Episode 46- "Navigating Your Child's Healthcare: Insights from Dr. Michael Parisa"

In this fascinating and inspiring episode of The Sweet Slumber Podcast, host Meredith Brough speaks with Dr. Michael Parisa about his innovative approach to pediatric care via direct primary care (a new approach that offers families 1:1 healthcare in their homes).

They explore the benefits of personalized care, the importance of mental health support for children and parents, and the challenges of traditional healthcare systems.

Dr. Parisa advises listeners on choosing a pediatrician and highlights the value of accessible care. He also shares zestpeds.com as a resource and encourages spreading the word about direct primary care to revolutionize healthcare.

Topics

• Challenges in traditional healthcare systems
• Building relationships with families for better care
• The need for a focus on mental health in pediatric care
• Helping parents understand and address children's mental health needs
• Challenges of accessing trustworthy healthcare providers
• Affordability of healthcare and benefits of direct primary care
• Positive impact of direct primary care approach in pediatric care
• Importance of building relationships and providing comprehensive support for mental health

Find Dr. Michael Parisa:

• Website: zestpeds.com 
• Dr Parisa's website: https://zestpeds.com/solon

If you're interested in working with Meredith, click here to set up a free Sleep Intervention Call.

If you'd like to learn about the Baby-Centered Sleep Consultant Program or Mastermind set up a call with Meredith HERE.

Don't forget to leave a rating or review and share your favorite episodes!

Keywords
pediatric care, direct primary care, children's healthcare, mental health, women's healthcare, prenatal care, postpartum planning, healthcare providers, supportive resources, safe sleep practices, breastfeeding, vaccine schedules, affordable healthcare, direct primary care benefits, pediatrician relationship, pediatrician accessibility, pediatrician support, pediatrician availability, pediatrician advice, pediatrician network, direct primary care movement, healthcare improvement, healthcare revolution, healthcare change

The Baby-Centered Sleep Consultant Certification Program Launches on November 11th, 2024!

Check out the links below & add your name to our waiting list so you can join our next session.

Learn More About the Baby-Centered Sleep Consultant Certification Program HERE.

Learn about our Baby-Centered Sleep approach, methods and principles, hear from a few of our graduates, and get to know Meredith HERE.

Chapters

• 3:35 Direct Primary Care Model: Dr. Parisa explains the concept of direct primary care, its benefits, and the differences from traditional healthcare systems.
• 5:25 Challenges in Traditional Healthcare: Dr. Parisa discusses the limitations and challenges of traditional insurance-based pediatric practices, emphasizing the impact on patient care.
• 7:34 Positive Impact of Direct Primary Care: Dr. Parisa highlights the positive impact of direct primary care, focusing on improved doctor-patient relationships and access to care.
• 9:12 Benefits of Lower Patient Load: Dr. Parisa explains the advantages of having a lower patient load in direct primary care, leading to better relationships and improved care.
• 13:29 Enhanced Patient Support and Resources: Dr. Parisa discusses the benefits of direct primary care in providing enhanced support, resources, and access to specialized services for families.
• 15:23 Passion for Pediatric Care: Dr. Parisa shares his passion for pediatric care and the satisfaction of helping children overcome fear during medical visits.
• 15:32 Building Relationships with Kids: Dr. Parisa discusses the joy of building relationships with kids and their families, making the doctor's office experience positive.
• 16:02 Mental Health and Support: The conversation shifts to the importance of mental health, especially for children, and the support provided by Dr. Parisa's practice.
• 17:18 Support for Women's Healthcare: Dr. Parisa emphasizes the need for trusted support for women, especially during prenatal care and postpartum planning.
• 18:10 Challenges in Parenting Choices: The discussion touches upon challenges in parenting choices, including bed sharing and breastfeeding, and the need for non-judgmental support.
• 20:33 Open-Minded Approach to Parenting: Dr. Parisa advocates for shared decision-making in parenting, addressing concerns about bed sharing and vaccine schedules.
• 22:37 Important Pediatric Health Topics: Dr. Parisa highlights important topics for parents, including introducing solids, addressing respiratory illnesses, and setting boundaries for visitors.
• 27:02 Direct Primary Care Model: The conversation delves into the affordability and benefits of the direct primary care model, emphasizing cost savings and accessibility.
• 29:11 Expediting Autism Diagnostics: Dr. Parisa discusses the rewarding process of expediting autism diagnostics, highlighting the impact of early intervention for children.
• 30:23 Developing a Relationship with Pediatrician: Dr. Parisa advises parents to have a trial period with their child's pediatrician and ask important questions about accessibility and support.
• 31:29 Finding More Information: Dr. Parisa directs listeners to zestpeds.com as a resource for frequently asked questions, blog information, and updates on new offices.
• 32:17 Spreading the Word: Meredith encourages listeners to share Dr. Parisa's information and the podcast with their doctors, advocating for a movement to change healthcare.

Transcript

Meredith Brough (00:00:01) - Hello, I'm Meredith Brough, your host. Welcome to the world of Sweet Slumber, where we unravel the secrets to peaceful and restful nights for babies and young children and discuss the difficulties and wonders of motherhood. As an experienced mother of five, sleep coach, childcare expert, and instructor of sleep consultants, I bring a wealth of insight and knowledge to the table. In this show. I'll be sharing my baby centered sleep approach so you can sleep well and wake up feeling refreshed and energized and help your little one thrive every step of the way. I'll also teach you how to let go of parenting pressure and confusion so you can embrace everything that you truly love, especially your child. You deserve a rewarding motherhood journey. So let's dive in. Hello and welcome to Sweet Slumber. The show dedicated to helping you build a brighter future for you and your child when it comes to everyday life and sleep. Today I've got a wonderful guest that I can't wait to share with you. His name is Doctor Michael. Parisa.

Meredith Brough (00:01:07) - Hello, doctor. Mike. Hi.

Dr. Mike (00:01:09) - Thanks for having me.

Meredith Brough (00:01:10) - You're welcome. I just realized that I didn't even ask you how to pronounce your last name. Is that right? No.

Dr. Mike (00:01:14) - That was that was perfect. Yeah. Okay. On to just about anything. So you're safe.

Meredith Brough (00:01:19) - Awesome. Thank you. So, doctor, Parisa is a board certified pediatrician and an active member of the American Academy of Pediatrics. He has spent most of his life in Northeast Ohio, completing his undergraduate degree at Case Western Reserve University, then medical school at Northeast Ohio Medical University. I'm sure you say that so much faster than me. He then called Columbus home, where he completed pediatric residency at Nationwide Children's Hospital, then entered into a brief pediatric cancer and blood disease fellowship at Saint Jude Children's Research Hospital. After a short period, he returned to Northeast Ohio, practicing as a general pediatrician, which allowed his wife and his growing family more time with their loved ones, but not at work. He enjoys spending time with his young children, his wife, and two Siberian huskies, in addition to any sort of outdoor activity, including biking, hiking, swimming, or just exploring all that the beautiful Greater Cleveland has to offer.

Meredith Brough (00:02:20) - Love that.

Dr. Mike (00:02:21) - Yes, yes. With the Huskies, there's fur everywhere. So if you ever come over to our house, you might even see some of my clothes. Now they're just.

Meredith Brough (00:02:28) - I can't imagine. I'm sure that's really messy. They're beautiful animals, though.

Dr. Mike (00:02:34) - Yes. And they have quite the attitude. Just like a toddler, which is great.

Meredith Brough (00:02:38) - Oh, really? That's so funny, because I've. We used to have a neighbor who would walk hers, and they did seem like they had a lot of personality.

Dr. Mike (00:02:44) - They do, they do. They're great. We love them though.

Meredith Brough (00:02:47) - So how old are the kids?

Dr. Mike (00:02:49) - So my son Nolan is four., my daughter Kennedi is two, and we're expecting our third in March, so.

Meredith Brough (00:02:55) - Oh, congratulations.

Dr. Mike (00:02:57) - Yeah, my wife and I both came from bigger families. I was one of three. She was one of five. We settled on maybe four, but I think after three were I think.

Meredith Brough (00:03:06) - We said we were done at four and we got five.

Meredith Brough (00:03:08) - We'll see where you end up.

Dr. Mike (00:03:11) - Yeah. It's the most fun thing I've ever done in my life with the kids., most exhausting as well too. But I wouldn't wouldn't give her anything.

Meredith Brough (00:03:17) - I totally get that. It's it's the best. It's wonderful. But holy cow, is it exhausting. So I guess my main questions have to do with this unique way that you're practicing in your business that I think a lot of people haven't heard of. So is that what we call direct primary care?

Dr. Mike (00:03:35) - Yep. Yes.

Meredith Brough (00:03:36) - Exactly that.

Dr. Mike (00:03:37) - Yeah. Direct primary care. So we say we are a concierge style membership based type of medicine. I think people understand the access with concierge is the subtle distinction between concierge medicine and direct primary care is that concierge will still be insurance and is still restricted by insurance regulations., direct primary care does not. So that is the happiest part of my job now is ideal zero. With insurance companies, we don't build insurance because we don't build insurance, and all of our families care is delivered within a monthly membership.

Dr. Mike (00:04:08) - We can deliver it as best we see fit. So we offer home visits for the first six months of life. We say so not having to worry about right? Packing up your newborn, bringing them into the dirty pediatric office, especially respiratory season that we're just starting into now. Like we completely eliminate that worry for families. We meet them in their homes. We can do just about everything in the home that we could do. In a normal office. We have 24 over seven direct access to your child's pediatrician. When people join our practice, they get our cell phone numbers. They text us, they call us. Everybody likes texting anymore. Anyway. Send us pictures of rashes. You're worried about something? You can always get Ahold of us. There's no waiting on hold with the nurse's line. There's no after hours call center. It's. It's your child's pediatrician., and, you know, again, because of the fact that we don't build insurance, it's just more freeing for both ways. You know, we can deliver the care that we thought we would be delivering during training.

Dr. Mike (00:04:56) - , after getting out into the real world, finding out that insurance based repayment has so many restrictions with it., and our families love it too. I think texting by far is the thing that they like the most.

Meredith Brough (00:05:06) - That's great. Yeah. Oh man, I can't even imagine what that'd be like. And some of the things that you said just kind of shot me back to the pandemic when parents weren't getting any support. Like, what a contrast. You know, what you're doing is what we need. And there's been such a lack for various reasons. Right?

Dr. Mike (00:05:25) - Yeah. And I think, you know, I previously was with,, a traditional kind of insurance based practice with a major hospital system up here in Cleveland., and it's not necessarily the doctors that that are causing the issue. Right. It's just the fact that you have to see so many patients in your given day to then, you know, get the repayment that you're expecting., and you get 15 or 20 minute time slots for kids when kids don't fit into those time slots, right, like you're seeing a kid once a year and expecting everything that they need to talk about.

Dr. Mike (00:05:52) - For one entire year in 20 minutes. It's just absurd., and, you know, we completely do away with that. Our visits now can be 60 to 90 minutes if need be. I can still get an ear infection in in 5 or 6 minutes and out the door, like back to school or whatever they're doing., but we have more time to sit down and unpack concerns with our families. We build those relationships. My breaking point with traditional medicine was I had a 12 year old again, right at the end of their 20 minute yearly checkup. We were going through the depression screener. They didn't end up filling it out because I remember being a teenager, you know, pre-teen just didn't want to listen to what was supposed to be done. Yeah, I wouldn't grab my papers. I came back into the room. They're off the charts depressed. They're suicidal. I'm like, this is not fair to you that I'm being so rushed because I have three other patients. I need the time to sit here and unpack this with you.

Dr. Mike (00:06:36) - , and it was at that point I said, there's got to be a better way.

Meredith Brough (00:06:39) - Wow. Yeah, that's a very impactful story.

Dr. Mike (00:06:43) - Yeah. And it was it was a breaking point for the better, because it was at that time that the person who hired me for my initial job had broken away and started to test pediatrics,, which is the first pediatric direct primary care network in the country. Wow. There are plenty of kind of one off people kind of opening and doing it on their own., that's been around maybe five years or so, but there isn't any networks in a network. I feel like sometimes people associate maybe a network with like a hospital system or something like that. It's absolutely not the case. It's more of just a supportive structure to set up the offices to give us the, you know, support that we need the EHR, the malpractice, things like that, and allow us to do the doctoring that we want to do., so we still have all the same freedoms that we would if we were doing it on our own, but with the support of a great team of doctors that have set this up.

Meredith Brough (00:07:34) - Yes. That's perfect. It really is. Because, I mean, I have a network. I go to people when I have questions and we talk about our cases, and someone will bring up something that I'm like, oh, why didn't they think of that? I know that, right? It happens. Or it's something you've never experienced. So, sure, I think that's awesome. Yeah, it's really cool. And thanks for clarifying because we don't want people to think incorrectly. Right?

Dr. Mike (00:07:55) - Definitely. Yep.

Meredith Brough (00:07:57) - Don't assume things. Please. This is all new., yeah. So you've already talked about some of the things that need to change in our system. Yeah., is there anything you left out that you'd like to kind of share?

Dr. Mike (00:08:07) - Thoughts? I think kind of, you know, talking back to some of those points, I think access is probably the biggest thing that we've seen., and access to somebody that they trust, somebody that they've built a relationship with. So plenty of our hospital systems, at least in the Cleveland area, are okay at getting families in to be seen most of the time, same day, which is great.

Dr. Mike (00:08:26) - Oftentimes they're not seeing the same provider, so they're seeing somebody that doesn't know the patient. They're able to be seen. They don't have their history. They don't have their backstory. They don't have that relationship with the family., so they might not pick up on some of these subtleties. And especially when you think about like a teenager, right. When concerns come up like that, you need that therapeutic relationship to be able to deliver the best care possible., so access to somebody that they trust., and I think just relationships too. Right. Like, I would love to have built all the relationships I possibly could have in my previous life in traditional, you know, practice., but with the fact that each doctor in a traditional pediatric insurance based practice has about 3000 patients per doctor., it's just not possible. It's not possible that those 15 or 20 minutes again once a year., now, once we're full, we only have 300 patients per doctor.

Meredith Brough (00:09:12) - Wow.

Dr. Mike (00:09:12) - That's why we have more time.

Dr. Mike (00:09:14) - That's why we can build those relationships. That's why our families have that access to us. Because we have more bandwidth to be there for them.

Meredith Brough (00:09:21) - One of the reasons you said that that happens with the 3000 is because they have to take on more clients to make the amount of money that they need to maybe run their practice and stuff because of insurance. Right. So what you're kind of saying.

Dr. Mike (00:09:31) - Is, yeah, there's more overhead., paying for your office staff paying, you know, especially as hospital systems are buying up more of these private practices. Now to at least in the Cleveland area, there's maybe just a handful of private practices left because all the major hospital systems are buying them up., so yeah, in our practice, there's no overhead. Essentially, it's just the doctors and the patients. So we cut down our on our overhead cost,, so that the money coming in is going directly to the doctor. So there's not all these other fines and fees and things that we need to cover,, because we just don't have those in our system.

Dr. Mike (00:10:02) - So that's why we're able to function with with less volume.

Meredith Brough (00:10:05) - It's amazing., 300 patients. Wow. You know, you were talking about having a relationship, and I thought, oh, he's going to die when he hears my story. I switched doctors because I wasn't happy., the one that I had. And my doctor ended up not coming back. She went on maternity leave and didn't come back. And it's been maybe almost a year, and I still don't have a doctor in my office because I'm going there for like, urgent things. And I haven't liked anyone. And there's so there's such a shortage of like, doctors and nurse practitioners in my area that I'm just like, I wasn't happy with my last one. I don't know what to do. So, man, I wish you were here.

Dr. Mike (00:10:46) - Hopefully soon. Yeah. So we right now we have offices in the greater Cleveland area. We're on the west side of Cleveland. I'm down on, you know, southeast side of Cleveland.

Dr. Mike (00:10:54) - And then we just opened up in Pittsburgh, PA as well too., so that'll be it for 2023. As far as 2024, it's really just finding the right doctor in an area,, that has pediatric patients, which is anywhere around the country. Right. But it's really just finding finding that doctor that's willing to buy into this., it's a little bit of a risk up front, right? Because you're going from the stability of a stable salary. That's a pretty good living. And,, even just a traditional pediatric practice., but taking that a little bit of a risk up front for that, I've never been happier in my job, like, ever right now. Yeah. Even though I'm not super busy, like, it's going to pick up, it's going to come. And just knowing that I can be more present for my family, more present for my my own patients families,, it's definitely worth it.

Meredith Brough (00:11:39) - That's awesome. And that's such a great point. If our doctors are happy and loving their jobs and not super stressed and you're hopefully it'll work as long as we want you to, but you'll be a better doctor and you've got these relationships like it just sounds like everything is winning.

Dr. Mike (00:11:54) - That's that's what we that's we're hopeful to, and I think some of the critiques we'll hear from, from people out there is okay, so let's say you're going from 3000 patients down to 300. So isn't that increasing the physician shortage? Well, just based on those numbers, some might argue, yes., but exactly like I just told you, right? I'm happier now. I guarantee you I will stay in practice longer. It's likely more attractive for people coming into primary care if they see this type of lifestyle. So I think over time that will shift. And even though we're seeing less numbers per doctor, I think they'll be more doctors who are interested in it because it is a much better lifestyle than traditional insurance based repayment can be.

Meredith Brough (00:12:33) - Yeah, absolutely. And you have to have that longer, broader vision, right? Yep. I love that so much in my mind right now. Like oh my gosh, where do I start., well is there anything else that you'd like to share,, about what you're enjoying now that you've gone into this different type of care?

Dr. Mike (00:12:51) - Yeah, I think the home visits have been my my most enjoyable part wasn't even an option with just previous practice because you couldn't write.

Dr. Mike (00:12:57) - You couldn't get through enough numbers that way., being able to meet families in their home, like, look over their bassinet, look over their bottles, they have specific questions about it. Breastfeeding concerns at their house, in their own environment. Like, we can handle all of this and sit down and talk with families. I think it's tough for new families out there now because there's so much information. It's so hard to decide what's good information, what's what's bad information, even for us sometimes. And with the fact that no matter what you choose, 40 or 50% of the internet is going to think you're doing the worst possible thing for your child.

Meredith Brough (00:13:29) - I know.

Dr. Mike (00:13:30) - Polarizing we are.. It's overwhelming. It's overwhelming. So know that knowing that my families have somebody that they can turn to at 830 at night, if they're up thinking about something like texting me, like, I would love to be able to take that worry off your hands., and it just makes me feel more whole as well, too.

Meredith Brough (00:13:44) - Yeah. Wow. Gosh, it's so amazing. I just love it. And and I just can't imagine, you know, I've worked with a lot of women who are very anxious. And, you know, it's not even just I don't want to go to the office because my kids will probably get sick going there. It's maybe I don't want to even get in my car. I don't want to leave my house. I don't want to take my child out, especially in the winter. Right. But also. They just have a lot of anxiety. And that's not good either. But there's a lot of people who are just kind of shutting down those,, the things that need to happen, they're not they're not doing them. And so maybe this is also helping you find moms who need to turn and get more support, too, like postpartum depression or anxiety. Absolutely. If you're primarily focused on those kids. But, you know, you said you're building a relationship. So I can't imagine you not noticing signs and not telling these moms they need to go talk to their doctor, right.

Dr. Mike (00:14:37) - And I think what's nice, too, is, you know, previously coming from a hospital system, everything had to stay in-house, right? Like, all of our referrals needed to be within the system just for kind of repayment. How the system works. Now that we've been able to step back and we're kind of independent, essentially, we're able to meet and find all these awesome people who are out in our community doing fantastic things for, you know, women and children that we just had no idea existed before. All of these doula services, all of these postpartum mood, you know, people that are out there, depression specialists, psychologists like it is incredible how many resources are out there we just didn't know about. Now we're able to connect and meet with those people and make sure that our families can get in when they need to be seen and not have to wait six months, you know, because of the system's backed up. We definitely are delivering better care.

Meredith Brough (00:15:18) - That's so exciting. Yeah. All right.

Meredith Brough (00:15:20) - So what are you most passionate about in your work?

Dr. Mike (00:15:23) - Most passionate I love when a kid comes into the office. Is terrified., not that I don't love that they're terrified. I love when we get to the end of the visit.

Meredith Brough (00:15:31) - I know you're kidding.

Dr. Mike (00:15:32) - This is a monster. No.. I love when we can change their mindset so they come and worried because I used to be that kid. I used to hate the doctor's office. I was so afraid of needles, so afraid of everything. When we have time to build a relationship with those kids, I love when they leave with the high five, we get them their sticker. You know, whatever it is, they give me a smile. They give me a coloring book thing that they did while they're in the office. It absolutely makes it so much worthwhile.

Meredith Brough (00:15:56) - That's awesome. What about different issues that you're addressing? What else are you passionate about?

Dr. Mike (00:16:02) - Yeah. So,, mental health, which has just exploded because of the partially because of the pandemic,, I think we're just, you know, maybe looking a little bit more now, too,, having struggled previously with some mental health issues, it hits home for sure.

Dr. Mike (00:16:15) - And knowing how I felt when I was going through those struggles, not knowing who I could turn to, who I could talk to when I needed something. Now being on the other side and being able to be a pillar of support for those families because I've built these relationships with their children, it just makes it so much better, because I remember kind of being in that same situation when I was younger, just not really knowing who to turn to or who I can talk to. But now I'm on the other end and supporting those those kids that, you know might have been like me back in the day.

Meredith Brough (00:16:39) - Yeah, that's really great. And I'm so passionate about that because I've got three kids with anxiety, depression, and some of those problems have gotten worse as my kids have become adults. And and so I am just a huge advocate for teaching parents how they can best support their kids mental health so that they have a better outcome. You know, there's just so many things that I didn't know when my kids were young about what they need with support.

Meredith Brough (00:17:02) - So I, I love that that's important to you. That's awesome. So,, is there anything else that you kind of see because my audience is women, is there anything else that you're seeing even though you're you're treating the kiddos?, that's concerning you with women's health care?

Dr. Mike (00:17:18) - Yeah. I think similarly to with the children,, access to someone they can trust and then reaching out when they have questions or concerns. So, you know, I in previous practice, remember plenty of our moms coming in, I don't know, maybe like 18 or 20 weeks just getting their prenatal care. Then they didn't have a care provider, first of all, that they trusted or even knew that they could get into. So hopefully being able to if this can expand, being able to connect some of these moms with, with people that we trust in the community who can be a voice of support for them, even if it's not necessarily their ObGyn. Right. All of these tools, services out there that we're learning about now, too, that can help moms with their birth plan and kind of walk through what to expect in postpartum planning.

Dr. Mike (00:17:59) - , again, it's just a person of support for them that I did not know existed before., and I think we as a society need to do a better job of promoting them because it is such a benefit for for moms.

Meredith Brough (00:18:10) - Yeah, I love that. I love that you recognize the value and all those resources. Of course, I'm a little biased, but that's right, because I have tried to connect with doctors in my area and. It's not even just that I can't get in to talk to there, to the doctors. I can't talk to the team. Nobody's interested. And that's so sad to me to know that there's these resources. And I hope you don't mind me bringing up something that we didn't plan. But okay, what I find is that a lot of women are lying about bed sharing. Are they're not talking at all to the doctor, even the pediatrician who who wants to know about sleep. They don't want to talk about it at all, because the advice they're getting doesn't align with their parenting values.

Meredith Brough (00:18:50) - And maybe they're just for the most part, it seems that doctors are sharing their opinions and their maybe their experience or something. They've heard they're not really getting the training on sleep. So it kind of drives me crazy that there isn't more of the referrals for me, for people like me, you know, sleep experts.

Dr. Mike (00:19:08) - And I think breastfeeding is another perfect example of that too, right? Like I went through training, I remembered kind of getting, you know, little tidbits of kind of tips and stuff on that. But we're not seeing and assessing that all the time. So we are by no means expert on it. Right? But families come into our office and I feel like sometimes they're given misleading information or potentially even just false information, and they just assume that that's fact, right? They don't know that, you know, continue asking questions. Or maybe that person doesn't have all of the training that they might need around this one specific issue. And I think I would hope most doctors or practitioners are able to assess their own limitations.

Dr. Mike (00:19:43) - Right? I know I'm not an expert in everything. I know who I can talk to to find out about it, and now that I have more time, I can learn more about those things. But being able to connect our families with, you know, supportive resources, it just makes absolutely all the difference. Exactly like you're talking about.

Meredith Brough (00:19:57) - I agree, I really appreciate that. I guess what I was looking for is just having someone that I think my listeners can respect you and appreciate your opinion and your insight. And so hearing that from you that like this, this is stuff that you haven't necessarily learned about, but you can it's just that it one thing I think is sad is that moms go to their doctors and think they're almost like gods. And so whatever they say, it's either that extreme of, well, they said to do that. So I'm not even going to listen to my own gut, so I'm going to do this, or I'm not even going to talk to you about it.

Meredith Brough (00:20:27) - So then there's nobody in their world helping them make choices, you know. So yeah, this is it's a tough thing.

Dr. Mike (00:20:33) - But I love and has done a poor job at that kind of over the years. And I'm, I feel like we're getting a shift in sort of that, that thought process. I feel like all decisions, all decision making with, with medicine should be shared. Right. Like this might be the prescribed treatment course for X, Y, or Z. But does that fit with your values? Does that fit with what you're expecting? There's a couple different ways to go about things. You know, thinking about bed sharing. I've got my advice. Like the ABCs of safe sleep is what we are taught, but if we're bed sharing, I want to make sure that we're setting up that environment to be the safest environment that we can be. I want all of my families to feel like there's a non-judgmental zone where they can talk through whatever questions or concerns, even if it might not necessarily be what I agree with.

Dr. Mike (00:21:16) - We will find the safest way to move forward through that together.

Meredith Brough (00:21:19) - That's awesome. So yeah, what I teach is a safe sleep seven from Layla. Is that what you do?

Dr. Mike (00:21:25) - That's. Yeah, that's where we're coming from. Yeah. Again, as we've connected with all of these people. I had never heard of that before., but now able to connect and learn more about what's what's out there. Yeah, it's been great.

Meredith Brough (00:21:34) - I'm so glad to hear it. Because bed sharing is common. It's everywhere and people are doing it, and sometimes they're doing it because they prefer it. That attachment style parenting. And sometimes they do it for survival. And I went into my work being against it. I was all about safe sleep, SIDs recommendations. But then I started working with people all over the world who were like, but we've done this forever in our culture and it's perfectly safe. It's really just those US statistics that are scary. Yeah. And then I had these people who were like, if I don't venture, I don't sleep.

Meredith Brough (00:22:06) - And that's scary too. We don't need women being institutionalized because, you know, sleep deprivation and not being able to, you know, be healthier to take care of their families. So yeah, I'm happy to hear a doctor who's open minded and and able to let their patients be honest, because that's people are afraid of.

Dr. Mike (00:22:24) - Yeah, definitely.

Meredith Brough (00:22:25) - Yeah, I know this is a tangent, so I'll stop.

Dr. Mike (00:22:29) - Space pick my brain. Yeah.

Meredith Brough (00:22:32) - We can talk about this for gotcha journalism.

Dr. Mike (00:22:34) - That's all.

Meredith Brough (00:22:37) - , so do you mind sharing some of the health topics that you like to educate parents on for babies and toddlers, or some of the important things that you make sure parents understand, or even what are you concerned about?

Dr. Mike (00:22:49) - Yeah. So important topics. I mean, there's so many things out there. And again, back to my point earlier about the internet being both great and not so great., they're getting so much information. So introducing solids is a huge topic of concern that we get for families.

Dr. Mike (00:23:02) - Right? And again, no matter what decision they make, it's the wrong one. Bye bye. Parts of the internet., there's pros and cons to baby weaning versus the traditional kind of, you know, on the spoon. Again, finding what makes sense to families, what they're comfortable with working through that. And then, you know, having the safest steps we can moving forward,, is what I love. To work through. Now that we're in respiratory season, RSV is starting to spike up in our area. I'm not sure if it's hitting where you guys are to. Flu is around. Covid is still hanging in there too. It is. It's an interesting time in. RSV is usually the number one reason for hospitalizations in the United States for young kids., and some can get pretty darn sick from it and end up passing away. So making sure that our families, extended families aren't coming up and kissing babies, especially if anybody's got any sort of sickness, keep them away for those first, you know, six, eight weeks, eight months, whatever it is.

Dr. Mike (00:23:51) - , you still need support.

Meredith Brough (00:23:52) - That was a broad range. I know you're just saying, like, when RSV is bad, right?

Dr. Mike (00:23:58) - When ours is bad. Yeah, like it's completely fine. I tell all of my families, especially in those first, like eight weeks of life, a fever in those first eight weeks of life. Usually we have to take it more seriously because of the immature immune system of the babies., so that's why I say, like, have a little core group of people you still need support from mom, grandpa, whomever it is. But outside of that, I would try and limit it as much as you can. Not because we're mean doctors. Some of us might be mean, but I'm not a monster from earlier, I promise., but we don't want your kid to get that fever and then have to potentially go to the emergency room for testing. Like that is not an experience you want to have.

Meredith Brough (00:24:30) - Yeah. Well, hey, my daughter in law told us that we couldn't kiss the grandbaby.

Meredith Brough (00:24:35) - It was weird, but we got used to it. Yeah. I'm. I'm a grandma. I followed the rule, you know, so I didn't enjoy it. But in summer, summer came and we were able to swim.

Dr. Mike (00:24:48) - And so much of that to. Right. Even in what you were saying. Right. It's trying to find out understanding and where someone else is coming from. Right. Like if they just gave you that blanket statement and it didn't explain or you didn't have an understanding of it, you just think someone's being rude. We see that all the time with with families who have alternative vaccine schedules, right. Like we all exist believe that vaccine saves lives. We know that just based on scientific data. But I think traditionally families might have come to an office and they hear that they they don't want to vaccinate on, you know, X, y, z schedule or what's recommended. And they kind of get kicked out potentially. We want to work towards vaccinating our patients. But if a family wants to go slower because they have concerns, I think until we can spend time and unpack those concerns with families, like I can talk for hours about, you know, the benefits of vaccines.

Dr. Mike (00:25:32) - But if that's not what they're worried about with their, you know, vaccine schedule, like it's not going to go anywhere., so now that we have the time to really listen to them and understand where they're coming from,, we've seen some improvement with that. Really? It's tough.

Meredith Brough (00:25:45) - Yeah, it is tough. But that's great that you care and that you're trying and that you've seen some change there. That's really cool. Yeah. And I think that's true. I mean, I think I was the the one patient people probably dreaded because I wouldn't let the doctor go in 20 minutes. I had too many questions. And there's just so I think once we talked before or you sent me a note about the,, stay on one topic thing. Oh, my gosh, I can't tell you how much that rubs me the wrong way when doctors will only talk to you about one concern. Oh, it's so sad.

Dr. Mike (00:26:16) - And I was, you know, I, I grew up being trained that way through training.

Dr. Mike (00:26:20) - Right. Because the restrictions of insurance based payment fill out.

Meredith Brough (00:26:25) - You have to have that category, right?

Dr. Mike (00:26:27) - Yep. And if we talked about anything else outside of kind of your well check, you potentially could be billed extra for it, which is just mind blowing to me. Again, that's just how the system is set up., yeah. And it hurt like going back and thinking now that I was thinking I was doing a good job when families came in with the list saying, okay, pick your top 2 or 3 things that you want to talk about today. Like, it pains me to even think that I was okay with doing that now, being on the side, because.

Meredith Brough (00:26:49) - I know it's so sad, but that's the norm. So good for you for having a conscience. I love that you have that opportunity to change that. It's just so exciting.

Dr. Mike (00:27:02) - We're trying. Yeah, we get a lot of questions too, about affordability. I feel like when families see that, you know, why would I pay for something else outside of what my insurance is covering for, for my care, our follow up questions that, well, first of all, what is your insurance cover, right.

Dr. Mike (00:27:13) - If you think about copays for office visits on evenings or weekends, when kids are still being kids and get sick and get hurt in urgent care, visit an Ed visit on a Sunday. Like those are expensive things based on our membership model. Like no matter how many times you use us, it's the same flat monthly fee. And if you pair it with a high deductible plan utilizing a health savings account, especially now that open enrollments, you know, getting close, the cost savings should show up if we're avoiding those co-pays, if we're avoiding an urgent care and ed visit, like every so often. And I think that's that's been one of the harder barriers we've seen is just that education from families and getting them to buy into the fact that almost certainly we can save them money if we're keeping their kids healthier and out of the urgent care.

Meredith Brough (00:27:51) - And that's true. And I have high deductible insurance, and I've had that for a long time. And it's ridiculous how much I spend in a year, especially before we reach the deductible.

Meredith Brough (00:28:02) - And,, so that would be like a no brainer conversation with me. We're paying for every visit.

Dr. Mike (00:28:10) - You are. Yeah, you are, but, I mean, people think insurance, okay, it's covering it, but it's it's not. Or it might, but you don't know. But yeah, that's been a fun one talking through. We're getting better at it. But I think the more we're spreading. The word in our area. And as we continue to grow across the country,, we'll see it catching on and being easier to sell in different markets, but we'll get there.

Meredith Brough (00:28:28) - How long have you been doing this?

Dr. Mike (00:28:30) - Yeah, so we opened in January of 23. So less than a year now we've made. We're growing as expected based on other practices around the country again. Our goal is to only really need 300 per doctor too. So it's not like we're, you know, needing 3000 like a traditional practice to,, and usually it's about, you know, 1 or 2 patients a week is the kind of projected growth.

Dr. Mike (00:28:50) - But I'm sorry I said.

Meredith Brough (00:28:53) - That's pretty reasonable.

Speaker 3 (00:28:54) - It is.

Dr. Mike (00:28:54) - It is. Yeah. And again, because we have more time currently, you know, we're not inundated with patients. We've been able to partner with some organizations around our area. So all of us got trained in autism diagnostics. So we're all helping out local therapy companies kind of expediting the autism diagnostics for kids so that they can get.


Dr. Mike (00:29:11) - They need. And that has been such a rewarding process, knowing that traditionally in, you know, standard practice, it's 9 to 12 months. Most places,, waitlist to get in for an evaluation., which is just terrible because those kids need early intervention. They need the help now.


Meredith Brough (00:29:29) - That's amazing. Oh, I just love that you've you've got that in your back pocket too, because it's really hard to get that diagnosed. I mean, the waiting list.


Meredith Brough (00:29:38) - Wow. That's really cool. You're making me think of all the resources I want to share with you so you can help families even more.

Dr. Mike (00:29:46) - And we love it. We love, love, networking. I feel like could be a 40 hour week job easily.


Dr. Mike (00:29:52) - It is so exhausting, but it is so worthwhile. And again, because we came from a place where we didn't know about all these resources that are out there. Now that we're able to step back, it's like drinking from a firehose, but it's it's great.


Meredith Brough (00:30:03) - And it's so beneficial to the people you're serving. Yep. It's so exciting. Okay. Well we're going to wrap things up here. It's hard to stop because I could ask you lots and lots of questions forever, but do you have any type of, I don't know, advice for listeners when it comes to, you know, their children's health care or their own well-being? Do you have any thoughts on some words of advice?

Dr. Mike (00:30:23) - Yeah, yeah. So I think, you know, thinking through your child's pediatrician, right. You're developing a relationship that you might see that same person for 18, 22 years, whatever it is, whatever that cutoff is, have a little dating period, right? Have a trial period where you're testing them out.

Dr. Mike (00:30:36) - All pediatricians offices should have a meet and greet appointment, where you can at least sit down and kind of talk with them, talk through your concerns. Ask them, how can I get Ahold of you? If it's after hours and I call, who's going to pick up? Right? Like, how can I access you on the weekends? Do you have weekend hours? All of those thoughts, I think because people just understand that, you know, the status quo is that's what's expected. My office might not be open certain days. Ask the questions. And if you're not getting the answers that you like, then look for a different practice because you should have all of your needs within reason. Be able to be met and be able to reach your child's pediatrician when questions come up. Because kids grow and change on the daily right? Especially as they're going through these early years of development, you need somebody that's going to be able to be there for you and support you through that.

Meredith Brough (00:31:17) - Yeah. Great advice.

Meredith Brough (00:31:19) - Thank you so much. All right. So so where can my listeners find you in your network so that they can learn more about this, even if you know they're not in Ohio?

Dr. Mike (00:31:29) - Yeah. So zestpeds.com. Zestpeds.com is probably the best jumping off point. From there you'll be able to see, you know, any of our new offices as we're opening up in the next couple of years, but that's probably the best jumping off point. There's plenty of frequently asked questions that goes through a lot of similar stuff that we had talked about today., we have some of our blog information on there again, as we're doing some podcasts, doing some article writing, meeting with community people, doing some talks. So that's a great place to go. We're also on Instagram and Facebook. zestpeds of Solon is where I am. zestpeds of Solon, Solon. But yeah, check us out on Instagram website. Probably the best place to start though.

Meredith Brough (00:32:08) - Awesome. Okay, so guys, what I want you to do is find him, share his information and my podcast with your doctor.

Meredith Brough (00:32:17) - Tell him about this because this is exciting. This can be a movement. We can we can change healthcare, you know, and hopefully you have a cool doctor that will listen. Otherwise tell another doctor.

Dr. Mike (00:32:30) - Yeah, I feel like I'm getting a lot of.

Dr. Mike (00:32:32) - Angry letters soon.

Meredith Brough (00:32:33) - Now tell your friends about this so that everybody can, you know, learn that there's a better way. This is exciting. Well, I'm just hoping that there's more brave souls out there who want to break away and and try this themselves. And obviously, your network's going to grow, but maybe they start their own out, you know, in other places. So yeah, it's really cool. Well, thank you so much for telling us about this direct primary care. And I love hearing your wisdom and your experiences. Just thank you so much.

Dr. Mike (00:33:01) - Yeah. Thanks so much for having me I appreciate it.

Meredith Brough (00:33:02) - Yeah we're welcome. Sorry about that. So thank you to my listeners for being here with us today. I hope you've learned some new things and you've enjoyed this conversation and that you'll take his advice.

Meredith Brough (00:33:13) - And until next time, I'll see you soon. Thanks for listening to the Sweet Slumber podcast. We hope you enjoyed today's. So before you go, please leave a review and hit subscribe and have a great day!