Thu. May 9th, 2024

I became a doctor because I wanted to help people, and that was true of most of the doctors I’ve met over the years. I am thankful God led me to become a family doctor, and it has been a privilege to take care of a full spectrum of patients: babies and elderly, men and women, healthy and sick. I am humbled by the trust patients had shown me, and as I believe every person was made in the image of God, I try to treat everyone with care and respect.

Somewhere along the way, the time I spent with patients became shortened and pressured, as demands of administrative paperwork, insurance- and system-imposed regulations and checkboxes, and involvement of multiple parties like pharmacies led me to spend more time on paperwork than seeing and caring for patients. How could it be the United States of America spend the most in healthcare but not be the healthiest among developed nations? How could it be that caring and dedicated doctors were so bogged down with paperwork and being told by non-medical people how to practice medicine that many were either leaving the work force or committing suicide?

In July, 2018, I attended a medical conference and learned more about a different medical practice model called Direct Primary Care. For the first time ever, I left the conference crying because I saw hope for patients to get better care outside of our current confusing medical system, and I saw hope for my friends in medicine to not be data entry paperwork specialists anymore but to be the medical doctors they were trained to be. When the speakers presented data showing patients in Direct Primary Care models over time became healthier and spent less money on healthcare, I felt it would be unethical if I didn’t try to offer patients this service, especially if the only thing standing in the way was my fear of opening a business. It was in the mixture of being inspired and being terrified I started contemplating the possibility, and the name came to my mind even before I reached my car: Olive Branch.

To offer someone an olive branch is to give grace and offer reconciliation. In this broken healthcare system and broken world, we all need grace and need to give grace, in order to reach our common goal of health—individual and community health. Doctors need to give their patients grace for not being able to comply with medication or lifestyle recommendations. Patients need to give their doctors grace for being swamped in paperwork and regulations that they were not able to get back to them promptly or “squeeze them in” the schedule anymore. Doctors and clinic staff need to give grace to administrators who make policies that don’t work out well on the clinical level and realize we all have good intentions and the common goal of taking care of patients, but we are considering things from different perspectives, so we need to work together more effectively. Administrators need to give grace to clinical staff and not assume they are lazy when they push back on certain new requirements because they are already working hard to take care of patients and trying to meet all the existing administrative demands that take time away from patient care. Primary care doctors need to give grace to specialists, and specialists need to give grace to primary care doctors. None of us are perfect, but I believe most of us can empathize and try to abide by the Golden Rule. Very importantly, we need to give grace to ourselves.

I know Direct Primary Care is not for everyone, and it will not solve all the problems of our current healthcare system. I had considered if it was unethical for me to leave my panel of 1200 patients to pursue Direct Primary Care and have a goal of 400 patients, when there was already a deficit in access to primary care doctors. If others could thrive in this fee-for-service, insurance-driven clinic setting, why couldn’t I? If some family doctors could see 30 patients a day, why couldn’t I? I finally came to accept I simply couldn’t. I couldn’t just refill blood pressure medications for a patient without discussing lifestyle challenges or stressors that were causing sleep problems and affecting his blood pressure. I couldn’t just do a routine physical without truly reviewing a patient’s chronic conditions and evaluating her lifestyle habits to advise on how she could become healthier physically, emotionally, socially, and spiritually. All this took time I didn’t have in the current system, where most doctors were being asked to move to 15-20 minute appointments (and 5-15 minutes of that time could be taken up by nursing staff doing their part to meet administrative requirements). I came to realize I could not continue practicing medicine in the current healthcare system the way it was, so if it was between quitting medicine completely or to attempt opening a Direct Primary Care practice to show my support and faith in this model and movement, then I gave myself the grace to accept I could only take care of 400 patients at this time, but, by God’s grace, I would be able to take better care of them.

So this is how Olive Branch DPC came about. I officially started seeing patients on 9/10/2019, and it continues to be a humbling and exciting journey as I continue to improve the clinic to better serve patients.

I was born in Taiwan and moved to Ames, Iowa, when I was ten. I’ve since loved the Midwest, and I’ve been in St Louis since late 2014.

Medicine for me is a calling to serve God and serve people. I chose family medicine because I love taking care of patients of all ages, and I love the continuity and connections I can make while walking through life’s ups and downs with people, to be there as a resource and an encouragement during times of uncertainty and fear, as well as during times of health and positive changes.

I enjoy working with my patients as a team to help them take better care of their physical, emotional, and spiritual health, so they can enjoy their life and pursue their dreams with their loved ones over the years.

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157740cookie-checkMy DPC Story: Dr. Katy Liu of Olive Branch DPC in St. Louis, MO
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By Maryal Concepcion, MD

A Sacramento native, Dr. Maryal Concepcion is a Filipinx creator and connector. She attended the University of California at Davis where she graduated in 2005 with a double major in Anthropology (BS) and Evolution & Ecology (BA). She had an unforgettable time as a California transplant when she got her MD at Creighton University in Omaha, NE. It was there she discovered hayrack rides, found her Husband, Dr. Jeremiah Fillo, and discovered her love of rural family medicine. Her residency training was in the unopposed family medicine program at Doctors Medical Center, Modesto, a training extension through the UC Davis Medical School. During her time in training, she returned to rural Superior Nebraska to complete proficiency training in performing colonoscopies as part of her rural family medicine concentration. After residency, she moved to Arnold, CA where she worked under the fee for service model with her Husband doing full-scope care for over five years. Though grateful for her experience in this role, she was driven to seek a better way of life and a desire to practice insurance-free medicine and that was when she discovered DPC. She is the founder and host of the podcast My DPC Story, a weekly podcast that educates and inspires by featuring DPC and direct care physicians. Find it at mydpcstory.com and on all major podcasting platforms. Most recently, she became the CEO and wearer-of-all-the-other-hats at Big Trees MD, the first Direct Primary Care in Arnold, a rural town of 4,000 in the Stanislaus National Forest located in Northern California. Her clinic was created as a telemedicine and home visit model without a brick and mortar space. But, the title she is most proud of is being a Mama to Asher & Nolan, her two ridiculously awesome and cuddly boys!

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