David:

[0:00] Today's my pleasure to have with me Heather Gessling, who is a general practitioner,

David:

[0:05] and she started her residency in 2010. However, in 2021, she was removed from her position because she didn't comply with the vaccine mandate. But since God has directed her and blessed her in a new way to serve her patients through what's called the direct primary care model. And since then, she has had more time, money, and been able to provide better service for her clients. but I'll let her explain how that works.

David:

[0:31] Heather, welcome to Redeeming Business Today. Glad to have you.

Heather:

[0:34] Thanks. Glad to be on, David.

David:

[0:37] Yeah. So Heather, what is one way you believe we can honor God in our business that other people may not know about?

Heather:

[0:44] Yeah. Well, so as a business owner, you're constantly having that sort of, you know, struggle between that desire to make money versus just a need to make money and support your business. But then also you have, as a person of faith, a Christian, you have a mission, right? So you're constantly balancing all of those aspects. You know, the aspect of serving people at the same time as growing a business, running a business in the black, doing a service to your community and your own employees and supporting yourself and your family. And so I think that the, the guiding light that I have is that I constantly feel like I'm going to follow my heart, follow my gut, follow my intuition, do what's best for me and the patient. And at the same time, trust in God that he's going to bless the business because I make decisions in my business that are, I feel like are incredibly gracious. Um, as far as my pricing or, you know, the profit margin, because my goal is to heal people and serve people.

Heather:

[2:09] And I feel like I've been blessed in that with being able to have good revenue and good capital to be able to grow the business at the same time is doing exactly what my mission is, which is to take care of patients. I don't know if that answers it. I feel like it's always just a balance.

David:

[2:30] It is. It is. I've been learning from Luke chapter 12, 13 and following about the man who asked Jesus to say, hey, can you talk to my brother and tell him to divide the inheritance with me. And Jesus said, who made me a judge and to divide between you and take heed for a man's life does not possess, does not possess. A man's life does not consist of the things which he possesses. And then he talked about the rich man and all the things that he had, and he tore down his barns to build bigger barns, and he's just going to take it easy for a while. And he said, you fool, this night your life is required of you. Then who are these things going to be whom you are prepared for? And he said, so is a man who lays up treasure for himself and is not rich towards God. And that's the balance there. It's like you can lay up treasures for yourself, but you got to be rich towards God as well.

David:

[3:29] You can't just be selfish and take it all for yourself.

Heather:

[3:32] That makes me think of the shift I've had in my attitude about retirement since starting my own business. When I was, excuse me, when I was an employed physician before I was let go, which is because of the vaccine mandate, which is the best thing that's truly ever happened to me in my life or my career, I would say. I mean, I have children, so I don't know if I can say that. And I'm married. But as far as the blessings and benefit of being forced into developing my own business, I would say it has been amazing. But when I was an employee, I was thinking all the time, how fast can I get out of this because it was so stressful. It was so, you know, it was just, it wasn't something that I felt like my body and mind could handle for forever. I was, it was a, I was a very, very busy physician. And I was thinking, how much can I save? How much can I put it towards retirement? When can I quit doing this job?

Heather:

[4:37] And, but now, now that I'm doing things where I'm not pushed to see 40 patients a day. I'm getting to express to my patients, my love and care in a completely different atmosphere and setting. I could work till 85 now. I mean, I seriously can just never stop. I own the business. I can see, you know, as little, as many as I want. I can, you know, delegate. And so I don't care about saving up like I used to. I mean, of course I'm still going to make good decisions and try and be faithful with my finances. But that desire to just save up money and no longer work is completely different, which I think is in line with what you're saying, because if you're just going to store up money and then retire, have you pulled yourself out of a mission? Have you pulled yourself out of being able to be used by God? Because now you're just upset on going and spending half a year on the beach. I mean, that doesn't seem like it's, that doesn't seem like a good use of time.

David:

[5:53] Yeah, that's another discussion. But yeah, I agree. And it's interesting that I've interviewed other people who are in their 70s, and they're like, a lot of people think I should be done by now. And I'm just keep going because I enjoy it. So that resonates with what you're saying today, too.

David:

[6:08] Very good. So 2021, you got released from your job and had to start all new. Can you give us a quick journey of where you were then to where you are today?

Heather:

[6:19] Oh, I'd love that. Yeah. So I had a feeling, you know, summer of 2021, that things were going to really change. I was just, you know, I knew that there was all of these mandates coming down and I wasn't in agreement and I wasn't going to be told what, you know, what I had to put in my body. And so I was thinking, what in the world am I going to do? And so when that happened and I was I look back on it and I and I'm amazed at my lack of fear, really. Like, I'm amazed that I wasn't like, oh, my gosh, I have no job.

David:

[7:02] Yeah, it was more of,

Heather:

[7:03] Well, this has happened for a reason. So that means God's going to take care of me. And, you know, I had made fairly good financial decisions. And so we weren't completely like destitute as far as money. We had savings. And so it was like, OK, well, there's a reason why I had to sit. We saved up money. There's a reason for me losing my job. So, Lord, you just paved the way. And he could not have been more clear. Like he helped me find the amazing, perfect location. And my landlord was even, you know, sort of missionally aligned with what I wanted to do. And then he just opened up other doors for another location. And now I just bought a third building in another location. So I have three locations in Missouri now. And the business has been, it's been growing. I probably have one of the largest direct primary care businesses as a single provider in the United States. And we've never once advertised. And it's always just come organically. And I think it happens because my energy and my heart is in what I do. And so it just draws people in. And the word of mouth is great.

David:

[8:17] Very good. So, you keep talking about the direct primary care model. Can you explain to my audience what is that and how is that different from regular healthcare?

Heather:

[8:28] Yeah. So, direct primary care, I think, is really one of the waves of the future because patients have realized that mainstream medicine doesn't seem to be what it used to. You know, You're just in and out. You may get seven minutes with your physician or sometimes even less. You just, you know, it's writing a prescription and moving on. And that's in the insurance world. Direct primary care is more of a membership model. It's not the same as concierge or boutique where it's a high dollar yearly fee, but the physician still takes insurance. That's not what it is. This is a monthly membership, a low cost. adults are only 65 a month. And that allows them to have access to me essentially all the time. They can see me in person, telehealth, phone visit, and anything that they need my clinic or nurse to do, they always have access to us.

Heather:

[9:26] Low cost family plans, it's only 140 for two adults and as many children as, you know, you have. And so they can get quick access. the visits are longer because I'm not having to see a quota in order to be in the black. And they get to sit and talk and we get to talk about ways to get off medicine instead of putting them on a medicine. You know, when you're in the insurance world and you're having to move through so many patients, the quickest thing to do is going to be to write a prescription. It's not going to be talking about, well, let's get to the bottom of this. Let's figure out why you're having acid reflux, it's, it's, it's never going to be the most time doing that is not going to be the most efficient use of time.

Heather:

[10:16] And so unfortunately, a prescription will get written. And that's not necessarily the best thing for a patient. And the best thing for a patient is to dig down, find the root of the problem, make lifestyle changes, dietary changes, and try and figure out how to heal the problem instead of just treat it. And mainstream medicine is mostly about treating. And my goal is to heal, reverse disease, reverse chronic disease, get them off of medications and make their lives thrive instead of, you know, just add one pharmaceutical after another with every visit. Sure. Direct primary care is a monthly membership for physician services. Now, a lot of patients have sort of a confusion. Like if they go in to see a direct primary care doctor, they don't get to use their insurance at all anymore, which is not true. They can still use their insurance for lab work. They can still use it if they need imaging. They can still use it if they go to the hospital. You know, they can still use it if they have to see a specialist. and I'm a physician and I, I do the exact same things as I did when I was in the insurance world. I still coordinate with specialists if necessary. I still, you know, order all the same things as far as, um, imaging and labs use the same, same lab locations that none of that changes.

David:

[11:45] Okay. So you talk about spending more time with people and somebody might say, if you have more clients, how can you spend more time with them and still take care of them? Do you see them less often then because they actually get taken care of or how does that work?

Heather:

[12:03] Well, yes, that's true. But I actually probably had a quarter of the patient panel that I had when I was in an employed position. I probably had three to four thousand and now I have about a thousand. And so because of that monthly membership and it's not, revenue is not tied to a actual in-person visit, then things that were required to have the patient come in and see the physician that could have just been dealt with over the phone, but then the physician wouldn't get reimbursed can now be dealt with over the phone or through a nurse triage or things that don't require an in-person visit. Now, if the person wants an in-person visit, they get to have that. We can schedule them. We hardly ever have trouble getting everybody taken care of day by day. And so my panel is about a quarter of what it used to be.

David:

[13:05] Okay. I understand. Okay. So would people be able to just have insurance and come to you or they just like skip the insurance and come to you and like what emergency things would that entail?

Heather:

[13:21] Yeah, that's a good question.

David:

[13:22] Like if I break my arm and I thank you, are you going to set it or send me something out?

Heather:

[13:26] I mean, there might be some primary, direct primary care doctors out there that have that sort of confidence and experience. I don't. I was trained to do that. I just didn't do enough to feel comfortable. I don't have any casting material in my clinic, but some do. I do a lot of things in my clinic that are part of the membership. I'll do biopsies, tonal removals. What else? A laceration repair if necessary. So things like that I can do in my clinic. And if a patient doesn't have or has insurance and they want to see me they get to use that insurance for lots of other things if they don't have insurance then I can do almost everything they need usually I can take care of almost everything they need I can take care of you know what an endocrinologist would take care of I can usually take care of regular follow-up of payments that they would need with other specialists because in primary care, and I'm pretty good at a lot of different things. And so as far as, you know, that type of medical care, I can do most of it. If they have an emergency... And they need a surgeon, can't do that. Or if they need, you know, orthopedic stuff.

David:

[14:45] You want to take away.

Heather:

[14:46] Yeah. If they have to end up in the ER, can't do some of those things. And I do other things too. Like I do IV fluids and can really manage them if they're pretty darn sick. I will always, almost always be able to keep somebody out of the hospital.

David:

[15:04] Okay. Very good. So a business, if I'm a business owner and I have employees and I have insurance that I give to them, how would this fit into my benefit package if I wanted to move to a direct primary care model?

Heather:

[15:19] Yeah, a lot of businesses are moving to direct primary care because they have found that it's a much tighter control over medical issues because they know that direct primary care physician is going to do everything in their power, not to have to send them to higher dollar specialists, try and prevent, you know, surgeries, try and keep them off of expensive medications. That's just the sort of MO of a DPC doctor. And, and, um, businesses and employers are learning this. So they could, I have had some, I have businesses that have come to me and we've made some contracts, like a reduced rate per month for their employees, you know, because they'll bring in several employees. And they actually make a benefit to their employees. Like if you sign up for DPC, this doctor, I'll reduce your insurance rates, or it'll be covered, you know, you'll get to see that doctor as part of your plan, and you won't have a copay, that type of thing. And we've worked out contracts with different employers for that.

David:

[16:29] Okay. So it's more individual with the business than just across the board. This is what you do.

Heather:

[16:34] Yeah. So usually it's, it's sort of, um, personalized and it's a contract with that and employer, that business. Okay.

David:

[16:44] Yeah, no, it sounds, it sounds good because yeah, I've, I've been in places and it does seem like you see the nurse, you sit around and you see the doctor real quick and then on your way. Yeah. Um, but having somebody to take time to understand and learn what's going on is very helpful.

Heather:

[17:02] And it's really rare. You just don't get that much, you know, where, I mean, I was, I was guilty of it. I felt like I was a pretty good doctor when I was employed, but I was still guilty of, you know, I, I couldn't, you know, I didn't have the time to really get to the bottom of things, or I felt like it was easier to just write a script or even worse, it was easier to just say, oh, well, let's send you to gynecology or let's send you to, you know, because in the insurance world and, or excuse me, in the mainstream medicine where you're an employed physician, especially for a hospital, they really like it when you refer to the specialist within that organization. In fact, they encourage it and they assess it and they tell you your numbers. You haven't been referring to gynecology. You haven't been sending patients to orthopedics. They are watching that. And so when you do it, you kind of get rewarded. So it's a system that is broken because of the time limits of the family medicine doctor. They are spending more money sending patients to, you know, referring them out or putting them on expensive medications because they just don't have time to get to the root.

David:

[18:19] Hmm. So you felt that you've, you felt that difference between when you were an employee to when you are now, then the difference in mindset as far as sending people away versus trying to help them out.

Heather:

[18:30] Yeah. Yeah. It's very rare that I would send patients to that. I currently send patients to specialists. I mean, it's almost like it tears at tears, you know, tugs at my heart to have to send them out. I'm like, no, I don't want to do that. You know, Because a lot of times, specialists, I might not be aligned with how they see things. Maybe they want to put them on a statin, or maybe they want to do something that I think would be harmful to a patient. I really will only send them out if it's absolutely necessary.

David:

[19:02] It reminds me of an audio tape I heard my brother sent to me. This is 20-some years ago, where he said, over here in America, we pay the doctors when we get sick so they can help us get better. I think it was Japan. They said over there, they pay their doctors to keep them well. And when they get sick, they stop paying their doctors. So it's the motivation to keep them well. It kind of reminds me of what you're doing. We're going to stop paying you if I get sick. I'm going to stop paying you. It's like, oh, wow. It's just a different mentality.

Heather:

[19:34] Oh, it's so good because then that puts the onus on the physicians to keep them well. They're not benefiting. They're not They're not generating more revenue because the patient's sick in that scenario.

David:

[19:48] Yeah. They have skin in the game to help keep you well.

Heather:

[19:51] Mm-hmm. Yes.

David:

[19:53] Okay. Very good. So 2025 is a new year. What are you looking forward to this year?

Heather:

[19:59] Oh, so we have a lot of new things that we're doing in this clinic. I just bought this new building for a location in Chillicothe, so I'm going to be building that. And we're bringing in a lot of new technology into our clinic, which has been really fun for patients to, you know, um, benefit from it. They just, they're doing all these new machines in my clinic and I walk in and see them and they're just glowing and happy. And I asked them how they're doing and they're just like, fantastic. You know, they have so much energy and they're improving. It's going to be fun to see how that I have, um, I have, uh, several sort of cutting edge technologies and ion chair machine that is like a super grounding machine. I have a, a new FDA laser specifically dialed in for hair growth patented technology and one of only six in the country. I have full spectrum infrared sauna. I have ultrasound machine that can be used therapeutically for musculoskeletal issues. I have a post-electromagnetic field machine that is used for helping with mitochondrial support and also toning up muscles. And so I have so many things. So it's going to, I look forward to really seeing the benefit in my patients with their health and wellness.

David:

[21:21] Yeah. So it sounds fun. Like you're getting all these toys and you get to try them out and help people at the same time. Yeah. So how can my audience find out more about you and your clinic if they were in the area or wanted to do that to learn more about the direct primary care model?

Heather:

[21:37] Yeah. So, and also I've talked about direct primary care, but also I have an organization called Healing United, which is focused on helping patients with detoxing, detoxing from, you know, emotional issues, detoxing from pharmaceuticals, detoxing and healing and reversing chronic disease. And that's at www.healingunited.today. You have to put that whole domain in. It's at .today. And if you get on that website, you'll see that there's a free 45-minute consultation, and you can kind of find out where you might be able to be plugged in best with those programs. So I do have that. That's with my business partner, Christian Elliott. If you're in the state of Missouri, it would be www.guesslingfamilywellness.com. And I'm on Twitter, Hguessling. I'm on Facebook. I'm pretty active on Facebook, Heller Guessling. You just rarely use it, Heather Guessling, MD. So those are the, those are the best places.

David:

[22:44] Okay.

David:

[22:46] So you've talked about a lot of different things. And so what is one small step my audience could take today to start down this path to direct primary care and to improve their health?

Heather:

[22:56] Yeah. So if you're a patient and you're unsatisfied with your current care model within medicine, I would go to Frontier. What is it called? FrontierTracker.com. DPC Frontier is what I would search. DPC Frontier. And you can go in and there is a list of all the different DPC clinics in the United States. And you can find one near you. There used to be, you know, 20 years ago, 15 to 20 years ago, there was like six. And now there's hundreds and hundreds because it's such a better model. And if you're an employer and you want to incorporate the DPC model into your self-insurance plan or into your insurance plan and lower your cost, just do the same thing, dpcfrontier.com, and go and find a DPC clinic near you and negotiate that. If you're not in the state of Missouri and you're interested in our detox programs, that would be at healingunited.today.

David:

[24:05] Okay. Sounds very good. And well, Heather, thank you very much for your time and encouragement to discuss the direct primary care model. And it's exciting to find out that there's better avenues of health care than we have at the present. And so friends, that's all for now. We trust that you have been inspired for today's talk to redeem your business, redeem your time, buy back your life and use it for God's glory. Remember that time has limits. You can't do everything. So choose wisely.