057 - Best Of 2023: PRACTICE: IMPOSSIBLE's Most Pinnacle Moments Of The Year!

Let's take a journey through the 2023 season of PRACTICE: IMPOSSIBLE! In 2023, Coach JPMD interviewed various guests who shared their insights and experiences in the healthcare industry. The episodes covered a range of topics, including the importance of passion in business, direct primary care and saving rural hospitals, the parallels between pastors and physicians, the impact of temperament on career paths and burnout, addressing misconceptions about chiropractic care, investing in real estate for physicians, the mind-body connection in healing, and the role of nutrition in cellular function. The season concluded with an episode featuring Jamie Schrier, who shared his journey from burnout to becoming a business coach for healthcare providers. This special edition episode highlights the very best moments of our 2023 season.

Show Notes

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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 (00:00.75)
Well, happy new year, happy 2023. Hope you are having a terrific holiday season. If you're not, then make sure you lean on a good friend or family. Thank you for listening to the Practice Impossible podcast. we've done in the past, I wanted to share a couple of clips from the season two. If you like what you're hearing and now watching,

hit five stars on your podcast app as this is an encouragement to me and it really helps. So in season two, episode one, we kicked off our video podcast with Gautham Dekar, a local independent pharmacist. And he has a passion to take care of patients and clients. And he shared his passion and he shared what he does to help businesses that are looking to do similar things to him. So take a listen.

So what's the one thing you could tell a physician that they should do in their practice in order to succeed? So I try to help physicians understand what they can do. And from your perspective as a pharmacist, you see and hear talk to a lot of doctors offices. So what's the one thing you could tell a doctor as a young physician that they could do in their practice to succeed? So I'm a pharmacist. I'm an entrepreneur and opened up my own pharmacy in group one to four.

recently opened up the infusion center now where we do all the biologics, IV antibiotics in Brooksville, we opened about three weeks ago. Congratulations. Thank you. And after I left Walgreens pharmacy, many of my friends, they came to me because they were tired of in a chain environment, a lot of stress. They said I want to open up my own pharmacy too. And I was already in the business. They asked for my advice and they would come to my pharmacy and I would tell them what license you would need.

where to go, where to apply distributor, where to get cheaper drugs, how to do marketing, that more business. But every single person that I gave advice and I would probably do the same advice to any physicians or any entrepreneur I would say in that matter. I always, I said before I'm a businessman, I'm a human. I had a lady when I opened the store, she lived 15 miles away from my store and she was getting Lecith or Furosamine and literally I was making 20 cents.

Coach JPMD (02:23.982)
on her prescription, not counting my overheads. And I still deliver to her because that's the thing to do. A 90 year old lady can't get to the pharmacy to pick up the script. It's my moral and responsibility to take care of her. I kept that motto and I told all of my friends who came to me for advice. said, do it, always at least for first year, do it that you're doing for charity. You are not doing this business for making money.

I have this motto after 15 years and I'll continue because that's my passion. You have to have a passion in what you do. Then you can do it longer durations. If you do it because you have to, then you will get burnout within a year two or three. So just have a passion in what you do and taking care of your patients whatever way you could. That's where I would say that's the success. Sage advice. Thank you for that. I think someone out there needed to hear that because we've got some

a lot of crazy things going on in this world. And if you're passionate about taking care of patients, do it. Do it. Because you're passionate about it. True. So in episode two of season two, and now that I'm saying these numbers, I think it's a bit confusing because we, I think I should be using sequences of the numbers of episodes.

But I digress. Maybe I'll renumber them in 2024, but let me know what you think. So Dr. Gross is a pioneer in direct primary care and he shares his personal and professional wins, particularly with his work in saving a rural hospital in Florida with direct primary care model of care. Let's listen into this clip and you'll be really intrigued as to what he did.

And I encourage you to listen that whole episode because it really embodies what we're trying to do in terms of helping physicians understand the business of medicine and also understand how to, how to lower the costs of healthcare and decrease your stress, stress and increase, longevity in the population. I'd love to talk a little bit about some of the work that we're doing in rural healthcare too, because this is something that doesn't just work in, in, know,

Coach JPMD (04:39.086)
in North Port, Florida, which by the way, is one of the fastest growing cities in the state of Florida, if not in the country. But we also have an arrangement in Arcadia, Florida, it's DeSoto County, second poorest county in the state of Florida. And we have a relationship with DeSoto Memorial Hospital. It's a 49 bed rural hospital. And if you're following the plight of rural hospitals across the country, they are desperately seeking life support and COVID was miserable to them. so.

We've probably in the last three years lost over a hundred rural hospitals and once they go, they don't come back. So we partnered with a rural hospital and if any of their employees sign up with our direct crime or care practice, the hospital pays for their membership for them. And then they restructured their employee health plan around our practice and said, okay, if any of these employees that are seeing Dr. Gross and his practice have any services done, they're a hundred percent automatically covered.

and will waive all co -pays and all deductibles. So they've given us free rein and eliminated all step edits, prior authorizations, and anything whatsoever, as long as it's done in the hospital. And so any service that's done through us is free to the employee and paid for by the hospital. And we're now four and a half years into that arrangement. We've saved by eliminating deductibles, eliminating co -pays,

providing access to free primary care with no co -pays, no deductibles. We've saved that hospital's employee health plan 55%. The employee's premiums have been reduced 30 % and have not increased one penny in almost five years. And so this hospital, while most hospitals are sucking wind, has had some of its best financial years in its history because we've taken their number two line item expense behind human labor.

which is their employee health plan costs, have reduced it by 55 % and frozen it for five years. That is something that is unheard of. If that were done in a Medicare population, that would be front page of the New York Times above the fold. One thing your team does not know about you. One thing my team does not know about me. Boy, I'm kind of an open book. Not sure a lot of people know that I spent three years as the...

Coach JPMD (07:01.388)
research coordinator for the Cleveland Clinic for their cardiology program before I went to med school because it took me four years to get into med school. and I applied and got rejected, applied and got rejected, applied and got rejected. And so I took a job as a, as a, this is not one word answer, took a job as a file clerk for the Cleveland clinics cardiology program. and in six months worked my way up to the research coordinator of the cardiology research program, which,

sort of launched my medical school prospects and so I worked for Eric Topol who's now the director of Medscape. He was the chairman of the department at the time and he basically is the guy that wrote me my letter for medical school and got me accepted to Case Western Reserve. So I appreciate his help immensely. That's an awesome story. In episode three, my good friend Zach Elliott helps me understand

the parallels of pastors caring for their congregation and communities and physicians caring for patients. I'd love to see more research on how doctors' temperaments shape their choices on career paths and burnout. So listen in on what Zach thinks about this and here we go. What is your take on that? you had any or seen any research on the pastoral side that looked at the personality types of pastors and what...

roles they should be in. Yeah. And now there's, there's probably, don't know if there's more work done for pastors, but I there's been some good work done on temperament and ministry and vocational ministry. But those differences that you called out, those are all from the MBTI, the Jungian based Myers -Briggs system. And again, Jungian based introversion, extroversion, sensing versus intuition, thinking versus feeling, judging versus perceiving. Those seem to be again,

Those are not necessarily subjective. And so you get disc, you get strength finder, there's all, any gram, there's a broad brush of temperament sorters. The MBTI, the Jungian based is a little more data driven if you want to say it that way. Yeah. And those, the reality that we can look at introversion, extraversion. You think about that like an anesthesiologist as an introvert. Yeah, I hope so.

Coach JPMD (09:24.256)
You know, maybe you've spent your whole life studying and you're comfortable studying and looking at the current data and that you're comfortable in there. That intuitive gift, if you open me up or you're dealing with the whole of my body, that intuition over time, I think that those could be really powerful indicators in the spiritual vocation in pastoral care. You think about putting an introverted, deeply introverted person who's maybe a thinker.

who's well suited to be a teaching pastor and they thrive and flourish just knows in a book, thousands of years of church history, studying doctrine that brings them so much joy. And then to get up and unpack that they love doing that. But to ask that person to go sit down with a grieving family and make sense of death in the moment, they're just not, that's not where they're at their best. And so we've asked that of pastors for a long time. We've said, we need you to be great.

at exegetical preaching and we need you to be looking at Greek and looking at Hebrew, nose in a book, hours of study. And then at the drop of a hat, we need you to be deeply empathetic and intuitive and extroverted to sit with this family for hours on end and then be able to meet new people and welcome them in from the sidewalk and the street. That's a big ask. And so I think that...

Even in Ephesians, there's a great text in Paul's letter to the Ephesians, to a church in Ephesus. This particular church, he said he gave some to be apostles, some to be prophets, some to be evangelists, some to be shepherds and teachers. And that archetype is pretty interesting. There's been some good work looking at temperament and those giftings to say that apostolic gifting is really an entrepreneurial gifting. It's the people who are thinking about...

pushing the boundary, moving to new contexts, always missional, kind of orienting their good for a moment and then they want to pioneer something prophetic types, being able to read the landscape and apply truth or wisdom into a particular moment, kind of keep the vertical and horizontal alignment of something. Evangelists being the people who are just outward facing, welcoming people in.

Coach JPMD (11:33.238)
And then you've got shepherds who are caring for people and sitting with people and the teachers who are really holding on and passing down wisdom. And in Paul's letter, he said, that's five different giftings and you need those working as a team. And I think medicine, if we think like that, I'd love to see more data. I think doctors may feel a lot of freedom to practice free. Yeah. And also to, to, get the resources that they need to

supplement what they are not good at. I think what we're doing is telling physicians, you're going to be an ER doc, you're going be able to do this, this, X, Y, Z. And then when a patient dies or a family member dies, you have to go tell the family. They may not be equipped to deal with that. And as you talk about that, I'm like thinking, how much stress are we adding to their lives? Well, think about a team environment where you have a chaplain, you have a doctor.

You have a social worker, you know, a team approach to medicine where that doctor is a part of a team, but we want that doctor do it, practicing their specific craft and being excellent at it and not asking them to then have to apply that across this other spectrum of things. That's again, that's a huge ask of people and it is temperament driven, gifting driven, expertise, training and experience, all that. Yeah. So, so then how do you tell a patient that

That doctor is not good at that because they are expecting you as a patient. I would think be good at everything to be good at. You need to be the, the God, you are the God quote unquote. so I, that's, that's interesting. Very interesting. think, I don't know if we can segue or you want to segue to concierge medical, but that's a great look and maybe culture is changing because I know I, I might be a great, a great friend. I'm a great audience member to your podcast cause I love and appreciate what

which you all do in the practice of medicine. And I think as somebody who relies on that great care, I want you to be great at helping me understand what I need most. And so if you say, know, I'm going to invite the chaplain to have this conversation. I'm going to invite this person in. What you have is my trust. In episode three, Aaron Dixon, my chiropractor, explains why he thinks fear is what gives the profession a bad rap.

Coach JPMD (13:57.774)
I love this discussion because you can tell Aaron it was speaking from the heart and he loves what he does. So take a listen. Why is it that chiropractors get such a bad rap? Well, that's a good quote. That's a good one. So it probably has to do with perception of danger. That's one of them. Reception of danger. Reception of danger. Correct. Right. So it looks scary or it sounds scary or it

is perceived as dangerous based on the outward appearance of what a chiropractor is doing, Twisting your neck, popping your neck, doing things like that. I mean, think about if you've never had a chiropractor adjust before and you walk in and it's usually for the last option, right? Like I've tried everything else. I don't want surgery. Let's try something different. I can't get rid of my back pain. I can't get rid of my neck pain. It is a very, I'm in pain. Like this is a scary thing. Somebody's going to manipulate my spine. Like I'm going to get paralyzed. You know, that's, that's a common, common fear.

I like to address that as it's common, and it's your perceived, you're perceiving that's what's going to occur. So I have to address that and it's okay, it's fine. Like that's a normal thing I hear people say to me all the time. And I just tell them like, it's one that isn't dangerous. You if it was, we wouldn't be here, right? We've had a lot of fighting along the way to become relevant.

Yeah, we've been accepted. We still aren't there, but we've come a long way, I think, as a profession because we just don't really hurt people. OK, is it dangerous? No, it's not. It's just not right. I'm not breaking necks. You know, we're not paralyzing people. So you've never paralyzed? No, never, never. No, no, no. someone's back. No, can't do that. No, no. You have to. The spine is strong. You know, there's a lot of ligaments and muscles to protect it. Like I, you know.

I could probably sprain strain somebody if I adjust them too hard. But no. But you're be taking a history. I know that when I saw you, I mean, you took a thorough history. Absolutely. You asked me questions. You almost didn't want to manipulate because you weren't sure what was going on. And you told me to do some exercise. Yeah, yeah. try to, and every patient is different, right? And I'm trying to remember how you came in. And I do remember that you're, I knew you had a disc thing going on there.

Coach JPMD (16:15.93)
And a lot of times manipulation is helpful in a short -term palliative aspect when you're dealing with discogenic pain like that. So, you know, obviously we want our patients to feel better and I want them to feel better as quick as I can. But So let me pause you there because you said I probably had a disc or you even said had discogenic issue. Let me tell my audience that I never had an MRI. I didn't have an x -ray. Dr. Dixon took a thorough history.

and understood that it was a dyscrogenic problem based on what he asked me and how he examined me. Which I think is really important for people to hear because a lot of times I think we flipped medicine around. When I went to medical school, was 80 % of the diagnoses were obtained from a history and physical. Only 10 % was labs, 10 % was x -rays. Now we flipped it where

80 % is actually MRI and x -rays and only 10 % is talking to the patient history and physical. So I think it's important for audiences, even though you may not be wanting to get advice from me and I don't want to give you advice, but I think it's just wise for you to understand that in medicine, you have to go to a doctor that's going to actually listen to you, take a history and examine you. So in the fourth guest episode of the season, Brett Riggins gives us so many nuggets that physicians can take away.

But when investing in real estate, he also shared his 75 hard story that you'll have to listen in order to appreciate the power of building healthy habits in your life. And he certainly did that. So my day may consist of eight hours of work, but it may start at five in the morning till nine in the morning and then maybe break for a couple hours, you know, go out or, you know, go to the gym. I just get to do what I want to do when I want to do it. So therefore I am wealthy.

Right? One other thing that I love doing is the gym. I absolutely love the gym. I did something called 75 Hard a couple of years ago. Changed my life. Changed my life. If there are any listeners out there who have heard of this, you should have done it already. But if you haven't, I'm going to yeah, man, 75 Hard, take a look at it. And the biggest piece of this, when I explained to this,

Coach JPMD (18:38.318)
this to you, you might grow in and moan a little bit, but if it triggers something in you, the biggest thing is taking action. That action will trigger compounding effects the rest of your life, I promise you. So 75 Hard is put together, I think Andy Frazella. Now he's got a potty mouth, so I would caution you on that, but he's a high performance guy. He's personal development. I'm not sure if Ed Milet had something to do with this.

or not either. here we go. 75 heart. It's 75 days of a challenge. And this challenge has a few things that you've got to do each day. Now, if you miss one of these things, you've got to go back to 70. You got to go back to the first day to hit your 75 again. So here are some things that I did that changed my life consistently. I still do them. This was led me into loving to work out and be healthy and eat differently.

So the first thing is you got to be on diet. It can be any diet, but it has to be a consistent diet. You can't have any cheat meals. There is no alcohol. You can't have any alcohol at all. You have to drink one gallon of water a day, which seems challenging at first, especially for smaller people. That's really challenging. You have to read 10 pages of non -fictional, of a non -fictional book every single day, 10 pages.

You have to take a picture of yourself every single day. And the final thing is you have to exercise twice a day for 45 minutes at a time. And yes, one of them has to be outside. So when you hear all of this, like, wow, this is a crazy challenge. But what happened to me, JP, in this process? And this was it was exactly

two years ago, believe. Man, I became a better father. I became a better husband. I became a better leader. I became a better person, which enabled me to do all of those things. In episode five, I interviewed Carla Manzurro, who is a co -founder of the Radical Remission Project. I was blown away when I read the book, Radical Remission, and so much.

Coach JPMD (20:59.432)
so that we're gonna be hosting a radical emission workshop in the Tampa Bay area in the spring. And there were so many great moments in this interview and I pulled out one that.

that you can do right now, right at home or wherever you are. And you can see the power of your mind and body through this exercise that she shares with us. And you know, there's something to be said about your body's healing powers, right? If we give it the right nutrients, we give it the right things, you can heal infections, you can heal certain diseases with your own body's ability to fight this stuff. So, sorry? Sorry. Go ahead.

I was just going to say the mind body connection is so important. And when we, you know, in the book and when we do the workshops, we really, really impress, you know, impress that upon people. Like what your mind believes is what your body's going to do for you. Right. And just a quick example, if everybody closes their eyes for just a minute and imagines a lemon, it's a sweltering hot day and you've got a glass of lemonade and there's a lemon in the fridge and you slice that lemon and put it in your lemonade.

You slice that lemon and you decide to put a piece of it in your mouth. What happens? What do you imagine happening? And everybody says, I'm puckering, salivating, right? You imagine that lemon and your body starts to respond to it. Are you sucking on a lemon right now? No, it's your mind and your body connection. And if your mind has that much power, why not put it to good use?

In episode six, Dr. Stacey Robinson shares her journey to running a successful functional medicine practice and this her take on food, chemicals and supplements and how they affect the Krebs cycle. I think in 2024, we talked about doing an episode on the cell and cellular function and the Krebs cycle and how different things affect the Krebs cycle. So I think this is something that

Coach JPMD (23:03.884)
myself and Dr. Stacey Robinson might actually do on a podcast. So I'll keep you posted on that. So nutrition is a huge part of what I do in my practice. Rewinding a little bit back to the Krebs cycle. Okay. So one of the lab tests I do is called a Nutrival by Genova Diagnostics, and it's a functional medicine lab to look at what the patient might be.

deficient or in need of to make the Krebs cycle work better. And for those who may not know the Krebs cycle is how we create, take food and turn it into energy for ourselves. And I believe that one of the reasons we have those higher nutrient needs, and I don't say deficiencies because it's really, I think a higher need for nutrients because we have so much toxic burden from

the foods that we eat, air pollution, personal care products, like all the chemicals that are introduced in the environment that haven't been tested for safety. And it's putting a burden on our Krebs cycle, right? So we need more nutrients. And I think looking at the Krebs cycle and trying to figure out which nutrients you need more of, what

your glutathione levels are because glutathione is one of the most important antioxidants and it helps regenerate ATP. So we are seeing a lot of mineral deficiencies because minerals are used for all those oxidative stress pathways. And I truly believe it's our toxic burden that's driving a chronic disease. And there's, it's not just my belief, there's evidence that that is the case. So in the last episode,

of 2023, Jamie Schrier describes how he went from being a burned out physical therapist to a business coach for healthcare providers and their businesses. And you'll hear his story and hear how he actually had a literal burn down or burn out of his office. And you got to hear the story to believe it. In that same episode, we also had fun with some rapid fire questions.

Coach JPMD (25:22.066)
and his pick for the next president was just hilarious. I'm going to share the reference to that answer down below, so check it out in the show notes. Who's going to be the next president of the US?

Hmph.

One of my favorite movies is Brewster's Millions with Richard Pryor in the movie. He had the little box that said, of you Bob. My hope is none of you Bob, but I have no idea.

So happy new year and thank you for listening. Thank you for watching. Lots more episodes and activities coming in 2024. So stay tuned, subscribe, share this podcast with someone you know and someone that you love. We appreciate you listening and we'll see you in 2024.