Ep. 202: Serving the Underserved in Urgent Care - Interview with Dr. Lindsey Fish from Denver Health Pena Urgent Care Clinic

PCMP (00:00)
Hey, welcome back. Walk-ins welcome family. We're glad to have you for another episode. And as always, we want to start off by telling you that we're here to help you get more patients, deliver better care, get repeat visits, scale your clinics. Part of that is bringing in awesome guests. But before that, Michael, what's that brother? What's happening? You know, we're in the middle of the burr months, right? Yep. Starting. And I know that in the urgent care space, this is where your volume is starting to pick up. You're starting to get, hopefully you're getting, starting to get a little busier. But we wanted to bring on somebody today that

She's seen a lot in terms of like, she's in charge of a lot of people in a lot of different ways. And honestly, it's kind of a different perspective because she's not part of what we think of a traditional urgent care. We're to go into that, but it is Dr. Fish. She is the medical director of Denver Health's Pena Urgent Care Clinic in Denver, Colorado, but she's also the associate professor of medicine at the University of Colorado School of Medicine. So super cool to have her on. She's been in it for 10 plus years. We're excited because she's going to bring some knowledge to the state that we really haven't

much about, which I'm excited about. So glad to have you on Dr. Dr. Fish, say hello to the Walk-Ins Welcome family and tell us one thing about you that nobody else knows.

Lindsey Fish (01:04)
Thank you.

Well, thanks so much for having me. It's a great pleasure to be here today. And one of my fun facts about me is actually when I was a kid, about 10 years old, I grew up in Minnesota and I fell through ice. But I was able to keep my head above water and obviously able to get out. So to be here today to join you guys.

PCMP (01:27)
Well, she took a preemptive polar bear plunge challenge and I love to say to get on the other side of that. I will tell you before we get rolling. Colorado to date is my favorite state. I love it there. I love, we're from Alabama. I love to go visit. I, you would put down that you like exploring the mountains and hiking and skiing and all those different kinds of things. And I just got to tell you like Denver, golden Colorado, Colorado Springs, all of that. It's just, there's nothing like it. You have to love living there.

Lindsey Fish (01:56)
It is fantastic. I would never move anywhere else. I've lived in several places throughout the country, but I can't imagine ever leaving Colorado because it really is just a fantastic place to live and raise your children.

PCMP (02:08)
Well,

we appreciate you bringing in your leadership with us today. We're looking forward to talking all about Pena urgent care. Here's the thing. It's part of a system. And I want you to just before we get rolling into any details, just give us the 10,000 foot view. What is it and how are you funded?

Lindsey Fish (02:25)
Sure. So ⁓ I'm at Denver Health, which is the safety net health system here in Denver, Colorado. So we have not only our hospital system as part of that, but we have a very extensive community health clinic network.

And our Community Health Clinic Network, of which our urgent cares are part of, is actually part of a federal system of federally qualified health centers. And we're actually the fifth largest federally qualified health center in the country. And what that means for people who've never heard of the FQHC acronym or word before is that we apply for and receive federal funding to provide care to underserved patients.

And so that's a very different sort of setup than, you know, a commercial traditional type urgent care. And so the two pieces that make us unique in my setting are this FQHC piece. We can talk more about the funding and the flow and the regulations that we are under.

but also that we're affiliated with a very large hospital system and a large hospital. And then as you mentioned, my last piece in my title is our affiliation with the University of Colorado School of Medicine. And so we're also an academic site where we do quite a bit of education and research.

PCMP (03:40)
I love that. So I'm going to talk about alcohol for two seconds, I swear I'm going to bridge a I'm going to bridge a gap. promise. And so here in Alabama, we have what's called an ABC store. Okay. And the ABC store is the only way alcohol is distributed in the state of Alabama. But there are also package stores where independent, independently owned

Lindsey Fish (03:50)
Gotcha.

PCMP (04:07)
liquor stores can operate, but they have to buy their stuff from this package store. Where am I going with this? The experience I have at an ABC store, while good is very stale, very, very sterile. think not stale, but sterile. This the same, it looks the same, all of that. Right. And then when I go into a package store, it's either going to be an amazing experience or it's going to be a dumpster fire and a gas station. There's no real telling. Right. ⁓

And so here's the juxtaposition, if you will, ⁓ a federally funded or a federally operated, however, an urgent care system that doesn't have to necessarily rely. And I could be wrong here, by the way, I'm open to being wrong on this. Doesn't necessarily have to rely on patient volume, like a privately owned ⁓ urgent care that has to make sure that their service is top notch and make sure that

their buildings are in the right spot and they have a lot of risk and a lot to evolve. I could be completely off base here, but am I making a parallel properly or am I totally off base here?

Lindsey Fish (05:11)
You're moderately off base. In the sense of what we do is we actually have to report everything to our federal grant people, right? So how many visits we do, ⁓ how many unique individuals are served.

PCMP (05:13)
Okay, I'm okay with this. I like this. That's good.

Okay.

Lindsey Fish (05:30)
What is their insurance status? What is their family income level in terms of relation to poverty level? So all those go to the federal government and are part of our annual reports in compliance with our grant funding. ⁓ And that grant funding is meant to kind of to your point, bridge the gap between the income we bring in, seeing patients and the care that we provide, recognizing that a significant amount of the patients that we serve have no insurance whatsoever.

And so we are not getting sort of, most of them we try and place on a sliding fee scale program. That's actually a requirement of this grant funding is to have a sliding fee scale program for our patients. But you can imagine if a patient is paying 10 or 20 or even $50, that is not covering the cost of the visit in terms of the care we provide. So the way I think about it is we are here to serve as many as we can, as well as we can and as effectively as we can. And

we get sort of some additional funds from the federal government acknowledging the fact that our patients are unable to pay for the cost of their care.

PCMP (06:35)
So I kind of love that in the fact that you're still interested in working toward delivering the best care possible, not just trying to get new patients through the door for the sake of turning a profit. the government, yeah, the government steps in and helps you subsidize that so that you can see as many patients as possible with the best care possible. ⁓

Lindsey Fish (06:45)
Absolutely.

Absolutely.

Absolutely. mean, the building I'm in, for example, was a brand new building built just 10 years ago when we opened. ⁓ We're opening another brand new community health clinic. So we are actively working to ensure our facilities are beautiful and up to date. ⁓ And we also have all of the quality metrics. Federally qualified health centers are predominantly primary care based centers. We can talk a little bit about that. But you can imagine that, yes, we absolutely have to report to them all of the quality metrics and how we're meeting those quality

metrics as part of the grant funding as well. So we can't not give good diabetes care or blood pressure care ⁓ or cancer screening cares in our clinics without there being negative impacts ⁓ to all of our patients obviously but also to our government funders and we have to comply with many Medicaid and Medicare requirements in terms of those pieces.

PCMP (07:52)
So I want to hook in a little you had mentioned a little bit about primary care. And like, that's a pretty big part of your puzzle. I'm fascinated because I don't know, maybe two or three years ago, I was convinced that primary care was going away. And urgent care was stepping in. Then recently, I've been convinced the other way of now, us millennial generations need a primary care of some capacity. And there's been we've had quite a few urgent care clients come on that

now are pushing the primary care a little harder than they used to. And or they have a separate primary care brand altogether. So I mean, you obviously are seeing it at a larger scale. Do you see primary care growing more than it used to? Or does it stay the same? Where do you think it's going right

Lindsey Fish (08:42)
Yeah, I think we absolutely need primary care and we need to grow it. ⁓ I don't know that urgent care is where that should grow. I think urgent care is a very different practice of medicine than primary care, but I think we need really good partnerships.

Because if people have regular access to primary care, they don't need the most expensive health care in the system. If we can avoid heart attacks, strokes, for example, by having people have well-controlled diabetes and hypertension, that actually benefits the system as a whole and the cost as a whole, besides the patient themselves who then is not experiencing a heart attack or a stroke.

PCMP (09:19)
It sounds to me like primary care is a vitamin and urgent care is a medication. Is that kind of the way to look at that?

Lindsey Fish (09:28)
I think to some degree, absolutely. ⁓

PCMP (09:30)
Okay. Yeah.

Okay. All right. So with Pina Urgent Care Clinic, you guys have been at this for more than a decade. You're seeing challenges on a regular basis, I'm sure with more competition than ever. don't pay scale works a little different for you, but that's still a major issue in the urgent care space. I don't know how much that affects you being subsidized. ⁓ And then just the

the fact that it's a volume driven game, what changes are you seeing? How do you see this going in the future?

Lindsey Fish (10:06)
Well, I have a lot of thoughts on that question, and I could take it a lot of different ways. What I would start with is, ⁓ well, first of all, I think what makes us unique is that the patients that we serve are generally different from your traditional urgent care patients. So I mentioned briefly, we have a large uninsured population. We have a large Medicaid population. And most traditional urgent cares are not

PCMP (10:08)
I like that. That's good.

Okay.

Lindsey Fish (10:31)
They'll see those patients, but require them to pay the cost of their visit upfront, which is not something that we require in a federally qualified health center. ⁓ I do think that ⁓ there is going to be continued growth in urgent care. To our previous conversation, I think this is going to be a reflection of

challenges with health insurance. So for our uninsured and underinsured patients and our Medicaid patients, there's some significant changes that are going to come up that are going to make it more challenging to be on insurance. ⁓ There's going to be cost increases for people who get their insurance through the health exchange program that may unfortunately make it difficult for some people to afford insurance and even people who get insurance through work.

continue to see, you know, 8 to 10 to 15 percent increases every year in the cost of their premiums. And so I think we're going to continue to see challenges for people to access health insurance. And then what happens is that people don't go see their primary care doctor because if they don't have insurance, they don't want to pay for something preventative because maybe they don't need it. And then we see an increase in need in acute medicine. So acute care like urgent care is in emergency departments.

So I think we are going to continue to see increases in acute care demand, ⁓ regardless of your setting. ⁓ One, because people will always continue to get sick, and two, I think we'll see, unfortunately, more people who are not able to get regular care.

PCMP (11:59)
with those things stacking up, ⁓ it kind of paints a bleak future. So let's go into an opinion around for a second. Like there's no right answer here. I just want your professional opinion because you also are in the education side of things. You're training up the next, you know, ⁓ urgent care or physician led, you know, in this space, what has to change? What do you think needs to change in order for us

to have a sustainable healthcare model that serves people.

Lindsey Fish (12:33)
Well, I think one of the biggest changes needs to be how we decide to place our money in terms of our value.

So ⁓ right now we put our money into acute care medicine, hospital medicine, and we don't put our money, time, and effort into preventative medicine. ⁓ And I think health insurance companies that are for profit contribute to a large degree on some of this type of stuff. Some of it is a reality, right? An urgent care visit is not the same cost as brain surgery, for example. So some of it is reality of it. But I think

You know, what is the phrase? An ounce of prevention, you know, is like, I can't think of it right now.

PCMP (13:11)
Yeah, know the phrase, I can't like repeat it. An ounce of prevention

or prevent a pound of pain or a pound of whatever.

Lindsey Fish (13:17)
Yeah, yeah, like

I think that's the reality. You know, if we if we as a society and a culture, you know, can really transition our opinions to, you know, prevention and healthy living where we're eating better and exercising and ⁓ maybe not consuming as much alcohol from the ABC store. ⁓ You know, these things that we know make a difference. ⁓ I think we can greatly impact overall health of our of our community and our and our world.

PCMP (13:35)
Dang it.

Lindsey Fish (13:46)
as well as decrease some of the costs that are associated with some of these things. But that's a hard challenge because eating right and exercising isn't easy, isn't cheap, isn't quick. And so there's a lot of things that would have to transition, I think, for us to be able to do that more effectively.

PCMP (14:03)
It's been said that you'll live with the pain of discipline or the pain of regret, right? ⁓ Not only is that for your health, but if things start making ⁓ positive changes in our health care and how we prioritize it, not even personally, but just as a country or as a government or all of this, we're going to live with either the pain of discipline of getting this right in the beginning, even though it's going to hurt. ⁓ It's going to hurt either way, right?

Lindsey Fish (14:07)
It's a one.

PCMP (14:33)
because it's gonna hurt either way. Yeah. So one of them is just going to make you healthier in the long run. exactly. Go ahead. No, I gonna say, so I think talking on the part where you're associate professor of medicine, is there been a trend of where your focus is and curriculum wise, like where it was maybe 10 years ago to where it is now? Because, know, like Nick has said, you're training up the next generation. Where is it?

this is just how we do things, right? Hey, things are, because I know right now, like we talk about all time to podcasts, like AI is changing, trying to change the game and some medical stuff, but not everything. So is that like part of that discussion? Or is like, no, you need to, these are the true things you have to follow. And then if AI shows up and helps, that's great. Where is that conversation going right now for all the young doctors you're working

Lindsey Fish (15:25)
Yeah, I think in the last 10 years, medical education has been significantly transforming and continues to transform. So I think one piece that is new ⁓ and different is there is a big focus during medical training on well-being and work-life balance to your point of sort of the benefits and the...

traps of sort of the electronic medical record, for example, which can help you speed up things and do things like that, but also can be very cumbersome and time consuming and recognizing where there are tools to make us faster, things like AI that can make us faster so that we're not spending so much time charting, for example. And that's incorporated into education sooner, I think, than it was before. I think the other big piece that's been a transition, at least here at the University of Colorado, is we transformed

several years ago to an integrated curriculum. So in the past, traditional medical school would be sort two years of classroom, where you'd sit in a classroom and learn a bunch of stuff for two years, and then two years of clinical experiences, kind of rotating through eight weeks of medicine, eight weeks of pediatrics, eight weeks of surgery, learning all the different specialties. And ⁓

We have now found that actually adult learners do much better with sort of integrated pieces where being able to take the classroom piece and apply it clinically right away is a much more effective way to learn. And so now our medical students get just over a year in the classroom, but they actually in that first year start out right away with clinical experiences. So seeing patients being in the clinics and by second years, they're sort of in rotations in the clinic full time with breakout sort of educational sessions.

And so it's an integrated curriculum of sort of combining the classroom didactic experiences with the clinical experiences from much earlier on that tends to help them be able to retain the information better and be better at the other pieces, right? Understanding patients, communicating with patients, being able to understand resources and challenges in the community and things like that that are not well taught in a classroom.

PCMP (17:33)
Do you you seeing a I guess now you're training Gen Z doctors to the degree, which that's kind of weird coming out my mouth to think about like that Gen Z is now become babies. Yeah, right. Like I'm a millennial like born in 1988. Like I'm like the end of that. But you know, you've seen some millennials that you were training at some point now you're training Gen Z. Is there just a different mindset with that generation? Or is it?

Just like, I'm just curious because we know here, like even in our company here, we have a pretty distinct difference in generations that work here. And there are legit disconnects sometimes where they all mean well, but then sometimes they just do not align. And I'm just curious if you're seeing that as well.

Lindsey Fish (18:18)
Absolutely, it's everywhere. mean, and that's, you know, as a, I mean, I'm a Gen Xer. ⁓ you know, I mean, I see it not only in our learners, but sort of even in, you know, the people I'm hiring, right? Some of these newer grad nurse practitioners or physician assistants who are, you know, potentially younger, because they didn't have quite as long of training as physicians need. So we see it both in our trainees, but also in our employees, you know, our nurses, our medical assistants.

PCMP (18:19)
you

I re-

Same. Hello.

Lindsey Fish (18:48)
There's definitely generational differences in how we all think and operate.

PCMP (18:53)
Well, I mean, we grew up in a classroom where you read a textbook. Yeah. And then you would have a lab or something like that. My children are 100 % on Chromebooks. They have one textbook per child under their desk. And it's not per child. They have one textbook per desk is what I mean. like, as the classes rotate, it's just a complete disconnect for me and how I learn versus how they learn.

It's wild. And you're absolutely right. The generational differences. I remember it used to be this conversation around boomers versus millennials. You know what I mean? here Gen X was stuck in the middle of that going, y'all are both stupid. ⁓ And then now you have it's Gen X and I've got Gen Z that that is coming into the office. then I'm like, why are y'all complaining? And Michael's like, y'all are both stupid.

But it is literally happening now. is funny that you say that Dr. Fish when you're talking about the adjustment to clinicals ⁓ now being incorporated into the learning. I'm only bringing this up because the audience already knows that I'm a pilot. So it's not it's not weird. They already know that. The I'm trying to make this because Michael tells them every time it's the first time I've ever broken up. I've been quiet. I'm the point is, is when I the most recent rating that I got certification that I got. ⁓

I did not understand any of the book until I put my hands on it in the plane. Right. And I think that works the same way in medical is like, how in the world am I going to know what I'm doing here? If I can't physically go do it here, like I'm reading about it, but I can't say I'm not making the connection. I love that it's going this direction in the education.

Lindsey Fish (20:36)
Yeah, I mean, it's definitely a great transition. I will tell you though that when you take a first year medical student and put them in front of a patient for the first time, that is quite an experience. ⁓ Maybe that's true if you take somebody who hasn't flown a plane and put them in the pilot seat. ⁓ But it really is, I mean, it really is about teaching sort of the nuance, right? So again, I can give you a lecture on blood pressure. We talked about that, on blood pressure. But what does it mean to explain to a patient?

PCMP (20:47)
I bet. I bet.

Exactly. I was going to say, put them in a plane and see how that goes.

Lindsey Fish (21:05)
that their blood pressure is high? And how do you explain to a patient that their blood pressure needs to be treated and how you're picking a medication? And how do you do that using an interpreter in another language? And how do you do that effectively? that is a skill that I can give a lecture on but is in no way meaningful until you are trying to have that conversation with a patient.

PCMP (21:30)
that I don't see how it's done. That was probably why I'm not a doctor at all. Here's what I want to do. Let's switch gears for a second. Cause I like to do that. I want to talk about marketing. This is a marketing podcast. ⁓ We're helping clinics grow their clinics. ⁓ Part of way you approach has to be different than the typical urgent care. So how are you doing marketing? Is it even part of your strategy? And if so, what parts of the marketing strategy are you executing on?

Lindsey Fish (22:01)
Yeah, so ⁓ I will tell you, my particular urgent care clinic is not actively marketing at this point in time.

PCMP (22:08)
Okay.

Lindsey Fish (22:09)
Our community knows who we are and has a relationship with us. We've been here for 10 years. Many of them come into our building to see their primary care doctors here because we're in the same building as a primary care clinic. And so we do not actively market. That being said, we still see about 10 to 15 percent of patients that have never been seen in the Denver Health System. So they're brand new to our system. ⁓ And that continues to be true. So I think, you know, our first marketing is being present in the community.

And we do that through lots of community events actually. So we do things like. Right, yeah, and it's you know, it's a different type of strategy in the sense of you know, we offer in August a back to school event where we provide children our community with backpacks and school supplies. And in a couple of weeks we're doing a trunk or treat in our parking lot where the neighborhood kids can come. They can get candy from us and they know it's safe candy and it's safe to be in our parking lot.

PCMP (22:42)
That is the marketing. That's the marketing strategy right there.

guys.

Lindsey Fish (23:08)
because it's not always safe to be on the streets around our clinic. And they come to that. And so I think we do events as community partnerships. That's done throughout our entire building. So it's not just the urgent care, but urgent care participates in all of those events. And so that is sort of our big thing. Certainly we are aware of sort of what I would consider your standard, you know, typical things, you know.

You can give us a Google review online and people can find us that way. But it's not a huge proactive approach. Now, that is not true. Some of the other urgent cares that Denver Health runs has a bit more of an active marketing approach. But just to your point, if you put a pin in my clinic, and again, I'm in urban Denver, so a very populous area.

a pin in our clinic and draw a three mile circle radius around us three miles in all directions. There is no urgent care or emergency department in that entire three mile circle. So ⁓ I have plenty of people who come here because there is no other option.

PCMP (24:13)
I love that you're you're in an underserved community. You're you're obviously offering underserved services. Yeah. But to an underserved community and you're probably in communities that the for profit clinics don't want to go to anyway. Yeah. Or it's just challenging for them. And I love how you said three mile radius, because we talk about three to five mile race. That's never been said on this podcast. Yeah. We talk about all the time where even when you're running your own campaigns, you stick the three to five miles max, because that's all you really should do.

But I love because I know you say, we don't do marketing, but we do these two community events. I love it. Like that's not marketing at all. ⁓ It's actually the wonderful grassroots that we love talking about because that's not what we do. But we love talking about how that makes an impact to the community. ⁓ And honestly, we've heard a lot of stuff about school community events that urgent cares have done. I don't know if I've heard of an urgent care that provides backpacks. I'd love to get a little bit more detail on that. Like what does that look like? How did you get the

the list of students that needed or are you just like, how does that work? I want to know more about that event.

Lindsey Fish (25:18)
Yeah, so we've got sort several clinicians in our building. And by building, mean within primary care, our dental clinic and our urgent care clinic who work with lots of community partners. The Denver Health Foundation, which is our sort of fundraising branch of our organization, also helps fundraise. And we go to different companies and businesses, ask them to donate supplies for us, as well as purchase supplies from funds raised through the Denver Health Foundation. And then we just advertise it. It's not an invite only event.

advertise,

I guess we do marketing, mostly within our own building. ⁓ We put up signs in our building. It's not like we're doing commercials or billboards or things like that. We just have signs in our building saying, on this Saturday is our back to school event and come get your school supplies. so people see it in the weeks leading up to, especially as families are coming into the building for back to school ⁓ physical exams and primary care and such.

PCMP (25:50)
You

Lindsey Fish (26:14)
are coming into the building, seeing the signs that we're gonna have an event on Saturday, or as I mentioned, the Trunk or Treat here in a couple of weeks. And those signs are just posted around our building for people to be able to see. And we just welcome the community in and we give out as much as we can until we potentially run out of supplies. So we do, those are our greatest events, right? The back to school event, our Trunk or Treat. We actually do a Christmas party where our community is welcome to come and Santa is here and we have presents for the children in the community.

especially for families that maybe can't afford to do Christmas for their family.

PCMP (26:48)
I love this. ⁓ I love that you're serving these communities. ⁓ I like the way you're marketing to these communities in a way that is mutually beneficial, not just self-serving. ⁓ Meeting a need, filling a need. These are type of things that ⁓ all of us could do more of. absolutely. And a lot of the trunk-or-treat side things. My church has trunk-or-treat and they even say it's the biggest outreach thing that they do because they have probably

1000 kids come through in a single night and it's just but you give back right you're just giving back community and I love how you talk this is a safe place to be because that you recognize that there they could be on the streets I just are not safe and it's just not a good time and so let's bring them over keep them safe for one evening and not worry about it let them have a good time so I just I love that absolutely love that this is my last question and then Michael you can wrap up with any questions you have and take us out to

⁓ You're dealing with ⁓ underinsured, no insured, Medicaid, Medicare, underserved communities. ⁓ From that perspective, what is the biggest challenge in actually serving this community?

Lindsey Fish (28:00)
Yeah, hands down our biggest challenge.

is not the medicine side, it is the life side. It is how do you help these people with housing and food and having a safe place? Maybe they're victims of domestic violence, things like that. The emotional and mental health struggles they're dealing with with, you know, trying to make ends meet to pay rent ⁓ or dealing with, you know, loss in the family or not being able to afford medical care and those impacts. And so the challenge that we face is really, I can write a prescription

for a blood pressure medicine pretty easy, but how do I support a woman who's crying with her children and saying, I don't have a home to bring my children to tonight and it's going to snow. Where do I bring my kids tonight so that we can be safe and we can be warm? And so I think the other side of it is just this recognition that health is not just medicine. Health is really about so many other aspects of home and food, lifestyle, job security and economic pieces that really mental

health, well-being, all those pieces are just so critical for people to be able to be healthy and it's not just about writing a blood pressure medicine.

PCMP (29:11)
I'm so glad that you said everything that you just said. It's exactly what I wanted to hear. ⁓ I was trying to lay that question up in such a way to pull this out of you because I think the heartstrings that are pulled are so much more important than the healthcare that you provide ⁓ because that's where real change happens. anyway, that's all. And so I think my only final question I could have with this is, okay, so you're being a medical director, you have to lead people, right? And there's a lot of that going on. And what you just said,

It's more than just the health care that's being provided. There's a layer to that. How do you lead your teams through those type of conversations that they have to go through on a daily basis? How do you encourage them and keep them on? Because I imagine, because at that point, people are pouring out from their cup quite a bit trying to help. How do they keep that from just draining them and burning out from it? What kind of leadership do you have to do for that?

Lindsey Fish (30:04)
Yeah, so ⁓ we have I have a multifaceted approach to it because it is a very demanding job. Although I will say any job in health care is demanding with different types of demands. ⁓ You know, sometimes when I hear about urgent care is where, you know, a doctor is having to see 60 patients in a day, for example, that would be very draining for me to see that many patients, for example. But I think twofold. One is I do monthly check ins with every one of my clinicians. And so we meet every month and it's very casual. It can be

PCMP (30:12)
Yeah, for sure. ⁓

Lindsey Fish (30:34)
two minutes or if somebody has something going on then it takes 30 minutes ⁓ and that is you know every month I do it ⁓ and ⁓ that I think is just so important for maintaining the relationship so I can understand what people are struggling with and provide them with resources ⁓ and then two the other thing is is I have worked extremely hard to create a very strong team environment

⁓ We are fortunate to be able to have multiple clinicians, multiple MAs and nurses and front desk staff working together at the same time. So it's not just somebody by themselves. And that we recognize that, you if somebody needs a break, there's somebody else there to help cover. And so, you know, our job is to sort of take care of all of these patients together as quickly and as well as we can. And that, you know, to be able to do that, if I need a five minute break.

then I need to take a five minute break, right? Or if I just had a tough encounter, then I need to take a break to recover from that. Then my team can see a patient for me. A different doctor could see a patient for me. And so I think the two factors I do is try and know my people and meet with them regularly so they have a safe space to tell me anything that's going on and I can support them. And to teach them to care about each other and support each other. And I think that has made just...

the biggest difference in terms of keeping people around and really being able to care for this population.

PCMP (31:53)
Yeah, that's all. We, we, we encourage monthly one to ones here that we do with our team. And we, and it's that mindset of like, Hey, if you gotta go do something personal or take care of something, we're here to pick up the, it's been dropped. Right. It's super like we love that. And that's so important. So I love it because I healthy culture. is. It's a, you're building a healthy culture and you're building a culture that wants to help each other.

It's not like a rock star situation, right? We're all... But no, because I think there's some challenge. think culture is a challenge in an urgent care space because you have those different types of staff, right? And you don't want somebody to say, well, I'm the one that's in charge or whatever. But like, no, no, no, it's a team effort. So I love that. I love that you're doing that. Because I think, because I honestly think your team is seeing a more challenging patient in a lot of

because it's beyond just the healthcare itself. Like it's not a, let me pay this copaying and make myself feel better. But like you said, like this person just told me that they don't have a place to go home to and I don't know what to tell them. You know, and it's just, there's so much emotion that goes inside of that. But thank you Dr. Fisher coming on today. It didn't go as where I thought it was going to go, but it went to a much better place. is why I write questions to.

I almost never asked one. Yeah. One question off of my list. Yeah, it's awesome. But you're a wealth of knowledge. I could see your leadership coming through this conversation. So it's fantastic. They're lucky to have you. Absolutely. For sure.

Lindsey Fish (33:25)
Thank you so much for having me. It was a great pleasure to be here.

PCMP (33:29)
Hey, if somebody wanted to connect with you, it would be the best place to do that.

Lindsey Fish (33:32)
Yeah, I'm on LinkedIn, so you can certainly find me on LinkedIn if you want to send a question.

PCMP (33:36)
We'll drop that. We'll drop the link to our LinkedIn profile in the show notes if you want to connect with Dr. Fish. Until then, thank you for listening. The work that you're doing each and every day in your communities is making a positive impact. Keep doing it and we'll talk to you next time. Thanks for coming on with us. All right. See ya.

Lindsey Fish (33:49)
Thank you.