Not many people plan for twins after having one child already, especially during residency. Fewer still plan to start their own solo medical practice immediately after training. Just about no one does all of this at the same time in the midst of a pandemic, but that’s exactly what I did.

We aren’t taught how to start a practice in medical school. The Kreb’s cycle is hammered into our brains, but not how to apply for an LLC or obtain a business license. I have absolutely no business background so thank goodness for Google, Youtube, and the physicians who have already done this. It was difficult, but not impossible. I made plenty of mistakes, don’t get me wrong, but overall starting a business is definitely easier than Step 1. 

When I graduated from my pediatric residency in July 2020, I had been planning my direct primary care practice for 3 years. I had been building my website and deciding how I wanted to structure things. My twins arrived and I was thrown into life as a mother of three under three, a wife, a graduating resident, a new business owner, and the primary care physician for my patients during a global pandemic. It was difficult, but not impossible. My plans to market by dropping into offices disappeared and I didn’t know how to network, so I did what everyone else did, and turned to the internet.

I started reaching out to those in the community via Facebook and Instagram, as well as using resources I already had, like my current OB. Then it just became about getting comfortable talking to anyone and everyone about my practice. I began posting things on social media about pediatric topics and eventually would connect with someone new in the birth/parenting community and branch out my network. I had dozens of Zoom calls with therapists, doulas, nurses, midwives, chiropractors, lactation consultants, business owners, OTs, PTs, SLPs, yoga instructors, and even an insurance agent! You never know who the right connection will be, so make them all. Through this, I learned about the truly incredible services Kansas City has to offer and it has allowed me to provide significantly better care to my patients and their families. 

I try my best to balance being a mother and working in my practice. I had my three-year-old practice his letters on my keyboard when I was building my website. I worked most when my twins were napping. The balance is difficult, but not impossible. There are days now where I don’t have childcare and I just bring my kids to my office with me. Like I said, difficult, but not impossible. 

So here’s the question everyone wants to know. How can I afford this? Well, I honestly think starting a practice directly out of residency is the best time to do it. You’ve never had attending money, so it’s not a huge pay cut. I had the luxury of time to plan this, however. My husband and I saved during my entire residency, knowing that I would go without pay for at least a year. Childcare isn’t cheap, so we had to make sure to save every penny.  As for the practice itself, I took out a loan. We only drew on the loan when absolutely necessary and otherwise used our savings. It’s been difficult, but not impossible. The silver lining of the global pandemic – interest rates are incredibly low. I’m now officially four months into my practice and just paid myself for the first time!

When it comes to practicing right out of residency, there is a huge learning curve. Being in my own clinic, however, means I have the time to research what I don’t know. I also don’t have an administrator breathing down my neck about the new ICD-10 codes or using the correct modifiers nor do I have 25 patients stacking up that I have to get through in 7 hours. It is scary being solo, but in today’s world, no one is really alone. I have my old attending’s cell phone numbers and they are always ready to help out at the drop of a hat whenever I have a question.

I truly love what I do and I can’t imagine ever practicing a different way. I get to offer my patients fantastic care without the headache of insurance requirements or dependency on RVUs and I get to set my own schedule so I can be present in my family’s lives. 

So if you’re considering direct primary care, do it. Make the jump. It’s difficult, but not impossible. 

Dr. Hughes is a board-certified pediatrician, breastfeeding medicine physician, and a mother of three. She started her new practice, Bloom Pediatrics and Lactation, as a way to provide quality, convenient, and accessible care to the children of Kansas City. Instead of allowing third parties to dictate care, patients pay Dr. Hughes directly, and in turn, get 24/7 access to their pediatrician. They can text, call, email, video chat, or meet in person. All typical pediatric services are provided. In addition to being a physician, she is also an IBCLC (international board-certified lactation consultant). She can assist with nearly all breastfeeding issues.