Episode Transcript
[00:00:00] Speaker A: Hi, welcome to It's a Kinetic thing with Karen Kay. I'm Karen Kay. And today we're just going to kind of talk about myself and how I got started in this industry.
[00:00:09] Speaker B: Okay, so let's go back to the very beginning. What, what got you into medicine in the first place? How did it all happen?
[00:00:15] Speaker A: I think it happened.
I knew from the time I was probably 7, 8 years old that I always said I was going to be a nurse when I grew up. I probably came from my grandmother, who I was extremely close to, and she was kind of the medical caretaker of the family, even though not officially a nurse. And when she was much younger, she worked with a old country doctor and kind of assisted him. And so she was always the one that took care of our infections and our boo boos and all of that. And so I think that's probably where my desire to get into nursing came from.
[00:00:53] Speaker B: And then what was your first medical.
[00:00:58] Speaker A: My first medical job immediately? Well, let's see. Even during summers during high school, I worked for a physician part time. My mother was his office nurse, receptionist, right hand person. And so I spent time up there. I would just do things like filing and things. He always had cool cars he would let me take to the car wash and wash for him.
And if he was doing some minor surgical procedures in the office, he would let me watch as well. So that was probably my first.
Not really a paid job, but just something I did to hang out. And then immediately after high school, I went to emergency medical technician school and I worked on an ambulance for several years after high school until I graduated with my associate degree in nursing.
[00:01:50] Speaker B: So when you worked for that guy filing papers and stuff, how old were you? You were in high school?
[00:01:54] Speaker A: Yes. I was surprised. 15, 16, 17.
[00:01:57] Speaker B: And so being there, you knew for sure that's really what you wanted to do?
[00:02:01] Speaker A: I had always known it, but I just further confirmed it.
[00:02:05] Speaker B: And then you did. Before you got into the world of aesthetic and wellness, you did other medical jobs. What were. How did it all begin with your first one?
[00:02:15] Speaker A: So first was an EMT working on a small ambulance service. I went after basic emt. The second level is advanced or intermediate emt. I took that then. I actually had already got accepted into RN school, so I was actually going to RN school and ended up also going to paramedic school at the same time.
So while I was getting my nursing license, I finished and got my paramedic license, worked as a paramedic while I was working my way through nursing school. And then my first Job right out of nursing school was in the intensive care unit at a, and I guess moderate sized town for Oklahoma. And it was a 24 bed ICU unit, multiple specialties. So we might have a child in one bed and a 90 year old with a head bleed in the other bed. So I did that for I think a year, year and a half. And I always wanted to go to the emergency department. And so after that I ended up in a position in emergency room and worked there for several years.
Well, yeah, probably seven, eight years until my first child was born. And my husband at the time, my kid's father, was a paramedic as well.
[00:03:33] Speaker B: Okay, so that happens a lot, doesn't it?
[00:03:35] Speaker A: It does. And then once. And it's funny because we knew each other through high school, but we never dated in high school and never set off to have our career pass mingle like that. But anyway, when, when my son was born, it was like one of us is going to have to have some sort of normal schedule, normal job. And he wasn't giving up as paramedics. So I ended up then transitioning. I think I did home health care for a while. I took a job for a large national insurance company, like health insurance. And my job with them was when someone was wanting a surgery that, you know, they needed approval for, or let's say they were chronically healed and then they needed a referral to home health or hospice, that was my job, is to initiate those approvals or denials. I think I was there about three years, which was a nice, you know, eight to five, Monday through Friday job. And they, that insurance company came in and laid off the whole team locally and they were just doing everything telephonic from their headquarters. And that occurred the day I got laid off. I think was the same day my then husband, my kid's dad surprised me with a subpoena for divorce. Oh, nice.
[00:04:57] Speaker B: And, and it's a good day when you have both things happening.
[00:05:00] Speaker A: Yeah, well, and, and I check our bank account and they're all empty. And so here I am, a single mom now, have two little kids, first time in my life I've ever been unemployed. I have no money in the bank, so I really needed a job quickly. And it just so happened that the local physician, medical director with, that I worked with at the insurance company, he also did hospice on the side.
And, and he's like, you should come and go to work for us at this hospice. You would be great. Because we need somebody that's comfortable in the hospital setting going around talking to the nurses and physicians about hospice, but also introducing patients that might need hospice care about what hospice is. And you're already used to rounding in the hospitals, you know, all those people, the case managers and things that makes referrals. So I ended up in hospice care.
[00:05:52] Speaker B: And what year was this, do you remember?
[00:05:54] Speaker A: 1995, I believe. And I did hospice care for several years. I ended up getting a job offer for a new company, a new place that was starting hospice from scratch. They were privately owned. They had been with one of the biggest national hospice companies in the country. And they were going to start a new hospice in Tulsa. And they needed a nurse leader. And so they hired me as the patient care manager. So I was going to direct all the nursing care, help them build that program. I stayed there for almost nine years, ended up being vice president of clinical services, chief compliance officer. We grew that hospice from Nothing to about 700 patients in two states, four counties in Oklahoma. And while I was there, I finally decided that I don't love being in charge of masses of people.
It's frustrating to me because I expect everybody to work the way I work and just do your job and take care of your people.
And I decided I really just wanted to be back working with patients again. It's hard to go backwards because that would have been probably a 50% salary cut. You know, when you're used to directing hundreds of people, including physicians and, and things, it was just like, I can't go back and be a bedside nurse. I don't think I'd be happy. So I went back to Nurs Practitioner School at that time, which was 2009, I went from my bachelor's degree that I had in 2009, finished a master's degree in 13 months, got my nurse practitioner. That's kind of how I got started. I even as straight out of nurse practitioner school, I primarily worked with elderly and geriatric patients. I did primary care and facilities for them. So they, you know, they don't go out and go to the physician's office, most of them anymore. They have a physician or a nurse practitioner that comes and rounds. And so that's what I was doing in multiple facilities, still working part time for the hospice that I used to work for, doing some of their hospice visits that they need a nurse practitioner to do. And I just decided I needed a little break from death and dying all the time. And it's a rewarding job and I love it and I'll never completely leave it, but it was just a lot all the time. So I wanted to, to try a different area as a nurse practitioner and see, you know, just part time if I would like it. And I thought, you know, I like this new med spa industry that was really kind of just starting to pop up about that time.
And it's so funny because I just kind of had that in my head when I ended up getting an ad wanting a nurse practitioner to work for this small company that did, they did weight loss and they did a little bit of hormone therapy and they did a little bit of aesthetics and they were willing to train somebody.
And so I ended up there and I liked it a lot, I learned a lot while I was there. And I saw though that I could do this myself and do it better. And so in 2017, no, 2016, I really started my own business. It was very part time. I was renting a room from another, an esthetician makeup artist, and I just rented a room from her and you know, kind of booked people word of mouth and things and started doing, you know, a few facials, micro needling, botox, filler, just kind of the basic synesthetic. And that slowly grew and grew. And it was Labor Day 2017.
The person who I had been renting a room from in her building, they were going to leave, their lease was up, her husband was getting moved to another state. And so I elected at that time to take over the lease of that entire building. I came in, I remodeled it, hired some estheticians part time, bought some bigger pieces of equipment like lasers and things, and we opened September 1, 2017.
That business grew very rapidly. We went from by appointment only to part time help to by the end of 2018, we had outgrown our little three room, 1100 square foot space. I now had six full time employees. We went to a space that was about three times as big. We built, built it out as well. It had six rooms, two restrooms in house, laundry, all of that. And that went on until 2020.
At that time I had made a business deal to sell my business.
So my business at that time closed down, became kind of enveloped by a larger med spa in town. And I thought I was ready to semi retire. At that time, I'd gone through Covid, you know, I had gone through 90 days of being shut down by the local government. I had had these employees. We had grown so fast. There was a lot of growing pains. I was figuring this out as I was going along and so I was really just going to semi retire, do hospice and maybe kind of relax and then a friend of mine, I've known physician. I know him from hospice. I've known him for 20 years. In fact, we laugh that he and I have known each other longer than he and his spouse or and my spouse have known each other. And we've always worked well together. And anyway, he had a private practice, and he had decided to try to start a med spa as well and asked if I would consider coming over and helping them. And I had agreed. It was initially like one day a week was all I wanted to do. Like I said, we went through some Covid closure again. We went through some things. I think the end of 2022, they had had a lot of issues with the men's spa. Just bad business deals, bad potential business partners, some. Some unethical things that happened to them. At the same time, his wife had been diagnosed with breast cancer, and she really felt like the stress of that place and all the headaches that they've been through had contributed to her cancer. And they just. Both of them wanted to wash their hands of the med spa. And they're like, but we don't want to hurt you. If you have been slowly growing your business, would you like to just take it over and run it for us? And I said, I don't really want to run it for you, but I'll just take over your lease. I'll rebrand it. I'll, you know, pay the expenses and just let me do it myself.
And they were happy with that. They were thrilled with that. I brought on another physician who I knew as a partner, because I thought, maybe this time I don't want to do it all by myself. That's a lot.
You know, I thought it'd be better to have a partner, have somebody there to help make decisions and help carry some of the burden. And so we opened January 1, 2022. Yeah, so we're going into our third year. We're two and a half years in. We have grown pretty steadily, I would say, actually pretty fast, considering I did really, this business. I really wanted to more focus on functional medicine, natural health, really looking at hormone replacement therapy, peptide therapy, medically supervised weight loss. That's really where I wanted of or most of the focus to be. However, I still have carried some clients from me from place to place, and they just won't let me quit, you know, some. Some aesthetics. So I still, you know, offer some skin care. I still offer some laser and micro needling. I still offer the, you know, Botox, dysport and dermal fillers. Too. It's just not where we spend our focus on advertising or education anymore.
[00:14:12] Speaker B: Okay, I want to ask you a few questions about the transition from hospice and that world of healing people and making them feel better health wise. And now you're making them feel better health wise and look better too, but I think have a better overall happiness with themselves. That transition, was that something you thought about or is it just a natural transition?
[00:14:34] Speaker A: You know, I don't think I really thought about it up front, but I had several people when I first started doing aesthetics. Like, how'd you go from being a hospice nurse practitioner to aesthetics? And they're miles apart. And I'm like, in some ways they are. Because usually in aesthetics and things, we're at people that are, obviously, they're pretty healthy, they've got disposable income and they're more worried about appearances where, when people are death and dying, they're, you know, they're more worried about comfort and, and where to go. But it's surprising.
The people skills, the conversation skills, the ability to be comfortable with people where they are comes across both. And you know, with aesthetics, especially if you can't communicate well, have an honest conversation with people when you're talking about their health and we're talking about hormones and you, they can't freely speak about their sex life and things, you're not going to get a good outcome. And the same, you know, with hospice patients. There are hospice patients that are still out there worried about their sex life, but basically you're meeting them where they're at with the concerns that they have at that time and helping them solve a problem.
[00:15:47] Speaker B: My other question to that related to that is, and especially I didn't realize you had worked for an insurance company. So you've kind of been on the backside of an insurance company and how it works. So going from the medical world where it's all paid for by insurance and you have to have a staff of people just specifically for insurance claims, to a world that doesn't take insurance and has nothing to do with insurance. It's all cash only. That's a whole different mindset. How does, I mean, obviously this is probably the better way to go for you. Less hassle and less stress. But what, how does that transition work in, in your head on that whole thing?
[00:16:24] Speaker A: I think it, you know, it took me a little while because I don't ever want to, you know, obviously I want to make a living. I want my business to be successful, but I don't feel like I don't ever want to take advantage of people. I don't want to rape people. There's a yes. We all want to make a living, we all want to make a profit. And do you have to do it on the backs of others? And do you have to like do you need to make five times what the cost was versus one and a half or twice? And so I've always tried to make mine a business that is financially feasible.
And by the way, there's hardly any practices out there anymore or hospital systems that are making a profit or financially feasible anymore or stay that way very long because of all the issues with bureaucracy and red tape and what the insurance puts you through. I mean you can call an insurance company and get pre approval for a surgery and you're being told this is what your co pay is. And then I as the provider bill that to that insurance company and they come up back with a denial of some kind.
Now I have to fight that. I have to have three people to go through and fill out all the paperwork and make copies of the medical insurance and fax them and call the right person and stay on them. And even if they agree it shouldn't have been denied and it was pre approved, they may decide to hold your money for 90 days or longer.
One of my physician friends right now, he's been found not guilty. I guess you could say that his care was appropriate and he should not have been denied. But he's still gotta wait six months to let them file an appeal, which they didn't even show up for the court case. And now he's got to give him six months to file an appeal. And in all the time his money is being held, but he's still got to pay all his staff and utilities and all that. And so we wanted to take all of that out. And just like if you want this service, we can provide it, but we want to keep our costs low, we want to keep our overhead low. I want to sit and have time with you. I want our, our standard appointments are 30 minutes to an hour, they're not every 10.
And we do that on purpose.
But if we had a ton of overhead we would have to go to every 10 minute appointments to keep people moving through to pay for all the staff that we had to have to file all that stuff. And so we chose to do it this way so that hopefully our patients are getting a better outcome. More education, more time with their provider. We're much more satisfied in providing healthcare because we can do it the way that we want to do it and without having to fight all those other issues. So that's why we decided to go that way. And there's more and more healthcare providers doing private pay only.
We do offer you a receipt, an itemized receipt with, you know, all the codes on them. And we allow you, if you want, if you have the time and energy and you want to go fight with your insurance, we'll absolutely give you the documentation to do it. But we're not going to hire and raise our prices to have three people in the back office fighting those for.
[00:19:30] Speaker B: Us doing all that. Which makes sense with your personality and where you came from in that world of caretaking and hospice, that you would want your patients here at your new place to have that same experience where they do get 30 minutes with you. It is a long appointment. It's not you're, you never see people waiting in your waiting room. It's all very much about that patient and making sure they get in the best care and getting the most time with you.
[00:19:54] Speaker A: It's absolutely what we want too. And you know, we work really hard to negotiate good pricing upfront to help keep our prices down. So for instance, our full lab panel that we do on all new patients, we charge $299 for it. And a lot of people go, well, I have insurance. I want to use my insurance for the lab. And I'll say, okay, we can do that. But once you do that, I'm out of the loop. Now the bill is between the lab and yourself and your insurance provider. And I don't have any control over what happens if they deny it or you don't like the contractor rate they had. So we did this the other day. A patient was adamant their insurance was.
I said, okay, we'll bill it to the insurance again, reminding you if something happens, it's now out of my hands. It's between the three of you. Insurance, patient, lab, and get a call back. Three weeks later, they got a bill for twelve hundred dollars for the labs that I would have charged them 299 for.
And that's after the insurance paid what they were going to pay.
[00:20:59] Speaker B: So they were out the 1200.
[00:21:00] Speaker A: They were out to 1299. And I'm like, it's out of my hands now. You took it out of my hands. And so that's why we don't play those games. Them.
[00:21:08] Speaker B: Well, insurance is such a game anyway.
[00:21:10] Speaker A: It is. If you ever looked at it, if any you were ever in a hospital looked at an itemized bill, you'd be appalled you know, they'll charge you $18 for a Tylenol, you know, and it's. And then. But the insurance has a contract, so they write this much off. But if your insurance denies it, then you got to pay that 18 for a Tylenol that you could have went and bought a hundred for less than that.
[00:21:32] Speaker B: Yeah, that's crazy. Well, even just being a patient and just, just being that person that gets those bills and trying to decipher and making sure that it's all legitimate charges yourself, even after the insurance company has gone over it, it's overwhelming. And the stack of bills you get after a hospital stay or a surgery or treatment of any kind is really overwhelming.
[00:21:55] Speaker A: It is. And that's why our patients know if they elect a service, they know up front what the charge is going to be.
They know when the charge is due. And, you know, as long as they stay within our contract, there's not going to be any surprises after the fact.
[00:22:09] Speaker B: And they pay when they're there. So it's not like they get a bill a couple days later. That's wrong or confused about because they're standing right there.
[00:22:16] Speaker A: Yes.
[00:22:17] Speaker B: When you check them out.
So here's a question just to make you think a little bit, but how would you describe your style or philosophy as a provider in this new wellness practice?
[00:22:29] Speaker A: I think people will probably describe me as direct to the point.
I'm not one to sugarcoat things. If you ask me a direct question that asks for a yes or no, I'm gonna give you a yes or no. And then if you want to know why, I'll give you my reason. But.
And whether you may like it or not, I'm going to give you what I think is correct. I'm also a big. I think, you know, from being in hospice and palliative care for so long, I'm very big, big proponent on.
You have to work with people where they are, and you have to accept that they are adult human beings are capable of making their own choice. So I may tell you this is really what I think you should do, and it's going to be the best thing for you. But you may say, you know, I don't want to do that, or I'm afraid of that, or I can't afford that, and that's okay. I'm not going to get offended by it. I'm not going to fire you. I'm not going to going to yell at you. I'm just going to say, okay, this is what I recommend. If we can't do this. What do you think about this? Or this? And then leave it to them to make the decision. I just want to make sure they make an informed decision and that they have, you know, the risk and the benefits of that decision.
[00:23:39] Speaker B: What is your most rewarding thing in this. In this job today?
[00:23:44] Speaker A: I think just having people come back and say, I had a couple in the other day, you know, started with the wife, and she got to feeling better, so she brought her husband, and now he's feeling better. And to hear them say, you know, I just. I didn't know how bad I felt, and I can't thank you enough.
I'll get choked up. Sorry. I can't thank you enough, the difference you've made and how much better we both feel. And then because we both feel better, our. We're happier together, our marriage is much stronger. And that's so much fun.
[00:24:18] Speaker B: Yeah. And I think it's. What's great about your practice is you do offer so much to a married couple or a couple that are together. I mean, there's. You offer just as much to men as you do for women. It's. I think people think about all the time when they think of a wellness spa. They use the word spot. Always feels like it goes female only.
[00:24:37] Speaker A: Yeah.
[00:24:37] Speaker B: But you probably have as many male customer or patients as you do female.
[00:24:41] Speaker A: Yeah, it's. It's very, very close. And, you know, we purposely avoid the term med spa.
[00:24:48] Speaker B: Right.
[00:24:49] Speaker A: For those reasons. So we just say we are a clinic that provides hormones, weight loss, anesthetics.
We actually added, you know, now we've got a lot of peptide therapy as well.
Yeah, it's. It is really rewarding. And it is interesting to see how much, once you get one partner feeling well, how they'll bring their other partner.
[00:25:12] Speaker B: In too, which I love that. I think that's so awesome, because you would have one person that would come in, and then they get home, and all of a sudden, wait a minute, I want what she's having. Or vice versa.
[00:25:22] Speaker A: Yeah. And it's fun to see these couples that have been married 25, 30 years and had kind of just become housemates that are back really enjoying each other's company again and enjoying intimacy again and feeling good about themselves and then really learning that they do still love each other.
[00:25:43] Speaker B: Yeah. I loved hearing those stories from you because I do think so many marriages are like that. It's stale, it's there, everybody's busy. They all have. They have kids or grandkids now, and life is crazy. They forget about that connection with each other. So the fact that you guys are getting that back for them, I, I love that.
[00:26:00] Speaker A: Yeah, it's really fun. And then, you know, even for other people, like I have a lady in her 70s and she's had multiple back surgeries and she was in pain every day back joints. And we got her hormones optimized and she's like, I don't have pain anymore. Like, I'm not taking pain pills. I'm out enjoying my land. So even, you know, it's not a sexual thing, it's just feeling better. Less pain, less brain fog. People tell me they're sleeping finally, again.
[00:26:34] Speaker B: I love that. What's something about you that your patients might be surprised to learn?
[00:26:40] Speaker A: Let's see. I'm a little bit crazy sometimes. I think people surprise that. I think people tend to think of me as kind of all business, very serious. Yeah. And I'm not all the time. I'm kind of silly and I, I don't. Maybe not as crazy now as I was when I was younger, but I had a bad habit when I was younger of thinking if anybody else, if I saw anybody else do something that I could do it too.
So I've jumped out of an airplane train before, parachuted. I've ridden a bull before.
I owned several Harley motorcycles, road Harleys, for a lot of years.
[00:27:14] Speaker B: I didn't know that part.
[00:27:15] Speaker A: Yeah. So there is some craziness in there.
[00:27:18] Speaker B: If you could only offer one treatment for patients for the rest of your career, what would that be and why?
[00:27:24] Speaker A: Oh, that would be hard. I'm tossed between, you know, weight loss and hormones and just because both of them improves their health so much and they feel so much and then they have such a better self esteem when they're feeling better and they look better. So it'd be a hard one. And plus, I know overall you're, you know, whether you're losing weight or whether your hormones are optimized, your overall health is going to be so much better. So I'd say it'd be a hard tie between the two of those.
[00:27:54] Speaker B: What's the average age of your patients starting on hormone replacement?
[00:28:00] Speaker A: Average? I'd say between 40 and 45. Okay. It's really interesting to see younger and younger.
I don't see it as much younger women, but I'm seeing younger and younger men come in with testosterone deficiency and symptoms of testosterone deficiency. More women in perimenopause not waiting until they're in full blown menopause to get some treatment.
[00:28:23] Speaker B: So much sense to do that.
[00:28:24] Speaker A: But I think our food supply is so contaminated now that we're not making the hormones that we used to. And suddenly, you know what? It was a normal level 20 years ago is not normal anymore. I mean, they've lowered what the normal level is, you know, and people aren't feeling well. And I think they just lowered it because it's what an average of what that age group is, not what it should be or what's optimal or what it has always been in the past.
[00:28:55] Speaker B: Yeah, our food system, it's bad. It is so bad. Yeah, really bad. Okay, I have two questions left.
[00:29:01] Speaker A: Okay.
[00:29:02] Speaker B: What advice would you give to your younger self just starting out in medicine?
[00:29:06] Speaker A: I think, you know, I probably would have went on to medical school. It's something I would tell my younger self. I didn't at the time because I grew up very poor. Just to get a college education was a big deal for someone in my family and knowing I was going to have to work through college, you know, and so I just felt like medical school maybe was unobtainable.
Not that I don't love all my years of nursing and being a nurse and the focus that we have instead of a physician, but being in a state where you have to have a supervising physician for some things, it's frustrating sometimes. I've been pretty blessed with the physicians I've partnered with, but there's some, there's some bad characters out there. So I think knowing what I know now, if I knew it back then, I just would have went to med school and I would have ventured out into my own practice doing this type of thing that I love a lot sooner in my life.
[00:30:03] Speaker B: Yeah, that's very interesting.
So for someone that's listening, who's nervous to start a wellness journey, what would you want them to hear from you today on getting started?
[00:30:13] Speaker A: I think do your research.
Don't take what somebody told you as the truth. You know, there we were in this age of, you know, Google MDs out there and, and tick tock and people are getting their medical advice. I actually was just on a, on a travel site and somebody is covered in a rash and they're asking people on, on a travel site what their diagnosis is and how to treat it.
[00:30:42] Speaker B: It's like tick tock is scary for that reason.
[00:30:45] Speaker A: It is. And you know, just like the hormones, there's so many old myths or incorrect research, inaccurate research out there and a lot of healthcare educators are not keeping up to date with the research and the evidence based practice.
So just because your old family Practice doc says hormones are bad doesn't necessarily mean they're bad. And is that just his opinion or his confirmational bias, or is that actually what the research shows? Because. Because the research doesn't show that. So I would say just do your own research and also be your own advocate and listen to your body. I have people every day come and tell me I have no, there's something wrong with me. And I really think it's my thyroid, but my doctor said my level's normal. Well, the doctor did one test, a tsh, which is the last test that's going to go abnormal.
I come in and I do a full, full panel. And yeah, their TSH might be normal, but they have no T3 or T4 where it's bound and it's not being used. And they feel horrible and we put them on a little thyroid and you think they. You change their world.
So listen to your body. You know it better than I do, better than your primary care doctor, better than anybody else, and advocate for yourself.
[00:32:10] Speaker B: And just keep asking their questions till you get the answers.
[00:32:12] Speaker A: Keep asking the question and keep, you know, if you're not happy with the answer that you're getting and you're absolutely convicted that there, you know there's something wrong, then find another provider that'll listen to you.
[00:32:25] Speaker B: Well, that's what I love about you, because I do feel like you really do. You run all the tests, you do look at everything to make sure that you're giving them the absolute best answer and options.
[00:32:37] Speaker A: Yeah, we, we definitely try. And I don't, you know, I obviously don't know it all and I don't have the answers, but I'm not afraid to say I don't know about this. Let me go find somebody that does. And fortunately, I've got a lot of smart friends in medicine, so.
[00:32:51] Speaker B: Okay, well, tell everybody how they can get a hold of you.
[00:32:54] Speaker A: You can reach us at 918-574-2376 is our phone number. We're at www.kineticclinic.net. you can email us contactineticclinic.net.
