002 - Work Life Balance In Pediatric DPC

002 - Work Life Balance In Pediatric DPC

Listen to Marina and Phill discuss work life balance while managing a Pediatric DPC practice. Check it out today!

 

00:00.00

Phil Boucher

A brief win.

 

00:01.71

marinacapella

Welcome to another episode of dpc pediatrician thanks for joining us today. Will today we will be answering the following question is there work life balance in pediatric dpc this is a question I hear so often. Because people who are contemplating starting their own dpc they want to make sure that this is something sustainable for the future for them. They want to know is it real is the grass really greener on the other side. In other words, all right? but but before we delve into that we want to just share some. Dpc wins for the week so Phil you start us out. What was a win for you this week.

 

00:39.90

Phil Boucher

My favorite thing this week was um I got to get out of the office quite a bit to see patients which is not something that I always do I am often at the office but we had a couple newborns born this week and we do newborn home visits so we got to do those and then I had. A patient that texted me a picture of their split open forehead and they were on their way to urgent care and just said do you think we need to go to urgent I said don't go to urgent care just come on over it. We'll take care of it and he was a really sweet like tennis year old boy I use um lat gel lidocaine adrenaline tetriccaine gel. Um.

 

01:14.39

marinacapella

So.

 

01:16.58

Phil Boucher

And the mom was really worried that he was not going to tolerate having stitches put in and he didn't even flinch like I just put some lat gel on came back late 15 minutes later stitched it up save them a trip to urgent care or the er just made their day and despite the fact that when they texted me I was out of the office. It just felt.

 

01:26.23

marinacapella

Ah.

 

01:35.92

Phil Boucher

Very much like I'm helping people in a real concrete way and I love doing stitches too. So I always tell people like don't go to urgent care. Don't go to Er text me if you need stitches because it's about my favorite thing to do I have a nurse practitioner who was in the Pediatric Er for years before starting with me.

 

01:43.35

marinacapella

Ah.

 

01:49.53

marinacapella

Ah.

 

01:53.80

marinacapella

Nice, Ah, ah.

 

01:54.11

Phil Boucher

And so we kind of fight over ah who gets to do stitch just she's done way more than me because of her time in the yeah Er But um, it's always something that we really like enjoy and it's It's a huge win for families to avoid urgent care of the Er because they can't get anywhere else to get their stitches taken care of and they just get used to.

 

02:11.26

marinacapella

Ah, yeah, fantastic and I can attest to the magic of let gel because having worked in Pete's urgent care I got my fair share of stitches and that let gel is magical. It really really does help a rare occasion kids anxiety just you know is too much, but it's not because the.

 

02:12.74

Phil Boucher

Texting us.

 

02:20.22

Phil Boucher

Um, yeah.

 

02:31.20

marinacapella

It doesn't work. It's just because of their anxiety but I love let Jill I have it too in my office. Yeah, excellent. So for a win for me this week yeah my dpc win this week is I got 4 memberships in like two days this week so

 

02:31.89

Phil Boucher

Um, yeah, how about you.

 

02:42.50

Phil Boucher

Roll.

 

02:45.17

marinacapella

Was really nice and one of the things that happens that I've learned is like there's some weeks that are really slow in terms of memberships and then there are some weeks where you just get a bunch of people and it was just people I think one of them was word of mouth. Um, and the others just found me online and they liked my website and they yeah.

 

02:51.25

Phil Boucher

Um.

 

02:58.20

Phil Boucher

It was just random like that's always my thing is like why did 4 people join this week but it was just random coincidental is that how it feels. Yeah, that's amazing I mean.

 

03:04.57

marinacapella

Ah, yeah, exactly so I got 4 new memberships with this week which was a good feeling.

 

03:13.70

Phil Boucher

I owe I'm a numbers guy and I always just like to mentally do the math like imagine those 4 members stay with you for 3 years like that was a really big week for you from a financial standpoint too and just to you know, be able to serve more patients.

 

03:22.58

marinacapella

Ah, yeah, definitely all right? So let's get back to this topic of is their work life balance and pediatric dpc Phil what would be your opinion just in general about this topic.

 

03:28.97

Phil Boucher

Yeah.

 

03:37.18

Phil Boucher

In the broad scope of things I think absolutely Yes, there is work life balance and I think it comes in a lot of different ways and it's not always the same as when you were in your fee for service model What that actually looks like and so I think it takes. Sitting down and saying what would work-life balance look like for me and I think one of the biggest fears, especially for Pediatricians is evening and overnight text messages and phone calls and what that's going to look like and I think that when I talk with Pediatricians that are kind of on the fence about it.

 

04:08.26

marinacapella

Ah.

 

04:10.73

marinacapella

Yeah.

 

04:12.25

Phil Boucher

That's probably the number 1 thing that I hear is well I don't want to be on call all the time. So I'll keep doing this job where I have to see 30 plus patients per day and chart all evening because I'm worried about text messages and overnight phone calls in direct primary care and I think that it couldn't be farther from the truth that you're gonna spend your evenings and overnights.

 

04:21.92

marinacapella

Yeah.

 

04:30.89

Phil Boucher

Um, you know dealing with fevers and rashes and vomiting and all of those sorts of things and this I learned for me specifically so we have about 560 members right now and I was I had no idea when I started what it would look like in the evenings. But what I didn't realize.

 

04:37.30

marinacapella

Ah.

 

04:49.50

Phil Boucher

Is the way that I was practicing before is every patient that had an illness was getting stuck waiting till the late afternoon or evening. You know their kid wakes up with a fever. They call the office they wait on hold they leave a voicemail they play phone tag. It's noon before they get a call back and they can't get in until 6 or 7

 

04:58.90

marinacapella

A.

 

05:08.30

Phil Boucher

And so things stack up over the course of the day in the big model of um, you know the high volume ah fee for Servicece pediatric model that most Pediatricians are used to like it takes forever to get in so they're not getting in. There's patients that are then having to call in the evening. It just stack stack stacks. Well now.

 

05:09.11

marinacapella

Um, ah.

 

05:27.38

Phil Boucher

Despite having 560 patients if you texted me right now and said hey my kid has a fever I think they have strep throat I would just say can you come over or can you come over this afternoon at 2 Let's get you seen because there isn't a huge, not volume of patients that I'm going to have to.

 

05:34.65

marinacapella

Yeah.

 

05:44.28

Phil Boucher

Sneak between to get that patient in so things just don't stack up the way they do and when when families are home with their sick kid. They don't they're they're just at home. They don't care if they come in at 11 or two p m like they just want to get seen and so their schedule is flexible if you can be flexible with them so it doesn't all stack up into the evenings.

 

05:49.27

marinacapella

Ah.

 

05:56.93

marinacapella

My.

 

06:04.20

Phil Boucher

And overnight and in two years I have never once taken a phone call overnight from a patient and mostly because we're really good I think at our onboarding process and setting those boundaries in place and like this is what to do.

 

06:13.16

marinacapella

Ah.

 

06:20.63

Phil Boucher

When you need something overnight I do get a lot of text messages overnight I actually encourage patients to text us at night because um, the visual of them texting us is really sits it well with them when I say I get a lot of text messages at 2 in the morning because not because like it's an urgent thing but it's they woke up. They're nursing their baby. Have a question. They don't want to forget so they just text us at 2 in the morning and then I see those in the morning I respond when the office opens and all of that. But I think that looks like work life balance to me is I can have my evenings I'm not going to get railroaded and stuck in the you know doing all sorts of things in the evenings because I'm able to take care of patients during the day.

 

06:44.90

marinacapella

Um, ah.

 

07:00.17

marinacapella

Yeah, yeah.

 

07:00.23

Phil Boucher

When their kids are sick and if it's overnight they know what to do? They know how to get the help that they need and they know that tomorrow morning they're going to be able to get in for an appointment because they're not going to have to be waiting till the phones turn on at eight o'clock to then try and get an appointment and you know wait in line in a queue they just book an appointment online for the morning. So that they know that they'll be able to get seen.

 

07:21.40

marinacapella

Yeah, ah and I love that boundary that you've set for yourself I think that is essential um that you tell parents yes feel free text me you know at midnight or 2 in the morning but I'm going to respond in the morning right? And so I think that's where some dpc pediatricians.

 

07:32.60

Phil Boucher

Totally.

 

07:39.30

marinacapella

Have trouble is that they you know in the beginning when you're opening your practice and you're desperate for people to choose you. You've sometimes feel like oh I have to do everything I have to bend over backwards for my patients so that they see the value of dpc and they love me and they stay with me.

 

07:43.80

Phil Boucher

Right.

 

07:56.53

marinacapella

So there's that little bit of desperation which I definitely like you know was guilty of as well. Um, and then as you get more comfortable and you get busier. You start to realize oh I can't do that for every single patient and because then that requires me to sacrifice myself and my family time and my personal needs too much.

 

07:59.55

Phil Boucher

Right.

 

08:07.54

Phil Boucher

Bright.

 

08:15.85

marinacapella

So then people start to kind of figure out these boundaries and and and it's hard though. It's better if you really have those boundaries from the beginning and you talk to people and you listen to people's stories in order to figure out what will work best for you in the long term and what will be sustainable for you.

 

08:22.63

Phil Boucher

Yeah.

 

08:33.72

marinacapella

People who get in trouble are people who don't have very good boundaries or are too afraid to set those boundaries but you really shouldn't be I mean people are going to respect you and they're going to love everything that you do even if you're not available at 2 in the morning right.

 

08:47.58

Phil Boucher

Exactly I think that's a huge thing is no matter what you do if you are available for them during the hours that you've stated that you're going to be available and you're easy to access in the ways that you've set up which is probably for most Pediatricians like parents love text messaging.

 

08:58.68

marinacapella

Yeah.

 

09:06.77

Phil Boucher

And so the fact that you do that you've already set yourself so different than what they're used to that you don't have to go above and beyond in every way for every patient at every hour of the day for them to still have a positive and much better experience with you that they're not going to just say.

 

09:22.22

marinacapella

Here.

 

09:25.16

Phil Boucher

We'll screw this I'm going back to what was even worse. They're going to say oh they set their boundaries. They had those boundaries in place and they were available and accessible when they said they would be which is a huge step up from the experience that we're having before so I'm happy with that and I don't have to. And and having like the the continuity of the relationship like they're paying their membership dues every month I know that they're happy enough that they didn't cancel um that just gives you that confidence that okay, what I'm doing is 100 % enough and adequate and providing really good care and really special ways of caring for patients I don't have to go.

 

09:46.94

marinacapella

Yeah, yeah.

 

10:02.80

Phil Boucher

3 levels above and beyond because then I'm not going to be taking care of myself and my family and everything like I I should be because I've sacrificed that work life balance unnecessarily.

 

10:15.40

marinacapella

Yeah, definitely definitely and I would say you know you have I think ah you shared at 1 point in a dpc face Facebook group how you have an after hours message. So if a family texts you after five zero p m or whatever it is.

 

10:24.70

Phil Boucher

Evening.

 

10:29.36

Phil Boucher

Right.

 

10:29.44

marinacapella

They get an automated message that says you'll respond you know later um with my practice I tell families that onboarding I'm available seven days a week via text email phone. Um I will do my best to see you.

 

10:40.51

Phil Boucher

So.

 

10:45.97

marinacapella

Same day or next day if you have an acute issue but I don't use the word twenty four seven because and I just I straight up tell families like I'm human I need to sleep I'm a deep sleeper so I probably won't answer the phone in the middle of the night. Um.

 

10:50.58

Phil Boucher

Yeah.

 

10:58.94

Phil Boucher

Totally.

 

11:02.13

marinacapella

And and they're totally understanding about that they get that they're human too. Um, and I also mention that you know if it's something that's not too urgent text me and I'll get back to you within a few hours usually it's faster than that. But sometimes I do have busy periods where I'm seeing patients back to back and.

 

11:13.70

Phil Boucher

You.

 

11:20.46

marinacapella

You know I don't get to answer everything right away. But I do glance at it and if it's something that I can respond to quickly I do that if it's going to take more time. It might take a few hours to get a longer response. Um, but I also tell them if it's something really urgent like your kid fell and might need stitches or you know.

 

11:38.55

Phil Boucher

Ripe.

 

11:39.70

marinacapella

Something really urgent happened call me and that way I know it's more urgent and so I kind of set those sorts of expectations and boundaries in the beginning but everyone does it a little differently and again just because I do it one way and Phil does it another way like you can choose what your boundaries are and what your system is some people are.

 

11:48.49

Phil Boucher

Right.

 

11:59.70

marinacapella

You know way Stricter Some people loosen the rules and do do respond to some phone calls in the middle of the night. It's completely up to you.

 

12:05.97

Phil Boucher

I Think that that is a really good synopsis of it works different for everybody and it might change over different ages and stages of your practice and what you have going on in your life. But the nice thing is you have these really good relationships with families.

 

12:15.76

marinacapella

Yeah.

 

12:25.15

Phil Boucher

Where they're going to understand if um, you tell them hey something changed in our home life and I need to rein in the boundaries a little bit. They're going to be like well you've been so grateful to us or you've been so helpful to us and we're just grateful for everything that you've given we totally understand and we've always felt like we were asking too much.

 

12:25.92

marinacapella

Ah.

 

12:44.49

Phil Boucher

We understand completely and we love you and we support you I mean just yesterday. Ah we got to to illustrate the the relationships that you develop with families. Um somebody had texted us a screenshot from Facebook of some dogs that somebody had written on a Facebook post I found these dogs I'm not sure they are. And 1 of my patients just thought they might be our our dogs because I post about our dogs on my Instagram sometimes and so they were like worried for me that we had lost our dogs and that somebody had found them like the level of care that patients have for you and the level of love that they have for the way that you practice and the way that you care for their children. Um.

 

13:06.91

marinacapella

Yeah.

 

13:13.70

marinacapella

Ah.

 

13:21.15

marinacapella

And.

 

13:23.20

Phil Boucher

Goes above and beyond whether or not you answered the phone at 2 in the morning because they had the sniffles and the cough like they expect those things and they're going to be really respectful of those things because they know how special what you do is and the way that you practice is so different that they're going to be so respectful of that.

 

13:30.99

marinacapella

Definitely.

 

13:41.31

Phil Boucher

And I find it very infrequent that we're having to like course corrective people overstepping their boundaries. But I guess I would like to know from your perspective What that's like um when people ah exceed or ask more than the boundaries allow for what have you had any experiences like that.

 

13:57.81

marinacapella

Ah, yeah I think I've had a couple where um, yeah, one that I can think of this wasn't necessarily boundary. Well it was me setting a boundary. It was maybe just a year ago. A new family had joined and they were older parents. Who And of course older parents tend to be a little more anxious because they just have more knowledge and you know, um, and so more worries coming out of that knowledge and um, they joined my practice. They saw their baby once or twice and then they had sent me a message saying hey we noticed that you're not requiring masks.

 

14:17.84

Phil Boucher

Right.

 

14:33.57

marinacapella

In your office and we're not sure if you if we feel completely comfortable with that and this was already around the time when most hospitals and clinics had like let go of their mask man and so I um I think I could have easily gotten defensive in that situation. Um.

 

14:42.24

Phil Boucher

Moving.

 

14:51.62

marinacapella

Or just bent over backwards and and said you know oh you know, like just to keep you like I'm going to do whatever you want me to do and I just kind of um, explained my rationale. You know we're really low volume clinics. So when this baby was coming in. There was usually nobody else around.

 

14:56.50

Phil Boucher

Right.

 

15:06.65

Phil Boucher

Yeah.

 

15:08.57

marinacapella

The rooms are used. Maybe once every hour we have time to clean them in between and so I just kind of explained our rationale and I said you know, but if this isn't a good fit for you like it's completely fine. You know, kind of just saying I'm not going to change because I feel comfortable with the way I'm doing it.

 

15:18.35

Phil Boucher

Yeah.

 

15:25.71

marinacapella

And I'm not anti-mask or anything. It was just like in this context, a mask was overkill and so um I I kind of practice setting that boundary of like look this is my rationale. Um, but if you're not comfortable. It's okay, like you can che to someone else.

 

15:26.72

Phil Boucher

Right? right.

 

15:42.40

marinacapella

Then I felt kind of weird at that time because it was one of the first times I was practicing you know saying hey like I might not be right for everybody and that's okay, instead of acting out of that place of desperation of like oh what do I need to do in order to keep you right? and that family ended up.

 

15:47.33

Phil Boucher

Um.

 

15:49.84

Phil Boucher

Yeah, yeah.

 

15:55.15

Phil Boucher

Right? you.

 

15:59.27

marinacapella

And they are still with me. They were fine with that answer and with the time that I took to respond thoughtfully to their question and there have been some other circumstances where families are I would say this happens rarely but really needy families where they are just needing a lot for you know, any particular reason.

 

16:14.43

Phil Boucher

Um.

 

16:18.86

marinacapella

Um, but I I think sometimes like people feed off of each other's energy and so if a family is really anxious and bothering you and texting you over and over and you are responding right away sometimes you kind of need to back off and delay your responses or like.

 

16:23.85

Phil Boucher

Or.

 

16:32.66

Phil Boucher

Totally right.

 

16:37.51

marinacapella

You know, demonstrate to them. It's like hey like I'm going to create some distance between this and I'm going to give you some time to kind of calm your fears naturally and then I'll respond but I'm not going to be you know I'm not going to just like you know respond to.

 

16:47.87

Phil Boucher

Totally.

 

16:53.46

marinacapella

Every message with worry like right right away it really depends on the context of course. But yeah, anyway, those are the things that come to mind so sometimes I have to kind of delay my responses intentionally in order to just not feed into that energy from the family.

 

16:55.74

Phil Boucher

Right.

 

17:07.90

Phil Boucher

I Think that's so that's such a good strategy because I think that is another concern I mean the overnights and the evenings being disrupted by text messages and phone calls and then the needy patients like I think there's this idea there was a show on Usa called.

 

17:19.27

marinacapella

Yeah.

 

17:25.70

Phil Boucher

Was some doctor those was in the hamptons I can't think like it was some concierge doctor that like would I mean it was all the super rich people and you'd like fly to their houses and you know put band-aids on their booboos. Um, but I think that that is another fear that Pediatricians have of I'm going to have all these needy patients that are just going to be super demanding.

 

17:27.94

marinacapella

Ah sure. Yeah, ah.

 

17:43.83

Phil Boucher

And I think my experience and in talking with other Pediatricians Some will be needy. Some will have epis like seasons of need. Um, where then you're like there must be something going on with them where they're needing us in a different way with their anxieties and worries and I can still put.

 

17:57.58

marinacapella

Yeah, oh.

 

18:02.16

Phil Boucher

Some boundaries in place knowing that this season will pass like I have a few families that are like that like they'll have more medical health parenting concerns and then things calm back down and I know over time like I've haven't known these families for years even some before I started my dpc like they'll have periods where they're more anxious and then.

 

18:13.60

marinacapella

Um, yeah.

 

18:21.29

Phil Boucher

It calms back down and like I can ride those those waves a little bit more easily. But I really like that strategy of like hey I've seen your met. It might just be intentionally not replying for a period of time or it might be saying hey I've seen your message and I'm going to give this some thought and get back to you? Well she must not think it's like an urgent issue.

 

18:24.19

marinacapella

Enough. Yeah. Yeah, exactly.

 

18:39.10

Phil Boucher

If she's going to give me some thought and then oh that's kind of nice. She's gonna give it some thought before she responds that must mean that like it's not just like a knee-jerk sort of thing when in reality you're kind of just giving yourself a little bitt of breathing time and like letting things calm down rather than feed into that anxiety and I think that those are 2 big concerns when it comes to work life balance with.

 

18:46.50

marinacapella

Yeah.

 

18:51.71

marinacapella

Yeah.

 

18:58.50

Phil Boucher

With patients in the direct primary care model.

 

18:58.82

marinacapella

Um, yeah, definitely and I think sometimes our anxiety because we are We are prone to anxiety just like our families are prone to anxiety and ah but sometimes we feed into it unintentionally if um is sometimes you know.

 

19:12.29

Phil Boucher

E.

 

19:15.66

marinacapella

I might find myself complaining about like oh this patient is or this patient that and then or this patient is so needy or this patient like wants me to fix all their problems but they're not willing to do their part and um, if I act out of that place I kind of feed into that. Um. Negative or a dysfunctional cycle as opposed to saying hey like you know I can only do so much right? I'm not responsible for their choices and I'm not responsible for curing their anxiety either. So I need to stay in a place where I am centered and I am calm and I can be a better pediatrician.

 

19:40.21

Phil Boucher

Right? um.

 

19:45.80

Phil Boucher

Totally.

 

19:52.72

marinacapella

If I do that.

 

19:55.23

Phil Boucher

Absolutely and I think that that really that rather than the specifics of the hours or things that you offer or try and boundaryize boundaryize I don't know what the word would be there. Um, those things really make for that.

 

20:06.30

marinacapella

Um, yes, ah yeah.

 

20:10.40

Phil Boucher

Work life balance that I think everybody is missing in the fee for service model that you can feel comfortable and confident knowing that okay I can put these boundaries in place and people aren't going to reject me, especially if I tell them in advance and repeatedly here's how.

 

20:22.80

marinacapella

Ah.

 

20:28.75

Phil Boucher

Practice works here's what to do at this time of day here's what to do when you have a kid with has a fever here's what to do when their um you know their elbow is completely fractured and sticking out of their body like here here's the different scenarios and here's what I want you to do parent.

 

20:41.17

marinacapella

Yeah, ah.

 

20:45.87

Phil Boucher

Um, and last time oops It didn't go quite like that. So here Fyi for the future here's what you should do? Um, when ah you know they're they're bleeding profusely like this is the appropriate thing versus when they have a little sniffle here's what you should do if you reinforce that on a regular basis then you can be confident that okay patients aren't going to reject me.

 

20:54.55

marinacapella

Yes.

 

21:05.22

Phil Boucher

Don't have to worry about like closing up shop because I don't ah you know help them through their stuffy nose kit at 2 in the morning like those are things that are outside of my boundaries and I'm okay setting those boundaries and some patients might reject me but by and large the patients that are a good fit for this practice aren't going to reject me needing to.

 

21:12.99

marinacapella

Um, yeah, um.

 

21:22.91

Phil Boucher

Sleep.

 

21:24.50

marinacapella

Yeah, exactly exactly yeah thinking about work life balance a question probably a lot of people have is do I get to take vacations because that's a big part of feeling balanced in your life. Um, how about you Phil have you gotten to take vacations.

 

21:31.97

Phil Boucher

Right. Yes, we we like to vacation and we like to have those moments away from the the rigors of life. We have 6 kids and so life is is relatively busy for us I think we're pretty kind of like low speed.

 

21:53.40

marinacapella

Ah.

 

21:55.42

Phil Boucher

Family in general we have done vacations so I opened in January of 2022 we went to Florida for a week in February Twenty Twenty two which was not intentionally planned that way but we had already planned the vacation before making the jump into direct primary care and we didn't want to undo our vacation.

 

22:05.62

marinacapella

Ah.

 

22:14.41

Phil Boucher

And so what I did for that one was I had a Pediatrician friend in town Essentially just cover for me. She would so calendar was blocked out and then sick patients my nurse or my office manager my nurse would triage them and if they needed to come in then they would schedule with.

 

22:19.80

marinacapella

Ah.

 

22:32.65

Phil Boucher

My Pediatrician friend that was covering for over her lunch hour and she had blocked off a little bit of time to do that and we just paid her like a daily rate to kind of cover the clinic and it was honestly ah super smooth and didn't have any problems whatsoever and so that really reaffirmed for me that okay we can do vacations and you don't have to give up vacations for that.

 

22:35.27

marinacapella

Ah.

 

22:45.40

marinacapella

Um, yeah.

 

22:52.39

Phil Boucher

Um, since that time I have a nurse practitioner that works in our office as well and so for vacations since that 1 episode like right when we opened. Um, she's been able to cover and we kind of plan in advance so that she can be available and then if there's things that she's not sure. She's not comfortable with she doesn't know what to do then she'll just text me or call me.

 

22:53.00

marinacapella

Ah.

 

23:06.87

marinacapella

Ah.

 

23:11.88

Phil Boucher

Um, to talk through those things when you have a lower patient volume like just having a blocked out schedule just for sick patients doesn't amount to a lot of visits or a lot of things coming up. Um, and so yes, we have vacations throughout my time in Dpc and even if I didn't have a nurse practitioner I would still take vacations.

 

23:14.24

marinacapella

Ah.

 

23:19.77

marinacapella

Yeah, yeah.

 

23:27.67

marinacapella

Ah.

 

23:30.87

Phil Boucher

And I would even if I could go back in time to that first vacation I would probably just let patients know hey we're gonna be on vacation as a family here's what to do if your kid is sick and needs something while we're gone and I truly think.

 

23:46.38

marinacapella

Ah.

 

23:46.55

Phil Boucher

My patient families would be perfectly fine if they knew in advance that we were gonna be gone and they could mentally prepare for that if they needed something they they wouldn't leave because I was going on a vacation with my family because they know that my family's important to me and I prioritize my family.

 

23:55.44

marinacapella

And.

 

24:03.64

Phil Boucher

When I'm at home and I prioritize their families when I'm at work and they would see that and be totally comfortable and understanding if we were closed for a day or a few days I mean I don't think you could take three weeks off and go to Europe and just say like see on the other side people. Um, but you could certainly scale things back in a.

 

24:06.67

marinacapella

A.

 

24:13.61

marinacapella

Yeah.

 

24:20.34

Phil Boucher

Ah, reasonable way for vacations. What about you.

 

24:20.92

marinacapella

Ah, ah yeah I did take two weeks often ah yeah speaking of Europe I did take two weeks off and I went to Paris last ah last September it was my our twentieth wedding anniversary and so we went.

 

24:33.80

Phil Boucher

Oh my gosh good for you.

 

24:37.70

marinacapella

Yeah, we went to Paris for ten days so I was essentially gone for about two weeks and I did email all of my families in advance letting them know the dates that I would be gone and what to do if there was something urgent so I had my my clinic partner essentially.

 

24:41.00

Phil Boucher

Yeah.

 

24:50.45

Phil Boucher

Yeah, yeah.

 

24:57.29

marinacapella

Cover for me and she was okay with that I did occasionally get some texts coming through but even even abroad, but it was completely manageable and she dealt with anything in the office that needed to be seen so you can do it I I Love what you mentioned about um, paying someone.

 

25:05.39

Phil Boucher

Yeah, yeah.

 

25:14.76

Phil Boucher

The.

 

25:16.32

marinacapella

Cover for you when you needed to and I think that's something that dpc pediatricians need to think more about add it to your budget when you're starting up if it's really important to you to take vacations and maybe take two week vacation sometimes you are going to need coverage.

 

25:27.90

Phil Boucher

Right.

 

25:31.89

marinacapella

And you either need to set up the expectation to your families in advance and have it in your contract that hey there may be up to certain amounts of time that I will be unavailable and signing up for this means that you understand I will send you an email or communication beforehand to let you know and this is the nearest urgent care right.

 

25:39.89

Phil Boucher

No.

 

25:49.60

Phil Boucher

Right.

 

25:51.75

marinacapella

So you can do that. But I think you know for um, quality of care. It's better. Probably if you have some sort of coverage while you're gone for an extended period of time and you can completely factor that into your budget have some money set aside now you raise your prices a little if you need to in order to have that wiggle room.

 

26:04.20

Phil Boucher

Right? right.

 

26:10.23

marinacapella

You can pay someone because I I hear a lot of dpc doctors saying hey what do I do like I can't afford to pay someone hey factored into your prices so that you have that wiggle room right.

 

26:17.81

Phil Boucher

Right? Well and I think the other thing that you have to keep in mind when I was a ah practice owner. Um it we had ah essentially for the most part it was a eat what you kill model if you see more patients you make more money.

 

26:29.53

marinacapella

Yeah, yeah.

 

26:33.22

Phil Boucher

Which means if you go on vacation. Not only are you paying for Disney world and the airline flights and the food and the $6 water bottles. You're also paying for the fact that you're out of clinic for a week and that cost just as much as Disney World to miss five days of clinic in dpc when you're at Disney World you're still making the same amount of money.

 

26:44.40

marinacapella

Yeah, sure.

 

26:52.72

Phil Boucher

Because it's a membership model like you don't have to continue to see patients or make up for that lost revenue I mean if you're gone so much that patients are annoyed and say all he does is go to Disney world.

 

26:53.67

marinacapella

Um, yeah.

 

27:05.42

Phil Boucher

Ah, we're going to go find a doctor that can see us on a regular basis then you're going to lose patients and you'll lose money but it doesn't affect you financially going on vacation the same way and you may say well we're going to go on vacation but I'm going to have 2 hours in the morning where I'm responding to text messages or doing virtual visits or something like that if you feel like that's necessary I wouldn't.

 

27:06.10

marinacapella

Um, yeah, um, yeah.

 

27:21.41

marinacapella

Yeah.

 

27:25.23

Phil Boucher

Typically feel like that was necessary especially for 2 hours maybe 20 minutes or something but um I think that that's definitely something to keep in mind when it comes to the cost of travel ah in the dpc model is that you don't stop making money and start making negative money.

 

27:28.65

marinacapella

Yeah.

 

27:41.80

Phil Boucher

Ah, the same way that you do in a fee for service practice.

 

27:45.24

marinacapella

Definitely yeah, well any other questions that you can think of related to this question of work life balance Phil.

 

27:50.17

Phil Boucher

What would you say would be if you had to look at the big picture The the key performance indicator the kpi of your worklife balance for you. What would that be like if you're going to say my work life balance.

 

28:00.61

marinacapella

Ah.

 

28:05.18

Phil Boucher

Is really good right now like what does that? What is the key performance indicator that tells you that you have good work life balance.

 

28:11.25

marinacapella

Ah, ah for me getting enough sleep is really important. So I ask myself am I getting enough sleep and I and I prioritize that so the answer is yes do I have at least one day off a week when I can just sort of relax and recharge.

 

28:19.59

Phil Boucher

Me.

 

28:29.17

marinacapella

Um, yes I actually work four days a week in the clinic but I keep myself busy with other things like this dpc pediatrician project and also I have I co-direct a nonprofit on the side. But that's really important to me so I'm able to kind of balance all of those things.

 

28:39.24

Phil Boucher

Awesome.

 

28:46.48

marinacapella

I Teach medical Spanish for my local medical school. So I have all of you these things that I love doing and Dpc has really given me the flexibility and freedom to structure my work life so that I can balance them all out and feel.

 

28:50.81

Phil Boucher

Are.

 

29:02.45

marinacapella

Like I'm still relatively balanced and there are some weeks that are crazier than others some weeks when like there's a lot of stuff to do on the business end for whatever reason right now. My medical assistant is helping me to enroll for Vfc vaccines and that's just a huge paperwork headache and so it's been.

 

29:18.87

Phil Boucher

That's a lot of paperwork. Yes Amen I would not be able to do that without help. Yep, there is no way.

 

29:21.11

marinacapella

But a lot of paper and thank goodness I have a medical assistant because I don't think I would survive that by myself. Yeah, exactly um and so it's been a little bit busier of a week and we're leading up to the pcpc mastermind next week so some weeks are worse some weeks are better. But overall I would say that.

 

29:33.55

Phil Boucher

Right.

 

29:40.16

marinacapella

I'm able to take care of myself and balance all the activities that are important to me and so I think work life balance is is pretty high for me.

 

29:51.60

Phil Boucher

That's awesome to hear I'm so glad for that. I'm glad that you have those indicators too that like things are at a good place because I'm able to do this and that and get the sleep that I need for me I think I would feel unbalanced if I was working into the evenings I don't like.

 

29:56.90

marinacapella

Yeah, yeah, what about for you.

 

30:08.93

Phil Boucher

Having to give my time in the evenings to work things if if I can avoid it and so um, if I have if I'm able to go home before 5 pm if I'm able to help make dinner and enjoy evening time with our kids and then get enough sleep that I can get up in the morning to exercise and do the things that I want to do those are the.

 

30:13.40

marinacapella

Yeah.

 

30:20.67

marinacapella

Um.

 

30:28.41

marinacapella

Now.

 

30:28.57

Phil Boucher

Indicators for me that that things aren't too fast or hard when I was in my previous practice. We'd have lots of evening meetings which I hated and and I got them to change it for a little bit but then it reverted back to evening meetings and I hate evening meetings like that destroys my work life balance when I'm getting home.

 

30:34.83

marinacapella

Oh yeah.

 

30:45.48

Phil Boucher

Late or when the kids are you know, already in bed or something like that. Um, that never happens now that I've been in Dpc but that was a more frequent thing and that really affected my ability to feel like I had compartments of work and home like they just bled into each other way too much.

 

30:48.48

marinacapella

Now.

 

31:01.97

Phil Boucher

Ah, in that period and so that for me is my key performance indicator I like being busy I like doing a lot of things and so I pack my workday full of different things to do some of it is seeing patients and some of it is projects like this or creating content for Instagram or all I have too many pots on the stove.

 

31:06.88

marinacapella

Um, yeah.

 

31:17.21

marinacapella

Um, ah yeah, ah.

 

31:21.47

Phil Boucher

At most given times but I'm able to shut all those pots off and let them sit and go home and just be with my family and that's for me the key performance indicator that things are in good alignment.

 

31:30.85

marinacapella

Um, yeah, yeah, and you um, yeah and I think that's something that a lot of Pediatricians value is their home life their time with their family I mean we love families and we love kids and so it makes sense that that's something that we would prioritize in our own lives. Um.

 

31:41.32

Phil Boucher

Yeah, first.

 

31:48.28

marinacapella

So Yeah I think it's totally Possible. You have to figure out what your ideal schedule is you have to choose what your hours will be. You have to make it clear to your families from the beginning when you will be accessible and when you won't and what your specific boundaries are. But if you do that I completely believe that. Ah. The work life balance that you can achieve through Pediatric dpc is actually better than what you can achieve working full time in the fee for service world. Would you agree with that.

 

32:13.92

Phil Boucher

Absolutely,, There's there if you are intentional. There's no way that it's not going to be better than in the fee for service world and you don't even have to have all the things figured out when you start you can you can iterate as you go, but you're going to have a better Work-life Balance. No matter what if nothing else because the volume is so much lower that you're able to get your charts done and then you're just going to be like well what am I supposed to do now I have all this free time and then you'll figure it out but no matter how you slice it. The worklife bounce is going to be better than in the fee for service world.

 

32:35.00

marinacapella

Um, yeah.

 

32:39.18

marinacapella

Ah, now.

 

32:44.98

marinacapella

Yeah I would say the 1 thing just to keep in mind though is that you're not just seeing patients anymore. You're not just a clinician who is an employee anymore you do have to find a way to balance the business aspect of things because you're the one responsible for filing.

 

32:54.28

Phil Boucher

Ah, right for sure.

 

33:02.74

marinacapella

You know your re-registration and your city license and all this stuff and if you're able to overtime build a team then you can have people to help you manage that. But in the beginning it is a lot. You know you're balancing your clinician life with your entrepreneurial life.

 

33:15.69

Phil Boucher

Right.

 

33:18.88

marinacapella

With your family life so being intentional just like you said if you were intentional. You can absolutely do it.

 

33:24.72

Phil Boucher

I think that's the other thing too that a lot of physicians don't realize like you feel like oh there's all this business stuff. It's going to consume me well I'm seeing 4 to 8 patients per day max I can set aside 2 hours and I can literally block my schedule for 2 hours from ten to noon on Tuesday mornings. To do Quickbooks. So yes I have to do that. But it doesn't mean it has to bleed into my evening or take over my life like I have you can time block for yourself and figure out those different productivity strategies that work really well for your brain in the way that you do tasks. To actually get those things done and maintain a work life balances despite having the additional duty of you know, making sure your licenses are up to date. You know, paying your bills doing your quickbooks those sorts of things like you can you have the time and bandwidth to incorporate those and then as you grow like you said you can bring on team members that then can.

 

34:10.54

marinacapella

Yeah.

 

34:19.93

Phil Boucher

Delegated those tasks This has been fun.

 

34:19.98

marinacapella

Absolutely yeah, Well hopefully yeah, hopefully this has given you all a better idea of what work life balance can look like in pediatric dpc and will help you to decide whether Pediatric dpc is right for you. Or not or help you even as you if you're already in this world of Dpc help you to figure out how you can set good boundaries and be more intentional about the way you balance your own priorities in your life. So Thanks so much for joining us and until next time.