marinacapella

I'll go ahead and introduce this one welcome everyone thanks for joining us for another episode of dpc pediatricians Today we're going to tackle a little bit of a challenging topic or at least one that gets asked about a lot and that is can you serve. Low income families within direct pediatric care and it's definitely something that I thought a lot about when I opened my practice and prior to even finalizing the decision to open my practice because if I look back at my trajectory and my why for medicine a lot of it had to do with.

 

00:36.61

Phil Boucher

Right.

 

00:39.34

marinacapella

Serving underserved communities and so that was really important to me and to my purpose as a physician and so it's something that I really thought about a lot and it's a hard question because I would say the answer is yes and no and you have to kind of be creative about it and it also depends on your community. Um I have been able to figure out ways to serve low income families in some ways but not in every way that I would like to so I'm curious and Phil I'm going to put you on the spot First, how would you answer this question how how or have you been able to serve low income families within. You're a dpc.

 

01:18.91

Phil Boucher

I think I'm much like you like this was really on my heart when I was thinking about it because I think there's this misconception that Dpc is just for rich people. Um, and that like the parents are just gonna be really needy and they're just gonna want high touch points and for you to cater to them and.

 

01:30.41

marinacapella

Ah.

 

01:37.67

Phil Boucher

I mean it couldn't be further from the truth like when we've looked at our our patient panel. We have 500 some patients. The vast majority are not wealthy. They're middle class 2 working parents. Um, they have a high deductible plan and then. They you know can do the mathth and realize the the benefit we have lots of nurses and teachers. Ah that are are members of ours. They're not all just wealthy people and ah so I think that's one of the misconception is this is just for rich people or something like that when it comes to serving those that are low income or that have special needs or those sorts of of things.

 

02:07.92

marinacapella

Um.

 

02:13.18

Phil Boucher

Like that's really important I think for most pediatricians that we don't give those up because some of those are the most important cases and the the ones where we're able to see our benefit most acutely that we're able to to help those families. Um, and so we figured out it in a couple different ways. 1 is sliding scale. And so that's just really straightforward like if people go to our website and they look at our pricing. There's a little click button there that says if you are lower income and are interested click here and then they'd like fill out a little information. We keep 20% of our patient panel as ah, sliding scale. And so that's just kind of something that we've stuck to is ah here's sliding scale and we don't do we don't like so have them submit pay stubs. It's truly just the honor system we say okay, do you need 30% off 60% off or 90% off in order to make this work for you and your family. And they pick that and then as long as we have 20%. We just continue to offer that and and give those discounts what we do so that like we don't get stuck and we can keep continuing to offer those discounts is every quarter will say hey you're at 90% off would you be able to are you in a place now. To go to 60% off or you're at 60% off. Could you go to 30% off and so that allows us to then like gently say we we have offered you this discount because you needed us in that time is it possible for you to move up a little bit pay a little bit more and a lot of parents do that and they're happy to increase because for 1.

 

03:46.22

Phil Boucher

Financial situation may have changed and 2 even if it hasn't maybe they've realized the value that we offer and and can realize okay, this is definitely worth what we're paying in more um and that has allowed us then to keep that open and offer that and I'm actually surprised that more people don't take us up on it. Um. And so that's 1 thing. The other thing that we do is free care like charity care is something that we do. There's some families that can't pay and that we've established some sort of relationship with them or honestly they just made a good case on the phone and like yeah, just come in. We'll take care of you. Um, there are some families that don't have insurance that were able to help. Um, either you know.

 

04:03.93

marinacapella

Ah.

 

04:23.52

Phil Boucher

Because ah, they're self-employed or they're not in the country with their papers. It would lick it legally you know we're able to help in those situations where a traditional clinic might not be able to serve them or would only be able to serve them at an extremely high cost like if you think about if you don't have insurance. And you need to check up for your two month old and vaccines for your two month old or something like that way over $1000 to get those things done in a traditional clinic where you're just paying cash for it. We're able to figure out ways to help serve those families in a very different manner and provide that level of care. Ah, to them and we actually do have a lot of patients with medicaid that come to our practice. Um and pay like the regular fee because they do the math and realize that the value ah exceeds ah the cost for them even though it's a monthly cost that they wouldn't necessarily have to bear. They realize okay, they can get us in quickly. They're responsive. They avoid unnecessary appointments. This gets me to work more easily so that I can not be stuck at home with a child all day that has a fever that I just need to get them in to get them checked out or get them cared for There's lots of ways that you know parents justify in their minds. Um. Why they would spend money out of pocket when they could not do that because of what we offer and so so those are some of the ways that we serve like in the same sort of way that a traditional practice that takes commercial insurance and that takes medicaid does um the other thing and I feel like I'm going on a long spiel here and.

 

05:48.19

marinacapella

Go ahead.

 

05:50.90

Phil Boucher

Now as I've gotten going is we're able to serve in different ways ways that a traditional practice because of the demands of insurance on the you know the the number of patients that you have to see to keep the lights on and the employees fed and all those sorts of things we are able to do some things that. Traditional practices just don't have the bandwidth for when I first opened we were in the heart of covid and things were rough and teachers were having a really tough time so we were able to set up like use our Mckesson account to buy a bunch of n nine five masks and teachers could just stop in and grab them as they needed because they weren't getting enough. At school I mean that doesn't seem like something that should have to done like that seems like something that schools should provide but they didn't so that was a need that we were able to fill shortly thereafter. There was the formula shortage and so what we did was we opened up a formula bank parents. You know we asked parents raise your cabinets if you have extra formula. Um. That you don't need bring it in and parents then could come and pick it up if they said my kid needs gentle easee or my kid needs new traagegen or 3 60 or whatever it is like come and get it from our office. There's no charge or anything like that. It is just Goodwill but there's a lot of formula that's just sitting. In cabinets from babies that don't need it anymore that we can help to redistribute that to people in need ah 2 other things that we do. So. There's a local big foster agency and one of the federal regulations is that they need a physical within 48 72 hours of entering the foster foster care system.

 

07:24.27

Phil Boucher

Usually they're coming from a different part of the state or they don't know who their primary care is or they just can't get in with their primary care and so we've said we'll we'll do those. We don't charge them for them or anything. We just do it for Goodwill but those kids then come in. We do their foster physical. We get them set up if they need followups and referrals. We can kind of help. To shepherd that along with the help of their primary care if they're nearby or not and so that's another way that we serve and then one other thing that we've done is catch up physicals. So there's a head start daycare in town. That's federally funded funded and 1 of the mandates is that they. Caught up with their physicals. Well a lot of these families have issues with transportation with timing of getting into appointments when they're working all of the other snags that go into that. So what we've done is we've gone to the the daycare center met the parents there done their physical at there make sure that they're up to date. So that they're getting the healthcare care that they need and also that the the daycare is able to you know, stay federally ah up to snuff when it comes to all the check boxes that they have to check so those are some different ways that we've been able to serve families and the last one that I'll say that I just thought of is we helped start a breast milk bank. So. Ah, for families that need breast milk if they if they need donor milk if somebody has a ton of donor milk and they want to donate it. They can donate it through us and if they need breast milk. They can come and get it through us or we've partnered with a it's a local center called the Malone Center but it's like for low income women and children.

 

08:59.43

Phil Boucher

Um, they actually have a ah ah van that delivers donated breast milk to moms and babies where they live and it's kind of it's kind of funny. It's like um, they kind of leaned into the milk theme with some like ah cow sort of branding on the vehicle. And like the milkman arriving sort of thing. Ah so that was kind of fun and fun and interesting. But that's another way that we're able to serve that a typical practice usually doesnt know the Bandwidth interest or ability to do where parents can come like there was just a mom this morning that came in like they have to get blood drawn before they can be a breast milk donor to the.

 

09:21.88

marinacapella

Ah, interesting.

 

09:37.38

Phil Boucher

The the milk bank So we kind of set that up and draw their blood and send it to the lab and all those sorts of things so that's another way they're We're able to serve low income families in another way outside of the typical practice and outside of the typical routine baby care that that somebody can provide how about you.

 

09:54.10

marinacapella

Excellent I I love all those things you're doing. Yeah I I do have a question for you though and I'll touch on it too. But um, when it comes to a lot of us have you know bleeding hearts and we went into medicine because we want to help people and then we end up we can.

 

09:55.80

Phil Boucher

What what? What was the? yeah yeah yeah.

 

10:03.74

Phil Boucher

Hey totally like Pediatricians for sure.

 

10:10.77

marinacapella

Run into the trap of undervaluing ourselves and not making the business financially work in order to try to give too much discounted or free service in the beginning I definitely was guilty of that I set my prices too low I Was you know, not bringing in nearly enough money to keep my business afloat and if our business does not stay afloat.

 

10:22.33

Phil Boucher

Let us.

 

10:30.66

marinacapella

Then we can't help people and so you really need to make sure that you are thinking through you know a charity care or discounted rates in a wise fashion. So you for example, you set a limit on 20% sliding scale right? So that probably helps to ensure that your business model overall still works.

 

10:32.48

Phil Boucher

Um, right.

 

10:42.25

Phil Boucher

Right.

 

10:50.41

marinacapella

But what else would you say to that point how is it that you're making able to make sure that your business is going to continue to thrive as a business while still doing these things to help out your community.

 

11:04.70

Phil Boucher

Right? I mean I think that is so important too because you can give away everything and then not be able to serve anybody. Um, and so the 20% was rather arbitrary and just felt like a good number to say it especially because most of the practices in town.

 

11:09.54

marinacapella

Are.

 

11:19.46

Phil Boucher

Um, have you know between 10 and 15% of their patients are medicaid anyway. So we were trying to do as well or or better than that um ourselves um from a business perspective I think being in the community does help to drive new business into the practice too.

 

11:20.90

marinacapella

Um.

 

11:38.11

Phil Boucher

So the milk bank The Formula Bank those sorts of things get our name out there and so not only are they able to help parents in need. But they do shine light upon our practice and get more you know media attention and all of those sorts of things at the same time, especially like during the formula shortage. We had so many patients that reached out and not.

 

11:40.56

marinacapella

Yeah.

 

11:57.53

Phil Boucher

Just our patients but just people in the community that needed a formula because the shelves were bare and they couldn't find what they needed and so that was really one where it helped shine light upon our practice the foster care one to the head start one has led to a partnership with doing Autism evaluations for the head start center which is. Ah, been a really good opportunity for us to help with autism diagnoses and make you know revenue from that from the Autism evaluations because head start pays for them rather than putting the the burden on those families and so I think those things come back to you and sometimes you don't know how it's going to play out.

 

12:27.80

marinacapella

Nice.

 

12:35.70

Phil Boucher

Um, certain that wasn't in the bucket list. But then they said hey we saw that you guys do these? can you do them for us. So not all those things like there isn't ah, always a good business justification for it from from a number sense at the beginning but then they do come back to you in different ways that you don't anticipate or.

 

12:42.18

marinacapella

Um.

 

12:47.80

marinacapella

Yeah.

 

12:53.78

Phil Boucher

Um, realize I mean we've had patients that have joined now that said you know we didn't join before ah but you helped us with at your old office location when we needed some formula and then when it was time for another baby. We're like oh let's go to them for our new baby because we kind of learned about the practice.

 

13:05.26

marinacapella

Um.

 

13:10.27

Phil Boucher

And so when you give back to the community in those ways I do feel like it just comes back around one way or another that you can't always anticipate.

 

13:10.89

marinacapella

Ah, yeah, ah I love that I love that? Yeah, so um, it all it all plays in together eventually. So I love that. Ah yeah.

 

13:23.66

Phil Boucher

Yeah, or it just puts good vibes out there in the universe and good vibes. Come back something like that. That's what I at least try and tell myself what about you I mean how did that decision go for you when you were starting out and what does that look like for you in your practice.

 

13:28.77

marinacapella

That's true. Ah exactly. Ah.

 

13:40.10

marinacapella

Um, yeah, ah to be completely honest, it was a little bit of a leap of faith I Just kind of felt like you know what? my my heart is pulling me in this direction I don't know exactly what it's going to look like I don't know how I'm going to manage to serve low income families. Exactly.

 

13:43.38

Phil Boucher

Well.

 

13:57.18

marinacapella

But I have faith in my ability to figure it out and to be creative and to and be open to opportunities just like you have been and so I open and of course I marketed myself as integrative Pediatrician um doing not just conventional medical care but offering some.

 

13:59.17

Phil Boucher

Right.

 

14:17.10

marinacapella

Complementary modalities as well and I just kind of waited and I I was not great in the beginning I was pretty slow to grow. Um, but people started finding me, especially people that were interested in a more holistic approach to Health. And so I was attracting a lot of middle class and some upper class families. Um, but I tried to also put myself out there in the community I attended some community events I even did a swap meet once where I ah was offering like ear piercing and like anemia checks. Um I tried to find ways to connect with um. Members of my community, especially the Hispanic community because that's where I'm from I'm fluent in Spanish and Bicultural. So I tried I tried to ask myself. Okay, how can I you know make myself known to members of that community as well and I did gather sort of this small population of.

 

14:54.18

Phil Boucher

Mean right.

 

15:11.94

marinacapella

Families who are either uninsured, um, some of them are on can't get insurance because their families are undocumented or their children are undocumented. Um, or they have insurance but they've had difficulty accessing care in the way that they need it and so I do have maybe like. Probably I don't know 10 or fifteen percent of my panel. Um, that falls you know within those categories and I offer discounted rates if they need them like you do and I think they just love the the level of care that I'm able to give as a dpc pediatrician um. And also the linguistic connection too. I think that makes a huge difference for people. Um some of them have opted not to join as members and I've allowed them to do just a fee for service type agreement so they just know that they're going to pay a certain amount each time they come in.

 

15:49.72

Phil Boucher

Right.

 

15:56.23

Phil Boucher

Look here.

 

16:04.93

Phil Boucher

Right.

 

16:07.20

marinacapella

For a sick visit or for a well child and I'm okay doing that because I know that the psychology around money when you don't have a lot of it can get complicated and it's very unique to each family and each individual and so the.

 

16:18.20

Phil Boucher

Rape.

 

16:22.83

marinacapella

Um, idea of having of paying for something that you're not using when funds are very limited is hard and so that's why I kind of allow certain families to just continue on a fee for service basis because I know that works with their.

 

16:27.56

Phil Boucher

Um, totally.

 

16:38.82

marinacapella

You know money psychology and their situation and I grew up in a situation that was economically hard and so I knew that every penny mattered and um, my parents would never have paid for something that they felt that they weren't using and so I've kind of adopted that mindset as well.

 

16:40.30

Phil Boucher

Right.

 

16:50.72

Phil Boucher

Right.

 

16:56.60

marinacapella

Although you know I'm not in the same same situation I was growing up but I know that everyone has a different psychology around money and that definitely affects that definitely affects. Even the people who choose dpc because some people can have all the money in the world but they still don't choose dpc because of their specific money mindset.

 

17:11.39

Phil Boucher

Um, totally yeah, right.

 

17:16.16

marinacapella

Whereas other people don't have as much money to spare and yet they really value and they see they understand the model and so they're willing to put their money there. But um I guess that's also getting to another question about that. We get about dpc is like.

 

17:23.50

Phil Boucher

Right.

 

17:32.20

marinacapella

Why is it that some families that I thought would follow me from my old practice. Don't and others that I never thought would follow me do and I think a lot of that just has to do with psychology and everybody has a different way of thinking about money.

 

17:38.54

Phil Boucher

Totally.

 

17:44.64

Phil Boucher

Yeah I think that was one we're we're moving a little bit away from the original question. But I think that's a really good point is when you open you're gonna be surprised at who follows you and who doesn't from your other practice and you're gonna think they'll definitely come with me they they will totally get it.

 

17:50.80

marinacapella

I know.

 

18:02.32

marinacapella

Um, ah yeah.

 

18:03.26

Phil Boucher

And then they don't and then you're like wow I can't believe these people because I thought they were having financial troubles when they talked to me before but they're right here you know on day one to to sign up and I do think that there's a lot of psychology that we just don't understand or that maybe we haven't ourselves communicated very well what the offer is that that for whatever reason they've decided that. It's not for them and I will say like two and a half years in I still have patients that I saw two and a half years ago that are still making the decision and switching over like two and a half years later and it's not like that they didn't believe in me or like me then and like me now they just didn't realize the value.

 

18:34.99

marinacapella

Ah.

 

18:38.91

marinacapella

Yeah.

 

18:40.38

Phil Boucher

Or didn't see it and then they're like oh my gosh just just the other week I know we're getting off tangent a little bit but but a mom had signed her child up and then had texted and said I have this unusual situation I don't know if you can help me at seven o'clock at night I was just sitting at the ah sitting in my car.

 

18:45.76

marinacapella

That's okay.

 

18:58.17

Phil Boucher

My kid was doing soccer practice and I called her. We talked it through She's like oh my gosh I would have if I had known that this is what you offered and what it was going to be like um we would have switched on day one and it was definitely not a money thing with them. It was just an understanding or understanding the value or having the.

 

19:11.66

marinacapella

Ah.

 

19:15.41

Phil Boucher

Psychology behind. Well why would I pay for something that I'm not using and then and then on the flip side I'll pay for Netflix and Hulu and Youtube Tv and all these other things that like I don't use the Netflix as much as as I should to justify the cost. But I do pay for that convenience every month so I think it just takes a lot to be some people.

 

19:20.53

marinacapella

Ah.

 

19:35.18

Phil Boucher

A lot longer to realize the value of that accessibility and convenience and closeness that comes in dpc that it just takes a while for them to realize that.

 

19:46.33

marinacapella

Yeah, and then circling back to the question there have been other um ways that I've found to serve the low income community. One of the major ones is that I stumbled on a relationship with a local company called my care and they help families. They're sort of a middleman that helps. Families connect to the medical care that they need after they've been in a car accident and they were desperately looking for a Spanish speaking Pediatrician because they largely serve the Latino community in Spanish speaking community and so they they.

 

20:04.37

Phil Boucher

And then.

 

20:15.15

Phil Boucher

Um, yeah.

 

20:18.65

marinacapella

Reached out to me. They said hey like we'll pay you. You know a certain percentage of the claim amounts and so at first I was hesitant because it's like I don't want to fill out claim forms and um I know exactly like.

 

20:29.90

Phil Boucher

Paperwork that sounds terrible I was trying to get away from all the paperwork.

 

20:34.37

marinacapella

Exactly and but I said you know what this is an opportunity to serve this community. That's really important to me. It's one page that I have to fill out and then I have to send them a copy of my note. So it's just the claim form and the note and it doesn't even get processed through the like the really really nit picky Health insurance companies. It's getting processed through.

 

20:42.56

Phil Boucher

Gotcha.

 

20:48.67

Phil Boucher

Great.

 

20:51.92

marinacapella

The car insurance claims so they just want something that shows that this kid received medical care right? Um, and so this company acting as a middleman pays the pays directly for the medical care and then they have to wait probably you know six months to a year to get paid out by the insurance company. So there you know.

 

21:09.10

Phil Boucher

Um.

 

21:09.90

marinacapella

I Just sort of believed in their their desire to help this community and in what they were doing and so I started seeing patience for them and it's actually wonderful relationship and the paperwork is a little bit painful. But I've trained my office manager How to do that and so she takes care of that now.

 

21:12.75

Phil Boucher

Right.

 

21:24.55

Phil Boucher

Nice.

 

21:26.51

marinacapella

Um, but I get to see these kids who have been in car accidents and they're usually they usually did not sustain any life threatening injuries. Otherwise they would have gone to the hospital and been hospitalized and done all that. But I'm seeing them a few weeks after the accident and they're having nightmares or they're complaining of back pain or neck pain.

 

21:33.81

Phil Boucher

Sure right.

 

21:45.82

marinacapella

Or they're just not as active as they used to be because they have you know some sort of physical complaint and I'm able to practice clinical hypnosis with them and my old fascal release therapy and use these other you know alternative and complementary modalities that I love using and it helps the kids so much and I see them.

 

21:54.17

Phil Boucher

Ah, yes.

 

22:04.71

marinacapella

About 6 or 7 times each just to make sure that we've worked through all of those issues I can see them longer if they have a more severe case and I just love doing that I love being able to exercise those different skills with this population and also be serving.

 

22:07.74

Phil Boucher

M.

 

22:14.98

Phil Boucher

Um, that's awesome.

 

22:21.20

marinacapella

What tends to be a much lower income population. Most of them are on medicaid or uninsured. So I love doing that and that's been a good relationship to build.

 

22:22.20

Phil Boucher

Probably right. I Knew you were going to talk about the hypnosis because I remember that from your talk at the Pe's dpc mastermind and and how that related to the car accident Insurance Evaluation. So I'm glad that you brought that up as ah, another way to serve families and make a huge difference that you wouldn't be able to do in a traditional but like you.

 

22:35.66

marinacapella

Yeah.

 

22:42.93

marinacapella

Um.

 

22:46.22

marinacapella

Yeah.

 

22:48.16

Phil Boucher

You would not be able to do that in a traditional practice at all like that just wouldn't compute with a traditional practice. So it's something that they desperately needed that you're able to do that You find professional enjoyment in and financial enjoyment and.

 

22:50.95

marinacapella

Exactly.

 

23:02.89

marinacapella

Yeah, exactly I had to figure out you know how to charge appropriately for it and at first I was trying to do these like hour long sessions and then realized actually my initial visit can be an hour and then my follow up visits could be half an hour and that's worked out really nicely so that I can. Um.

 

23:04.72

Phil Boucher

Break.

 

23:19.58

marinacapella

You know, not lose too much income if they're not showing up and then also just make sure that financially it works out for me. But yeah, those are some of the ways and that I've been able to figure out how to serve both you know, middle class families upper upper class families as well. And.

 

23:21.17

Phil Boucher

Right? like.

 

23:39.16

marinacapella

Many lower class families. So um, it's worked out more easily than I realized it would in the beginning I was definitely fearful that I would not be able to figure it out but you know if you open your mind and if you're willing to just um, be creative and partner and put yourself out in the community.

 

23:44.54

Phil Boucher

Right? right.

 

23:59.15

marinacapella

You can find ways to make it work.

 

24:00.42

Phil Boucher

Totally yeah I think that's one of the things that I've learned and I think that gosh I still have some former colleagues that will call it concierge care and it's really worth telling people. This is not concierge. This is direct primary care Concierge is different. You pay for access and then they use your insurance.

 

24:14.15

marinacapella

Yeah.

 

24:20.27

Phil Boucher

And it's thousands of dollars per year direct primary care is low fee monthly fee. No insurance hassles or anything along those lines and so I think making that distinction clear to patients, especially if they've been mistold. Ah what your care is like and making sure that they understand.

 

24:36.17

marinacapella

Yeah.

 

24:39.43

Phil Boucher

Um, the actual cost because me but most people think oh concierge care that must be like $5000 per year and they they build my insurance that's just outside of the ballpark I'm not going to look into it. No this is direct primary care. It's very different and it's focused on building relationships not just squeezing you for more money.

 

24:43.20

marinacapella

Um, yeah.

 

24:56.60

Phil Boucher

Ah, to get access to me.

 

24:57.20

marinacapella

Oh absolutely? Yeah, although I will also support some of the pediatricians in our dpc community who do choose to use that um term of concierge or they'll call themselves concierge style care or and that's so.

 

25:10.80

Phil Boucher

Yes, yes.

 

25:13.96

marinacapella

Okay, too. It depends on your community. But um I I tend to side with you Phil in terms of like I try not to use that term because again ed evokes this um feeling of like oh that's only for wealthy families and again it depends on your your.

 

25:25.89

Phil Boucher

Right.

 

25:31.19

marinacapella

Practice area and the population that you're targeting. There's nothing wrong with targeting a higher income population If that's what you want to do? um, no judgment from us there. But you know regarding this question that many people have of can I serve lower income families. Yes, the answer is yes and I know.

 

25:35.73

Phil Boucher

Right.

 

25:49.60

marinacapella

Um, one pediatrician in Indiana um, she she does call herself concierge and she targets this like higher income population because she lives near a boarding school but she's told me in conversations and she's you know, shared at conferences that she also gives.

 

25:58.98

Phil Boucher

M.

 

26:06.55

Phil Boucher

Right.

 

26:07.37

marinacapella

Free care for people for Spanish speaking families in her community. So She's not necessarily advertising that um because she has to limit the the amount of that that she does um but whatever population you primarily serve. You know you can also do other things um to kind of give back. If you want to.

 

26:28.42

Phil Boucher

That makes me think of 1 other thing and then we'll wrap this up I think but um, the idea of having your families that are that are not you know under financial strain that have resources. We usually know who's who.

 

26:42.40

marinacapella

Yeah, yeah.

 

26:43.92

Phil Boucher

When it comes to patients because we form those good relationships having them sponsor other families is another avenue we haven't done that we haven't really explored that. Um I think that there's some at least if you wanted them to be able to get a tax deduction. You'd have to start a 5 a one c three and all those sorts of things but there's certainly practices out there that do that like if would you? um.

 

26:57.70

marinacapella

Yeah.

 

27:03.61

Phil Boucher

You know patients that realize the value of what we offer and are more financially you know set up right now would you consider sponsoring a low income family to be a part of this that has specific needs and that's something that is certainly worth exploring to. We just have never really given it.

 

27:18.94

marinacapella

Yeah, ah yeah, definitely yeah, well hopefully this has helped answer the question if you had it on your mind of can you serve low income families.

 

27:22.83

Phil Boucher

Much exploration. But that's something that you could also consider as well.

 

27:35.55

marinacapella

Within direct primary care. Ah, the answer I would say overall is yes, but it might might take um, being creative and fostering relationships in your community. Thanks so much for joining us have a great week.