Full Transcript Introduction to the Podcast and Guest 0:00 And what I've learned as I've got less burned out and more into the weeds is that this whole 0:06 personalized medicine thing is for real. And as patients, you have a right to demand it. 0:12 And it's a little bit hard on your doctor and providers that are trapped in a system 0:19 that makes them see patients every 10 minutes. It's not their fault unless they're as burned 0:25 out as I was. ah They do care and they want to do more and they're trying and they do an 0:31 amazing job with the 10 minutes they have. know, it's, there are other options out there 0:38 that are, you know, this direct primary care thing that I'm doing that, you know, it saved 0:45 my career along with hormones and some, you know, some, you know, basic functional medicine. 0:51 Have you made it past menopause or are you going through it now? I'm Dr. Pat McShane and 0:57 on the Women's Health Span Voices podcast, I'll guide you through the health challenges 1:02 of the menopausal years and beyond, guiding the way to thriving in this powerful era of 1:08 your womanhood. Hello and welcome. Today, it's my great pleasure to introduce Dr. Clint Carter, 1:15 who has an unusual background. He has a conventional medical... background and then has moved into 1:22 kind of a novel practice approach and more of a functional medicine approach regarding clinical 1:29 care as well. So I think I'll let you explain a little bit more about all of those things.
Direct Primary Care and Practice Model 1:35 Dr. Clint. Thank you so much for having me. This is, this is fun. Yeah. I went to medical 1:42 school and then went to family medicine residency and learned all of, it was a great residency, 1:48 learned all of the in the box things that that I thought was what all there was. And, some 1:56 of the functional medicine things that have come about since then have all been, they 2:01 would have been punchlines during my training. But when I got out of residency, part of my 2:06 interview process was to go look at clinics that where I was supposed to want to work. 2:11 those clinics were miserably depressed. Like everyone there, the patients, the doctors, 2:17 the staff. I was like, I am not doing this for a living. So then I, you know, I was like, 2:21 I was screwed. I'll go to the ER. I did a lot of ER in my training. So that's really where 2:27 I cut my teeth. After residency, obviously I did a lot of moonlighting and ER during residency. 2:32 And so I did that and it was fun until it wasn't. I'll... Uh, but by my introduction from there 2:39 is just really now I'm running a direct primary care practice where my patients pay me monthly 2:45 and I can give them all the time and attention that I need. And, uh, it's been really rewarding. 2:51 And you have a number of other, uh, clinical staff working with you, including your wife, 2:56 who's a nurse practitioner, as I recall, uh, as, a couple other NPs and you have different. 3:03 kinds of medical approaches within your same practice under your same roof. So maybe tell 3:09 us a little bit about that. Yeah. So, you know, we started out, my wife and I, you know, when 3:14 I first, know, my story, my bit is that, you know, so I was in the ER for 10 years or so. 3:21 last few years of that completely burned out and, and disillusioned and decided that I 3:28 didn't want to do ER anymore. And I'd already decided that I didn't want to be a clinic doc. 3:33 So I decided I wasn't going to be a doctor anymore. mean, apparently though, you know, I didn't 3:37 know that there would be any other options. And so I decided I was going to build tree 3:41 houses for a living. There's a, you know, the tree house master guy and then Washington and 3:46 Oregon looked like he was having a blast on TV and I know how to build things. So I was 3:51 going to start that company and my wife and the Lord sort of intervened and said, well, 3:56 why don't we try this concierge medicine thing. And so we went to a conference and came back 4:02 thinking, I think we can do this. And then one thing led to another. And the next thing you 4:07 know, I was, we were opening in this practice, she and I, she was in cardiology full time. 4:12 I was doing ER full time. So we started a membership based practice with no members and went on 4:19 working two jobs until this thing could float. But the goal I think was always to just be 4:24 she and I and a nurse or MA or two. and it's just, we've had. Really, a lot of the growth 4:31 has been that patients wanted to be a part of it, but I've had other providers that wanted 4:36 to be a part of it. so whenever the volume allowed, I would hire one of the people that were begging 4:42 me to hire them and then, and then next and then next. And so we've been, as it turns out, 4:46 I think we've been called to grow this thing that is direct primary care, that is membership 4:51 based medicine where... the patient is again, the center of their own healthcare and that, 4:59 you know, we get insurance out of the way. We don't take insurance at all. That they have 5:02 insurance, they can use it with, you know, x-rays or specialist or, you know, other things. But 5:08 for everything that we can handle in the clinic, everything's at our cost. And so we just, we've
Burnout, Menopause, and Hormone Therapy 5:12 got, let's see, a part-time physician and about four or five nurse practitioners, PA. And it's 5:20 just been a blast. Being a doctor is fun again. Being a patient is rewarding and, you know, 5:26 people are taking control of their healthcare. It's fun. Tell me a little bit about some of 5:31 the lifestyle approaches that you have placed on your background on your website about making 5:38 the best of our health, especially as it regards women who are beyond menopause, let's say age 5:44 50 something or 60 and beyond what kinds of things to work with, with that group of women. 5:52 Well, it, so I started out just what made me special was time, right? Like I say, I sell 5:59 time. You get, there's no waiting room. There's no wait. When you come in, we bring you right 6:05 back. Everybody's blood pressure is just a little bit high because we just brought them in from 6:10 traffic and they, you know, We just, I'm like, hey, let them take a breath before you take 6:14 their blood pressure, please. And then, and so what I was finding is that an hour at 6:21 a time, as often as they wanted, wasn't enough. It wasn't all of my in the box residency 6:31 training tricks. Something was missing. I was getting these women, they're working out, they're 6:37 eating right. They look good on the outside and they just feel terrible. Whether it's a. 6:42 perimenopause 45 year old or post menopause 55 year old female just I mean the world is 6:50 run by women 40, you know 60 they make all of the healthcare decisions for their whole family. 6:56 They buy the things, the workforce, they're everywhere. And it's just everything was getting 7:01 harder and harder and harder and they their 40s, you perimenopause became really difficult 7:07 and then menopause would hit and it was just They come in and be like, my other doctor says 7:11 that I'm fine and that all my labs look normal and I feel like I'm dying and I can't think 7:18 and I can't sleep and I don't care and I help me. I don't want to be with my husband anymore. 7:25 Yeah. Yeah. No, yeah. have no, yes. No. Thank you. Absolutely. And I've, and I, yeah. And 7:32 so, um, what I ended up, my partner who helped start Miami select a year before me said, Well, 7:38 what about, when are you going to get into hormones? And I was like, when I'm not a weirdo for being 7:43 a concierge doctor in Tyler, Texas. And so finally I just gave in. was like, okay, this hormone 7:50 replacement cult thing, I'll go because my patients need me to go, but I'm going to be very guarded 7:56 and I'm just going to, you know, I'm just going to try to take some, some pearls away. And 8:01 of course I got in there and it was everything that I already knew plus infinite, right? Like, 8:07 So, so, so much more. And so then I got kind of frustrated. like, where was this? Why was 8:13 I not taught any of this stuff? It all makes perfect sense. It fills in the holes perfectly. 8:18 And, and I think the answer ultimately is insurance doesn't pay for any of that stuff. So why would 8:23 you waste your time learning that stuff? Cause you're not going to get reimbursed for it. 8:26 And it all kind of went back that way. So ultimately I came back from that and lives started changing. 8:32 So that did two things. it at least two things. First, was, it filled the hole in my practice 8:39 that I saw with my, my peri and post menopause females. the men, was already trying testosterone, 8:47 but this really filled that knowledge base. And then two, it was the door that opened it 8:51 to a room full of doors that I didn't know existed of things like peptides and functional medicine 8:59 and lifestyle. And it just like. You know, the things they don't, they don't teach you anything 9:04 about diet or exercise in medical school. Not a thing. Like it's, it's, uh uh, you know, 9:10 it's, it's given lip service, but there's no, I don't know anything about nutrition after 9:16 med school or residency. know, low fat, eat less. I don't know. All of it was bad. And 9:23 so what I realized with the hormone door that opened for me, that helped my practice, my 9:29 staff, my me. my patients, it opened the idea that there's so much more out there that we 9:36 weren't taught and that our patients need and our patients are demanding. finally we're able 9:41 to, I was like, well, let's go find out. that instead of saying, well, that's all there is, 9:46 it became, I'll go look that up and I'll get back to you. Yeah. And so it really, it's been, 9:51 it's been a fun journey. I just, I just came back from a A4M conference and again, many, 9:58 many doorways that were open. This was a women's health through the menopause. And again, 10:05 the emphasis certainly on hormones, but also everything about lifestyle that, that you just 10:12 mentioned and just, you know, many, many things that most people have not been trained in. 10:18 in conventional medicine and, I'm not sure about the naturopathic docs or the PAs or 10:25 NPs, whether they're getting anything beyond, or you just have to teach yourself. And obviously 10:31 our audience is, is teaching themselves today by listening to this. So, so congratulations. 10:39 So, so you. Yeah. Kudos to you and tell your friends. Yep. Absolutely. So when you started 10:48 to use more hormone replacement, did all these kind of non-specific, but quite powerful 10:55 symptoms diminish in most of your patients at that point? Yeah. So the hormone thing starts 11:01 to sound like snake oil real quick, right? It's like, Hey, you're tired, you're unmotivated, 11:08 you can't sleep. You're pushing through and working out anyway, but your body's not responding. 11:14 You don't have, you're anxious, you're depressed. Brain fog. Your, your mood is all over the 11:19 place. don't, brain fog, you can't think, you can't concentrate, you can't remember. veto 11:25 is like, well, yeah, I mean, is there much more to life than that? And so what I found was 11:31 I could get people through some of that stuff without replacing hormones and addressing their 11:37 hormone balance. But so often. This person's thing was brain fog and energy and they just 11:45 bounced back. you know, we do, so we do bioidentical, we do creams, trochies, but pellets is a 11:53 big part of our practice because we can really, we really feel like it's as sort of natural 11:59 as you can get, blood flow dependent. When you exercise and your heart rate goes up, you get 12:04 more hormones. When you rest and don't, you get less hormones in it. It sort of mimics 12:09 kind of how your body would do it anyway. And every once in a while, if we time our pellets 12:14 wrong, they'll run out before we get the next one going. And we're pretty good at avoiding 12:18 that, of course. But what you would find is that symptom is the first thing that comes 12:23 back. So if brain fog and energy were their main thing, towards the end of their pellet 12:29 life, if we time this thing wrong or they start working out more and burn through it faster 12:32 and we didn't know it, that's the symptoms they get back. If it's sleep and libido, if it's 12:38 depression and anxiety, know, whatever your combination of symptoms were that were just 12:42 unwilling to improve without replacing those hormones, that it's life-changing to that patient 12:49 who's been battling with that for usually a decade or two by the time. They give in and 12:57 go to someone outside the box, outside of their, you know, insurance, primary care and OB, the 13:03 OB-GYNs in my area are not on the hormone train at all. That's still, I recently got a report 13:10 from a patient that we had, that we sent to them and on the bottom of it was like, you 13:16 know, a women's health initiative, you know, disclaimer at the bottom about hormones being 13:23 bad for you and how they're. that they're going to kill us all and the smallest amount and 13:29 all that stuff. And it was like, do you guys, I mean, you're supposed to be the hormone experts, 13:35 keep up, but oh it was hilarious. Yep. It's not hilarious if you're the patient with all 13:42 the symptoms. the other piece of the hormone replacement story is all cause mortality and 13:49 cardiovascular mortality, which again, isn't something that the woman comes to your office 13:55 saying, You know, I'm trying to prevent heart disease. I mean, some people do, but, uh, they 14:00 may come and say, I'm trying to present prevent bone disease, but not, you know, heart disease 14:07 and all cause mortality. So that is improved by the use of hormones, seemingly, you know, 14:14 most of the data. It's amazing. They, they really, most of the time when they, most of the time 14:19 when they come to me, they are thinking that what they're about to do potentially is trade. 14:25 health and longevity and heart disease and cancer risk to just not feel like they're dying all 14:33 the time. to not be leathering is the opposite of that. It's the opposite. Yeah. It's like, 14:42 it's, they've been, mean, listen, the women's health initiative, they were trying to do the 14:46 right thing. In fact, they assumed at the beginning of the trial that it would make people healthier 14:50 because estrogen and progesterone do that. However, progestins and synthetic, you know, estrogen 14:59 mimics don't do that. They're bad for you as it turns out, but they didn't know and they 15:04 were just doing the best they can with what they had. they've since, the authors have 15:08 since come back and said, hey, are bad, go get some bioidentical hormones and it'll be okay. 15:12 I mean, maybe not quite that endorsing, but they have at least admitted that there's a 15:16 generation of demented, broken down folks that were deprived of... health because 20 years 15:26 ago, 25 years ago now, the information was just off. Faulty. Yep. Definitely faulty information.
Thyroid, Adrenal Support, and Functional Medicine 15:32 Maybe not designed the best either, study starting people so late at 65. So ideally you get people 15:39 in in their fifties and or whenever they go through menopause, but it's not too late at 15:45 any age. sounds like, yeah. Yep. So well, good. Yep. And, and I've got, I've got the oldest 15:53 person I have. on, oh, sorry, the oldest person I have on hormones right now is like in their 15:59 eighties, I think. might have, I don't think I have anyone in their nineties anymore, but 16:04 um everyone's like, well, if I start this, when do I, I mean, is this going to be forever? 16:08 like, well, you can stop it anytime you want to feel terrible and start dying faster. I 16:12 mean, it's up to you. Tell me, tell me a little bit about, besides the sex hormones, know, 16:19 estrogen and progesterone. I, I not sure whether you use testosterone. DHEA, then also adrenal 16:27 hormones and thyroid, if that's part of your general workup and recommendation for people. 16:35 Yes. So in my training, we didn't do a lot with DHEA or Pregnant Alone or a lot of the precursors 16:43 on that front. Definitely have seen benefit from... folks that even aren't on full hormone 16:50 replacement. really feel like there's a big role there. There's probably a very important 16:55 role for balancing your hormones with DHEA and some of the other, you know, precursors slash 17:01 sex hormones. But my main practice is testosterone in men and women. Men run out of testosterone 17:09 these days, surprisingly earlier in their thirties. think the... Most likely reason for that is 17:15 something between stress and this stuff in our food, just the toxic environment that we live 17:21 in that your body is just not sure what the heck's going on. And you're all stressed out 17:26 and your body moves its resources away from procreation to just surviving with the adrenal 17:31 gland until those guys run out. And so I do a lot of, I burned out in my mid thirties 17:35 and was depressed, burnout, low T. Hashimoto's, I was a disaster. I wasn't going to jump in 17:43 front of a bus, but I wasn't going to jump out of the way either. was, it was the end of my 17:48 medical career as I knew it. I wasn't going back to that. But then my partner took care 17:55 of me and he, and my business partner started replacing my hormones and started addressing 18:00 my Hashimoto's. so that brings us to, so females, the way that I treated is women tend to run 18:06 out of their testosterone in their, around the age 40. naturally because their reproductive 18:12 years are mostly behind them. so things get a lot harder and then menopause hits and they're 18:17 out of their other estrogen and progesterone and then it all sort of, it's like, you know, 18:21 the hill gets a lot steeper after that. And so I encourage testosterone replacement in 18:28 the perimenopause phase for sure. Maybe even a little progesterone where it's helpful. And 18:33 then estrogen and progesterone for sure in the post menopause phase for... The thyroid, when 18:39 I went to hormone training, they introduced me to the concept of T3 and T4. Honestly, 18:47 in family medicine training, all they taught us was TSH and Synthroid. So TSH is thyroid 18:57 stimulating hormone for our audience. That's a brain hormone. That is your brain's opinion 19:04 about your thyroid. So didn't measure a single thyroid hormone. actually during my residency. 19:10 And then the only solution to that is if your thyroid, if your TSH got high enough that it 19:15 was technically out of range, nevermind your symptoms, you had to be out of range. Then 19:20 we would fix TSH with this synthetic product called Synthroid that fixes the heck out of 19:26 TSH, which it doesn't necessarily make you feel any better. So the training was, hey, guess 19:35 what? Your thyroid hormones matter, your TSH. matters less and Synthroid is not the best 19:43 way to address it all. So we use a lot of T3, which is your active thyroid hormone, whether 19:48 we get that in a desiccated thyroid product like Armour thyroid or NP thyroid or we have 19:56 some patients that just do synthetic T3 and T4, but the And then Hashimoto's just checking 20:07 for antibodies against your thyroid. So Hashimoto's is what I have and that's antibodies attacking 20:12 your own thyroid. And you know, we would have just given a bunch of synproid to low to high 20:18 TSH and never looked past it. But now we know, oh gosh, your thyroid's down because your body's 20:23 attacking yourself. Let's see what we can do to help address that. And in the meantime, 20:27 you need some T3 as well. And so that you, you're not just... You know, your TSH looks better, 20:34 but you're still cold, tired, fat, and your hair's falling out. But hey, your TSH looks 20:38 good. So don't worry about it. we go a better. get better. It's aging. Let's change gears 20:44 and talk about our toxic environment. And if you do any kind of testing and what your approach 20:51 is to reducing the... toxicity that you may find or think may be part of the woman's symptoms 20:59 or medical conditions. Absolutely. know, so, you know, especially in that period. So when 21:05 you go through menopause, your body's just, I don't know, for lack of a better term, it's 21:09 kind of out of its hormones. All you're left with is your adrenal glands, you know, squeaking 21:14 out a little bit here and there, which can be optimized. And I did kind of skip that. do. 21:18 We do have some supplements and things to help support the adrenal, you know, adrenal stress 21:23 and the adrenal fatigue that come with living in fight or flight all day, every day and most 21:30 of the night. Cause you can't fall asleep because you can't turn it off. And the cortisol and 21:34 the way that affects how you feel and your weight gain and all those things. It's crazy. But 21:39 you know, so much of that and You're, especially in a perimenopause state, that 40 to 50 age 21:45 range where everything's getting harder and their testosterone is low, but their cycles 21:49 are getting irregular and the mood is getting a little crazier. So much of that can be addressed 21:54 by cleaning up the diet, getting rid of the preservatives and then the additives and trying 22:01 to go organic whole food and kind of watching your... you know, watch your macros at the 22:08 very least and then start paying attention to your, um you know, supplementation of your, 22:13 of your micros as well. So we, I am not functionally certified yet with A4M or anyone, but a couple 22:21 of my nurse practitioners are going through it now. I've gotten sucked into uh the continuing 22:27 education of running a practice so that more and more of my people can continue to help 22:31 folks. But I've been getting my functional training one patient at a time because I'm surrounded 22:36 by docs and providers that are. so it's been, and running and hey, and having a podcast has 22:42 been super educational. It's been so fun with getting everybody's slightly different point 22:48 of view and perspective on gut health and all of the inflammation that comes from there. 22:53 And the, know, the credit card worth of plastic that we eat every day and the, the, the toxic 22:59 sort of things in our food and in our environment. And, know, just open our patients' eyes to 23:04 the, to the truth that what you put in your body and what you put your body through matters. 23:10 That's, that's been super helpful for our patients because they're getting the same information 23:15 that, you know, I was getting when I was in residency, which is, you know, just kind of. 23:20 Eat a few less calories and pray and hopefully you'll feel better and maybe look better. that's 23:27 not, it has not proven to be true. There's a lot more. What I love about the functional
Toxic Exposure, Nutrition, and Learning Beyond Residency 23:32 medicine world is the, like one reason I'm not functional medicine trained because biochemistry, 23:36 it wasn't fun the first time and there's so much. information to know and how the body 23:42 works. I'm finding it very refreshing to hear your honest, um, retelling of your journey, 23:49 not, not just setting up the practice and your personal journey, but the journey of learning. 23:54 Because most of our audience again has probably started out with the Western medicine approach 24:01 with their physicians or those of the audience who are physicians, you know, and. Even naturopathic 24:09 doctors, again, things are changing all the time and there's more to learn and know. So 24:15 it's very refreshing and I appreciate your honesty. Thank you. We're all learning. I do think 24:23 that, I do think, I think the data suggests that with all of the information that's coming 24:30 out where the information age, there's studies going on all the time about all these things. 24:35 I think the amount of information that we would need to know as physicians or as providers 24:40 doubles every five years. So it's literally not all knowable, but we do, if you're not 24:48 trying, you're so far behind that it's kind of laughable actually. Yeah. Yeah. It's sad. 24:56 It's hard. It's, it's hard. It's a lifelong commitment basically to healing oneself and 25:02 our patients. yeah. um A different topic, cancer screening. And our patients know it. 25:09 Yeah. Yep. Yeah. And it's too bad because conventional medicine anyway gets very siloed and, know, 25:17 oh, you have, you know, trouble breathing. I'll send you to the pulmonologist. You know, every 25:23 symptom deserves a different specialist. Once you get into a certain age range, I can. Relate 25:29 to that. And that's unfortunate, especially since often the symptoms are again, a reflection 25:37 of an underlying situation that isn't going to be fixed by another prescription. Just 25:43 to reflect something that was on your website, cancer screening testing that I presume by 25:50 that, mean going beyond the typical things that we do to rule out colon cancer, breast cancer, 25:57 et cetera. Have you started using any of the laboratory tests? have. think that, you know, 26:05 we, everyone who comes through gets screened for genetic risks. So we use a company called 26:09 Myriad that, that, you know, if you've had enough of the right cancers on the same side of the 26:14 family, there's a good chance you have a gene that puts you at a higher risk. And we, so 26:19 we do that at a, everyone gets screened, you know, over a certain age, 40 or something through 26:25 there. And then, because we are probably younger because, know, women with breast cancer are 26:30 40s when you start anyway. So I think everyone who comes through as an adult gets that family 26:34 history screening. And we do it every year just to make sure that there's no new information 26:38 or no new genes out that we need to know about. And that's really just risk. And then for 26:43 pure cancer screening, we've, we use a blood test, a single blood test that can detect up 26:49 to 50 cancers in the bloodstream. It's put out by a company named Grel and it's up and 26:55 coming technology that is pretty good. It's really good at the aggressive, more dangerous 27:03 cancers that are going to be in the bloodstream, right? You're doing a bloodstream test. So 27:07 if you've got a well walled off cancer in a distant part of your body, be it breast or 27:13 prostate or someplace like that, it's not going to catch that very well. But anything invasive, 27:20 anything trying to metastasize, it's dropping um free DNA. Like cells die and break down, 27:28 the DNA gets into the bloodstream and before it gets processed and recycled and reused, 27:33 um this test can pick up DNA and kind of tell you where it's coming from and... You know 27:42 what the primary probably is and there's 20 cancers or so that it's really good at that 27:48 are the top, the top 12 cancers that kill folks in this country checks for all of those. Breast 27:56 cancer already has a pretty good screening test. This one doesn't replace that for sure. Prostate 28:02 cancer is tough because it's really walled off in there. But those were pretty good at catching 28:09 and treating. at baseline anyway, but this helps with colon cancer, especially anything aggressive. 28:14 helps with the big killers in the space. And it's just a young evolving tech. So I think 28:21 by the time our kids are getting of age, they're going to be able to test for most things in 28:27 the bloodstream or something similar. I'm almost ready for the Star Trek thing where they just 28:32 do the light up and down you and then you're like, oh, okay, gotcha. eh That's good to know. 28:38 One of the advantages of our practice, yeah, and one of the advantages of our practice is 28:43 time. We are able to spend the time to really dig in with it be like, okay, what's in your 28:47 family? And they're like, nothing. And then you keep talking and like, oh, well, yeah, 28:50 there was that. And then you keep talking and oh, there was that. And so we're really able 28:54 to, and be like, oh, by the way, did you know that low testosterone is a prostate risk factor?
Personalized Medicine, Screening, and Patient Advocacy 28:59 And did you know that this lifestyle, this increased adipose tissue that you're carrying around 29:04 is a cancer risk? So there's so much more. mean, the three killers in this country are 29:11 heart disease, cancer, and dementia. And diabetes being sort of the fourth horseman that feeds 29:16 the other three. And those are all things that if you start addressing them early, make a 29:20 big difference, but cancer included for sure. Yeah. I think certainly for heart disease, 29:26 somewhere around 70 or 80 % of it is supposed to be preventable by lifestyle changes, know, 29:34 smoking, diet, exercise, you know, the long list, sleep. And, and similar for dementia. 29:41 I think that picture's starting to get a little bit clearer. When I was an ER doctor, no one 29:47 was special. No one was individual. Everyone thought, I run a fever at 99. I'm like, sure 29:53 you do. I don't care. Right? Like whatever. I got you. You're not dying. You can leave 29:57 now. And what I've learned as I've got less burned out and more into the weeds is that 30:03 This whole personalized medicine thing is for real. And as patients, you have a right to 30:09 demand it. And it's a little bit hard on your doctor and providers that are trapped in a 30:17 system that makes them see patients every 10 minutes. It's not their fault. Unless they're 30:25 as burned out as I was. They do care and they want to do more and they're trying and they 30:31 do an amazing job with the 10 minutes they have. But, you know, it's, there are other options 30:40 out there that are, you know, this direct primary care thing that I'm doing that, you know, it 30:47 saved my career along with hormones and some, you know, some, you know, functional medicine, 30:53 uh medicine. You know, what's fun about it is that it shows that there are other ways. 31:02 You know, if every doctor in the country or every provider in the country became a direct 31:07 primary care provider, we'd have a 10 to 1 provider shortage because a regular doc in an insurance 31:13 system has 2,000 to 3,000 patients on the rolls easy. And a direct primary care doctor can 31:19 only have 300 to 500 and do it well. It's not necessarily the only way, but it is a way and 31:27 it is a disruptive industry, which means we are out here proving that it can be done better 31:35 and different. the, you know, all of the EMRs now have in the last 10 years have that are 31:41 coming out or coming out with their version of something like a patient communication portal 31:48 that kind of works sometimes, right? And that they're They're trying, but you have the right 31:53 as the patient to demand more. And if there is a direct primary care doc, which direct 32:00 primary care is a terrible name, but it just means membership based with no insurance. I 32:04 want you to have insurance probably for emergencies, but I don't want you to need your insurance 32:09 for access to your doc. You know, your average, or if you have insured, some doctors are true 32:15 concierge doctors, which means that they are, they take your insurance for the stuff that's, 32:21 you know, basic stuff. But then you pay a membership for added access to your doc. But that, what 32:28 that means is ultimately in either way, um, that you have 24 seven access to your doctor. 32:33 You can call them, you can call me anytime of night. Now, if you call me in the middle of 32:37 the night for a refill, I'm going to get a little grumpy maybe, but for the most part, my patients 32:41 understand that they can just... text the app for a refill, but call me if they're having 32:46 an urgent concern and it's not abused and it's lovely. So that brings me to the second point. 32:51 Not only should patients demand it, but providers don't have to settle either. There are more 33:00 and more of these practices popping up. um There are, we had a residency reunion here recently 33:08 and two other Well, four of us in a two year span are all doing some version of direct primary 33:15 care or concierge medicine. And it's really, and we only had classes of six or seven per 33:22 year. So it wasn't, know, it was a pretty good percentage of people. were like, no, we're 33:27 smart and good at this and this system is killing me. So we're going to do something better. 33:32 And so I would encourage the patients and the providers out there that might be listening 33:36 to, do not settle. and to demand better. And if you're a provider and you've got a good 33:45 following and you're thinking about busting out and starting a thing on your own, um definitely 33:51 reach out to me and I would love to help you in any way I can because I've been there. Well, 33:57 I didn't do it that way. That's the smart way. I did it with zero patience. But if you have 34:01 a following as a prep, that's a really great way to start. Yeah. Good. Well, that's good 34:07 to hear. And thank you for saying all of that to both the patients and the docs and other 34:13 providers who are out there. Anyway, I hope that my audience agrees that we've learned 34:19 a tremendous amount from you today and thank you so much for your insights and please like 34:24 and share this information with your friends. So thank you so much, Dr. Clint. Hey, thanks 34:30 Dr. Pat. I appreciate it. Thanks for listening to the Women's HealthSpan Voices Podcast. If 34:36 today's episode spoke to you, follow the show and share it with a friend ready to take charge 34:41 of her health. And please leave a review. It helps more women find us.
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