Meet Peds MD - Ten years of knowing families by name.

Speaker A: As a pediatrician, as a membership based pediatrician. Now with all of this knowledge, these amazing focus group parents, a supportive spouse, uh, you know, a great work, life balance, uh, what is it that. That's. That's the, that's the gift, right? Like, that's what we all aspire to, hopefully have one day.

Speaker B: Um,

Speaker A: but what do you want to be known for?

Speaker B: I think, I think one of the biggest things, um, I guess think about the answer to this question is I guess what do I want my kids to think of me is that I was willing and able, with the right support group, to invest in myself to build something different, um, to. To venture out into the unknown and, and just to build something that makes parents lives easier. Right. That, that's, um. I always kind of fall back on that, that mental load of being a new parent. Um, and this is not just pediatrics specific. Obviously when we offer adult medicine, you know, we, we all just move through healthcare, right? As, as we now move through, you know, pediatrics into, you know, eventually family medicine, taking care of ourselves. And so I think that's probably how I'd answer that question is just being willing to invest in yourself. Um, which is harsh. It's very, very hard to do that. And, um, again, requires an immense support system and certainly not just a, you know, one. One pony show. So, um, great question though. Yeah, very good question. Well, this podcast is produced by Concierge Medicine Today, LLC. All rights reserved. Concierge Medicine Today, or CMT, was founded in 2007 and serves as the industry's trade publication and annual medical conference organizer. Please note, the information shared on this podcast and across all CMT platforms is intended for general informational purposes only and may contain errors or omissions. Nothing in this podcast nor across CMT platforms constitutes medical, financial, legal, nor professional advice, and CMT is not liable for any inaccuracies. CMT encourages listeners to conduct their own research and consult trusted advisors before taking any action. Based on the content presented, no mention, interview or link should be considered an endorsement. This content is primarily intended for a healthcare audience and may not apply to all listeners. Thanks for tuning in.

Speaker A: Good morning OR Good evening, Dr. Preneur Nation. You're listening to Concierge Medicine Today's DoctorPreneur Leadership Podcast, and we have a special and unique physician practice today to talk to. We have Dr. Trey Williams. He is with Peds, Maryland, and I like how he described it off air. Adaptive primary care, Adaptive direct primary care. And he's done something really unique in the space of membership medicine. Dr. Trey, thank you for being with us.

Speaker B: Yeah, thanks for having me. Excited to be here.

Speaker A: So before we jump in, uh, we asked this, ah, a lot of all of our guests. You know, what kind of drew you into healthcare from the beginning? Was it part of the family business? My dad was, my aunt was, you know, or was it like you had a personal story or a spouse had an issue or a child, um, maybe a sibling? What drew you into becoming a physician you are today?

Speaker B: Yeah, it's a great question. Um, it was not a family thing. Um, I'm actually the first physician in our family. My dad was a Southern Baptist preacher. Um, so I'm being honest, like kind of peeling back all the layers. It was, seemed like a stable job. Seemed like, um, obviously, uh, something that respected, um, and it seemed like a smart move.

Speaker A: Right.

Speaker B: Uh, kind of just foundationally wanted to set my family up for myself and my family up for more success than, you know, maybe I had as a child. And um, I think for a lot of people it just seems like a good route. And I love people. I love talking to people, meeting new people. I knew that I actually spent time working in a hospital as a nurse assistant between college and medical school, trying to figure out, is this really what I want to do? And I found that I really, really loved it. And um, so yeah, that's what really drew me in. And then as I got into healthcare, I just realized how much I loved kids and still a big kid myself, as most pediatricians would say. And um, just really love, loved just that population. Um, so I haven't regretted it for a minute.

Speaker A: So it's interesting you chose pediatrics versus the other specialties. There was probably a decision point, maybe it was a longer decision point. But what kind of made you say, you know what? Primary care is not really where I want to be.

Speaker B: Mhm. I think the inflection point for me was really during my time as a nurse assistant, um, you know, I was working with adults to start out and you know, I just realized that when I, when I started working with kids and prepared kind of my time working with adults, what I, what I found is that, you know, an adult in the adult world, you know, the, the health problems, the problems that we have, you know, a good percentage of them are because of, you know, life choices, decisions that, you know, things we're doing to ourselves, right? And uh, you know, choices we make, et cetera, Obviously lots of things that are outside of our control. But in kids, I just found that it was the, the, the complete Opposite it's the things that I would handle on a day to day basis or would see or would be diagnosing. Um, you know, we're just, you know, just fell upon them. Right. And it wasn't, it wasn't by any, you know, usually intention.

Speaker A: Yeah.

Speaker B: Especially young kids. Uh, it just had a, I still have a soft spot for, for young kids. Um, that was probably kind of one of the early inflection points for me. And then I just really liked how you can integrate work and play.

Speaker A: Right.

Speaker B: With these kids. And, and then also kind of the, the, the, the, the veterinarian type. I have to figure out what's going on because my patient can't tell me exactly what it is. I also found that kind of challenging, uh, just the, the puzzle piece I guess of okay, let me put some of these clues together. Relying heavily on observation. Um, I just found that all very satisfying. And you know, now that I'm a parent of, of two kids, I find even more. I have a heavy passion for first time parents because it's such a big transition. I talk to my families a lot about mental health. I'm very passionate about mental health and having a baby for me, my first kid really affected my mental health. It was very hard. I had no real people I could talk to because everybody assumed and told me I would be a great parent because I was a pediatrician. But you know, anybody that has kids knows, especially in the medical field that being a doctor is very, very different than being a parent. And parenting is very much on the job training and so very passionate about my first time families and supporting them through the transition to having a kid because it is just huge. But um, anyways, yeah, it's just been solidified over time that you know, it was the right choice for me.

Speaker A: Talk about communication challenges. It's had to you kind of put yourself into overdrive of having to learn how to communicate with something that can't, you know, person that can't communicate. And then you're getting the feedback and maybe too much feedback or not enough, you know, or the worried well parent who's like, you know, well in jumping them jumping in versus like just give me a minute to, to examine. You know, I'm sure you've had to deal with those types of things over the years. Um, what's one story that kind of comes back from those early days that's like this helped that that moment or that season really helped prepare me for what I'm doing today and we're going to jump into that in your peds practice. Um, that's really unique here in just a minute.

Speaker B: Yeah, I think, uh, one. One, not necessarily from. Well, I have a few examples, I guess. Early career. Um, you know, I started out in the Air Force. I was an Air Force pediatrician. And um, you know, it was, it was, it was a grind, especially coming out of residency. It was nice to have where I was stationed. I was lucky to have a lot of pediatrician support, some bases. It's just you. I don't know what I would have done in that situation, just being myself right out of residency. But um, you know, just the um, these, these young airmen who were having, having kids, um, you know, even despite only having, you know, 20 minute appointment slots, you know, being able to spend time with them and kind of uh, mentored them in a very simple way, help uh, alleviate their, their fears. You know, being available for them was really powerful for me. But then as I transitioned out of the military and I started working more just what I consider, you know, corporate healthcare. You know, I, uh, kind of an inflection point on, on two ends. One, you know, there were plenty of situations where just reaffirmed, you know, I did the right thing. And, and this, you know, this is something I'm really passionate about. What was, you know, very small, uh, you know, newborn coming in on it. This reiterates for me over and over again the importance of, well checks. When a lot of people ask questions like why if my kid's doing well, why do I need to go in? Um, but a very small, uh, baby who came in for just a normal checkup, no parents had no concerns. And you know, during physical exam, um, you cannot do uh, checkups virtually. I see some of these corporate healthcare places doing it. It blows my mind. Uh, but you know, during the exam, felt a large mass in the belly and obviously knew it was concerning. And you know, the. Obviously I had a very busy day, you know, 25, 30 patients on average. But in uh, that moment obviously knew something was wrong. Kind of shared with the family the plan and you know, felt a lot of satisfaction, you know, a lot of tears. You know, working with the family through that diagnosis and management, he's thriving. And I saw him last week, he's doing great. Um, you know, no, no issues, no long term problems. It's amazing, but kind of on two ends. 1 I realized this is pretty cool, right? Like again, this form, this, this baby. But tell me what was going on. Parents had no idea. And you know, the exam itself just brought this out and we Ended up, you know, figuring it out. So it was really satisfying from that end. But what was also frustrating was I couldn't like be more available with that family or uh, you know, support them more. I did visit them in the hospital after he had his operation, um, you know, after work one day. And I thought to myself, like, why, why can't I be more available for this family or really support them more? They're having tons of questions and, you know, no real place to answer and understanding me messages. I can't get back to them until potentially next day. So kind of one of the early, um, you know, kind of light but also kind of dark at the same time of like, you know what, you know, this worked for this family. But could this be better? Uh, could care be better? I guess in a way.

Speaker A: So we had a physician, uh, years ago, he said if you want a patient for life, go visit them when

Speaker B: they're in the hospital.

Speaker A: You know, when they're at their lowest point. It's not a matter of you're, you have hospital privileges or you don't or you're overseeing. It's not about that. It's that you're there, you know, you're just present. And um, you know, three kids, their own fair share of healthcare issues, um, you know, I've dealt with myself, you've had yours, uh, you got two kids. And uh, you know, it is, it is rough out there as a patient. And you know, we talk, we do work every single day here about physician burnout. But there's a whole other thing that's way larger patient burnout that's out there because we put on this invisible suit of armor when we go to a doctor's office not knowing what we're going to be charged, upselled, um, whether or not that practitioner is even in there today. We're not informed, um, we're usually misinformed from the front office. And then what do we do? We, you know, physician practice, medical operations and leadership is, well, I'm just paying somebody else pretty much minimum wage or a little bit more to run the front office. And we're going to do it how the other person did it before you. And nothing really ever changes. And so you chose to make a change from corporate from um, where you were at. And you saw that there was something, there was an opportunity, but there was work, uh, life balance as well. That was a big part of your decision to start PEDs MDs. And uh, you started a pediatric, uh, membership based care practice where essentially the same doctor who Knows your kids by name, happens to be the same doctor who is there every single time. Tell us about what the light bulb moment was for you when you started PedsMD, where it's located and a little bit about that, uh, origin story.

Speaker B: Yeah, yeah. So the, to your point, medicine for parents, for anybody, for adults too, is a black box. And we interact with one point on that black box. You're right. Like you show up at the office, you know, especially for if you're sick, you don't know who you're going to see. You don't know.

Speaker A: Right.

Speaker B: Or you're in an urgent care and you don't know anybody there. Right. You don't know how it all works, uh, what kind of a bill you're going to get, et cetera, et cetera. You're signing all these things, you know, split bill forms and all this, all this stuff. Um, and none of it's, none of it's explained to you? Uh, it's, it's just a, it's a, it's a the wizard of Oz curtain. It's just like a, I don't know what's happening. Um, but, you know, I left corporate healthcare and I was working, ah, at a different job, not really very much administrative focus, not really patient care focused. And hey, I missed it. I really did. I realized I actually really loved primary care. I love getting into my families. I love following them in their journey, seeing the kids grow up. I love talking about development, very passionate about, you know, infant and child development and, you know, love kind of explaining to parents saying, hey, here's not knowing what to do. I don't, I don't. I didn't love giving out forms saying, here's what to expect next. I like explaining why, like, why are we having these changes? Um, and so I missed it. And uh, you know, I had a few very loyal patients who found my personal, uh, you know, social media profiles, LinkedIn. Again, people used in mail credits to send me videos of their children breathing or, you know, a weird rash or other things. And um, again, kind of joked with a few of them that, you know, hey, I, I can keep, I keep doing this, but you're gonna have to pay me, um, you know, to be on call for you. Right. And you know, they, much to my surprise, several of them were like, sure, yeah, we'd love that. And you know, I totally thought this was just gonna be a, you know, I can see some patients on the side, people I knew, ah, really well, help them out, be available for them in a Very limited capacity, of course, but, um, uh, you know, six months later, it decided, this, this is what I want to do. This is what I want to, you know, if, if I can, you know, as physician parents, you know, we have access to, you know, we, we diagnose our kids for better or for worse. We, we treat them. You, you have your, your partner has a doctoral call, right, for, for your kids issues, if you're a pediatrician, et cetera. And so I was like, why can't other people have this? Like, if I, like, would. I think people would actually be willing to pay for this if I have this small group that is expressing, you know, their frustration about the healthcare system and how hard it is to get in touch with their doctor. Uh, you know, I had a lot of experience in virtual care at the corporate job running the Jordan's Hospital virtual care programs. And I knew that about 80% of the time, if you're sitting in a pediatrician's office for a safe visit, it could probably be prevented with either a phone call to your doctor, a message, slash, picture, you know, e visit, obviously, those kind of things that they want to charge for a virtual visit. Right. One of those things could likely solve it. And, um, so much of those, ER visits, urgent care visits, ah, sick visits and the pediatrician's office are avoidable. And, um, anyways, long story short, obviously with consultation with my wife, decided to, you know, take the full plunge and, uh, jump in and start offering, you know, different tiers, but specifically primary, uh, care last January. And that's what just, you know, we just took off. Um, and I think people just really. Corporate healthcare focuses on volume. It's transactional, Right? Yes, there are great, great doctors in the system. Right. Certainly want to make that very clear. Uh, great providers in these, in these corporate healthcare problems that they're victims of the system. Right. And so are the patients. Right? The patients and the doctors lose, uh, to your point about burnout on both sides. And, um, you know, it just made it very clear on all my meet and greets, which are, you know, sales calls. Right. But all my meet and greets, people express their frustrations about what it was and how, how, how nice, you know, it could be. And so, um, you know, the growth has been incredible. And, um, you know, people seem to really love the model. And for me and for my family does provide that work life balance. It allows me to be resident for my kids, and I see two, three kids a day, tops. Um, on average, I guess I should say. And that allows me a Lot of flexibility. If I do have, for example, last week my kids were sick. I can. I message my parents and they're. I've never had one person get upset at me. They're actually more worried about my kids. They're like, you know, hey, you know, my God, he's sick. I'm so sorry. Um, which is just a total change. It's just, it's just incredible. Um, but, uh, but yeah, well, clearly

Speaker A: you sound happy and you sound like you're in a good headspace, you know, compared to most. And I always think about my job, my seat on the bus in this industry of memberships and so on is, uh, I get to talk to 98 of the doctors I talk to are happy, you know, I mean, like yourself. And a big part of that happiness, especially for, uh, family oriented individuals and physicians, is, you know, the support of the spouse. You know, this could be a. Hey, honey, I got this idea. And, uh, if the spouse is usually not on board, every indicator barometric reading is. If they're not on board, just wait for them to come around. It's not a, uh, no. It's a no for now, but not forever. What was that conversation like? I'm sure because she works in healthcare, it was a little bit more like, yeah, I'm empathetic, just do it. Or was it like, you need to do a little bit more research? I could see my wife saying something like that.

Speaker B: I, uh, I think, you know, my wife had seen the growth, uh, and how much, I guess, work I had put into it from, you know, July of 2024 to January of 2020. Uh, 2025. Yeah, I'm trying to get my years right. And she, she actually. The conversation is actually a lot more straightforward than I anticipated. Um, you know, I kind of laid out, you know, I certainly didn't put a business plan presentation for her. But hey, we're gonna go away to

Speaker A: a cottage and I'm. Don't worry. I, I called the herder, uh, friend. He's like. I called the front desk of the hotel and I asked if they had a whiteboard. You know, she's gonna be so impressed.

Speaker B: Um, I just laid out, you know, my idea, the thoughts behind it. We kind of came up with a, you know, if we don't hit this point by, you know, X months, uh, three. I can't. It was three to six months. I can't remember. Um, you know, maybe we should consider having you go back to, you know, corporate healthcare. And then I think the, the other. I think the Piece that made it easier for her was she saw how flex, how, how much easier our life was with me being. Having that flexibility of being remote. I was fully remote. I travel, intermittent travel, but I was fully remote. And I, uh, I think that helped put. Move the dial a bit, knowing, like, okay, yeah, you can do this. And it will also help, you know, you can pick up the kids, you don't have to cancel, you know, clinic. And you know, you can drop the kids off in the morning because she's an anesthesia. She goes to work at, you know, 6, 6:30 in the morning. And so the morning's usually around me to get them dropped off or settled or you know, early on with the babies, you know, nanny. But I think that helped a lot is just the, um, the work life balance aspect of the conversation was very big for us and um, you know, allow. She's. She has her own ambitions, allowed her to, you know, continue to, you know, pursue. Pursue her endeavors while allowing me to kind of like, try this out. And you know, I think, I think we both went into it with very positive mindset. We kind of knew attraction. Um, there's momentum that felt like was building up already with folks. Uh, the money that I was already making on a monthly basis at that point, you know, provided us a little, a little glimmer. I mean, I had imposter syndrome until I hit, you know, 75 to 100. I mean, even at 50, my wife was like, hey, you're doing something cool. And I'm like, I don't know yet. You know, I don't know if, you know, this is, this is real or if this is going to take off. But, you know, just. It kind of just. We didn't even really talk about it again. It just kind of kept growing so quickly that it was just like, this is awesome. I want to keep supporting you in it. So. And she obviously, I tell. Tell folks, um, you know, she's p. Biggest investor, right, as far as, um, you know, financially and obviously emotionally and other things and um, make that, make that very clear to people that I, you know, could not have done this without her.

Speaker A: So, yeah, um, it's amazing to have a very supportive spouse. And there are plenty of physician marriages out there that don't always have that. And so, you know, knowing how, knowing the stories I've heard, you've heard, you've seen it firsthand, uh, that is very special. So, yeah, um, congratulations on building something so meaningful and so. And also having your greatest cheerleaders out there too. Uh, so let's talk a little bit about the box. This, you know, you had to create the container before you launch it out is a good business, um, what any good business leader does. And so you created the box, you created the container, you did the planning. You know, whether it was in a notebook or scribble pads or you know, computers. Uh, what is the model you're using? Why are you using that model? How did you learn about these different models? Because there's micro practice environments, then there's cache only environments, then there's dpc, then there's employer based dpc, then there's hybrid models and there's concierge. So they're all fall more or less under a umbrella of membership medicine. So where were you taking your cues from? Was it other physicians, was it other business models outside of healthcare? A little bit of both. What's your thoughts?

Speaker B: My mom's, uh, you know, hands down the I, I, I built this practice to fit my mom's needs. Uh, my parents needs generally pediatricians deal with moms, but you get what I'm saying. So it's, it was really my parents that have helped and continue to help guide, you know, how, how we, how we build, how we continue to build the practice, how we continue to build out, you know, the portfolio of benefits that you get for, for membership. Um, started as very, when I, when I started this kind of was a side gig I didn't have. I was not even thinking about having an office. It was more I'll just come see you, your kid's sick, right? And you just pay me, you know, this flat fee for a visit and you know, I get, I get to see you again and, or do a strep test or RSV test, you know, whatever it may be. Um, you know, it was very little overhead, uh, still, but I have very little overhead. Uh, I mean the most expensive thing on my expense sheet is my social media person, um, because of the emphasis on more on house calls and again virtual interactions. But it was very much built just as we grew, you know, in January last year when we went full time offering primary care. You know, big thing was like vaccines, right? How do we figure out, you know, how to a, both stock and protect our stock of vaccines and then you know, how do we administer them? The just logistics around that. We've just kind of figured it out as we've gone. Right. And I have, uh, Emily's my, um, she's helping, she's helped me found the practice and she's also our nurse. I've known her for a very, very long time and so she's been very helpful in kind of helping operationalize things kind of as we grow and as we've figured out kind of new services we want to offer new things. And so it, there was no playbook that we reviewed. Um, it's been my, it's been my mom's. So I have a mom focus group that I convene intermittently. Um, even if it's just virtually to give us feedback and to help us, you know, pressure test ideas, um, even things like pricing. Right. And they've been instrumental in really helping, you know, build this very, you know, unique type of a practice, uh, that really doesn't emphasize those old school house calls, but layers on a lot of, you know, modern technology on top of it to make it, make it possible.

Speaker A: So I presume no insurance, no Medicare, obviously your age demographic there, uh, but no insurance either. No employer contracts, just purely membership or subscriptions.

Speaker B: Yeah, we are in network with a few insurance companies, but we submit nothing to insurance companies. I don't receive any money from insurance companies. Obviously by design. Uh, I tell my families, I want what's best for you and your child. I don't want what's best for, you know, insurance company A, insurance company B. Um, and so we, we uh, do not work directly with insurance, but we are a network with a few providers. I have folks that want to submit super bills count towards their deductible or whatnot. So uh, it's, it's uh, cash pay, um, uh, you know, again, subscription based, monthly, annual, um, uh, subscription fees. Um, so yeah, we just like to keep it simple. Like healthcare. I tell people this all the time. Healthcare again, that black box healthcare is unnecessarily complicated to kind of peel back all the layers. You can actually make it pretty straightforward and kind of like stupidly easy. I tell people. And that's what I want my parents to feel. I want them to have as little friction as possible. And um, that's the, that's what they consistently say they enjoy.

Speaker A: Yeah. And if you're a parent, I remember that day. I remember we were, I think like Northside Hospital. Of course, you know, Baby Factory had a lot of births and we had all three of our kids there. And I remember looking out the window at the car, at our car that I just pulled up to the circle and I remember looking out our window down to that and thinking, I can't believe they're going to let me take this thing home. Like I am so unequipped ill prepared. Yeah, I've read some books. My wife has definitely read more books. Not, you know, you think about your family, your histories. You're like, this is. You think about your growing up, you do a lot of soul searching, and, um, definitely, you know, what you're providing with the services that you're offering. So talk us a little bit about some of the services that you're able to offer. Um, and that you. You're like, that one was a kind of a surprise. Like, I. I didn't realize how great that service would be and that maybe came out of the mom's focus group.

Speaker B: Yeah, yeah, yeah. So, you know, the services we offer, again, if you're in my service area, we offer house calls, which probably the number one thing my families love is not having a. In a waiting room. Uh, they don't care if I'm five minutes late, they're at home. Right. Um, and so they love, you know, having. Having checkups, you know, sick visits available as house calls. But probably the second biggest thing that people love is just being able to text me. Right? People are tired of patient portals. They're tired of logging in. They're tired of, you know, they associate patient portals with days, wait to hear from their doctor. Uh, you know, we have access to, obviously, patient portals that our patients can use. They frequently use that to send media because it doesn't come through very. Via, uh, text, which we use first, uh, um, to communicate. You know, that's our text platform, HIPAA compliant. Yeah. And my families love that. Right. They just love being able to text me, you know, the, the random question. Or, uh, especially my new parents, you know, oh, when do I start vitamin D? Or like, what, what. What is this again? Rash. Babies are rashy. Uh, or you're making this weird noise. What do we do? Um, so that those are probably the two biggest benefits that my members enjoy. Uh, some of the other things, you know, they get unlimited virtual visits. So if we need to, you know, I don't schedule a single sick visit. Zero. I have all my schedule zero scheduled sick visits because my families know that when their kid is starting to get sick or has some symptom, maybe they don't know it's their first cold. They know they can text me and put that kid on my radar. And then, um, unlike a lot of other offices, we actually take it a step further. We're very proactive. When one of our kids or members is sick, we put them on what we call our get better list. And. And we text them every day. Or even twice a day, depending on what's going on, to check in with them. Right. And I'll explain how that helps prevent phone calls late at night. Cause a lot of people assume you must get blown up all day every day on weekends, et cetera. And I don't, um, I have some interesting stats I can share with you with that. But, but they have direct access to me. Right. So it's not, you know, we don't have a triage person who's triaging. They actually talk directly with me. And, and that's really powerful. Again, kind of back to the beginning of if you had access to your doctor, if you could talk to them, you could probably avoid an ER urgent care sick visit in the pediatrician's office where if your kid's not sick now they are, they've picked up something else, especially in sick season. Um, and then the other, uh, my members get a bank of included, uh, in person sick visits to try to help, uh, reduce over reliance on in person visits. Right. But then the other thing that my families really enjoy, especially you know, if they're traveling, etcetera, as they get a telehealth kit that I provide all my families as part of membership, uh, that allows us to diagnose and follow ear infections, for example, or you know, rule them out or, you know, uh, they have throat pain, we can take a video, uh, of the throat, they can send it to me, um, you know, simple pulse oximeter, thermometer, just simple things that can help reduce the help, uh, increase the ability of me to triage what's going on, see if they need to go somewhere locally to be seen in person. For example, um, full story is I actually diagnosed a, uh, ear infection for a kid who was in Portugal and was able to coordinate with the um, pharmacist, um, there that spoke English to, you know, figure out the antibiotics and get them to the family. And so, you know, just the way we can coordinate care, uh, virtually is, is really powerful these days. So yeah, that's kind of a, I guess a quick overview of kind of what membership entails. I have different membership levels depending on what you're looking for, but the primary care membership does include vaccines as well. We don't bill insurance for those. We don't charge our members any extra for vaccines. It's just part of all rolled up in the membership. But I'm not a big fan of nickel and diming, nor do my parents, you know, like that or want that. They like that. It's very simple, very transparent. Um, very easy for them to understand.

Speaker A: Um, I'm looking at, uh, some of your tiers. Uh, what was maybe one of the surprising focus group moments when you were building the container, building the pricing strategy, building the service offering that came out of the focus group. Because a lot of physicians we talk to, especially entering and even existing in membership medicine, regardless of whatever model they choose, is they're not charging enough. And the altruistic side of physicians and their training is the wonderful strength, but it's also a greatest weakness because a lot of times you're not charging enough, but you don't realize your value is. One physician we talked to said, yeah, I was treated like I was six inches tall, you know, for years. And I now, I believe that. And so coming out of that environment, I'm now recognizing that I have value. And for me and my kids and my family and uh, you know, being in, stuck in that sandwich generation caregiving spot as well, uh, I can say that the physician in the physicians in my life and my kids lives are probably one of the top 10 most influential people in my life, behind my wife and kids, you know, probably number six if I was to, you know, think about my family first. And so the physician's voice in our lives carries a lot of weight. Um, what was one thing that maybe you struggled with related to the value of what you're worth when you're creating this? And then maybe that focus group was like, that's too much. Oh, that's, that's just right. Or man, you're like a Groupon deal. Like, this is so good, but don't charge that.

Speaker B: Yeah, I think pricing strategy is tough and it's very hard when you don't have a lot of benchmarks. Right. If you're just opening a typical DPC practice, there's tons of benchmarks. If you're opening up another type of practice and there's lots of benchmarks, that could be easy, right? For me, it was, uh, very much unknown. Um, and I think the discomfort all of us feel when we are setting our pricing is, I think early on, when traction is obviously slow, the first thing you think of is we're too expensive. People, people seeing this number and they just don't want to sign up. That's the worst thing you can do. I think you really need to decide where you want to, you know, positioning, right? How am I positioning myself? How, how is my brand, right? What do I want my brand to be? Do we want to be a very premium product, you know, in the dpc Market, which I, you know, I would say house calls is probably a pretty, I mean, seems to me pretty premium. Um, have somebody, have a doctor come to you? Um, so we knew we wanted to be a premium product. We didn't want to rely on, we don't, we didn't want to have to rely on volume. Right. Like having an office, having, having a set clinic obviously reduces the downtime for the doctor. Therefore you can see more people and uh, have more volume. And you know, you're going to, obviously if you have that kind of volume, you're going to want to price yourself a little lower. And so we obviously did, you know, market analysis here in Charlotte on other DPC practices. You know, you can, you can learn about a lot of these models just based on their website feedback I've gotten from, you know, members that, you know, they've either moved from one practice to another, vice versa. And you really need to, again, uh, you, you mentioned it. Know your own value, right? Like what, what do I. And there are, there maybe are, there are some good benchmarks for this. But, you know, what is a pediatrician's hour of time worth? Right. And kind of think about your offerings from that perspective, including, you know, having the same doctor on call for your family is when we have another doctor come on board, the only time she's not going to be on call for her family is as if she's on vacation, you know. Right. And we'll have an adult doctor covering for her adult patients. But, um, you know, for me, the same when I'm not, the only time I'm not on call for my pediatric patients is when I'm on vacation. Um, and so you have to think about all these things and it's always takes a lot of time and, uh, an effort. But I think the biggest thing that, the biggest thing I'm glad that we did is we created the pricing structure and we stuck to it and we really resisted that temptation to drop it down, you know, lower, lower, lower, uh, which would mean we can get an office, have shorter appointments and, you know, the quality wouldn't be what we want. We wanted that top tier premium quality. Uh, and that's what, you know, we're offering our families. And it's been consistent up to this point.

Speaker A: Well, good for you. I mean, that is usually one of the biggest hurdles, you know, is. And it's a struggle of like, ah, you know what? I will just. And I've, because I, you know, you've probably heard about them, you've seen them, maybe you've talked to them. Maybe we know them. You know, it's like, I've seen. You know, it's like, well, we'll treat your. We'll treat this one. And it's buy one, get one, you know, and. Or it's $8 per member per month. And it's like, how are you planning? Just, you know, we've asked. We've done physician polls of asking a difficult question. Look, if your physician went out of business tomorrow, how much or how little would your patients actually care? And why are those patients leaving? And they just don't see the value in you at $8 per member per month? And I get the altruistic idea of, yeah, let's be everything for everybody at all times. And. And then also let's be a physician that wears that like it's a badge of honor that we made no money. You know, and it's like, okay, then you. You overlay on top of that, the influence you have that your words are weigh a thousand pounds. Like, five words from my doctor right now would uplift me or encourage me or, like, great, you know, I got to work on my LDLs. Um, so, you know, I see. Uh, anyway, if you want to riff on that for just a minute, but then I have another couple of questions for you before we come in for a landing.

Speaker B: I have a couple. Couple of thoughts just around that. I think, you know, the positioning goes also to, like, branding. Like, if you. If you want to market yourself as a premium product, you know, we don't give discounts, right? We don't. You know, there's no promos that we. That we give out, and that's by design, right? We. We tell you, um, what I had to learn most about starting this practice is how to. How to. How to sell, right? That is, I emphasize more like, okay, I. I feel confident about my pricing. Focus groups. Feels good about my pricing. Knowing what I'm offering, I need to sell it, right? And that was. That was hard for me. And how. Just simple things, how you position it. You know, we. We always talk about how this is an investment, right? Not a, uh, this is the. This is the monthly cost or the monthly subscription. Like, here's the monthly investment, you know, in your child, right? So it's how you just position things and how you sell yourself, and then again, knowing your worth and knowing when people tell me, like, Trey, that that might be a little above our budget. I'm sorry, like, but that. I mean, this is what it is, right? And. And, you know, I can explain why this. This, you know, this is what it costs. And so, you know, I think the, um, you know, how you market yourself, how you brand yourself, how much you invest in your website, for example, how much you invest in other things. Um, you know, so if you. If you aren't willing to do those investments, you know, either yourself or by paying someone else, then, you know, you won't command that. That premium. And so I think that's important. So just knowing ahead of time, you know, we want to go in, we want to be here, we want to be in the middle. You know, we want to be more approachable, economical. Therefore, we will have more volume. You have to decide kind of where you want to be, and then, you know, build everything around to that and then learn to sell to in that way. Uh, which is. Which is hard for. For doctors selling. I mean, I went to business school. I'd never took a sales elective because I never thought I'd have to sell anything. And I really wished I would have. But, um, biggest challenge for me was that sales part. But, uh, my wife, she'll listen to my calls sometimes. She's like, oh, that. Yeah, that one went well. I'm like, yeah, it's kind of automatic at this point.

Speaker A: So, yeah, yeah, it takes a while. And, uh, I know years ago when I was talking about concierge medicine, before DPC was kind of even a name in the picture as far as terminology, you know, you would talk to everybody. Small town, rural newspaper. And then, you know, it'd be like, I wish I wouldn't have said that. I wish I would have said that differently. And then over time, it takes years, you know, to perfect the. And it's still getting perfected, right? Still changing. It's still like, uh, I could have said that. Simpler, shorter. Uh, and so it's all about, you know, how you're communicating. Communication is such a big part of this. But one of the rare things I think that's interesting about your practice, about your. Yourself as an individual physician, is your mba. Uh, you know, that is encouraging to see that not only did you get your degree from your medical degree from University of South Carolina, but you also got an MBA from University of Chapel Hill over there in North Carolina. And so why. Because that seems extra. It seems what, you went to school just to be a doctor. That's a huge undertaking as it is. Like, why also have the mba? And I find encouraging from a patient perspective, but also as a business leader to say, yes, if you're going to do this, you have to know about business. In fact, it was a fellow physician of yours. You probably know him or don't know him, but he said years ago, uh, in order to stay in business, I have to know about business. And so why the mba? What has it given to you as far as maybe a return on investment?

Speaker B: Yeah, I think it's a great question. I originally got my MBA because I'd always thought I wanted to go into hospital administration of some sort. Uh, worked my way up, uh, the ladder. And I started to do that at my corporate healthcare job again in virtual care, and started my MBA as I was transitioning out of the Air Force. Um, did just a standard MBA program, which I found profoundly impactful for me. I learned so much. I intentionally did not want to choose a physician, only one. I wanted to meet people from other industries. And it was fun. I was obviously challenging having a small baby, uh, when I started, but I, um, found it really, really fun. I learned a lot. And I think what I tell people is if you're just going to open up a practice, one practice, maybe hire a couple doctors, you don't need an MBA for that, right? You can figure that out. You're a professional. Like you said, you went to medical school. You can hire people to support you, pay, uh, companies to obviously run the administrative side of the business, uh, when you're not dealing with insurance. Certainly a lot simpler. Uh, the ambition we have as part of our practices, not only to just have this practice here in Charlotte, uh, again offering adult services later this year, but is to, you know, why we're taking on investors right now. So we can build this and drop it in another city. Right? Drop it in, you know, eight, eight to 10 cities here in the Southeast and turn this into something, you know, a lot more, um, you know, with that. I think that I don't know if I could have done that or set the found work, but the foundation groundwork to, you know, scale this into something different without, uh, that experience or without bringing somebody else on, diluting equity who could help do that, uh, which only impacts me. And so I found it insanely helpful, M to have this background. Again, I wasn't as well rounded as maybe I should have been with the sales piece, but, um, with the marketing and, uh, certainly the financial side and just putting plans together, um, financial projections, etc. You know, stuff that at its core is really, really important. Not only for if you're running one business, but if you're, you know, trying to scale something and build something bigger. I found it insanely helpful and um, very thankful that, you know, I did that. And obviously the Air Force supported me, um, you know, in, in covering the cost of that because it, I definitely think it's, it's paid dividends and will pay even more dividends down the road.

Speaker A: Yeah. While you're speaking the language I love to hear when I hear these interviews, uh, you know, performance pro formas, financial projections, you know, focus groups, uh, and I, I go back to the idea of your voice carries weight. As my physician. And what I don't want for any physician is for them to try something like this and then fail in 18 months or six months. Not because of, you know, they didn't maybe usually because they didn't see their worth and they were too low in the price point era, uh, area. But they don't recognize that your voice carries so much weight to your patients. And then we lose you to bad business practices is usually the case. Uh, so we're going to now move into our lightning round of questions. You can be however brief or long winded as you would like. Um, but, uh, I could talk to you probably for another hour. I have so many questions written down on post. Its here, but let's talk about, um, you know, when you are building the container, the legal, the operational. Uh, we talked a little bit off air about using AI operationally. I remember interviewing a physician, uh, not too long ago, a couple of months ago, and he said, you know, look, there's AI assistants. They can build the schedule. Like, we don't need the person to be doing that for you. You know, like there's things that these tools can use and can help you with. So how have you used AI in that? But also when you were building the legal, operational, practical, contractual side of this, how did you go and get help? Was it one of the moms in your focus groups or a friend or an mba, you know, you know, or physician who. Or I'm sorry, a physician friend who was an attorney, uh, who you were referred to. Walk us through a little bit about those processes.

Speaker B: Yeah, yeah. So the, uh, you know, certainly the focus group has been helpful, but a lot of this has been, um, you know, networking with folks who are building business. I'm lucky to know a lot of people in here in Charlotte, especially, uh, certainly in the financial industry, but lucky to know people who are just connected. And that's been, it's just, I feel like so much of this just been like kismet. It's just kind of like I meet the right people and it's like, wow, that's perfect. Um, I need to do a legal audit of the company. Right. Make sure we're buttoned up and our agreements look good. Right. Um, and so we, um. It's been a lot of networking. I think that's, that's probably early on networking. I did that heavily because I didn't have a lot of patience networking, not only from a business perspective, but networking for, um, you know, professional, uh, you know, um, introductions that are going to, we're going to help advance the business. And so, you know, we have a great legal team that, uh, we work with, a great firm we work with that specializes in, you know, PC, mso, uh, setups because again, we have the professional entity. But, um, we're, we're thinking a bit bigger than just, you know, just one practice. And so we have a, you know, team that specializes in specifically that, you know, social media was a big push for me early on just because, you know, the target demo I'm looking for spends a lot of time on Instagram specifically. Um, I do have younger, younger families that are coming on board that spend, uh, more time or tell me they have found me on TikTok. But, um, you know, we decided to invest a lot in. When I have a lot of time, uh, in social media early on. Did it all myself at first. Now I have a person, luckily, that manages it for me who's great. Um, and, you know, just, I guess, finding the right people, surrounding yourself with, with the right people. Um, and if you don't know, ask.

Speaker A: Right?

Speaker B: Like, ask for support, look for support. Don't be willing to go into debt. Right. A lot of people are scared of debt. That's the vital part of any, any business. Uh, it's just part, it's part of having a business. But don't be scared to invest in your company in these ways, uh, to make sure you're doing things right, you're setting things up the right way and again, that supports the brand. Right. If you're doing all these things, uh, more, you know, early on, I guess. So hopefully that answered your question.

Speaker A: It did. And it's, it's affirming because I say these things and I'm not a physician, but I am a patient. And the perspective that that gives me from my seat on the bus is that I do know what it's like to sit on the other side of the exam room from you. I do know what it's like to look at your website as a patient, as a prospective patient, as a paying customer, and know what it's like from my side. And we, we repeat often that it's no longer about being the best doctor in the world anymore. It's about being the best doctor for the world, for your patients and for your local community. And to be surrounding. I was, was at a doctor's office last Wednesday and he essentially is echoing some of the same sentiments. Surround yourself with good people who, people who don't know, who know what you don't know. You know, because I have to come to a point where I don't know everything. Yeah, I know all about this. But that's why we call it a practice, right, the practice of medicine. Because we're still learning. We're always practicing, we're always learning. Um, and so I'm encouraged, um, that uh, what we put on repeat that sometimes, you know, feels solo and siloed is, you know, you're living it out. Um, a couple of other questions for you. Um, you're looking at scaling this, looking at building it, putting in another physician. Um, oftentimes this is the most, uh, you know, rewarding. But also sometimes like, uh, yeah, that was also the hardest thing we did was bringing on the first and the second. Um, and maybe looking at this future forward. Like I want to work, I don't want to work in the business, I want to work on the business. Right. We hear that a lot. Um, and for so often. What's the physician mantra? Well, I'll just work harder, you know, and longer. And yeah, you know, because I'm used to that, that's, that's comfortable. So as preparing this to potentially scale, add on additional doctors, you know, what does that, what challenges are coming up for you? Are you, are you thinking this is the right time or maybe we're moving too fast or you know, what's the long term goal? Maybe even taking this into college campuses or taking it in into different states, you know, or just, just, you know, hey, I got a good, I got a good annual revenue. It's working. And the work life balance is amazing.

Speaker B: Mhm. Yeah. I think we're in a service industry, right? We are in an industry. We're not selling products to scale. I have to have providers, right? I have to have other doctors. I mean, there's no if, ands or buts about that. So the question of hiring another doctor is there's no guessing that at all. Uh, to make more money in a service industry, you have to have, offer more services, right. And expand your services, you know, other ways. Um, and so, you know, the, the it's definitely time to bring on another doctor. I know that for sure. Um, I think the challenge is, you know, for a lot of these doctors, I mean, we're, we're different than a lot of practices and we're offering a guaranteed base. Um, it's not a, you know, eat what you kill, come on kind of part time and build up to it, which I, I know is a model a lot of practices do use. But, you know, we want to, we know it's risky coming over to a model that is not again, benchmarked, uh, not necessarily proven, uh, at least you know, at scale. And this, you know, this key hire, this first hire is definitely a key hire, you know, in the eyes of both, you know, the cap table as well as just the business. Right. I need to dilute myself as the brand. I cannot. You can't. I cannot be the brand of Pizza D. Right. This won't work. Uh, it'll just be. I'm hanging my shingle here in Charlotte myself. I'll work and then I'll close my practice when I retire or sell it. Um, that's not what we want to do. So I have to, I have to dilute myself as, as the brand of PedsMD, which means bringing on other doctors, having them on social media, doing videos, not just me. Right. Seeing other faces, et cetera. Um, so I think the big challenge for us is, is bringing on that new doctor. And, you know, explain. It's risky. Right? It's a, we're a startup. Um, it's. There's a lot of unknown for them. And so I think, you know, we're working hard, obviously with the legal team and hr, et cetera, to, you know, come up with a, A package that helps de. Risk it for them, um, while also protecting us as well. Right. Because we're going to be investing in this doctor and we hopefully will get a return. So, um, that's probably the biggest challenge is the, uh, the acquisition of, of the doctors. The funnel's been pretty strong. It's just actually like closing the. Closing the, uh, you know, the sale, bringing them on, you know, having them sign the, uh, the actual like, you know, employment agreement. That's been the. Right. The biggest challenge. Yeah.

Speaker A: Interesting question as we have a couple more for you, you know, share a little bit about the demographics of the practice. You know, yes, you've got children, but the buying decision happens with the m. With the mom, the dad, whoever, um, the family members. And I, because I'm not familiar with pediatrics as a specialty related to the male versus female demographics. I am familiar with marketing demograph and usually the healthcare CEO of the family is the mom, right? She determines where we're going to go, who we're going to see, when we're going to do it. She's usually booking all the appointments. It's rarely, uh, it's not always, but it's rarely the dad who's doing all this kind of stuff. Um, so you being a male physician in a primarily, you know, healthcare CEO, female buying decision maker demographic, um, you know, have you found that to be true? I mean, because I would think that that's a little bit of a challenge as well. Just that's who I've got to make pay me for my services. Um, talk to us a little bit about that from a marketing perspective.

Speaker B: Yeah, I mean pretty, you know, membership wise, preven split with the members, you know, uh, male, female. But when it comes to who I interact with on a daily basis, 90 of the time, maybe 95 of the time, it's, it's moms. Right? That's why, you know, most of my, my focus group is moms. The way I market things, the things we give away, um, on social media, for example, all geared towards moms. I think my social media is probably a very good example demographic of what, um, you know, who's looking to, to work with me. Um, I, I'll take this all the way back to childhood. I grew up with three sisters, so I, you know, it's, it's not um, selling, selling to moms is, is, is not, is not challenging. Um, and again, knowing the product that you have, you know, friend referral is obviously very strong. They see me on social media. Um, you know, we're lucky enough with social media help. We have over 20, 000 followers, uh, on our, on our account. And so they see me on social media and they see these videos and I'm already building trust with them, right? That's, that's, you know, what, what they want is someone that they feel like they can trust. Uh, and then I think the other big thing that these, these moms generally are looking for is, is a healthcare partner, right? Someone who will partner with them on their healthcare journey. Because there's so much information out there and so many sources including you know, obviously AI and they want someone who they can just like talk to, who's gonna be straight with them, um, you know, help them understand their options, not you know, feel, make them feel pressured into any decisions. And I think those uh, those things kind of make, make the relationship just a lot smoother, a lot easier. Um, but definitely, you know, millennial moms.

Speaker A: That.

Speaker B: That's how I would summarize the, uh, you know, my target demo whenever I'm, you know, on social media, we're making videos, is kind of who we're really making content for. Uh, you know, my followers are 90 female, um, and, you know, aged, you know, anywhere from probably the peak is around 32 to, uh, you know, late 40s. Um, and so it's, um, it's a great demographic. And, uh, obviously it's going to change a lot as we move into the adult side of the practice. But, um, plenty of folks here in town who, you know, fit that and fit that, you know, addressable market.

Speaker A: And I see part of that brand is the hat wearing backwards. You know, like, I pay attention to those little small marketing details because I think that that's so important. It's the devil is in the details. You know, it's like, uh, you want to make a change in your practice from a dental perspective. Like, make sure that you're putting mouthwash station in the breast room for your patients because, you know, they're interacting with your coffee breath all day long. You know, like, do those little things, and then what can you do next week that's a little bit different? Um, and my daughter and wife and I just finished watching the. All the seasons of Gilmore Girls. And so when he went, I forgot what his name was, but when he went to the backwards hat that had the little emblem logo, I don't know if you've seen it, but it was like, oh, that's such a bad, you know, decision. You know, this was the 90s, the early 2000s, and it was like, okay, he went back to it. You know, he went back to the original hat because it was obviously, you know, fans were crying out like, hey, don't. Don't do that.

Speaker B: And.

Speaker A: Which makes sense from a marketing perspective for those learning marketing lessons on this who are physicians, is that usually 8 out of every 10 of your paying clients are going to be 10 plus or minus years of whatever age the current physician is. So if the physician, for example, is 40 years years old, most 8 out of every 10 of your patients are primarily going to be between 30 and 50. Not always the case. Obviously, your specialty leans heavier against a younger demographic of purchasing power. Um, so a couple of last questions. Uh, what book would you recommend a physician who's interested in this, who's exploring this, uh, or what book is currently on your audible library or on Your nightstand right now that you're like, it doesn't have anything to do with business, just a great pleasure reading.

Speaker B: Um, I, I really like, uh, there's, there's a couple books I really like. Atomic Habits. Probably everybody says that, but it's, ah, it's just a great book. Um, you know, at tie frame, a lot of my conversations, you know, when we're talking about changing behaviors and you know, toddlers or even ourselves as parents, you know, um, you know, small changes can lead to, uh, you know, big outcomes. And so that's probably one. There's another book. I'm blanking on the name of it. I read it a while ago. Um, it's about building. It's called Traction. That's what it's called. I can't remember the. There might be a few books with that name. It seems like it'd be pretty common. But there's, um, one book in particular I read early in my journey that, you know, really, it walks through kind of the different channels that you can use. You know, print which people think is dead and obviously it's not, but many different, uh, channels. And it's important early on as you're trying to figure out, you know, where your, where your funnel is, where you should really focus your funnel. Uh, it helped a lot, right? I mean, I was doing simple things like I had brochures I printed out and I literally walked around our neighborhood, which much of my neighborhood is my target demo now. I was putting brochures on people's, um, uh, porches in their mailbox. Um, you know, radio did a little radio early on. Uh, other, other things. Um, just trying out different channels to kind of know where she focus your attention, which is not normally everywhere.

Speaker A: Right.

Speaker B: Um, and social media was, was a big one for us. Um, so anyways, the, that book I think kind of helped, helped reassure me in a lot of ways about how difficult traction can be early on. Um, you know, sticking to your guns. Right? Again, back to pricing, right? You gotta, you gotta find. It takes a while to find traction and you have to. It takes, it takes frankly, just some trial and error, uh, including money. Right? You got to spend money to make money, um, to figure out what works and what doesn't.

Speaker A: That's awesome. Thank you for that. Um, all right, our final question for you, um, is as a pediatrician, as a membership based pediatrician. Now with all of this knowledge, these amazing focus group parents, a supportive spouse, uh, you know, a great work life balance, uh, what is it that. That's, that's the, that's the gift, right? Like that's what we all aspire to hopefully have one day. Um, but what do you want to be known for?

Speaker B: I think, I think one of, one of the biggest things, um, when I think, I guess think about the answer to this question is I guess what do I want my kids to think of me and is that I was willing and able, with the right support group, to invest in myself to build something different, um, to venture out into the unknown and just to build something that makes parents lives easier. Um, I always kind of fall back on that, that mental load of being a new parent. Um, and this is not just pediatrics specific. Obviously when we offer adult medicine, we all just move through healthcare, right? As we move through pediatrics into eventually family medicine, taking care of ourselves. And so I think that's probably how I'd answer that question is just being willing to invest in yourself, um, which is hard. It's very, very hard to do that. And, um, again requires an immense support system and certainly not just a, you know, one, one pony show. So, um, great question though. Yeah, very good question.

Speaker A: Well, congratulations, Dr. Trey. You have created something very unique in this space. And I've seen a lot, you know, I mean, I'm not seen it all, but I've seen a lot. And um, you know, your social media is so likable. It's whoever is doing your social media. Uh, my background is in marketing and pr, so, you know, I understand what good marketing is, what lousy is, and there's too much lousy out there. And so I'm really encouraged that, you know, what, when to worry about rashes and when what we heard in the 90s are back and you know, all these different things, I love it. And um, you know, the importance of our conversation today related to business, marketing, branding, um, what you've learned in, throughout this journey and just how it has created a better work life balance for you and your family. Um, you know, you can't ask for a better gift or reward for your hard work, your years of tireless service to others. So thank you, Dr. Trey, for being here. We'll put the links to your website and to your social media, your Instagram and so on in the show notes, uh, in the next couple of weeks and uh, hopefully, hopefully, uh, somebody will learn something.

Speaker B: Yeah, yeah. It was a pleasure being here. I appreciate the time.