.
I would love if you could sharewith the audience.
Especially because we are at atime now where they quote, big,
beautiful Bill has passed and itis now affecting communities
like this lovely community thatyou live in and you work in.
So can you tell us a little bitabout what roles have you been
(02:13):
in throughout the years thatyou've been in
Dr. Emily Holt (02:16):
New Orleans?
Sure.
Well, first of all.
Thank you for reaching out tome.
I'm totally fangirling overhere.
And it it, if it wasn't forthings like your podcast, I
would not have my own clinic.
So thank you for what you'vedone for the movement.
So yeah, I started in, I, when Igraduated my residency in New
(02:37):
York City, I moved to NewOrleans with my two sons at the
time, and my husband and Istarted working for a fairly
qualified health center.
And I fell in love with thatpopulation, honestly, that that
population of people who werevery hardworking and needed
healthcare and that clinic wastheir safety net.
(02:58):
Really?
Dr. Maryal Concepcion (02:59):
Yeah.
Dr. Emily Holt (02:59):
And I knew that I wanted to be that doctor for
people for the rest of my life.
When I had my third baby, Iactually left that FQHC while I
was on maternity leave.
Wow.
Because.
I could just tell that there's,you know, before I, I quit, I
was waking up at 4:00 AM to, tofinish charting and, you know,
(03:23):
after having been up severaltimes, breastfeeding the other,
one of the other ones.
And at night I just, it was notsustainable.
Mm-hmm.
Um, And I was probably seeingbetween 22 and 26 patients a day
at the FQHC.
I really enjoyed the patients,but New Orleans is a pretty poor
(03:45):
city in the, in, insocioeconomic status.
And so a lot of patients werecoming from backgrounds of very,
very meager means.
And as many people who work atFQHCs can I probably identify
with I would spend a lot of my15 to 20 minutes with a patient
Googling or looking onWalmart's.
(04:07):
$4 list mm-hmm.
To help them figure out whichtwo of their six medications
they were gonna purchase thatmonth.
Yeah.
And so it felt a lot, like Iwasn't helping many people, but
at the same time I knew howimportant it was to be there.
Mm-hmm.
And have places like that, FQHC.
(04:28):
So, it really hurt to leave, butI also knew that.
I could not, it was notsustainable for me, my family,
my mental health, my physicalhealth.
And so I, and I left to go to ajob that had a much better work
life balance.
I was at the Tulane UniversityCampus Health Center for six
years and.
(04:48):
I really enjoyed that job.
I really enjoyed the patientpopulation there.
Mm-hmm.
It, I, I realized that if Ihadn't even known what
adolescent medicine was, I mighthave decided to do a fellowship
at some point.
It was, it was just a funpopulation to work with
especially as a mom.
Mm-hmm.
I felt like all those students,those kids, those young adults
(05:11):
were my kids.
Yeah.
And, and I really enjoyed.
Having a little bit more time tospend with them.
Mm-hmm.
And it, it occurred to me thatso many students who came to
college actually had very littleeducation about them themselves,
their bodies, their health.
And so this felt like a reallyfun opportunity to spend the
(05:34):
time with them and educate them.
So.
Yeah, that's, that's what it,and then I, I left to start my
practice, so after that, sothat's pretty much, that's
pretty much it.
As a doctor, it, as prior tomedical school, when I, I went
to me, I went to undergrad atTulane University and I did a
master's in public health.
(05:54):
There.
I worked in between those twoedu educations as an emergency
medical technician for the cityof New Orleans full-time.
I chose night shifts because youwere guaranteed at least one
gunshot wound per night.
Dr. Maryal Concepcion (06:10):
Oh my gosh.
And
Dr. Emily Holt (06:11):
I loved those adrenaline rushes.
Wow.
I actually thought I wanted tobe an emergency room doctor and
you know, I, growing up I didn'tknow any doctors.
Yeah.
There's nobody in my family isreally in medicine, and so
that's why I became an EMT.
I wanted to know what it waslike.
Sure.
And I thought for sure I wasgonna go into er'cause it was
(06:32):
just way too fun.
All the trauma, not knowing whatwas, what you were gonna get
called to next.
This was back when we treatedCHF exacerbations with IV pushes
of lasik.
Oh man.
And I, I just seem to remember,I mean, I wasn't a paramedic, I
was the emergency medicaltechnician, so I didn't have the
(06:54):
same skill level, but.
I, I remember we, when we codedpatients, the back then the
paramedics would push drugsthrough the endotracheal tube.
And you know, I learned so muchand it was fun.
Talk about dopamine rushes.
But actually I happened to beworking full time when Hurricane
(07:14):
Katrina hit the city of NewOrleans and that experience.
You know, I could talk for anhour about it, but the nutshell
was I was stranded with mypatients.
They split, there were about 86of us working for the city's new
Orleans EMS, which at the timewas called New Orleans Health
(07:34):
Department.
And they gathered us togetherthe day of the storm and they
said, okay, this is it.
This is the big one.
This is the storm we've all beenexpecting.
It's gonna be a direct hit, acategory, four or five, a direct
hit on the city, and we expectthe city to be destroyed, and we
expect communication towers togo down and it's too late for
(07:57):
people to evacuate.
Yeah.
And the Superdome, which isnormally used as a, a oh, what's
it called, A shelter.
Last resort is not going to beused as a shelter.
So people will have nowhere togo.
And so we know they're gonnaneed help.
So we're splitting you up intosmall groups and we're posting
you throughout the city Wow.
(08:17):
So that you can provide medicalcare.
And I wound up at the Superdome.
And so long story short, this,we got to the dome with all of
our equipment as the, after thelevees broke and as the water
started to rise.
We were stranded there with sixfeet of water surrounding the
(08:38):
dome with the thousands ofpeople who had come to the dome
because they expected it to be ashelter.
Wow.
And it took three days for fema,the government to show up with
helicopters.
And in that time, I had nochoice but to get to know my
patients.
Yeah.
All we did was triage.
(08:59):
I mean, we.
We, we took patients, the oneswho needed to go first, and we
didn't know what was coming.
'cause it's true, allcommunications were down.
Geez.
So we didn't know.
We didn't know if we shouldexpect a boat or a helicopter.
But we took the patients who weknew needed to go out first and
put'em in a, essentially a pile.
We tagged dead patients.
(09:20):
We, we separated the ones whocould hang on a little longer.
And I, I mean.
Being in such an environment ofjust desperate humanity and I
was in it with my patients.
Yeah.
I didn't have any food or watereither.
(09:41):
Yeah.
Made me realize how importantrelationships were with the
people I cared for.
Yeah.
And how much I wanted to knowwhat had happened to them.
Yeah.
What was happening to them.
And so those long-termrelationships were something I
had never considered and it mademe completely changed my
(10:01):
trajectory in medicine.
And I, I, from then on, Idecided I wanna be a primary
care doctor.
I wanna get to know thesepeople.
And I want to live my life withthem alongside them.
Yeah.
I don't wanna treat'em and treat'em is how he would call it in
the emergency room.
Dr. Maryal Concepcion (10:17):
Totally.
Dr. Emily Holt (10:18):
And that is.
Dr. Maryal Concepcion (10:19):
For the listeners, that is literally a
pervasive term or a phrase, andthat is so realistic, but it
also absolutely speaks to theperson you are that you know,
you are so mission driven toeven become a physician, a
primary care physician versus anER physician, or you know,
somebody who is going to takecare of people only in the acute
stage.
(10:41):
Here we are now.
Fast forwarding to 2025, thisquote unquote, big, beautiful
bill has passed.
And like I mentioned in thebeginning, we're already to see,
we're already seeing the, thefallout of what happens when
healthcare is not a human right.
When human rights are not ahuman right.
(11:02):
Depending on the color of yourskin, your orientation, your,
you know, whatever it is.
There's so much divisivenessright now.
It's really, really achallenging time.
And earlier we had aconversation about what happens
(11:29):
when a clinic that is.
Taking care of the patients whoyou, you know, the, the, the
avatar of the patient who youused to care for.
The person who goes to the FQHCclinic when their care is being
threatened because of funding,because of government funding
can no longer be used for fillin the blank, you know, ism
(11:51):
right now that is going on.
What.
What are you hearing from peoplein the community who are also
with that same mission that youhad choosing primary care?
What are they asking you inorder to help these patients?
The same as you wanted to helpyour patients when you became a
doctor?
Dr. Emily Holt (12:11):
Yeah, I mean, you know, I think it's a
difficult time right now inmedicine because.
Politics seems to have creepedin, in such a way that I've
never seen it before.
Hmm.
You know, literally today afederal judge blocked the Trump
administration's.
It, I don't remember if it wasan executive order or I think it
(12:34):
was or it was, maybe it was apart of the big beautiful bill
that said that plannedParenthood could not take
Medicaid funding.
You know, that's been a reallybig issue in the deep South
because it's very hard for womenin Louisiana to get good
healthcare.
(12:54):
Full stop.
I think we have one of thehighest maternal mortality rates
in the United States, and Ithink Mississippi might be
number one on that list, andwe're number two, but.
And then to break it downfurther black maternal mortality
is by far the worst, and it's eextremely divided.
(13:17):
It's, it's, it's a much biggerjump in terms of how bad it is
mm-hmm.
Than it is for other, for whitewomen.
So when it comes to like, it, itkind of depends on what you're
talking about.
Mm-hmm.
Because it feels like there's.
Different interests.
Mm-hmm.
And physicians, they aren'tnecessarily all aligned.
(13:37):
Yeah, sure.
I mean, I'll just be totallyhonest with you.
I'm a member of the LouisianaAcademy of Family Physicians a
proud member of the LouisianaAcademy of Family Physicians.
We really don't, and I'm on thelegislative advocacy committee
and we really don't talk aboutthe bills that.
Are impacting women's health.
Dr. Maryal Concepcion (13:59):
Yeah.
Dr. Emily Holt (14:00):
We didn't even discuss the fact that Louisiana
made Mery stone and misoprostolcontrolled substances in October
of 2024.
We were the first state to doit.
That's not even something thatLouisiana Academy of Family
Physicians is.
Is vocal about.
And frankly it's because they,I'm sure it's because, I don't
(14:22):
know.
'cause no one tells mespecifically, but they don't
feel they have the support.
Wow.
And so it's, when you ask aquestion like that, it's
honestly hard to answer.
'cause some physicians are outthere saying, you know, how can
we support the patients who are.
No longer gonna qualify forfederally qualified health
(14:43):
centers because they'reundocumented.
Yeah.
Because of the big, beautifulbill that was specifically put
in there to try to stopundocumented patients from
getting healthcare.
Mm-hmm.
How are we gonna serve thosepatients?
Federally qualified healthcenters locally are very
concerned about that.
Mm-hmm.
They are going to lose fundingand they can't make up the gap.
(15:07):
Also gender affirming care.
They, there is one federallyqualified health center that is
still providing it andeveryone's kind of got their
eyes on them and wondering Sure.
Are they gonna be able tocontinue?
Yeah.
Because there are even wholeuniversity systems in other
states that have stopped theirgender affirming care programs.
(15:29):
Mm-hmm.
So it's a very fluid situationand large.
Populations of people'shealthcare
Dr. Maryal Concepcion (15:36):
are at risk.
Absolutely.
And you know, I, I think abouthow there are probably listeners
who are saying things that Idefinitely hear in California,
like, oh, but that's not gonnaaffect me and.
That's absolutely not true,because as we see, you know, if,
if people are no longer workingat jobs, it affects the, you
(15:56):
know, the supply chain.
If people are no longer withaccess to healthcare, where are
they gonna go to the emergencyroom?
And so when you actually have anemergency, you might be one of
how many if that hospitalremains open.
Because if the Medicaid andMedi-Cal reimbursements are
enough that they will stay open.
Who knows?
So.
The complacency and the, youknow, the thoughts of like,
(16:20):
that's not going to happen tome.
When you, when you see thathappening, but you also see
people in the community who aretrying to look to the future and
look with, with that, with thosetypes of situations happening,
how to prepare to offer an an, apathway for people to, to
(16:41):
access.
Care, access, healthcare, notinsurance.
What are the conversations thatare going on in Louisiana?
Dr. Emily Holt (16:50):
Well, if you, you're not gonna have the
government funding like we wereused to having, and that's
pretty clear that that's goingaway.
Who can fill the gaps and how?
And so just today we, I had aconversation with an FQHC
locally about you know.
(17:10):
Should we look for grants?
Should we look for benefactors?
Should we, and, and you and Iwere talking about, you know,
should we, should I make aprogram for some people who are
able to, to pay more, almostlike that Robinhood mm-hmm.
Model that you mentioned so thatother people who can't afford it
can pick it up.
I have lots of service industryworkers.
(17:32):
Mm-hmm.
And who are members of my d, myDPC.
Just today I had to join andthey, they told me they each
make six, about$16 an hour.
They applied for Medicaid andthey were told they don't
qualify.
They don't, they don't, theymake too much, but they would
have to pay$400 a month if theywanted a marketplace plan.
And they certainly can't affordthat.
(17:53):
Yeah.
And so, you know, the struggleis where, where am I gonna spend
my time?
Mm-hmm.
How, how am I gonna defend,divide my time?
And while also trying to growand run a business and reminding
myself that I can't, I can'tsave everybody.
Yep.
And it's, it sounds so trite,but it's something that I've
(18:18):
struggled with from since I wasan emergency medical technician.
Yeah.
And so protecting myself is alsopart of this equation.
Mm-hmm.
My practice isn't even really.
Profitable right now.
I'm, and so, you're asking themillion dollar question.
Mm-hmm.
And a lot of people are puttingtheir heads together to try to
(18:40):
figure out how can we fill thisgap.
I am a little scared that I knowwe're not gonna fill it for
everybody.
Mm-hmm.
And there's gonna be a lot ofsuffering.
Yeah.
Yeah.
Dr. Maryal Concepcion (18:51):
And all of what you are saying is so
true and it's so.
Painful at the same time becauseit is so true.
And in my opinion, it is totallyavoidable because especially
physicians like you and myselfhave been saying, you know, we
have to uncouple insurance fromprimary care for a very long
(19:11):
time.
There are thousands of doctorssaying that, but yet at levels
of bureaucracy that are at, youknow, in different
organizations, different levelsof the state, government, et
cetera, that is not the defaultyou know, thought process of how
do you do any healthcare withoutinsurance is not it's not the
default.
It is definitely being morefamiliar because people are
(19:33):
having to be creative.
But I think that yes, it is themillion dollar question because
if we could fix everythingtomorrow that would be
fantastic.
Unfortunately, too long, in myopinion, we have left this
pipeline of medical students andresidents to the, the wolves of
corporate medicine.
And like I was there in termsof, I was an employee, I didn't
(19:57):
know how to do anything else.
But when those are the onlythings that are presented to
you, you, you're only taughtcodes in residency and you're
only taught the insurancesystem.
It leaves, it, it's almost likea, a learned helplessness and.
When people like you and I arecoming to the table to have
conversations to try to fixthings definitely you've, you've
(20:19):
even taken a big, you've takenalready a big step in being a
part of a safety net.
Tell us about your affiliationwith Bija Clinic.
Dr. Emily Holt (20:27):
Yes, I'm really excited about this.
So, Dr.
Byron Jasper, who is a DPCphysician in Baton Rouge, and he
somehow figured out how to alsostart a nonprofit Baja.
And he brought me on literallyas recently as a couple weeks
ago as an affiliate to his DPC.
(20:49):
And what, what I understand andwhat I, the MOU that I signed
said is that I, as an affiliatecan benefit from programs that
are accessible to his nonprofit.
Mm-hmm.
Like for example, i'm nowconnected with the public health
department, so I now have rapidpoint of care, h, hiv mm-hmm.
(21:12):
Syphilis and Hepatitis C teststhat I've, I can make available
to anybody.
And I also have access to his isit three 40 B pharmacy?
Mm-hmm.
Pricing.
Now the FQHCs in town also usethis pharmacy.
It's called Aveda.
And as I understand it, thelarger the pot or the larger the
(21:36):
nonprofit, the lower the pricesget Sure.
For the three 40 B pharmacy.
And so if currently I actuallydon't know if, if Dr.
Jasper has other affiliates.
I think he does.
I think he has three otheraffiliates.
Okay.
But you know, as long as all ofus are still quite young in our
businesses and we don't have.
(21:56):
Thousands of patients like the,these FQHCs do.
The, the three 40 B pricingisn't gonna look exactly like it
would for an FQHC, but the morewe grow together, the better the
prices get, essentially for ourpatients at the pharmacy.
And the more we're able to helpother patients mm-hmm.
(22:17):
Who are in need.
Yeah.
And so that's one of certainlyBaja is mission driven.
Absolutely.
And, I really respect that andit's what I, what was, what I
was drawn to when Dr.
Jasper was talking to me aboutit.
And so one of the things that hecan do with Baja is any sort of
donations to Baja or the themoney that comes from the three
(22:39):
40 B pharmacy can be used anddistributed to affiliates for
things like paying formemberships for patients who
can't afford the, the, themembership fee.
Which is really exciting.
Yeah.
Dr. Maryal Concepcion (22:52):
And I, I think it's, I, I love that we're
talking about this.
I love that we're together justbrainstorming as a movement, how
to fill in these gaps, becausethey're gonna get larger and
larger, especially for thecommunities who are in the most
need.
And that doesn't matter whatyour, what state you're in, it's
literally going to happen toevery community, urban, rural,
et cetera.
(23:13):
So I'm wondering in terms ofwhen you were mentioning, you
talked with an FQHC, what are,do they understand what DPC is
or what is the conversation interms of you educating them
about what DPC is?
Because I think this is helpfulfor people who are.
We're on one side of the, thecommunity.
(23:33):
We're always talking DPC, andthere's clearly other people in
the, you know, and not the DBCcommunity yet who are speaking,
but we only know how to doinsurance.
So how are you speaking and howare you educating people who are
not always in the DPC space,like yourself and myself?
Sure.
Well, I
Dr. Emily Holt (23:54):
first they feel out what they do know.
Mm-hmm.
Because it's really.
I guess it's not astonishingbecause this was me maybe four
or five years ago.
I didn't know what DPC was.
I didn't have a clue that waseven something that could be
possible.
Sure.
And then with the FQHC, it'sclear that they know very little
(24:14):
about the model.
And they're so entrenched inthe, you know, of course,'cause
they have to be, how to pay forhealthcare using government
funding.
And obviously also commercialhealth plans.
And so they are very entrenchedin the mechanics of using
insurance and government plansto pay for healthcare.
(24:35):
Yeah.
So, you know, as my husbandnoted, there were 12 people at
the table in our Zoom call andprobably 11 of them did not
practice patient clinicalmedicine.
Yeah.
They were administrators andthat, and that's not a.
Knock on them at all.
Like that's the system that theyhad to set up in order to
(24:55):
service thousands and thousandsof patients.
And thank goodness for them.
Yeah.
Because otherwise those patientswouldn't get any care.
Dr. Maryal Concepcion (25:04):
Yeah.
Dr. Emily Holt (25:05):
But it's a very, very different model mm-hmm.
Than DPC.
And so they, you know, theystart asking out just extremely
basic questions like how do youeven get patients?
How do you market to them?
How do they know you exist?
You know, what do they do?
What do you do after hours?
And it's like exactly the samequestions that I asked.
(25:25):
Yeah.
When I started mulling this overin my head and I'm like, wait,
what is this beast?
Dr. Maryal Concepcion (25:31):
I've never seen this before.
Yeah, it totally, and you know,it, it's so interesting'cause
that's exactly what I wasthinking when you were saying
that just now is like, wow,where did those questions sound?
Where do they, how come Itsounds familiar.
And I have also have been inthis place of like, oh, like.
This is a real thing.
I remember going to my firstsummit only because somebody
(25:52):
told me to, and I had zero ideawhat DVC actually was.
And so this is fascinating.
And I I, it, it's exciting toothat more people are, it's
unfortunate that they're beingforced to look into another way,
but it's like, what a time to beinnovative.
And going back to how youmentioned creative ways to
offer.
(26:13):
Your DPC offerings to differentpeople in the community.
I'm wondering, are you guyscoming together as you know, the
region within Louisiana to havemore of these conversations?
Louisiana's a state.
Where are you guys in terms ofwho in the DPC community in
Louisiana is coming to the tableto try and brainstorm with
(26:34):
people who are not yet in theDPC space?
Dr. Emily Holt (26:37):
Yes.
So that's actually also been areally exciting.
Sort of recent movement in, inLouisiana, there's a handful of
DPCs, many of whom have beenopen for over, I would say six
or eight years mm-hmm.
Who are coming together andforming a coalition.
Dr. Maryal Concepcion (26:55):
Mm-hmm.
Dr. Emily Holt (26:56):
We've already kind of all met for dinner
together and had a good time inBaton Rouge and met each other
in person.
I don't necessarily know thateverybody wants to be part of a
coalition.
Sure.
Everyone's in different placesin their practice and their
lives right now, but there'sdefinitely a handful of people
who are, are looking to start aLouisiana coalition.
(27:18):
Mm-hmm.
And getting that movement goingwith the networking.
I met a handful, you know, theDPC summit 2025 was in New
Orleans this past weekend.
Yeah.
And, and I, and I met a coupledoc private practice doctors who
were from Metairie, who was asub, that's a suburb of New
Orleans.
And they were dp, DPC, curious.
And so we're sort of envelopingthem Yeah.
(27:40):
Under our wing at the same time.
And I don't really, I don't knowwhere it's going, but just
having.
The fellowship in the firstplace has been really, really
fantastic.
I've learned so much from theLouisiana doctors who came
before me, and it has been sucha privilege to, to speak to them
and work with them and learnfrom them.
(28:02):
And I just, it makes me want topay it forward.
Yeah.
That's awesome.
And I
think
Dr. Maryal Concepcion (28:05):
that that is, that is literally getting
at, you know, what we enjoy withour patients, having a
relationship with them when wehave a relationship amongst our
own community.
That's so powerful because then,you know, even just by talking
out about something like, youknow, oh man, I'm really
struggling with accessinglidocaine or whatever it is, you
(28:26):
don't know.
Just same as as when I talk onthe podcast and then somebody
randomly will say like, oh, Iheard that and it made me move
to this different state and opena DBC.
Like, we never know who we'regonna meet or talk to, but when
it comes to.
Working together with all of ourdifferent experiences, I think
that there is always going to bepower in community and coming
(28:48):
together to move forwardtogether for the community.
So I think that's fantastic thatyou guys are, you know, even
looking at how do we worktogether.
And I I will say that this issomething that J Keith said the
DBC coalition echoed thisweekend is that even though now
the HSA legislation has passedthe Primary Care Enhancement
Act, this is where the workreally happens because as more
(29:11):
people are going to be impactedby losing healthcare, as more
physicians are going to bereplaced by non-physician
providers, as more access pointsphysically are going to close,
and more people are going tolook into DPC because of
whatever reason, includingnecessity.
This is where we have to speakup, in my opinion to make sure
(29:34):
we do not rebuild a system thatwe are have just left.
Dr. Emily Holt (29:38):
Mm-hmm.
Yes, absolutely.
And then to speak a little bitmore to that in terms of the
physician empowerment andleadership.
Being as important as it is inthis day and age, I am one of
the they're called clusterleaders of the reproductive
health access projects.
So I'm one of the colu leadersin Louisiana.
(29:59):
Given that it's a, a veryrestrictive state for women's
rights, it's actually quite apropo to call us a cluster.
But we, we are currently in theprocess of setting up.
A group.
Mm-hmm.
Sort of, I don't wanna call it aproject, but a meet and greet
almost with the emergencymedicine, reproductive health
(30:20):
access project.
Because as physicians indifferent specialties and people
who care about, in thisparticular circumstance, it's
gonna be women's health or humanrights when it comes to those
who menstruate.
Or bear children.
Mm-hmm.
You know, we have got to reachout to whoever we can to help
(30:43):
each other.
Mm-hmm.
And that's not something I'veever seen before.
And I am, I consider myselfsomebody who's really been in
the advocacy space for a longtime.
And so maybe that's a, a silverlining.
You know, family medicines andemergency family medicine
doctors and emergency medicinedoctors coming together to
(31:06):
strategize.
Absolutely.
'cause we need all hands on deckright
Dr. Maryal Concepcion (31:09):
now.
Dr. Emily Holt (31:09):
Yep,
Dr. Maryal Concepcion (31:09):
a hundred percent.
And I will say here that ifadvocating for our profession,
advocating for our patients,advocating for human rights,
access to healthcare, all of thethings, if that.
If that, you know, really makesyou fired up as you're hearing
this, I definitely would saytalk to your, you know, your
colleague in DPC.
(31:30):
See how, if they've advocated,where have they gone?
Local Chamber of Commerce, citycouncil, state, federal where,
because I will say that ingeneral, whether it be local or
whether it be federal, I, I willsay that one of the things to
keep in mind is that.
DPC has always been bipartisanand it remains so in this.
(31:54):
Time of extreme divisiveness andwhere we can advocate is
literally telling about howwe're delivering care to
patients, not how we'redelivering care with religious
beliefs or politicalaffiliation, but literally this
is the access and quality ofcare that I can deliver to my
patient that I have arelationship with over time.
(32:15):
And that is.
Quite powerful.
And so I say that because evenbefore we started recording,
that was a concern that I washearing is that how do you
advocate if, you know, medicallywe don't all agree, we're not
talking about how we can cometogether, put our heads together
to.
Ensure ways of people accessinghealthcare and not health
(32:37):
insurance.
thank you so much.
It, It's so wonderful and justfulfilling to know that there is
a doctor out there like you whohas literally followed her work
and her mission and making surethat they tie together at all
times.
So thank you so much for whatyou do and I'm so excited for
everyone to hear this.
(32:58):
Thank you.
Thank you.
You as well.
I really appreciate you.
Thanks for tuning in to My DPCStory.
If this episode inspired you,please leave a five star review
on Apple Podcasts.
It helps more physicians findthese stories when they need
them the most.
If you're new to DPC, you'rejust beginning your journey.
Head to the Start Here age@mydpcstory.com.
(33:19):
I've put together a practicalstartup guide and highlighted
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Go to the Contact Pagemydpcstory.com and leave me a
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(33:41):
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Until next time, this is MaryalConcepcion.
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