060 - Empowering Independence: A Journey with Dr. Laura Purdy, America's Favorite Doctor To Reduce Burnout In Medical Practice

In this episode of PRACTICE: IMPOSSIBLE, America's Favorite Doctor - Dr. Laura Purdy talks about her life as a solo physician and business owner.  She discusses her time working in innovative care, her knowledge of MSO agreements, and her licensure in all fifty states. Managing one's finances well and earning an MBA are two other points stressed by Dr. Purdy. She opens up about her time in the military and the difficulties of juggling family and career. She goes on to talk about how her spiritual life and practice have been affected by social media. Finally, Dr. Purdy shares her enthusiasm about what lies ahead and the possibilities it presents.

Discover how medical graduates, junior doctors, and young physicians can navigate residency training programs, surgical residency, and locum tenens to increase income, enjoy independent practice, decrease stress, achieve financial freedom, and retire early, while maintaining patient satisfaction and exploring physician side gigs to tackle medical school loans.

Transcript

Coach JPMD (00:00.054)
Yeah, so we have a, it's a MSA -MSO agreement. Does that ring a bell at all? Absolutely. We do those with insurance companies. Yeah, so we made one. So the PC is the medical group that I no longer own and run. And then the MSO is in an MSA and I'm the president of the MSO or the CEO of it and has a management services agreement with my clinic, which is no longer run by me. I hope if you guys are listening to this,

hit rewind and listen to what she just said because most doctors don't understand what you just said. And it is key in really becoming your independent, the independent doctor, a business owner that you should be, I think, because we have so much talent, we have so much knowledge and people are not even considering this, but you know, my business partner and friend, Dr. Singh has had an MSO for years and what he does is he,

I mean, he's able to charge whatever he wants for that management service agreement based on whatever he wants. He's in control of that. And people will pay it because that is rare. It's a very rare commodity. But it also has one, it allows whoever the organization is to go to one person, one source for the multiple things that they need rather than go to individual doctors who knows what they're doing, like you said. That's what I do. That's brilliant. That's basically what it is. But you're not dealing with insurance companies.

Wonderful. So tell me how that that is. How is it not dealing with insurance companies? Welcome to the practice impossible podcast with your host, Jude Pierre MD, also known as coach JPMD discusses medical practice topics that will guide you through the maze that is the business of medicine and teach you how to increase profits and help populations live long. Your mission should you choose to accept is to listen and be transformed. Now here's your host coach JPMD.

So welcome to the Practice Impossible podcast. Today we're with Laura Purdy here, New Year's Eve. She has graced us with her time on the Practice Impossible podcast. And thank you for reaching out, Dr. Purdy. I know that there was some questions of whether you can make it here and you made it. And when we spoke, I just felt that there was some like -mindedness going on and we kind of...

Coach JPMD (02:25.302)
understood each other without even speaking too long because you're doing independent stuff. you know, season two is all about independent practices and learning how to practice free of corporate medicine. tell us about yourself. How did you become America's favorite doctor? Because that's, that's intriguing to me. Well, so there's two versions of the story, right? The technical version of the story was we went to make a trademark and the one we wanted was taken. And so America's favorite doctor was what we landed on.

But because we were thinking about America's doctor, right? Because I'm licensed in all 50 states. I've worked for hundreds or for or with hundreds of different virtual health, innovative care companies. And I've had patients all over the country in every state, right? So, and my brand is high quality care that's empathetic, compassionate, patient first, but not physician sacrificing. A lot of times patient first has been used.

as a euphemism for running the healthcare professionals into the ground. That's not what our brand is. And so after a few years of living that out, America's Favorite Doctor came as a natural extension of providing high quality care to people all across America, but America's Doctor was taken. we went with favorite. you're America's favorite doctor. So how do you get licensed in 50 states? Because I know how hard it was for me to get licensed in Florida. How did you do that? Help.

I had help. I work in the innovative care industry and just for definition sake, I say that instead of things like telemedicine or virtual care, because what I've learned is that digital ways of doing healthcare is not the only healthcare of the future. So I say innovative care because for me it represents the future of healthcare as a whole. So if I say innovative care, that's what I mean. What was your question? Sorry. 50 states. mean, you're in 50 states. You have to have help with that.

So I worked at several innovative care companies and over, you know, from 2016 to present. And really, especially if you're a leader or a manager or a medical director, if you're an administrator in these types of companies that are providing nationwide telehealth, virtual care, innovative care, you need to have all those licenses because your company is nationwide.

Coach JPMD (04:48.31)
your patients are everywhere. And so as a leader, it became something that I needed. So I got all those states because I worked at a series of companies that said, it was like three different companies getting different sets of licenses. I would never recommend doing it on your own. I think I've had more background checks than anybody in America in their whole lifetime. You know what saying? So give me an example of an innovative company.

Aside from telemedicine, what is another innovative company? So for innovative healthcare, I would say things like, for example, there's a lot of innovation done being done in remote patient monitoring, whether it's devices or wearables or even like virtual inpatient wards where there's machines or devices that are helping you monitor the patient and you're reviewing the data in addition to the patient. Also just simply new technology like new EHRs that come out, new like connected

Like for home care, there's otoscopes and stethoscopes where the patient can put it on, but you can hear it. So those are just a couple of examples. But at the very, very leading edge of the tip of the spear of health care innovation is a lot of exciting developments. OK. So when you say the devices, are you contracted then with a device company or the health care companies that are using those devices?

All of the above, mean, so I have worked with people all across the industry because when people come to me, they're looking for someone who understands medicine, also understands innovation and also understands business. That's kind of a niche. Understanding medicine, innovation, and Doctor understanding business, huh? Right. And so, right, you're right. And so I've worked with anybody. Okay. those are just some examples. Now you have an MBA or did you, you do have an MBA? Where'd you get your MBA from?

I got my MBA from Southern New Hampshire University. And again, it's not the most prestigious university, but it was 100 % online. And I did it while I was working full -time and having kids and all that. And so I think it's a great program that busy professionals who don't have time to go to graduate school, I think do have time to do it online. Yeah. Yeah. And I wonder if, it for everyone though?

Coach JPMD (07:06.606)
because some doctors don't necessarily need it or are running pretty successful businesses without it. Why did you do an MBA? What was the main reason for you doing the MBA? Yeah, well, I did it because I needed it. I was just thinking as you were making that statement about not everyone needs it, you'll know if you need it, right? I think you'll know if you need it. Because for me, I got all the way into, I think I was a chief medical officer by the time I said,

I have no idea what the business people around me are saying. And I know they have no idea what I'm saying, but I can't teach them my language. So I need to go learn theirs so that I can be more effective. So I didn't really go because I wanted to learn how to run a business. I went because I needed to understand what was happening around me. That's a good point. Yeah. And I like that. I like that. So did you grow up in the area? I know that you moved to Miami and now you're doing the work down there.

Where'd you go before? Where were you before then? I've been so many places. I grew up in Southern Kentucky until 1999 when I was two or three years old. then I moved. Southern Kentucky. Where is Southern Kentucky near? So Southern Kentucky, imagine, are you familiar with Corvettes? So know Corvettes, the car, are made in Bowling Green. So that's where I was born. Southern Kentucky. Southern Kentucky. Where the Corvettes are.

If you ever drive down the road through Bowling Green, Kentucky, there's this massive Corvette museum off to the side of the road. The huge yellow thing with the, you can't miss it. It's like a terrain feature. I was born there. Not at the Corvette museum, but in the town where they got you. But so I lived in Southern Kentucky for 15 years and then Indiana. Then from there I lived in Hawaii. And from there I lived in Washington, DC, followed by Georgia, North Carolina.

Tennessee and now, yeah. So it's gotta be either military or parents of military. Military, yes. No, I was not from a military family, but I did join the military and they gave me the opportunity to live in some great places. That's great. So when did you start? When did you, I mean, you started out of college or out of high school? Yeah, so in 2005, I was graduating undergrad and you remember.

Coach JPMD (09:29.55)
2005. So I'm trying to think of when I graduated. Okay. So you're younger than me. Not by much, I'm sure. No, no. I graduated high school in 89. Yeah. Yeah. So. okay. Shoot. It's a long time ago. So I graduated high school in 03. Okay. But I graduated college in 05. Okay. at that time, the war was huge. You probably remember. the second war. The second, was that the second Iraq war or the?

It had to. Wait, what am I thinking about? No, that was the... was OIF, or I mean, it was during those first few years of the Iraq war, right after September 11th. That's right. So was 2005. 2005, yeah. I mean, it was new. I'm thinking the 1990s. No, not that far back. Not quite that far back. Yeah. So this was the early 2000s. And when it was time for me to go to medical school, which you remember what

All of that was like, my dad called me and said, I'm not paying for your grad school. And I said, well, I'm not paying for my grad school. Uncle Sam keeps offering to pay for my grad school. So I guess since it's not you or me. Yeah. So you had Uncle Sam pay for, so when that happens, you go to military medical school or military? You get a choice. So there's two ways to do it. There is one, you may have heard of it, the uniformed services university in Washington, DC. Okay.

Think I have, but I don't know. It's at Bethesda. Sometimes people say Bethesda Naval or whatever. It's across from NIH. And so you can do that or you can attend any school that you want, but you get a stipend. I went with the military university because you have like a full paycheck and no debt or anything. So I did the military from 07 to 2021. It's 14 years. So do you have to be in a particular service or?

because you're in the military school, because I know that the Marines don't have that track and you have to go into the Navy or something like that. Yeah, the school was actually quad service. So you have Army, Navy, Air Force, and there's a fourth service. You may have heard the public health service. They usually provide like federal care. OK, is that the national, what do you call it, whether you forgive your loans? I can't think of it. Probably.

Coach JPMD (11:57.09)
I didn't do that one, so I'm not sure. But they would provide like reservation care, federal, they to federal facility, but they're not necessarily military, federal officer, something like that. Nevertheless, I chose Army because I wanted to maximize my opportunities of getting in there. Navy doesn't have their own doctors, the, I'm sorry, Marines don't have their own doctors, but just it would be the Navy that serviced them. So I chose Army and -

The rest is history, really. So you graduated medical school without debt? Correct. And residency. Yeah. That's the Dave Ramsey way. Woohoo. Buying my three -year -old cars and putting my cash in the freezer. So you were in Nashville before. We just talked about that. you mentioned Dave Ramsey. And I'm like, I know him very well. Because I actually became a coach, Dave Ramsey coach, after my trauma, my life trauma.

I needed to understand how to deal with finances. So I hired a coach. That coach got me on track to be debt -free because I was carrying a 20 -year -old medical school debt. It was pretty ridiculous after buying property, selling property, doing all these things and realized I had to do something different. so he got me on track and his team got me on track and then I became a coach. Spent two or three days there.

It's a great experience. you didn't have to go through that, but you said your parents or your dad was a Dave Ramsey guy. My dad was a huge Dave Ramsey guy. think, I mean, I don't, I don't know all the details because I was a child, but I remember the books being around listening to all the probably tapes. bet it was tapes at the time. Maybe do we have tapes? Yeah. A -Track, A -Track or cassette? Cassette. Cassette. Not A -Track. Do you even know what A -Track is? I do. We had one. Cassette tapes.

So I was around the practices, I saw it being done and I understand the principles of saving and yeah, my family was big into Dave Ramsey. So do you think that shaped you at all or do think that helped? It definitely shaped me. I have always been very big on not accruing debt and the times when I have, I've paid it off right away. I've always paid my cars off right away. I've already put away for college for the kids. There's several things that I saw my dad do that I...

Coach JPMD (14:23.534)
I have a very diverse investment portfolio, started putting into mutual funds when I was 18. Against my will, by the way, I was taken to an investment office and said, you're gonna write a check, you're investing right now. You know, that's interesting, because me and my wife just had the conversation about funding a Roth IRA for the kids, for the minors. And I probably shouldn't say this on podcasts, because they may listen, but I'll tell those that want to hear. Someone told me,

Your child, you can fund a, what you call it, a minor or, geez, minor Roth IRA. I want to say pediatric. That's probably not the word they use. I know. I didn't go to MBA school. So basically, if they haven't earned income, you can fund a Roth IRA, 5 ,000 bucks, maximize it. Don't tell them about it. And in 35 years, they'll have half a million dollars. That's If they invest in the right vehicles.

The problem is when they get to 18, you can't do it for them. They have to do it themselves. So you always want to do it when they're like 12, 13, whenever they can start working. As soon as they get their first paycheck, you dump five grand into this Rathaurite and you let that grow. You have to know about it. It's beautiful. And in 30 years, they're half a million dollars richer. I that. Definitely recommend it. I haven't done it yet. But if you have young kids out there listening. I mean, I have 529s. It's something. We started out with a college plan. Absolutely.

But I think it's worth it and you have a long time to plan Yeah, and it's not that much money if you look at the grand scheme of things for the benefits that they're gonna get It's just that they have to you know, have to shepherd them and show them the way and just like your dad did so kudos to him So, what are you doing now? You're here you moved to Miami. You're still doing telemedicine. You're still medical director What like what are your roles now because it sounds like you're doing a lot. Yeah

Well, the last six months of 2023 saw a phase of the business where I took all of my sole proprietor work and I said, this is too much work. I mean, I do have a team and we can talk about them as well. I have a lot of people who help me do what I need to do on a daily basis, but I said, this is too much, right? This is sole proprietor work. This really needs to be a formal corporation. So I took all of my sole proprietor work, which was

Coach JPMD (16:48.344)
you know, a virtual clinic as well as partnerships all across the country, freelancing, doing consulting work with other companies. And I said, this is now a business. We have a medical group where the delivery of care is going to be. We have like a management company where all the nonpatient care is going to be, and I'm going to be the CEO of it. Okay. As opposed to the everything to everyone all the time of it, because it's hard to do it all. So I found a medical director to run the medical group for me, hired a

couple more internal staff to make things a little more structured. And now I'm the CEO of my own health system, I guess. So when you say health systems, do you have doctors working for you that are doing the work that you used to do? They do. And are they contracted or you're employed? They are W -2 part -time because it is difficult to navigate potential. This is going to be a very business statement that I'm going to say here.

difficult to navigate potential misclassification and labor lawsuits with people that are 1099s that you try to manage, like a W -2. So I choose for them all to be W -2 so that there's more top cover and protection on how to kind of manage those folks and there's less risk. Yeah, so part -time W -2 means that you pay their Medicare taxes and do you get to, do you have to contribute Well, so the taxes are still required to be paid.

But the difference is they're not on a salary. It's hourly. So if I say, coach, I pay you $10 an hour to do this work, I know it's fair compensation. It's fair market, It's fair market. So I say, $10 an hour, and you only worked three hours this week. So then when it comes time for the pay period, you would only make $30. But of that $30, you're then going to pay the Medicare taxes and social security, but it's going to be a lower amount. Correct.

And you don't have to worry about the 1099s. You give them a W4 or whatever, W2 at the end. That's very interesting. Where'd you learn that? Trial and error. Really? I've done both ends of the spectrum. 1099s are two. Now, again, this is with the caveat of this is relevant to my business model and may not be to everyone And we're not giving tax advice. We're not giving business advice on the podcast. We're just hearing stories about other people that are doing things that are cool. So the first thing we started out was 1099 because if you have

Coach JPMD (19:12.052)
a low volume of things, but you really need it to get done. You can pay a little higher bit of a premium for people to spend less time, but to get those things done for you faster. Supply and demand, it's market economics of work versus people to do the work. The problem with 1099s is you cannot control their work schedule. For a lot of states, there comes a point in time where the amount of control you're exerting over that person

actually qualifies them as W2. So when that became the least ideal scenario, the pendulum swung in the other direction and we did full -time W2 salary for everyone. What I learned is that full -time W2 salary work from home is a breeding ground for complacency. Absolutely. And accountability is not as good. So the pendulum has landed on part -time W2 with a cap, right? So if you can't be working 80 hours a week of W2, so

If we have people who are consistently working more than 20 hours a week over the course of however long we decide, they will become salary part -time. If it's above 30 hours, they will become salary full -time and then the hourly goes away. Yeah. And then you can gauge how much you pay them based on the work that they've done in the past and what you're going to be doing in the future. Correct. We learned the hard way. Smart. I wouldn't use that word. I would say it was a hard earned lesson.

Well, this is the wisdom that we try to impart to our guests, our listeners and watchers now of the podcast. But there are options, and I didn't know that. Here's my piece of wisdom. There are options. If you don't know which one to use, ask around. Even a simple HR consultant would have been incredibly useful for me at the time had I known that that's what I was needed. Yeah. But you weren't doing that beforehand, though. You were working yourself.

You were the 1099 or were you doing part -time W2s? For me as the CEO and business owner, I just worked my tail off. Yeah. But the people who, yeah, I was the one who was doing the work and then I was, I paid people to help me. This is how it happened was as the tasks that I needed to do became too great, I started finding people to do the ones that didn't require a physician. So usually they were 1099s, but then when they were working so much and they became W2s,

Coach JPMD (21:38.35)
And then we learned with clinicians that the clinicians part -time W -2 is best for us. Yeah. And that allows them to not have to work multiple 1099 jobs because there's a law against that as well. If you're the only person paying that 1099 employed or person, then they can be considered an employee and then you're, you haven't paid their taxes. Right. Yeah. That's how we, that's actually how we figured that out. Part of how, cause Tennessee is very complex and

Here's the other thing to say, every state is different. So you got to know your labor laws. If you're going to be a boss of any type of people, whether that's administrative staff or other doctors, you need to know your state labor laws. So that business model that you have now, that's what you've done for the past six months, that's what you were referring to? Yeah. we have a, it's an MSA -MSO agreement. Does that ring a bell at all? Absolutely. We do those with insurance companies. Yeah. So we made one.

So the PC is the medical group that I no longer own and run. And then the MSO is in an MSA and I'm the president of the MSO or the CEO of it and has a management services agreement with my clinic, which is no longer run by me. I hope if you guys are listening to this, hit rewind and listen to what she just said, because most doctors don't understand what you just said. And it is key in really becoming your independent.

the independent doctor, business owner that you should be, I think, because we have so much talent, we have so much knowledge, and people are not even considering this. my business partner and friend, Dr. Singh, has had an MSO for years. And what he does is he's able to charge whatever he wants for that management service agreement based on whatever he wants. He's in control of that. people will pay it because that is rare.

It's a very rare commodity. But it also has one, it allows whoever the organization is to go to one person, one source for the multiple things that they need rather than go to individual doctors who knows what they're doing, like you said. That's what I do. That's brilliant. That's basically what it is. But you're not dealing with insurance companies. No. Wonderful. So tell me how that is. How is it not dealing with insurance companies? But what's really interesting, what I've learned.

Coach JPMD (24:02.88)
is that even when you're not dealing with the insurance companies, they're still dealing with you. Yeah, they still want to deal with you too. They want to deal with me. They would love more than anything to deal with me. But it's really hard to get away from the insurance companies. we are completely cash paid. Completely cash pay, completely direct to consumer, no controlled substances. I mean, it is the lowest low threat you could ever imagine, right? For the virtual clinic. Obviously the...

other arms of the business do other things, but specifically for the delivery of care. But what we've learned is that you can be cash pay all day long, but when your patient goes to the pharmacy to get a prescription, you've just used insurance. And that's a pharmacy claim. And I didn't know what on earth that even was until, I don't know, six months ago. And so what I've learned is you're still using insurance and they're still using insurance and they still have jurisdiction to come and talk.

about what I'm doing or what I'm not doing, even though I'm not taking their money, but I'm taking care of my patients and the patients are trying to use their money at the pharmacy. It's been a long year, coach. Yeah, and I found that out the hard way too during COVID. Where a particular pharmacy, I'm not going to call this pharmacy yet because I don't want to get in trouble. Not today, but he'll tell me and I'll call it out. Yeah, it starts with a W.

But there could be several that sort of W who actually refuse a prescription for ivermectin for me. They still do actually. know who you're talking about and they don't fill weight loss prescriptions for me anymore either for absolutely no good reason. I mean, I'm telling you right now, when I say no good reason, mean, no good reason. There's no good reason, especially given that we've prescribed more toxic things to patients than ivermectin, let's say, or hydroxychloroquine, whatever.

But to stop a physician from prescribing a drug because it's quote unquote dangerous. Ibuprofen causes renal failure. Absolutely. You know what? You can actually overdose on water, coach. And I'm concerned about the amount of water being dispensed from these pharmacies. Yeah, we should find Zephyrhil. It's dangerous. It's dangerous. Yeah, we're going to get in trouble. But that's okay. I don't care. I mean, I'm not telling a lie. No. Water is dangerous if you drink too much of it. you drink too much of it, absolutely.

Coach JPMD (26:23.31)
Or not enough. It's just, it's ridiculous. But yeah, you can't get away from insurance, but we can educate our patients. We can educate our consumers, the consumers that, hey, there are other ways of doing this. I have an HSA account where I use cash. my wife actually sees a functional medicine doctor. We pay a lot of money, unfortunately, but that, fortunately, I shouldn't say unfortunately, fortunately, we have the ability to make those.

But she's providing care that's directed based on deficiencies that she has that no other doctor would do. And so when you can say that you can take patients off of thyroid medications by supplementing and doing things with diet, and that I think is huge. It's amazing. But it's not being done enough. We should be doing more of that. Yeah, and I actually started to partner with Genova Diagnostics. don't know if you I Genova.

Okay. Yes. So we're going to do a series on the Krebs cycle. I know, I know, wait a minute. Ew. But the Krebs cycle, if we understand the Krebs cycle and then prescribe medications based on the deficiencies in our cellular function, how much better will we be as a population? I'm ready to find out. Maybe I'll finally learn the Krebs cycle. Yeah. I looked at it the other day. I'm like, what's all this plus minus?

So it's gonna be an interesting 23 year old, forgot all of that. This is long gone. Yeah, but it's important. Even what sparked my interest in it is because when we got the results of my wife's Genova diagnostic blood test, one of the things that they had in it was a Krebs cycle. Like she has a deficiency of her Krebs No, she has deficiencies in the glutathione and fatty acids, whatever those deficiencies are and I don't remember, but we'll definitely get into it.

but it was fascinating that it went back to the basics. That's what, you know, we are prescribing too much in this country when we can look at nutritional deficiencies that can actually cure things. So I'm going into No, I think it's great. I think it's great. So you're all over social media too. So I guess as part of that team, cause I'm looking to try to get to where you are. So for the people who are listening.

Coach JPMD (28:41.152)
Earlier today, Coach said, you're all over social media. And I said, good, that means people are doing their job right. So that's what I need then. I need people to do the job right. that's interesting because most doctors are not on social media. Most doctors are not as social media friendly. And I think it's important to go where the people are and to go where your consumers are so that they understand what you do. Well, the people who are listening to this who've been around me for the last year and a half are

just falling out in the floor laughing because I don't think anybody would have used the term social media friendly to describe me ever. Really? No, my social media presence is 18 months old. It is a year and a half old because when you're in the military, they tell you that if you do social media, bin Laden will come get you. I mean, somebody's gonna come find you and get you and something awful will happen to you if you have a public presence. And so I never did. And it was actually, it wasn't really, I had

to work through a few things, to feel safe being on social media because as a service member and being in special operations and things like that, we were conditioned to know that social media wasn't safe. And so - think about that. It's a big deal. And my friends who were in the army or veterans are going, mm -hmm, yeah, I'm still looking for them out my window. But I tell people I've done it for a year and half and nothing bad has happened to me yet. Nobody's come to get me yet.

And I don't think they're going to, as far as I can tell. But if you're a physician and you're thinking things like owning businesses and hiring employees and doing social media is intimidating, I promise you it's not that it's intimidating, but that it's just new. This is where marketing is done these days. This is how your patients find you, because that's where they're going to look for you.

Get comfortable being uncomfortable and learn new things. We can do that. Yeah, I think that's what we are conditioned not to do once we leave medical school. We're told to do things. We're told to, this is how we need to operate. And that's what I try to do on this podcast and just help physicians understand that there are other people doing powerful things in this world. And what you're doing is just amazing because you are showing people that

Coach JPMD (31:06.318)
This is how we can do things and not have to be tied down and have a team that works for us and with us and promoting your brand and what you're trying to do. So kudos to you for sure. Thank you. So tell me about family, family life. Kids. I think I saw some kids on social media in Orlando. Everywhere. I try to take them with me as often as I can, but I do have four kids. They are 10, 8, 6 and 3. Wow. Yeah, it's been a very busy.

It's been very busy decade and they're wonderful. mean, they are very resilient. They've moved to a lot of different places. They've tried a lot of new things and I hope to have them finally settled in the place where they get to be for a while. We have a nice family, a nice community out there in Miami and they understand who I am, what I stand for and why I do what I do, which is very important to me. But in the upcoming year, I think

For me, there will be a much greater emphasis on family. Not that it was de -emphasized before, but I do think that especially in the next three to six months, we're going to slow down, make sure that we're healthy, that we're okay, that we're safe. And we've had a lot of big changes in the last six months, right? And so they are my biggest investment. They are my best investment. They are my favorite investment. And...

The next three to six months, I hope, will be evidence of that. That's awesome. You have family down in Miami? We have chosen family. Chosen family. No actual family, but chosen family, which can be just as wonderful. That's awesome. And I have a young kid. Well, my youngest is 13. So if they're ever up in Tampa.

You need a babysitter. That'll be fine. You might have a 21 year old who loves babysitting. Thank you. You have a free, I'm going to say free babysitter. You're so funny. you. you. So you're doing telemedicine. We talked about functional medicine. One of the things I always wanted to find out from those that are doing a lot of telemedicine is how do you deal with not seeing patients face to face as often? And when did you stop seeing patients, I guess?

Coach JPMD (33:25.102)
Face to face. Well, when you hear the true story, of course you do. That's what we're here to do is tell the true story. I in -person patient care, face to face care was always very hard for me. Gotcha. It was hard for me because my nature is to give. I will give time. I will give energy. I will give resources. I will give away my own schedule. I will give and give and give and give and give and give and and and patients are inherently in a position to take.

And I was, family medicine, so outpatient, but in the army, I had a hospitalist job. So most of the time I did actually work inpatient. And for me, because direct patient care was constantly a state of giving and giving and giving and giving. I think at the time I didn't have the boundaries to be able to stop the patients where they needed to be stopped. I ran myself into the ground immediately, even residency. was too much because

I wanted to be able to stay and give them the time and give and give and give and give and I couldn't and that was hard for me. So right off the bat, I said, this is not going to be a good fit for me personality wise because I can feel how much of myself I'm giving away. And I think that was part of what drove from outpatient to inpatient. Right. So for me, I telemedicine and I liked it more than the face to face care because I was protected a little bit emotionally from

The patients, I mean, I want to give them everything they want. If they're angry, I take it personally. And when they tell me they're going to sue me, I believe them and it messes with me. And I hear that kind of thing a lot. Threats, threats. I'm very susceptible to threats and intimidation, I guess. And so I stopped working. So I did do some PRN hospitalist work, about one shift a month for about a year and a half. And I got to the point where I realized that I just

didn't enjoy it so much. I missed being in meetings. I missed talking to entrepreneurs. I missed working on things like operations and initiatives. I like business. I really do. But I also like medicine. So for me, virtual care has given me a better balance because I feel like the boundaries are already in place. And so I'm less susceptible to being completely drained and burned out from the day to day.

Coach JPMD (35:49.752)
So I think it speaks to the temperament also of the human being. mean, there's certain things that I don't think physicians should do based on their temperament. Agreed. And I'm trying to figure out, and I've done some research. I haven't really found much on temperaments and physician specialties. But I don't know in medical schools these days, are they even looking and talking to students? they taking assessments of what they should be doing? I don't know, but I've known a lot of, no offense anybody, but I've had a lot of children, so I can say this.

gynecologists who maybe could have had definitely very different temperaments because they're working with pregnant people. know? Or, you know, anesthesiologists or radiologists who, you know, shouldn't be talking to them. I know. That's just the example that comes to mind. But I agree with you. There should be some sort of a personality match as well. For sure. So I've done a couple things. I've done rapid fire in previous interviews before.

We're going to do it little different this time. And we're going to try to ask you some questions. So it'll be some easy questions initially and then maybe they get harder. I don't know. see. I'm not in the habit of doing things easy or the regular way. So let's do it. So I used to do, you know, one word answers, but now you can, you can embellish or for the new year. He knows how hard that would be for me. Thank you coach for working with my limitations. So what's your favorite book and why maybe?

Animal Farm. Animal Farm.

Why? Because I read it when I was 12 and I loved it. And then I read it again when I was 14 and I loved it. And now as an adult, I'm really starting to understand it. And I appreciate it for what it is. And if you've never read Animal Farm, it's a satire, go read it. Yeah. So I haven't read Animal Farm, but I read 1984. Yeah. So that was scary to me. Yes. I read that around COVID. don't do that.

Coach JPMD (37:53.614)
What? Don't read Animal Farm like at the next election or like just save it for a quiet vacation. I did not do that. Favorite food? Chocolate. just off the bat. Boom. Chocolate. Last place you traveled internationally? Mexico. Cruise or land? no, it was a cruise. I forgot about it. No, no, no.

Mexico was a land trip, but there was a cruise since then. So you're saying. Last like non -cruise vacation. I've had one international trip as an adult to Mexico last year and I got COVID while I was there. It was great. Actually, let me keep talking. The Mexican primary care doctor came to my hotel room.

and just started giving me shots of, don't even know what he was giving me shots of. Turned out to be dexamethasone and neomycin for my, what turned out to be COVID. So did you end up doing anything else? I got some packs a little bit eventually, but I was thinking neomycin. Like I've never prescribed this in my whole career. don't think. It's, you know, sometimes I think in the, in the,

these countries, because I grew up in Haiti. Of course. And I actually did some work after the earthquake. it was interesting how they just wanted care. So we would go to the areas where it was hard as hit. Everything is devastated. And they'd come and complain of, let's say, a headache. We gave them Tylenol. And they were happy. happy. They were happy. They left. I'm like, I could have given them water, and they would have been happy. Give them a hug. They'd be happy. Yeah. Wow.

One thing that brings you joy when you're caring for patients. When I'm able to help them solve a problem that they genuinely thought they weren't going to be able to solve. When people say, I don't know what I would have done. And a lot of that is like nights, weekends, and travel with telemedicine. But when people are saying, I have no idea what I would have done if you hadn't have helped me, so thank you.

Coach JPMD (40:11.552)
I love making, I love knowing that I made a tangible, meaningful impact in that person in that moment. Fair enough. Now I know the answer to this, so I probably should, I'll ask another question. Would you work for a hospital system? I know the answer to that. No, no, you don't know the answer to that. So this is how I would respond to that. What job are they offering me? If they need a.

Chief Innovation and.

changing the way we do things, officer, then absolutely I would sign up for that job in Heartbeat. Good answer. But to be a clinician, I would rather go work at Starbucks. I hear ya, I hear ya. Favorite child? All of them! Teddy, that's the cat. Teddy? That's a, all right. Just kidding. You got out of that one. No, I don't, I don't have a favorite child, and because they're all amazing.

but they also all have either things from me or things about themselves that I just love so much about them. So I could tell you what my favorite thing about each of them is, but I definitely do not have a favorite. Good answer. It depends on the day though, right? I gave you a hundred million dollars today. What would you do with it? If you gave me a hundred million dollars today, what would I do with it?

Coach JPMD (41:42.712)
something incredible.

But I wouldn't know what that thing is off the top of my head because that would be a really irresponsible way to spend $100 million. So I would pause and make a plan to do the most good and create the most impact that I possibly could with $100 million. And then I would do it. Okay. What's the one spiritual habit that you have practiced?

Coach JPMD (42:10.254)
So that's a good question. And I don't know because the spiritual aspects of my life are one of the things that have had a complete, what do you call it when you're doing a renovation and the first thing you do is you break everything? Demo? So I did demo on my spiritual life this year and I'm working on deciding what comes back in and fills in those holes. Yeah.

One thing your team does not know about you.

Coach JPMD (42:50.702)
So they don't know that you know everything. don't think they know that I know everything. Okay. I think that, but here's the thing, okay? When you are the boss, it all makes its way back to you, all of it. And just because your boss knows something doesn't mean that they're acting on it. So assume your boss knows everything.

This is gonna be a clip. This is definitely gonna Please do. Assume your boss knows everything because your boss is your work mom, is your work dad. And if they're doing a good job, of course they know everything. It's their company, like it's their home. You're their employee, like you're their child. It is their job to know everything, right? So that's. Okay. I know, I know team, I know. Where do you see yourself in 25 years and why?

I have no earthly idea because I've known myself long enough to know how predictably unpredictable I am, but I'm tremendously excited for where I'll be in 25 years because no matter where it is, it will be on purpose and it will be incredible.

What a good way to end. Can't add to that. Thank you so much, Dr. Purdy, Laura, for being America's favorite doctor. Thank you, coach. And for being on the Practice of Puzzle podcast. We really appreciate you. And you probably should have another session when we can have some sheet music. Yes. So you can play some.

something for us. What Coach learned today is that the only way I can play music is if it's physically on sheets in front of me. So we're going to surprise her with some sheet music next time. I can't wait. Next time you're in Tampa, just give us a ring. Just come on over. Even with the kids. Love to meet you kids. They'll love it. With the free babysitter. Yeah. I'll make sure my daughter's around. Thank you. Thank you again for listening to the Practice is Possible podcast. you know what to do. Share this podcast with your friends, your family, anyone that you love.

Coach JPMD (44:56.066)
You want to help in the business of medicine because we want all physicians to practice impossible. Happy New Happy New Year everybody.