Finding Her Lionheart: Dr. Maria Rutmann’s DPC Pediatric Practice in Rural Maine

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Maryal Concepcion (01:18):
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.

(01:39):
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

(02:02):
care.

Dr. Maria Rutmann (02:06):
you can do this, no doubt in my mind, you
can do this.
Will it be easy?
No.
You're gonna have doubt and it'sgonna be challenging, and you're
gonna have to troubleshoot my,you might have to make some
sacrifices along the way, butyou can absolutely do this.
You made it through medicalschool, you made it through
residency.
You may have made it throughfellowship.
You are a smart, capableindividual.

(02:28):
And I would encourage everybodyto just really hone in on their
internal fortitude that perhapshas been quieted down, whipped
out of them, perhaps because ofthe demands on the system.
I would encourage everybody todig down inside to their sense

(02:49):
of purpose.
I really strongly believe thatwe are all, no matter what you
do, you can be a CEO, you can bea janitor.
It doesn't matter if you'redoing your job well, honorably,
honestly, you are contributingto the world in, in ways that we
might not even understand,right?
Like it's a, that, that rippleeffect your patients need, you,

(03:12):
your community needs you, youcan't pour from an empty cup.
You will be a better doctorbecause of it.
So absolutely find that roarwithin you.
You can do this.
No doubt in my mind, anybodycan, we all have to lean in into
our own strengths, delegate whatis not our strengths, but you

(03:32):
have something to bring to thetable.
Everybody does.
You absolutely can do this.
I'm Dr.
Maria Rutman of Lionheart DirectPrimary Care, and this is my DPC
story.

Dr.
Maria Rutmann was born inVenezuela and completed her
medical education at the CentralUniversity of Venezuela or UCV
in 2011 at pediatric residencyat Miami Children's Hospital.
Now Nicholas Children's Hospitalin 2014 after residency, Dr.
Rutman made the beautiful stateof Maine her home quickly
falling in love with thepeacefulness of the county and

(04:10):
its kind, hardworking, tightlyknit community.
Also falling in love with oneMainer in particular her.
Husband Lee Smith As a mother oftwo young children, she
understands the challenges thatcome with raising happy, healthy
children and treats each of herpatients as if they were her own
outside of her medical practice.
Dr.
Rutman is an avid scuba diver,swimmer and non-fiction reader.

(04:31):
She has an interest in interiordesign and is currently learning
German and has the cutest clinicdoors known to mankind.
Welcome to the podcast, Dr.
Rutman.

Hi Marielle.
Thank you for having me.

This is such a treat.
It was so awesome meeting youfor the first time in person in
New Orleans and then it was suchan even bigger treat when we got
to meet each other again inMaine for dinner.
So this is such a treat and it'sjust a call out out there to
people If there are DPC doctorsaround you or if you're gonna
be, flying somewhere wherethere's DC doctors around you

(05:07):
call people up.
It's just so wonderful,especially this time of year to
be around, family and be aroundpeople who are supportive and
people who are like, oh my gosh,guess what I did in my clinic?
And it just makes you so excitedto hear other people's stories.
So, getting into Dr.
Ruttman's story, I would love ifyou could start us off with

(05:28):
where do you live, because whenI said in your bio the county as
a Californian, I had no ideawhat that meant and then I
learned about it when you andDr.
And Doctors Lucas were tellingme about what the county is in
the state of Maine.

So I'm in northern Maine, the northern
most part of the continental us.
I'm not from there.
I married a county boy.
So, it's, it's home now.
But I grew up in Venezuela, soit was it's a big change.
I've lived in Miami, I've livedto New York and I feel like I
keep going up north and I'mgonna end up, up there in the
North Pole with Santa

Good time of year for that though, so.
Oh my gosh.
Yeah.
I mean,

well,

we're used to the snow and the cold,
so just bring it, right?
Yeah.
And.
In terms of Maine, just for,just for clarity for the
audience, especially if you'reme and you have you, you're
state centric on your geographyand that's not the state of
Maine.
Maine is freaking huge.
Can tell us about how huge itis.
'cause I was like, what?
It's New England.
Whatcha talking about?

(06:27):
What?
So you guys were educating me onthe state of Maine and so I, I
really wanna set the scene for,what, what the state is like.
And then let's talk about accessto healthcare.

Yeah, so Maine is massive.
People think of it as a verysmall state, but actually
driving from Portland, forexample downstate to where I am,
it's a good four and a half hourdrive, and I still have about an
hour and a half north beyondwhere I am to reach Canada.
But you know, healthcare is abit of a desert here in a way.

(06:59):
So my town in Presca, we serve Idon't even know, but it's a huge
radius.
I have patients that will drivedown an hour and a half.
To see me.
And the same with PE people thatare like an hour and a half
south of where I am.
The closest like biggest centerthat I have as a referral center
is Bangor, and that's smack inthe middle of the state, and
that's a two and a half hourdrive.

something I wanna call out here too is
that you are a DPC pediatricianin particular.
And we're at a time when DPCI,I, I have said this throughout
the whole like existence of myDPC story, but we are always at
a time where DPC is, is wantedand needed and even in Presca.
Talk to us about your, yourpediatric population because

(07:40):
like here in Arnold, we're anhour and a half from the nearest
nicu.
But like I think about everytime I go to a school
production, I'm like, there's alot of kids up here.
There's like multipleelementaries, not as many as
Sacramento, but there's multipleelementaries and I think about
not all these kids are part ofthe practice yet.
Like where are they going forhealthcare after January?

(08:00):
So, for your population being,within four hours of both Bangor
and Portland, I'm just wonderingwhat do patients have to access
in between all of those

spaces?
It's been certainly challenging.
So I've been in the area forapproximately eight years and in
the time that I've been here,I've seen many smaller practices
and surrounding towns close.
So right now we're basicallydown to two, decent sized
groups, my old group and, thetwo bigger hospitals in the
area, I guess.

(08:34):
And that particular group hassurvived over the years,
primarily with Locums.
So it is very challenging.
But precisely because of that, Isaw an opportunity because like
you said, where are these kidsgonna go?
Right?
And, and there's noalternatives.
Like DPCI, I believe is afantastic option, but, it might
not be the option for everybodyand that's okay.
But, but families can choosewhen there's diversity of

(08:57):
options.

Dr. Maryal Concepci (08:58):
Absolutely.
And I, we will definitely getinto the personalization of your
practice and your delivery ofcare to your patients, but I, I
think about that is so true.
It's not for everybody, but forthe people who have joined on
your practice, I am so glad thatthey probably have, a completely
different outlook on whathealthcare access is now.

(09:21):
And I'm wondering if you cangive us some examples of
comments you've heard fromfamilies about DPC is I won't go
back because Dr.
Rutman did this for me, or, as amember of Lionheart I
experienced this.

It's, it's been a wild ride.
It's been so rewarding andfulfilling to see people receive
it so well.
So oh, so many stories come tomind, but, but here's, here's
what fuels me is that being asmall community, I know the bulk
of my families, these are notstrangers that I'm seeing,
right?
They are my kids' classmates.
They are kids of friends ofmine.

(09:57):
They are my baggers of thegrocery store.
So providing a certain level ofcare is.
It really is a almost like aduty to me.
It, it really fuels a differentlevel of, of purpose for me.
Because you're, you're not in abig city.
It's not anonymous.
These are people that I'm seeingall the time, right?
So I, I really just wanna do thevery best that I can for them.

(10:21):
So, for example simple thingssimple stories.
So many come to mind.
I think people are really,really valuing the convenience.
So I had a mom that was blownaway, just this was a couple of
days after opening because shegot up at 5:00 AM The kid had
been coughing the whole night.
She decides, oh, I'm gonna takehim in.
Suddenly she remembers, oh,there's an app.
So she just self scheduled anappointment.

(10:43):
I saw the kiddo by the time itwas like nine 30.
They had an antibiotic at handby 10 and out they went out the
door and they had a really busyweekend coming up.
So she was like, this would'vebeen a whole ordeal in
traditional practices.
'cause now you're.
Calling being placed on hold.
Sometimes you get the busysignal, they don't call you
back, and sometimes you waste afull day just trying to get an

(11:04):
appointment.
And this is a busy mom, like sheworks a full-time job.
So she was super appreciative ofthat.
I've also had situations of likeafter hours, stuff that we can
troubleshoot via text and peopledon't have to go to the walk-in
clinic.
Simple things like colds orbigger things like I've already,
sutured and glued and stapledkiddos.
And again, they're not waitingthree hours in an ER and getting

(11:26):
a hefty bill.
So, families are absolutelyloving it.
Particularly the, theconvenience and the ability to
text me

for anything.
Amazing.
And I, I am laughing a littlebit here because having seen
your practice go from suppliesin your garage to, you know
what, what it is now, I'm like,I'm like, yes, she used the
staple remembers our like, it'sso good.
But I, I wanna ask here, becauseof you, not necessarily not
being from born and raised inMaine, but being born and raised

(11:56):
in Venezuela and then going toMiami and then going up north as
you described also Santa, likeif you need a, a remote DPC, I'm
sure you can get in with Dr.
Rutman, but, I, I think aboutwhat is it that drew you to the
county?
Because I think about there'speople who are like, I don't
ever see myself practicing inrural America, especially if

(12:17):
like you've seen places likeMiami.
So I'm wondering, what was itfor you that drew you to this
community that you are a part ofand that you are serving with
your practice now?

People are just incredible here.
They're kind, they watch eachother's back.
They're hardworking and honestand I, I've never seen anything
like it again.
I've always been a city girl.
So this sense of like we goteach other's back is, is really
incredible.
I remember when I was pregnantwith my son so many folks
dropped off meals and, peoplethat I, I knew, but I wouldn't

(12:53):
have expected that level ofdedication, or for example here,
there's a lot of farmers too.
And this summer there was agentleman whose combine caught
fire and within.
You had other farmers in in thearea, this one, cleared this and
that one, brought whatever theheck tractor, I don't know much
about it.
It's like a foreign language tome.
I'm still learning.
But the point is that theypulled together, they contained

(13:14):
the fire and were a significanthelp to the fire rescue
responder crew that was there.
And it's, it's just reallyinspiring.
But from a medical standpointtoo, I just love that in rural
settings you are just forced todo more for the patient.
And, and I like that challengebecause you have to be cognizant

(13:36):
that for any little specialistis, a two and a half, four hour
drive for a patient.
So I think we, we get topractice richer medicine in
rural settings.

That's so beautiful.
I love that.
And I feel it's another t-shirtthat needs to be made that rural
medicine is richer.
I love that.
when you were in Venezuela, whenyou were in medical school, did
you always wanna be apediatrician?

Honestly, no.
I, I'm so scattered.
I have many, many interests.
I think my first love wassurgery, but here's the problem.
I, I don't bounce outta bed at5:00 AM like my husband does.

(14:57):
So very quickly, I realized thatas much as I liked surgery it
was not going to be conducive toa healthy lifestyle for me.
But I had lots of interests.
I was the kind of student thatwent through every rotation,
just really, really likingeverything.
I fell in love actually withpediatric cardiology before I
fell in love with pediatrics.
And I, I've always worked withkids.
I was a summer camp counselor.
I, taught swimming lessons andall the things like, I've always

(15:20):
loved kids and how funny.
And how they surprise you withthe most random comments and you
just chuckle the whole day afteryou see them, right?
But but no pediatrics, actuallyI, I did it wanting to pursue
pediatric cardiology originally.

was it pediatric cardiology in
particular that drew you to theMiami program, which is now
Nicholas Children's Hospital?
Correct.
I

did, we, what was it, about a year and a half
worth of an observership therewith the cardiology team, which
was, they were nothing butwelcoming and amazing and
supportive.
I, I will forever be thankful toall my attendings there and the
nurses and fellows that I workedwith.
It was just an incredibleexperience.
But I was there for about a yearand a half while I was in

(16:04):
parallel taking like my stepsand stuff before I got into
residency.
So it was, it was amazing.

When you were in Miami, I can just
imagine that even though there'sa lot of specialists having.
Having a big center, you'reprobably gonna do a lot,
especially in the world ofpediatrics and even yes,
cardiology absolutely, likeyou're mentioning, but just the
amount of specialists that arethere.

(16:32):
You, you get exposure to a lotof things that you might have
interest in as well.
So I'm just wondering about whenyou went through residency, what
did, did you have the goal ofleaving Miami and did that
change how you approached, whichattendings you would rotate more
with, or, which, which rotationsdid you set specifically for

(16:56):
your externships?
I think about Dr.
Lauren Hughes saying how sheknew that she was gonna go into
her own practice after, so sheintentionally, networked with
attendings differently, knowingthat she would, want to connect
with these people after.
But she would also want to workthem, work her patients up as
well as they would beforecontacting them a, after she

(17:16):
opened her own practice.
So I'm just wondering what wasyour experience in terms of
designing your residency to beable to be an attending after?

Oh my goodness.
There's a lot of layers to thatquestion because I'll be
perfectly honest I shifted gearsmultiple times while I was in
training.
So I went in completely ahundred percent passionate about
cardiology in pediatrics,pediatric cardiology as a second
year match.
And I had gone to a couple ofconferences and met with a few
fellows, and I realized veryquickly that it was not only

(17:47):
competitive to get to, but moreconcerningly.
It was very hard to land a jobafter training.
And I got a serious amount ofcold feet to the point that I
withdrew from the match.
And then I was like, well, inparallel I was doing PICU and I
fell in love with picu.
I had very little exposure topicu as a medical student in
Venezuela.
So this was just like, oh mygosh, this is amazing.

(18:09):
I can do CICU and I'll justpivot and, and do that.
And then third year came aroundand that's when the, the PICU
match happened.
And for personal reasons at thetime I kind of shot myself in
the foot a little bit and onlyapplied to a couple of programs
and didn't get in.
And this still stinks to date,but you know what I don't mind

(18:30):
sharing it because sometimes inlife.
Sometimes, actually, oftentimesin life, the magic happens in
our hardest moments.
So it was in third yearresidency that because I didn't
get in into ICU, I shifted gearsand I said, well, I'll just do
primary care.
At the time I was on a J oneVisa.
I'm like, it's, it's gonna workout.

(18:50):
I'll just.
I was single.
I didn't have kids at the time.
I'm like, I'll just save money.
I'll go somewhere rural where Ican get rid of my waiver
requirement and also get topractice like again, richer
medicine.
And and then once I get that outof the way, I'll go back into
fellowship.
And it was a complete leap offaith to coming to Maine.

(19:10):
I didn't know a soul.
I just, I loved the group that Iwas with and I just felt a pull
in my heart to come here.
'cause I just felt at ease here.
I kind of wanted to experiencefour seasons and something
different than, than Miami.
Financially it makes sense too,again, because I wasn't in an
expensive city and saving was agoal of mine.
But fast forward, this was at apoint in my life that I was

(19:32):
like.
I am, I am done dating.
Like I'm so done.
This is just not for me.
And I was totally at peace withthe fact that it was just gonna
be me and my golden retrieversbecause I'm not a cat lady.
And and what ended up happeningis that a week after I moved
here, I met my husband and fourmonths later he's proposing.
And I will take that what felt,I guess at the time, as a

(19:56):
failure of not getting into ICUany day because it, got flipped
it.
And it, it has now been thebiggest blessing because I would
not have my husband and my kidsand this practice and all the
life that we've built here inthe last eight years had it not
been for that.
So, it still hurts a little bit,but I'm, I'm thankful it, it was

(20:19):
a blessing.

I'm so grateful that you shared that.
But also I think about how.
You, you talk about the matchand we are, we're all familiar
with, people in our classes,friends that we know who had to
scramble.
But I think about even in thistime in medicine, people are
losing their jobs.

(20:41):
Just like my husband wasreplaced by a non-physician
model.
So it's I just, I, I think it'sso great that you shared because
just that the idea of when, whenstuff hits the fan and you're
like, this is the worst ever.
But it's as you shared the, thepresent, it's like the past
eight years have been onlybecause.
This, this really like heart,like this thing that hurts still

(21:04):
to this day happened, butwithout that happening, you
couldn't have had what you havenow.
And I think that I, I, I, I saythat especially to those doctors
who may have been replaced bynurse practitioner, may have
been told that like their jobsgetting eliminated because of
lack of funding or whatever itis.
But just know that like you'restill doctor, whatever your last

(21:26):
name is, and that doesn't changewhether you're employed or not.
And I will say that it, itsounds a little pollyannish to
just like.
Echo what you said.
And it wouldn't have hap yourlife wouldn't have happened had
that not happened.
But you know, I I am, I am withyou.
And that things happen for areason.
And if it sucks so bad thatyou're like, I, I don't know how

(21:51):
to get out of this mind spaceof, I, I I, I don't see the
purpose in what just happened tome.
If you feel devalued, pleasecall a DPC doctor who is near
you in another state practicingin the same specialty.
Just because we can see thingson the other side that we
couldn't when we're in the thickof it.

(22:13):
And so if you are listening,yeah.
If you are listening, you are sovalued.
And I, I, I think that, that,that is so necessary to hear in
this time where PE and VC arereally impacting healthcare
continually, even I mean to thepoint now where especially kids

(22:33):
and people on Medicaid andMedi-Cal are gonna be suffering.
So, with that, I, I wanna askyou about then your experience
with your group because, your,your group definitely was a, it
was a fee for service group, butI'm wondering if you could tell
us your experience there andwhat was it that made you

(22:54):
transition into Lionheart DPC?

So, my group was really phenomenal.
The whole time that I was there,I really enjoyed it.
So, I was in a group of six Ifor service, hospital-based,
inpatient outpatient model.
The group was always fantastic.
You had different personalitiesand different styles, but at the

(23:55):
end of the day, everybody wouldkind of get to the same
conclusion and outcomes.
So clinically, we all trustedeach other and parents just kind
of gravitated to whoever theyfelt the most comfortable with.
And it always worked out great.
My issue has never been thegroup but the reality is that
the job changed and morphedquite a bit.
And in the eight years thatI've, I've, I was here and it

(24:17):
kind of reminds me of that,story of if you put a frog in
boiling water, it jumps out.
But if you put it in lukewarmwater and you gradually turn up
the temperature, eventually it,it doesn't jump out and
eventually it dies kind ofthing.
That, that's, I felt like kindof was happening with how
medicine was changing.
And, and not just because ofthe, my hospital, but that's
just the landscape of medicinecurrently, but I just felt like

(24:38):
we were losing autonomy andbasic things like scheduling
appointments were gettingshorter.
We were seeing down thepipeline, people retiring or
needing to grow the practiceagain.
I mentioned that.
And a few other practices in thearea were closing and
recruitment was justextraordinarily difficult.
So, all of it compounded.

(25:00):
My hospital also went through abig merger a few years after I,
I came then you had the pandemicand I mean, the temperature was
just rising really quickly forme.
And I, I think it boiled down toyes, moral injury.
But largely because asphysicians we have all the
responsibility.

(25:20):
And none of the autonomy.
So I, you can't practice thatway.
Like you gotta give me somelevel of leeway to say, Hey, I
need more time with thispatient, or this process isn't
working, or this metric doesn'tmake sense.
Why are we chasing this?
Or, okay, I understand that wehave to chase it for financial
reasons, however we're doing thework and not getting, not

(25:41):
getting it credited.
So can we fix whatever'shappening in the background?
And it, it gets exhausting towork that way.

And I'm just wondering when,'cause it,
that's another beautifulstatement.
We have all the responsibilitybut not the autonomy to achieve
that.
What were some of the thingsthat you tried to make changes
in your, in your group?
Especially because you justexplained that there was a

(26:09):
merger that had happened.
Because I'm wondering if therewas an example of how the
autonomy became even less afterthe merger?

Yes, for sure.
So when I came here our ruralhospital was kind of its own
little thing, you know, Iremember interviewing with the
CEO and after the merger,everything was getting dictated
by downstate in an effort tostandardize and, consolidate.
And I, I mean, I understand itfrom a business perspective, but
you, you have to also from abusiness standpoint understand

(26:42):
that the county is a verydifferent thing then?
Eastern Maine Medical Center inBangor.
And so I wouldn't say that itwas just me.
I feel like our group as awhole, we were really trying to
convey like, we need access.
If you don't want our patientsto end up at the walk-in clinic
or in the ER plugging up aneight bed er that's staffed with
one physician at nighttime.

(27:04):
We need to be able to fit peoplein the same day.
And, and that was just gettingharder to do again, for a mix of
things, administrationrequirements and managing higher
volumes and shorter visits, etcetera.
So it's just, it's just not onething.
Right.
It's,

it's all of it.
Absolutely.
And as you described thetemperature getting hotter,
what, at what point did you say,this is, this is not the way
that I can continue goingforward in my medical career?

Well, I can't look back at one particular
instance, but.
In general, it was a feel ofthis is bleeding into my home
life.
I was coming home feeling likemashed potatoes.
I have two toddlers and I wasjust like sitting on the couch.
They're just like, I don't evenhave the energy to play right
now.
Dinner, what, what?
I have to make dinner.
I was just like not functionalat home.

(27:58):
And I am generally a pretty.
Upbeat positive person.
I don't consider myself to beespecially moody.
And I found myself just likeborderline depressed.
And it was, when day after daymy husband would come in, Hey,
how was your day?
And I'm like kind of like eor.
I'm like this he's gonna starthating me.

(28:19):
What is happening?
That's on the personal side.
On the, on the patient side or,or the practice side.
I think what really broke me waswhen we went to all 20 minute
appointments, with the exceptionof three for the day.
Which honestly at that pointyou're running so behind and you
got so much inbox work to dothat it's all the same.
But in parallel with they tookout away our scribes.

(28:41):
So, that was, that was just apunch in the gut because how,
how do you do more with lessconstantly, right?
Yeah.

Yeah.
And.
That's so real.
And I'm guessing that they're,that the listeners are
translating that into their ownexperience, what they've seen
and been through in their ownpractices.
Like how do you do more withless, less time, less resources?
That's so ridiculous when youtalk about the scribes being

(29:11):
taken away.
I think about that in thehospital when we were practicing
in fee for service the hospitalprovided scribes and billers and
coders, but for the outpatientdoctors, if you would like that,
absolutely you can have it.
You have to pay for it yourself.
But but if you're a hospitaldoctor, then we can, we'll help
you out.
It just, it's, it's so, it's soridiculous and especially when
we think about what we, you andI are doing now in that it's

(29:35):
totally opposite of the way thatour practices have been created
and built and the way that we'reflourishing now.
When you were in this place of,I'm feeling.
Work in affecting home life.
The practice itself is just nottenable to the quality of care I
wanna deliver.
How did you start learning aboutother ways of practicing and had

(29:58):
you heard about DPC first orwere you ever thinking about
your own private practice in feefor service?

Well, for start, I, I might choke up here
'cause this, this is, this isamazing.
It was you, it was because ofyou.
And never in my wildest dreamshad you asked me a year ago,
would I've ever imagined that Iwas going to be sharing my story
on my DPC story because it wasactually my husband who's very
much an outside of the boxthinker.

(30:25):
He found your podcast and hesent a link to me and he said,
Hey, check this out.
Have you heard about DPC?
And I hadn't, to be honest.
Or at least not.
Like really tried to wrap myhead around the model and I
think I said this to you when wemet, but it's, this is really
full circle, but it, it was youand and this, the episode was so
compelling and I remember just,reading a little bit online

(30:48):
after that.
And then fast forward, what Idid is I took a few days off.
For staycation and I bought theon demand DPC summit from 2024,
and I just sat there with mycomputer for a few days and did
the whole conference right at myliving room.
And I think it was like three orfour days maybe.
And then by the end of it I waslike, I'm doing this, I'm doing

(31:10):
this.
There's no question this ishappening.
And this was back in October,2024.
And so from October throughlet's see, like February, March,
I was just like planning.
And then, after work every day Iwould just chip away, start it
with, by the domain and pick aname and get a logo and meet

(31:30):
with the lawyer, set up thebusiness and, get a fax number
and da, da, da.
All the little things.
And finally gave my resignationletter.
What was I, I think it wasFebruary in the hospital.
I got done in May.
And all through the summer, Ijust worked full-time in the
clinic.
So our our space, I absolutelylove it.
I poured my heart and soul intoit.

(31:52):
I love interior design and Ireally wanted a space that
conveyed.
A sense of peace a sense ofwelcome, that people would walk
in and immediately like theirblood pressure would lower.
And, and I think we've achievedthat.
It's very rewarding, but, but itwas a complete gut job.
I mean, this place was a mess,and mind you, in rural Maine.
And there's not a whole lot ofcommercial options.

(32:12):
So this was a complete gut job.
And so I, during the summer, Ibasically GCed the project which
I'm, I'm thankful that I had theluxury to take that time off,
both for the practical needs ofgce, eing the job, but also
because I, I really needed toheal.
It was so amazing to just spendthe summer with my kids and feel

(32:33):
human again.
And, and I, I think asphysicians, we are wired to pour
into others constantly.
We're not very good about takingcare of each other ourselves.
And that was.
Really eyeopening to me.
I guess I, I, I hadn't realizedhow stressed, how flat, how numb
I was until I just, I don't needto sound dramatic, but I, I felt

(32:57):
like coming back to life andbeing myself again during the
summer.
And we opened in September.

Dr. Maryal Concepcio (33:03):
Beautiful.
And I just think about and I'malso cheating'cause I can see
you as we're talking, but it'slike you have a picture of a
lion behind you and I justknowing that your practice is
lionheart, DPC, it just, andyes, I worked at a zoo for eight
years, so I can technically hearJohn the lion like doing his
thing in the morning andshouting.
But it's I, I mean, you, you.

(33:26):
Recognized where you were, yourecognized that mashed potatoes
is not a great feeling to befeeling when you go home and you
like, you just went at it whenit comes to watching these
summit recordings, listening topodcasts, connecting with
people, and so Lionheart, justfrom your story is so

(33:46):
representative.
I can, I can, it's just, it's soi'm just gonna keep going and
I'm gonna roar and go do yes, dowhat I need to do and be me.
And, but I'm wondering at, atwhat point did you choose that
name?
And because I'm thinking withother people out there, you
don't have to have, my name,medical clinic or whatever, it's

(34:07):
like you can have the autonomyeven with the branding and the
naming of your practice.
So how did you choose Lionheart?
Well, that, I'm

glad you asked'cause I love the name.
So it's, it's multiple layers.
It, so I'm Christian and it wasreally, I, I, so I started out
trying to figure out names,something related to Maine and I
was coming up with nothingcouldn't really land one that I
was in love.
And, and I remember thatafternoon, I was, I just okay,

(34:36):
I'm just gonna think aboutsomething else.
And I sat down to do my Biblestudy and suddenly it was like
lying.

Like lion?

Yes.
Lion lionheart.
This is, yes, this is perfect.
I don't know, I startedbrainstorming, but to backtrack
a little bit it resonated withme because the lion symbolizes
courage.
And I think I needed that at thetime to step in into a different
model.
But patients also needed to stepinto a different model
themselves.
I.

(35:05):
I'm inspired by Lions.
How in the wild, like they'revery strategic together.
When they hunt, for example,they take care of the young
together.
They're a community basedanimal.
And that's again, something thatresonated with me because that's
what I'm trying to build withinthe clinic is community and
trust and partnership.
There's also, little storiesthat for example, one of my very

(35:28):
first patients in in the area,he was about two when I started
seeing him.
And I remember checking his earsand I was like, Hey, there's a
little lion in here.
And he got the biggest kick outof that and he is now 10 years
old.
And that young man, every timethat I see him, every time
Marielle, he asks, is the linestill in there?
Is the line still in there?

(35:49):
So to me, the line also, it's soprecious.
Yes, it was just representativeof that relationship built over
years and that trust.
And I've had, this particularfamily, I, I can think of many
things that we've gone through.
That trust was just a keycomponent of the outcome.
And so the lion symbolized allof these things, but, but first

(36:10):
and foremost, just, just faithand, and, and praying about,
praying for courage to dosomething different and do it
well and, and trust that there'sa bigger purpose for it.
And, and I found it in DPCbecause I can take care of my
patients better.
I really can provide betterwholesome care for people in a

(37:05):
way that would, it is justimpossible in fee for service.

Incredible.
And I will call out here, thatcourage, I very much manifested
in the best business cards ever,and I, which I still have yours.
It is Dr.
Rutman gives me her businesscard, and she's this is, this is
a thick business card.
It's like super professional andlike you hadn't even finished
gutting your clinic.
You stu your stuff in thegarage, but you I, I, I, I

(37:32):
wanna, I ask here like, why abusiness card?
Why did you make the businesscard like you did?
Because you didn't have yourdoors open yet.
And but it was still okay tohave a business card and start
making claim to your future.

Yeah.
That's so funny.
So the, the practicality of thebusiness card itself was a, a
recommendation from a goodfriend of ours who's a, a very
successful real estate agent.
And she was like, get thethickest ones that you can get
because people feel bad throwingthem away.
I love Jane.
She was actually the one thatintroduced me and my husband.
So, she's, she's pretty amazing.

(38:06):
But then as far as, yeah, Iwasn't ready, but, but I was
ready, like it was happeningand, and I think sometimes we
tend to focus so much on thefinish line that we discredit
all that we're accomplishingalong the way.
And in my heart, even thoughthings were still in the garage

(38:27):
I could see it clear as day inmy heart and in my mind, like
to, to the littlest detail, likewhere I have like stickers on my
reception area and the examrooms.
It was in my heart and in mymind it was so clear.
So.
It, it was just, yeah, thatlittle card was just symbolic of
what was to come.

And it's so beautiful and I, I hope that,
especially for the listeners whoare in this moment of whatever,
but they're thinking about DBCor planning DBC or even if
you're going through rebranding,I will say that too.
Like the idea that you justshared that it's like you were
ready.
Like that, that is notdetermined by, if you have

(39:08):
everything to this point openand you're ready to see your
first patient in person in yourphysical space, you might not
have a physical space, but likewhen you are, this is what I'm
going to do in your head.
Mm-hmm.
You deserve to have a businesscard.
You deserve to have yourwebsite, you deserve to have
your social media handle.
Those are things that are, it's,it, it's, it's healing for our

(39:30):
souls.
In that, we are literally.
These things reclaiming autonomythat we should never have lost
in medicine.

A hundred percent.
And we are also very, tend to bevery goal oriented result driven
folk.
And going back to the businesscard is silly, but I remember
when I finally got them afterprinting, I ordered them on, on
Canva actually.
And, it was just a simple littlebusiness card, but it
represented so much because atthat point the website was up

(40:01):
and running.
The fax number had beenselected, which in which was
linked to my EMR.
So like my EMR was ready to go.
I had a physical space.
I had the logo, I had thebusiness, I had my color scheme,
I had pictures taken.
I had open social mediaaccounts, which I, I don't love
social media.
That was a pain in the butt toput social media accounts and

(40:22):
get them up and running.
Like it was all these littlethings.
And it was, I felt so proud.
'cause it's like I am makingprogress.
I'm getting traction.
It felt amazing.

Absolutely.
And I, I've loved, seeingprogress in visual pictures,
like throughout your journey sofar.
But I have to now, I have to nowcall out what I mentioned in
your bio, the world's cutestdoors ever, because you talk
about community and you talkabout, having the sense of being
together.
I mean, to the point of evenboth parents and kids have their

(40:55):
own doorways.
Tell us more, please.

So when I started just daydreaming about
the space, I really wanted it tobe child friendly and have it
just be fun, I thought about,oh, do I put like this fun
little play area in the waitingroom?
And then, well, I got here.
Well, okay, the waiting room's agood size, but it's not that
big, so I can't do that.
And I, I remember checking onPinterest and I saw this

(41:21):
playroom with the doors.
I was like, oh, wouldn't this beamazing?
And I ended up connecting with avery, very talented, gentleman
who did the doors custom madehere, and they're solid maple.
They go perfectly with ourdesign.
But when I met with him thefirst time and I showed him the
picture, I'm like, can you pullthis off?

(41:41):
So it's like a little four footdoor in, inside the, the big
door.
And you could just see thecreative spark in his eye.
He was like, oh yeah, this isgonna be fun.
And immediately he's likeclearing his desk, starting to
draw stuff.
So it was, it was just reallyfun.
But it was symbolic of, how do Isay this?
It was like just a visualrepresentation of of just having
a space that's fun and for thekids.

(42:03):
It's, it's not the other wayaround.
Oh, we're gonna repurpose thisspace and I guess we'll throw
pediatrics in there.
No, it's I want my patients tofeel at ease when they come
here.
And sure enough, when I had myopen house and I had the first
few patients come into theclinic and they went through the
little doors, I, I teared upbecause the sense of joy in
those kids' eyes, they've neverseen anything like it.

(42:25):
They were having so much fun andnow, like they're not scared to
come here.
They I had a good complimentfrom a mom not too long ago.
I was actually taking care of alaceration for their little guy.
And he's hurt.
He's like legitimately hurt.
And the mom goes he was bawlinghis little eyes out.
And the minute that I said,we're going to see Maria, he

(42:45):
stopped crying.
He was looking forward to it.
He was excited.
I was like.
That's amazing.
That's, that's perfect.
That's exactly what I'm shootingfor.
Oh, and get this, you're gonnalove this.
'cause I'm all about likesymbolism and stuff.
So I went to pick up the colorfor the the doors and, and the
gentleman that was doing them hegoes, I can do lacquer.
Just go to, whatever hardwarestore and get any color.

(43:06):
Sherwin Williams, BenjaminMoore, I don't care.
Get whatever I can do any.
So I went over and, they havethe big wall with all the
samples and I'm like, oh, thisdark teal, this is perfect.
Teal's my favorite color.
It's the color of our logo.
I pulled it out.
You wanna know what the name ofthe color was?
You Venezuelan CI was like, thisis perfect.
This is meant to be.
Totally meant to be.

(43:27):
That is

awesome.

Yeah.
So I know just little thingslike that teeny tiny things, but
it's just joy is just sprinkledall throughout the space and I
absolutely love it.

That's amazing.
And I just, I think about, ourkids are little in age, but it's
I think about how even withNolan, our youngest, who just
turned five I'll say, he'll,he'll have some issue and I'll
be like, would you like helpwith that?
Or, you got it?
Mm-hmm.
And usually it's, you got it,but it's yes, the safety of you
as the doctor, you who they'reseeing this personalized space,

(43:59):
but just, I go back to the doorbecause it's like I can even
open my own door to my doctor'sappointment.
Thank you.
Parent of mine.
You can stay behind as I entermy own door like it is, I can
see Nolan just like going nuts.
So when we visit Presca, I'mgonna be like, we gotta go check
out the doors first.
Oh my God.
Sucks.
So awesome.
Hundred percent.

A hundred percent.
In, in, in this.
Same train of thought with whenwe did the remodel, the
bathroom, that the space hadonly had one sink.
And in the remodel we actuallyadded a sink.
Sink.
And it's at a lower height atthe height of a child.
Precisely because of what you'resaying because it's, it fuels a
sense of independence and as aparent, you, you wanna nurture
that.

(44:40):
Right.
So, I can think of many timesthat I picked up my daughter at
whatever.
Mall or something, bathroom andah, you're squishing my belly
and my sleeves are wet.
And it's like this whole thing,right?
But here the kids are like, oh,wow, I can do this.
This is cool.
And like the toilets, like I gotlike seats that have a little
toddler potty training seatinside the seat, and little

(45:01):
things like that the space istruly meant to be for them.
I was also very intentional withthe colors that I use throughout
the clinic.
Again, I said teal is myfavorite color.
But other than that, I reallykept it with a very neutral
calming color scheme.
Precisely because kids areoverstimulated nowadays.
Parents are overstimulated,people are coming into the
office, everybody's slapping.

(45:22):
And, and again, I wanted it tobe a grounding, calming space.
And I think we've,

we've achieved that.
That's awesome.
And in terms of the spaceitself, can you give us like a,
can you just give us a, adescription of the visual
layout.
So if you enter the front door,what does your patient
experience in terms of thewaiting room that's not used for
waiting and the, what, what isbeyond there?

So it's the layout is, it's an L-shaped the
shorter part of the L is morelike staff office space.
So have a little break room.
My office is there and a secondbathroom where I also have a
washer dryer to take care oflike washing the gowns and stuff
for the patients.
But then the longer part of theL is the waiting room and then
our exam rooms.
You walk in, kind of in thecorner, the first thing that you

(46:13):
see is the reception area whereI'm sitting at.
Another story about when weremodeled the space actually had
a, one of those little slidingwindows,'cause it used to be, I
don't remember what business washere many years ago, but it, it
had one of those doors at awindow, sorry.
And I told the contractor, I'mlike, can you, can you take this
out and fill it up and sheetrock over the side?

(46:33):
I don't want this.
He's you sure?
But wouldn't that be useful?
I'm like, no, I hate those.
They're so impersonal.
It's like an immediate barrierwhen you walk in to a doctor's
office and people are on thephone and they slam the thing at
you.
I hate those.
So, I was very proud to rip thatout of the space.
So when you walk in, we have, wehave an open desk.
And I think it, it immediately,it conveys that sense of we're

(46:55):
at the same level.
We are friends here.
There's no, division of youpatient, me, doctor.
Not at all.
It's like we're in thistogether.
But then we have five examrooms.
I know in my heart this is gonnagrow.
I've only furnished three out ofthe five.
But yeah, it's it's been a wildride and it's been fun.

And tell us, I, we've mentioned the
garage a few times, but it'stell us about your strategy in
knowing that like your clinic ishappening.
It's like it's already in yourhead.
What are some of the things thatyou look back now and you're
like, I am so glad that I hadthese things because you're
already open and treatingpatients

well.
I, I'm just really proud that Ihad very few things.
I was like, oh, I forgot that.
It was really cool that becauseI had time, I was able to think
from the bigger items to little,little gritty, I need two by two
Gs or whatever.
I, I think my favorite tool sofar has been the vision
screener.
I, it's expensive as I hesitatedto buy it, but you know what,

(48:00):
it's, it's been remarkablebecause so nobody in the area
has it.
I, as pediatricians, we are bigon prevention and what you see
with patients that develop, lazyeyes and amblyopia and all of
that is that a lot of kids can'tcomplete a vision test until
they're four or five.
And by that time, if there's anissue, it's, it's well

(48:21):
progressed.
And oftentimes if you're pickingup earlier, it's, it's because a
kid has already developed thelazy eye on exam, right?
So, that to me was just theepitome of preventative care.
That doesn't happen in fee forservice, because if you look up
the reimbursement for a visionscreen, it's like less than$10.
So why would any hospitalsystem, because they're all

(48:42):
strapped for cash, would buy youa$10,000 piece of equipment.
They're just not going to.
Right.
But for me it's, it's with theway that our overhead works and
because the numbers in DPC aredifferent I can do that.
And I'm doing screens as earlyas six months and I've already
had a really, a really goodcouple of pickups.
And, and then you give thefamily a fighting chance to

(49:05):
tackle this before it becomes anissue, right?
Because it takes a while to getthe kid used to wearing glasses
or it takes a while for thepatching to actually work or
even for them to tolerate it.
And then you get to, God forbid,the point of surgery and the
surgery's not always effectiveeither.
So talk about something withlike permanent consequences that
now I'm able to pick up becauseof this fantastic tool.

(49:27):
So that, that's one that I lovefor sure.

I love that.
And as you were thinking aboutit, I'm like, one, my snarky
comment.
My head was, and I'm saying itout loud definitely not enough
money to buy a vision screener,but definitely enough money to
put your logo on an arena forsports like that, because that
absolutely makes sense.
But also on a more serious noteour DPC pediatrician she comes

(49:52):
to the home once a year and theboys are like minus the shots.
The boys are like, man, I'm soexcited.
We get to show her, we get ourLegos set, and then that, when
that vision screener comes out,man, it's oh, everyone needs to
be quiet.
We gotta shut the lights off,guys.
It's, it's a big production bymy kids because that's how

(50:12):
they're experiencing the doctor.
And so it's I love that you'rementioning that, especially, I,
and I think about this, we'reboth rural.
It's like the tools that wehave, like we have a like anter
I guess that's what it's called.
Yeah.
An audiometer.
And I, I think about these aretools yes, we can use for our
members, but these are alsotools you can use in, if you're

(50:33):
doing, especially pediatricclinics.
'cause we're, we're talkingpediatrics here.
If you're doing community healthfairs or whatnot, I mean, you
already have these amazing toolsand usually because these tools
are so, like the, the modern daytools that we have, these are
things that like you don'ttypically see in fee-for-service
clinics a lot of time.
So it's even one way ofmarketing your practice and how

(50:57):
it's different than otherpractices.
So I think that that's a, it's agreat tip.
When it comes to you mentioningthe person who was like, oh man,
I'm so excited to do these doorsfor you.
Do you have any tips also onworking with the community in
terms of having them come on todo projects for you?
Because, we've talked in thepodcast before about do you

(51:18):
barter, do you not barter?
How do you approach it giventhat some of these people could
also be members as well?

I think, I think it's a case by case basis,
right.
I've, I was very blessed thatliterally every single
contractor we worked with wasextraordinarily talented.
And, and, and it was fun.
And I was here all the time, soI really got to know them.
I know that a few are thinkingabout joining.
I've had a couple that havealready joined.
And I just, I think my advicefor people would be don't just

(51:48):
focus on the membership.
Don't just focus on the money.
Be a good person, do thingsright.
Be a kind human being.
The money and the business willfollow, honestly.

When it comes to opening day, your
practice is ready with thedoors, with the, the colors,
with the welcoming environmentthat you've created, how was the
community response?
Because people, like you said,they already knew you as part of
the community.

It was really positive and it was very, very
exciting.
I had businesses in towns andflowers and friends and family
that don't even have kids juststop in to say hello.
And there were patients of minethat came in that hadn't seen
over the summer and, with peds,like they changed to match,
right.
So it was, it was just reallycute to see.

(52:35):
I had a couple girls come hereand do face painting for the
open house, and we had I orderedsome macaroons and cookies with
the logo and stuff from a localbusiness.
So like we're, we're just reallytrying to keep everything local
and a few teachers of my kidscame by and I, I don't think I
even have words to describe howfulfilling that day was.

(52:58):
The, just people cheering you onpeople.
Saying wow, I'm glad that you'redoing this.
I can see that this is gonna begood for the community.
I, I love having options.
I love what you're providing.
And, families talking not justabout care for their kids, but
it led to really goodconversations about insurance
and, and care as a whole, right?

(53:18):
So like people are, it's almostmy sense is that people are
frustrated with the system, butthey don't quite know what the
options are.
So it was great not just to dothat for me as a practice and my
pediatric patients, but, but forfamilies and adults and
businesses to start thinking

outside the box.
It's so true.
I literally just had aconversation with somebody whose
doctor went to conciergemedicine in Texas, and I was
like, did they, did they evenknow about DPC?
So I think about when you talkabout that people might not know
that DPC exists.
This is why I'm so grateful fornow you, not even just

(53:57):
listening, but now sharing yourstory so other people can hear
your story because this is whatmatters in that.
We have representation asindependent physicians who are
in communities all over thenation.
I mean, I, I was so excited tobring an example of Dr.
Katie Bird Greer, who'spracticing on reservation land,
like Amen.

(54:18):
Rural doctors like you andmyself, people who are like Dr.
Natalie Gentilly and Dr.
Kirsten Lynn, opening an MSOwhere there's billboards of
people with Super Bowl ads andthey're thriving.
So it's there's so many examplesof how DPC works, but knowing
that DPC is a thing and thatconcierge medicine is different,
these are such important factsto know about medicine as of

(54:41):
today's world of medicine.
I love that your community wasso welcoming, but I'm wondering
if you can talk to us about theconversations and how they went
with people who were like, but Idon't necessarily know what this
is compared to your old practicewith you taking insurance.
So how did you talk to familiesabout what you're doing and has

(55:02):
that changed?
Because now we're in November,you opened in September, and I,
I would assume that even just inthat short time, you're.
Personalization of how you talkto parents has even changed.

Yes.
You grow in, in confidence, Iguess, to talk about it and,
'cause I don't like comingacross as salesy.
Right?
I think we all struggle withthat, but we also see the value
of what we're offering.
And, and I think you grow inthat confidence to, to talk
about it.
Not from a salesy angle, butjust this is really cool and you
need to check this out.
Right.
But, but it's, it's, how do Isay this?

(55:37):
People have different needs.
And I think what I'm finding isthat I have a little bit of a
melting pot of reasons whypeople join the practice.
So I have the folks that valuethe convenience.
I have the folks that value mebecause they trust me as their
provider.
And then I have folks that seethe cost savings because they
are uninsured or they're aboutready to drop their insurance.

(55:59):
And so I think my advice forfolks would be to find what is
motivating the other party andtry and identify those barriers
or the challenges that they'refacing to have just a productive
conversation, right?
Don't just approach it from theelevator pitch sales angle, but
just these are human beings.

(56:20):
You are an alternative.
How can is this gonna be a goodfit?
I think my favorite part of theconversation is when I tell
people it covers all of yourvisits, the monthly membership
covers all of your visits.
And they look at me kind offunny.
I'm like, yeah, and like todrive the point home.
I'm like, doesn't matter if Isee you one time that month or
seven because you had a terriblesinus infection.
Like you don't pay a pennyextra.
And they're like, oh.

(56:42):
And then suddenly it's inperspective, right?
Because I pay more for my phonethan what my mom monthly
membership fee is.
A pedicure is, 75, 85 bucksdepending on where you live.
A massage is hundreds ofdollars.
So it really boils down to whatpeople value, right?
Some people, like I said, willvalue the convenience.
Some people will value thesavings.
Some people value you.

(57:02):
And I think, I think they needto understand the value before
they come on board.

I love that answer.
And I ironically just came fromdinner in Sacramento with a DPC
doctor who's practicing in ElkGrove, and we were talking
exactly about this.
Like the, the, the way that Ithink of the pitch, so to speak,
is very different than what,what I thought the pitch was
like when I opened.
And it's very much more of whatyou're describing right now.

(57:30):
It's tell me about your accessto healthcare.
What, what is, what are yourbiggest frustrations?
They will tell you what theywant to hear, and it, it's very
common that, when and when wethink about marketing and you
need multiple passes for aperson to actually hear the
message that is changed.
The, the, the number of passesneeded is changed when they're
telling you what they needupfront.

(57:52):
So I think that that is reallygreat.
And I, I, I thought about thistoo, just on your website, when
you have services listed, youhave, InBody scan, you have
medical ear piercing, you havefourth trimester care.
And I, I think that it justspeaks to that you're doing this
anyways, but also just the waythat it's called out on, in
different sections on yourwebsite, that might be what the

(58:14):
person is starting.
To experience your clinic by,but that's not it.
There's way more that goesbeyond just those services.

Yes.
And, and I have more in thepipeline because I think what
I'm trying to identify is areasof need.
And I love learning.
I love a challenge.
That's one of the things thatover the past few years has been
hard for me is that every daylook the same.
I get bored easy.
I'm too a DHD for it, right?
So, like I'm in the process ofgetting my lactation consultant
certification and I'm doing acourse on doing tongue ectomies

(58:46):
for my tongue tie babies, andjust, I, I would love somewhere
down the line to incorporateallergy testing in a safe matter
as well, because again, thoseare things that people are just
waiting months and traveling farto, to get answers for to, so,
that's been really interestingto incorporate.
And I love the freedom.

(59:06):
To do it in, in terms of time.
But also in terms of I don'thave to ask any administration
for permission of Hey, what doyou think of me offering the
service?
I can just do it.
I love that autonomy because I'mgrowing and, and at the end of
the day, the patients are gonnabenefit from it as well instead
of just cutting throughadministrative red tape,

And I think also for the listener who
hasn't checked out your websiteyet you even have a note that
says if you are.
If you're needing a service, letme know what you're needing
because there's more servicescoming and I might be able to
deliver that.
I mean, it's very it's, it's,it's almost like asking an
open-ended question, it's likemm-hmm.
There's not necessarily a, A, B,C, D or E there's no other.

(59:47):
And it, it allows the communityto, think about oh, I, I
actually do need this service,but I haven't been able to find
it anywhere else.
So I think, I think that's verylovely that you have that on
your services page, on yourwebsite.
Thank you.
Yeah, thank you.
Going into the next year, I'mwondering,'cause we were talking
about he just healthcare accessin Maine and how it is being

(01:00:09):
impacted already, but I'mwondering what do you have on,
your, your plans for next yearin terms of strategies that
you're thinking about already,that are already built out in
your head and.
What do you think about andwhere are you when it comes to
growth with another physician oranother non-physician provider

(01:00:29):
joining you?
Because like you said, youexpect it to grow.
It's just a matter of taking itday by day and that will happen.

Dr. Maria Rutmann (01:00:36):
Yeah.
I think my goal, my, my dreamnot necessarily with a concrete
timeline'cause I'm just trustingthat it'll happen when it's
meant to be.
But I would like to bring in anadult provider the amount of
families that have told me whenis there gonna be an option for
us as the parents is crazy.
The access to care in the adultworld is, it's, it's really

(01:00:56):
heartbreaking up here.
My dad for example, not too longago he had an appointment, he's
in his late seventies.
The office had to reschedulehim.
It wasn't him that missed theappointment or anything like
that.
They pushed him out like fivemonths.
So, there, I, I, I see a need, atrue need.
And I would like to be a part ofthe solution for people.
So that's, that's probably mybiggest one.

(01:01:18):
As far as marketing I'm justtrying to remain flexible and,
and we're all learning as we go.
I don't think there's a cookiecutter way, but like one fun
thing that I actually justsolidified in the last week is
that we have a junior hockeyteam in town.
This is the first year that thisteam is playing.
They're called the NorthernMaine pioneers.
And I initially had approachedthe team to say, hi, Hey, can,

(01:01:42):
can I be of service to yousomehow?
Because I mean, honestly, whereare they gonna go, right?
Pediatrics is gonna say, theseyoung men are too old for us,
they're not gonna see them.
Adult practice is gonna be like,oh yeah, we'll see you.
Here's your appointment inApril.
Right?
And then walking clinic can'treally handle concussions or
what if they're struggling withmental health?
'cause they're away from family.
I mean, we got kids from halfwayacross the world, right?
So I'm like, I think I can meettheir need.

(01:02:03):
So, we, we put a little packagetogether for them and over time
I've actually gotten to knowquite a few of them, and they're
really remarkable young men.
And they embody what Lionheartis, right?
Like they're being courageous,they're being bold, they're
pursuing their dreams, and I'mjust like totally inspired and
on fire by all of them.
So, I'm actually gonna be theirdoctor for the whole team now

(01:02:25):
for the season.
And that was a complete curveball, right?
Two months ago.
I, that this wasn't even in myradar and it, it just happened
and it feels right and, and it'sbeen fun.
And it's helping me grow toobecause, now I'm taking care of
these like really competitiveathletes and younger adults,
which is a little different thanwhat I've done in the past.
And, and and again, it's justfueling that sense of purpose.

(01:02:46):
I spoke to or have spoken to afew of their parents and let me
just say that there.
Gratitude for a peace of mind, Iguess, for having somebody be
there for their boys, who theremight be men, but to the
parents, they're still littleboys.
It's it's, it's really sweet.
It's really endearing and that'swhy we went into medicine,

(01:03:09):
right?
To be good to people and dothings right.
And I needed that.
I missed that.
Does that make sense?

Dr. Maryal Concepci (01:03:18):
Absolutely.
And a huge congratulations.
'cause that is awesome.
Thank you.
And I, I think that, even the,the pairing of you, you
described it as a curve ball,but it's like you being in a
moment where you could be openand they needing a doctor who
was open enough to take care ofthem in the manner that you can,
again, it's just things happenfor a reason and that's a

(01:03:40):
beautiful pairing.
And I, I know that they're,they're just going to be
experiencing healthcare sodifferently and especially
things like hockey.
And so, and excuse me, notsoccer, hockey and football, the
things that I'm like, oh my God,I dunno if you've never played
those kids of mine, but I, I Iwould be so much more I would be
so less anxious as a parent ifmy kid had a deep c pediatrician

(01:04:04):
like you.
And that's, that's why we havedp, C-P-A-D-P, ccp, pediatrician
for our boys.
So I think that's awesome.

yeah, they've been a perfect example of the
value of access because therewas one morning, for example,
that I was dropping off mydaughter at school and I get a
call from one of them and says,Hey I think I may be concussed.
Can you see me today?
I'm like, yep.
I'll see you at 10 Swing by theoffice.
Easy, right?
It was just so easy.
Or I've already troubleshootednot just with them, but with

(01:04:31):
other families.
So many things via text.
And, but again, you're comingout of this place where there's
a relationship where there'strust, where communication is
easy.
It's instant, right?
You're not going through playingphone tag or what's that game
like that you kind of sit nextto each other and you pass along
a message.
By the time it makes it throughthe whole group, the message is
completely different.
I feel like telephone thathappens.

(01:04:51):
Yeah.
Great.
I feel like that happens in, intraditional practices, because
you're going through, a coupleof front staff members, maybe a
couple of nurses are amazedbefore the, in bouncing the
message back and forth.
It dilutes the situation.
Not only does it create a delayin care, so, um, yeah, the, the
value of having communicationwith your, with your provider,
with your doctor is just, I, Imean, in my mind, it's

(01:05:13):
priceless.
It's, it's one of the thingsthat I love the most about DPC.

Dr. Maryal Concepcion (01:05:16):
What would you say to other DPC
doctors who are not at thismoment, letting that lion heart
of their own out into the worldand they're, they might be
quashing it.

So one of the things that I love the most
about DPC is the time that itallows me with the patient.
And I'm not just talking aboutlike me not rushing through
life.
It's when I can actually get tothe meat of things by listening
to people in, not just a fiveminute appointment.
I can spare you from unnecessaryreferrals.

(01:05:52):
We can tackle things better, wecan tackle things efficiently.
I remember I had a patient nottoo long ago that they had
asthma and had seen multipleproviders along the way.
And when I spoke to the parent,they were like doing all the
things right, like they were onthe right meds and like, why is
your asthma still a disaster?
It shouldn't be this way.

(01:06:12):
You're, everybody's done theright thing.
So it occurred to me like, can,can you show me how you're using
the inhaler?
And they were using an Achamber.
And they were just, kind of likespraying it to the kid's face
and putting it down and the kidwas not effectively getting the
medication.
And that to me was just such aeyeopening wow, like this is
this, this is basic, right?
Because nobody took the time toteach this family how to use the

(01:06:36):
A chamber.
That was a fa like a failureright there.
Granted, there could have beenmiscommunications along the way,
people sometimes leaveoverwhelmed, I'll, I'll give
everybody involved, grace.
But it was, it was just like,wow.
So it's little things like thatthat I think having time with
your provider is, is crucial,but also, again, when we can
tackle a lot without having torefer you and, but, but it takes

(01:06:59):
time, right?
So, it, it's just for me that's,that's one of the biggest values
in, in direct primary care forfamilies.

So powerful.
Well, thank you so much Dr.
Rutman, for coming on andsharing your story.
Thank you, Marielle,

for having me.
This has been wonderful.
Really.
DPC I think saved my career.
You hear that often.
And thank you in particular forputting this out there because
you are such a heavyweight inthe community and you are
reaching people that I, I don'tthink I, I don't know if I
would've come across DPC had itnot been for you.

(01:07:34):
And, and, and I'm thankful foryour efforts into putting this
podcast together because you'rechanging lives by getting this
information out there.

Thank you so much.
That is so sweet.
Oh my goodness.
It makes my day.
Thank you for listening toanother episode of my DBC story.
If you enjoyed it, please leavea five star review on your
favorite podcast platform.
It helps others find the show,have a question about direct
primary care.
Leave me a voicemail.
You might hear it answered in afuture episode.

(01:08:04):
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
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.

(01:08:26):
Until next week, this isMarielle conception.

All Episodes

Episode Transcript

Popular Podcasts

Stuff You Should Know

The Joe Rogan Experience

Two Guys, Five Rings: Matt, Bowen & The Olympics

.css-15opob5{left:0;position:absolute;top:0.8rem;} All Episodes

.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}Finding Her Lionheart: Dr. Maria Rutmann’s DPC Pediatric Practice in Rural Maine

Episode Transcript

Popular Podcasts

.css-r6mb8g{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:1;overflow:hidden;}Stuff You Should Know

The Joe Rogan Experience

Two Guys, Five Rings: Matt, Bowen & The Olympics

All Episodes

Finding Her Lionheart: Dr. Maria Rutmann’s DPC Pediatric Practice in Rural Maine

Stuff You Should Know