podcast

Speaker 1 (00:00)
You. One of the things I’ve experienced really in my journey is spending the time to be able to talk to people. I spent a lot of time meeting and talking to other practitioners that had ventured out and set their own private practices because you get a lot of useful information just knowing what were the hurdles, the impediments, the challenges that folks had faced when they had ventured out to start their own private practice. I thought that was a very, very helpful approach.

Speaker 2 (00:35)
This is Pittsburgh, a place where a rich heritage of making things and a fierce independent nature come together to create a thriving entrepreneurial community. Whether you’re a small business owner looking for ideas or inspiration or you’re an enthusiastic supporter of local businesses, you’ll find it here. I’m your host, Darren Volano, and this is the proprietors of Pittsburgh Podcast.

Speaker 3 (01:02)
Hello, everyone, for my behind the scenes episode. Today we’re going to be meeting with Dr. Nikhil Asher. He just opened up a new private practice in the Cranberry area. I just pulled up out front and the place looks amazing. It’s really beautiful from the outside. I’m excited to go in and take a look. We are going to get a tour, a sneak peek around the facility and get a chance to sit down and talk with Dr. Asher and learn more about his practice and what he’s doing here at Aspirational Health. So let’s go. Hello, Dr. Asher. How are you doing? Good to see you. Thank you very much for letting me in. This is amazing. What a beautiful facility. Yeah, thank you. If you just give me a second, I’m going to grab my couple of bags out. We’ll do it today. My guest is Dr. Nikhil Asher. He is the founder of Aspirational Health. Dr. Asher, thank you so much for being on the podcast today.

Speaker 1 (02:05)
Thanks very much.

Speaker 3 (02:06)
This is an amazing appreciate it. Yeah, thank you. This is an amazing facility. I was so impressed when I pulled up. I live very close, just up the street and had not noticed this transformation taking place here in this building. So you’re going to have to tell us more about that. But just to get started real quick, could you just tell us a little bit about Aspirational Health, the work that you do here for somebody that’s not been in your facility? I know it’s new. Could you just tell them a little bit about it?

Speaker 1 (02:30)
Yes, I’d be glad to. And thanks, Darren, for making it over. So we opened back in August. We are a new brand new healthcare facility here in the area that offer primary care services. Our goal is really to be able to establish patient relationships with the community and offer personalized primary care. I mean, a lot of times when folks ask why we did this, it’s really just being able to bring primary care back to the basics of getting to know folks that come to us for their health care needs, having long lasting relationships, following them through, and being able to offer comprehensive services for health improvement, for optimal mental health and fitness. So that’s what we’re about here.

Speaker 3 (03:12)
Yeah, and I know from talking to you before and also from reading about you on your website, that the integrated aspect of this is very important. So I just want to just talk about that for a second. And by integrated I mean two things really, because it can mean a couple of different things. On the one hand, integrated for patient care. So you’re bringing patients in and you can treat the whole patient as you were just talking about really a holistic approach to their care. And also integrated in the sense that you have a facility that does more than one thing. You have what makes this unique is part of this looks like a traditional medical facility, but it doesn’t because we’re about to see in a few minutes that you have a fitness area as well, which is really unique. And so it’s integrated. The facility is integrated. Could you just talk for a minute about the importance of integration on both of those levels and just why it’s so important as a central theme and mission for aspirational health?

Speaker 1 (04:08)
Absolutely, I’d be happy to. So a whole aspect of primary care really involves looking at lifestyle, looking at sleep, looking at nutrition, looking at mental health management. And one of the things we’ve noticed in primary care is that when you look at siloed approaches to care, which is just medications or a whole lot of advice, and then you don’t see the patients again for many months after that, it really doesn’t yield a lot of beneficial outcomes. What’s most helpful really is the advice, but then following through with facilitating health improvement. And that’s really one of the reasons why we established this health and Wellness Center, because we wanted to be able to have that partnership model with our patients in that they could come back right here at their primary care office and be able to get a whole spectrum of health improvement services. And with that, I mean being able to work with just a dietitian that can help them with their nutritional management and developing food plans. For example, working with a yoga instructor that can help them with yoga therapy, which can be a very important aspect for a lot of patients that need help with chronic pain or stiffness and joint problems.

Speaker 1 (05:23)
We have a fitness instructor on staff that does fitness consults and then helps patients develop a way to be able to implement an exercise program. And we have sort of the whole range of folks that have never exercised for long periods of time and want to get back to people who already are regular but want to see how they can further improve their exercise routine. And then we have mental health counselors which we think is a very important aspect of preventative medicine, which is how do we help patients with optimal mental health, stress reduction, management of anxiety, depression, grief, PTSD. So we thought that we really will be able to contribute to the health if we looked at a multidisciplinary disciplinary, team based approach rather than the siloed, fragmented approach that unfortunately, you see so commonly.

Speaker 3 (06:12)
Yes, absolutely. Speaking of that, let’s take a little tour around. We’re going to see that fitness room in a minute. Maybe we can start with a little bit of the medical side of the house.

Speaker 1 (06:20)
Absolutely.

Speaker 3 (06:21)
Show us some of the traditional rooms you have here. And everything, again, looks brand new. This is beautiful and well decorated and very warm and inviting. So let’s take a look at that and see what we can see.

Speaker 1 (06:33)
Yeah. Darren. So this is our entrance when patients come in. As you can see, one of the things we did with our facility is just be able to keep it as open and allow as much natural light as we could. So you could see that when patients come in, they come to the waiting area where they can wait, and then when their appointments are ready, we’ll bring them into our patient rooms. We do have five patient rooms all along here at the back and each patient room. And I’ll walk you right into one here. Spacious. This is a patient exam table. Usually the patients will come in, we’ll get their initial vital signs checked, then they’ll wait and we’ll be able to do the interview first sitting, and then I’ll get them over onto the exam table and do a full physical. One of the things we had wanted when we developed this space is that we wanted to try and decrease wait times as minimum as possible. So we actually facilitated a drive through check in for those patients that wish to be able to sit in their cars and wait until their appointments were ready so they would come into the check in area.

Speaker 1 (07:33)
And I’ll show that to you here in a moment. We check them in. They can fill out a lot of their forms in their vehicles while they’re waiting. And when the appointments are ready, we’ll call them and they can walk in straight through the door directly into the exam.

Speaker 3 (07:47)
Terrific.

Speaker 1 (07:47)
Yeah.

Speaker 3 (07:48)
Has that worked out well for you so far? I’ve read about it on your website and it seemed like an innovative and a smart idea. Not just in the age of COVID or in the age of a pandemic, but just in general, because the waiting room can be a bit of a downer of a process in a traditional setup and to allow people the freedom to wait in their car or to run a quick errand. There’s a lot of businesses nearby. There’s a lot of things that people could do to be able to do that and then just come in when your room is ready. It’s like, why aren’t more people doing that?

Speaker 1 (08:16)
Right? I mean, to be honest with you, for folks that come in for urgent care issues, which is typically your respiratory infections, we’ll have families that will bring their children with respiratory infections. This is the perfect setup because there isn’t really any exposure to anybody else, either patients or staff, and they can conveniently be seated in their cars until their appointments are ready. But you’re right. I mean, honestly, for anybody, that really the comfort of their vehicle. Maybe catch up on phone calls or whatever other work that they may need to do. They can wait until their appointments are ready and come directly in. But in terms of the response to that, I mean, it’s mixed because the traditional approach is waiting in the waiting room, which, like I showed you earlier, we have several patients that just prefer to be there, which is perfectly fine. But for those folks that want to come and use the drive through, a lot of times we’ll have folks that will come back for blood work, for example, or for vaccine shots. Same thing. They don’t have to wait their turn. They can just come in through the drive through check in, and as soon as the appointment is ready, we’ll call them in.

Speaker 1 (09:16)
They can get their vaccine shot and leave right back through the same door that they came in through.

Speaker 3 (09:20)
Yeah, it’s great. Let’s take a look at that, see.

Speaker 1 (09:22)
What that looks like. So we have five exam rooms right here, and then over here we have our drive through check in area. So this is our staff break room. And then I’ll bring you right here to the back, right behind the screen.

Speaker 3 (09:39)
Oh, terrific.

Speaker 1 (09:40)
And now this is our check in. Wow. So as you drive into the facility, you’ll see a sign which says Patient check in. I don’t know if you saw that. So it sort of directs you into the drive through lane. You come right here at the check in window, you get checked in, and then we have you wait in your vehicle until your appointment is ready.

Speaker 3 (10:01)
And we should say that part of the reason why you’re able to do this is because of what this building was before you took that over. Maybe now is a good time to tell us what was this building and also what did it take to turn it into this, because it looks totally different and really beautiful. You would never guess what was here before, but obviously this drive through is a bit of a giveaway. Tell us a little bit about what was here and also the length of just how long was the construction process and what did it take to get it to this condition?

Speaker 1 (10:30)
Yeah, absolutely. So this was a drive through restaurant building. Actually, it was a fast food restaurant. And what turned out was that when we were looking for a location to start the new health and wellness center. We were looking at different locations and had never thought that we’d find something that was so close to 19 as this is. And when this came on the market, as the restaurant closed, we said there couldn’t really be a more ideal location because of the convenience of folks to be able to turn in right at the lights there at the intersection of 19 and Freeport. And then you have a great open parking lot. So there’s a lot of parking space. It’s easy. As you can see, there’s really no climbing any stairs or there’s no difficulty in being able to access the building from the outside, from the patient’s car. And so when we looked at the drive through that they had, now this drive through was actually at a different location, so the construction was made so that the drive through was right here. Who wouldn’t like being able to conveniently check in and wait in their vehicle, as opposed to waiting an overcrowded waiting area?

Speaker 3 (11:33)
And how long did it take to convert this whole bit? When did you take possession and when were you able to finally open it?

Speaker 1 (11:39)
Right, so we took possession of it, I believe it was March of 2021, had to go through the licensing process to be able to get the license to begin construction. And then the construction took around nine months or so through this past winter, and we were able to open. So this possession was available to me back in June, but we were able to then set up our property and get ready to be able to start seeing patients in August, which is when we opened. Wow. Terrific. Yeah.

Speaker 3 (12:09)
Let’s take a look at the other.

Speaker 1 (12:10)
End of the building and then as we move over to the other side of the facility, that’s our wellness area. The nice thing is that we have a door connecting right to there, and the door has a big glass window right in its center. So this is where we can actually sometimes speak through and make sure that our patients are being able to get the benefits of having an integrated wellness studio right within the medical facility.

Speaker 3 (12:33)
Yeah, this is beautiful. It’s very well lit, tons of windows, floor to ceiling. So this is really terrific.

Speaker 1 (12:40)
Wow.

Speaker 3 (12:41)
And what are some of the programming that you’re able to do here? It looks like you’re definitely set up for yoga. You got a big open force, you have some weights and some other things that you can do as well. What’s some of the programming? What’s some of the services you’re offering? And maybe how will that change in the coming years or whatever in terms of what you’re planning.

Speaker 1 (13:00)
So, as you can see, we have a very large open space here and are able to facilitate a wide range of different programs for wellness for patients. So it’s sort of multifunctional in its use. So at the present time, we have a yoga instructor. Her name is Megan Howley and she offers yoga for patients that are seeking just the benefit of being able to get individualized yoga therapy. Patients can make an appointment through us here with the office. She does different types of yogas, including vinyasa and astanga. But what I really like about how she approaches yoga for patients is that you really don’t have to have any previous background. She’ll work with you in terms of developing a plan and then work with us as a medical team to define goals and develop a yoga program that’s really medically oriented in a way to help improve aspects of balance, aspects of pain and stiffness and musculoskeletal symptoms. The other programs we have, we have fitness instructors who are able to provide a fitness consult just to talk. Like I was saying initially, developing exercise plans for patients, everything from folks that have never exercised to folks that have been regular fitness, folks that want to look at ways in which, how they can further improve their levels of cardio respiratory activity or function, endurance, muscle strength, et cetera.

Speaker 1 (14:24)
So they do have the fitness classes right here for that. We do have a registered dietitian that will conduct one on one counseling for nutrition management. And again, that’s all very medically focused. So folks that are interested in weight management, for example, or cardiovascular risk reduction if they have abnormal lipids, she does one on one consultations as well as follow through on ensuring that patients are able to meet their nutritional goals. And then starting this January of 2023, we have a physical therapy group that’s going to be starting here, providing physical therapy. Patients that get referred to us can come right here at the same location to get their physical therapy. As you know, we have a lot of needs for physical therapy for patients. They also offer chiropractic treatments and then they also have their own panel of patients that they’re able to help bring to this location if this is closer to their home, to be able to get their physical therapy treatment.

Speaker 3 (15:21)
So this sounds like a partnership or a collaboration of some sort. It’s a separate company, correct?

Speaker 1 (15:26)
Yeah. For physical therapy. Correct.

Speaker 3 (15:28)
So Dr. Asher, one of the things we talked about earlier was your background in medicine. You have the specialty in internal medicine, but you have the fellowship in critical care as well. Those seem to me like the perfect complement for what you’re doing here because the internal medicine, obviously that covers you on the primary care front, taking care of patients, really understanding their well being. But then the critical care, you are running an urgent care facility as well as part of your practice here. So how do those two aspects of your background play into your ability to run this practice, to build this new practice, and to offer the different levels of service that you can provide to your patients?

Speaker 1 (16:05)
Yeah, no, thanks for that question. Really. I just see it as a spectrum, right, from preventative health to chronic disease management to more acute conditions, and having that broad spectrum of being aware of the spectrum of disease in patients. Things such as, for example, what are the important areas that you can focus on from a preventative perspective that can decrease disease exacerbations or decrease the rate of hospitalizations, for example? Those become really important when you have had that broad experience. So I certainly find it very beneficial for me to be able to use the skill sets in taking care of patients at this practice. One thing I can tell you in critical care, for example, is that we really see the most severe aspects of disease. And a lot of the times we notice some of the gaps in health care, if you will, that lead patients to ending up in an ICU. Those areas, gaps, for example, are really something that I’m very passionate about to fill because a lot of it comes down to good access, to good follow up, to having the relationships with your providers that you feel comfortable in communicating and approaching when concerns, questions or issues arise.

Speaker 1 (17:30)
So those are some of the gaps that I most certainly try to fill in this practice, which is facilitate good communication for our patients so that there should be no impediments or no concerns in them approaching us for any questions that may arise. And then also helping them recognize the benefits of health improvement from a wellness perspective so that they can engage with us frequently to be able to meet those goals.

Speaker 3 (17:55)
Yeah, and one of the things we talked about earlier is, again, being an integrated facility. There’s a lot you can do here. You can cover a lot of areas. Now, you still might have a patient who’s going to require the need of even more specialized care. Maybe they have a unique scenario. They need to see a specialist, something that’s out of the expertise that you’re able to do here. So one of the benefits of them coming here is, again, you’re treating the whole person. What do you do in the scenario where you need to refer them on to another specialist, but they still plan to come back here for their overall care? How do you do that in a way so that you’re integrating, that you’re keeping that line of communication open with the patient so they don’t feel lost in the big health care system and they lose track of what they’re doing? Because that can happen. Many of us have had the experience of getting care in a big system and there’s a lot of benefits to big system. They have a lot of resources. The care can be great, it can be excellent, but it can be siloed.

Speaker 3 (18:52)
As you had mentioned earlier, you can get a little lost in that system. Not sure where to go. How do you get them to come back to get that compass pointing true north getting back here to Aspirational health and so you can ask them questions about what they just did and keep the whole picture in perspective.

Speaker 1 (19:09)
Yeah. So before we started the practice, actually for a few weeks prior to us actually opening our doors, the first thing we did was we actually got in our vehicles and we visited as many local practices as we could to be able to have a face to face introduction with the providers there. Our area, as you know, is quite concentrated with a lot of different groups and practices, which is nice because patients do have options for healthcare services. We reached out whether it was orthopedic groups dermatology Urology made a visit and met with their practice managers as well as their providers in the cases in which we could. We also have had a fantastic relationship with management at Ahn Vexford in order for us to be able to have the introductions to their subspecialty groups, as well as their diagnostic services for testing and procedures, as well as UPMC passivent. And we actually have direct liaisons who we work with that help us connect with any of the groups there so that we have that direct practice to practice communication. One of the things I can tell you, and I’ve mentioned it many a times with our patients too, is that primary care is about having one person oversee all aspects of care.

Speaker 1 (20:27)
Because when you start looking at fragmented care with the Siloed approach we talked about earlier, a lot of things can be missed. And it’s really just not beneficial for patients when providers are not working together as a team. So what we do is we tell our patients we would like us to be the overseers of all of their health care in terms of subspecialty care. And so hence, for us to be able to communicate directly with practices, for us to be able to exchange information when folks go to other practices, to get their subspecialty care and then follow through once they’ve had their care. To be able to discuss any questions that the patient might still have is a critical part of our mission for integrated health care. So that is certainly something that we spend a lot of time on and put a lot of emphasis on.

Speaker 3 (21:20)
Yeah, that’s really impressive that you go out into the medical community, you introduce yourselves, you let them know that you’re here. I didn’t even expect that answer. I was thinking more of with the advice you’re giving the patient to steer them back to you and also to make sure that you’re letting them know that you’re a central point for them. And it sounds like you are doing all that, but in addition, you’re really making yourself, you’re making those introductions, you’re letting them know that you’re here, you’re getting known in the community and the medical community and that’s really smart. So you can kind of hit it on both ends and really, like you said, be the overall manager of your patients so that you can keep track of everything they’re on because you want to know what’s that long list of medications? What are they doing so that you can better treat them here?

Speaker 1 (21:58)
Yeah, I mean, honestly speaking, the medical community is pretty close knit in that there’s always going to be connections that you can find that can help you get in touch with providers that your patients might be going to to seek health care. Sometimes it’s just as simple as just picking up the phone and reaching out to the provider and saying, hey, we shared this patient together and what do you think about their condition or concerns and how do we work together as a team to be able to meet their needs? And we’ve done that in some cases. It’s very important that we do that because we have to make sure that their care is well connected. It’s not a lot of hard work. And a lot of times you’ll notice that folks will even appreciate. When, for example, somebody reaches out to me to tell me about the care that they’ve provided to a patient of mine, I’m deeply appreciative because it’s so important and it’s really the way it used to be and should be.

Speaker 3 (22:51)
More cooperation.

Speaker 1 (22:52)
Yeah.

Speaker 3 (22:53)
So your practice strikes me again as an outsider, somebody who’s not working in your industry as something unique, especially here in the Pittsburgh region. There are very few doctors there are a few, but there are very few doctors that are doing it the way you’re doing it that are approaching it the way you’re approaching it. Building a practice, taking a holistic approach, creating a facility with the well being and the wellness under one roof, trying to provide the nutritional and the exercise and the daily habit. Trying to provide that advice as well as just the traditional medical advice, which as we know, you go to see a lot of. Again, not trying to knock the traditional providers. I mean, there’s a lot of great physicians out there, there’s a lot of great work out there. But you can be churned through the system pretty quickly and you can feel lost and not sure what to do, especially when it comes to lifestyle, things like what changes do I make? There’s just so much confusing information. So your approach seems new and different in a lot of ways. And I’m wondering, number one, if you agree with that, if that’s true in terms of our region, are you on the cutting edge in that sense?

Speaker 3 (23:53)
If you want to think about it that way in terms of the way you’re building your practice, but also in terms of just stepping back and looking at the greater country or even beyond. Is this a new wave of the way primary care and the way these practices are being built. Do you see more of this happening in other major cities and other major parts of the world? And is this something that’s just catching up in other places? Because I’m wondering where the idea came from for this, for you. I know some of it’s driven through your passion for wanting to take care of the whole patient, but also just this business model. Did you see examples of this and said, yeah, I see this happening and taking shape and I want to be on that leading edge?

Speaker 1 (24:36)
Yeah. What I can tell you is you referred to this earlier. When it comes to bigger health systems, there are some fantastic services and options for patients to seek because of the complexity of care that is available in bigger health systems. So what I notice is that our region here is very sophisticated in the health services that we’re able to provide, right? I mean, you can get the most modern, highly complex, highly sophisticated health care in this area and that’s fantastic for people. They don’t have to travel out. But what also happens in a set up like that is that sometimes you start missing those connections where it’s easy access to sort of pick up the phone and be able to reach your provider, get your questions answered. Or really sort of focus on more of the facilitating of all of the health goals in one location, as opposed to having to travel to different location locations. And in a field like primary care, there’s not a lot that has changed in terms of how we approach patient care because most of our focus is on preventative medicine, lifestyle optimization, nutrition, good mental health, decreasing the risk of adverse outcomes like cardiovascular disease, diabetes, strokes, kidney disease, et cetera.

Speaker 1 (25:56)
Not a lot has changed in primary care in terms of that. Sophistication really, primary care is about relationships, it’s about trust, it’s about being able to feel comfortable with your providers, to share information and then have that access to come back and ask questions or discuss any concerns. And I found that with the degree of sophistication and just sort of the magnitude of health complexity in terms of the practices that are out there, that seems somehow to get lost. And perhaps it’s just the byproduct of what happens when systems get very sophisticated is that you lose some of those traditional approaches of care. And so I absolutely found that to be an aspect that people seemed to want, again, kind of like in the traditional way that they had always perceived their family doctors to be. And I thought that if we were to introduce a model that sort of started really looking at those basics attributes of a primary care practice, it would be hugely not only appealing, but also beneficial for patients because they can really start now feeling that they can be at home with a place. Like ours and get the health care as they have always desired.

Speaker 1 (27:15)
And so I’m hopeful that this model gets the attention that it deserves because this is the way I think is the best way to approach preventative medicine.

Speaker 3 (27:28)
Yeah, like you said, there’s coming back to the traditional way of the old way of doing things with a model like this because you’re focused on relationships and building that back up. And we all know that the better the relationship, whether it’s with a patient or if somebody listening to this has a different type of business, your customer or whoever, the better that relationship, the better the communication, the better you can solve the problem or address the issue. The problem becomes when you get churned through the system and you don’t have a chance to communicate, you get 30 seconds with your doctor or something, things get missed. And the more we can spend time with patients or clients or whoever they are, the more we can address their needs. So I think it’s a big world and there’s room for lots of different models, right? Your model fits in nicely with what’s already here and it gives people some choice and it gives people a chance to experience different levels of care in a different way. And I think that’s great. And the other thing too, I wanted to point out is just coming in here and just spending a little time here, it seems very inviting and appealing.

Speaker 3 (28:26)
And I know that that’s an aesthetic, but it still matters because the way a person enters a building, whether it’s a medical building or whatever, is going to really impact what happens inside. And if they feel warm and inviting and welcomed and not treated like a number, not churned through the system, that person maybe can open up and allow you to work with them in a way that they wouldn’t otherwise. Because we all know, again, there’s a lot of institutional settings where we feel a little bit closed in. And some people are nervous, some people don’t know what to say, some people don’t know how much time they have. They’re trying to get it all out. They might burst into tears because they have just so much on their shoulders they don’t know where to turn. And so just having an inviting setting, that makes a huge difference.

Speaker 1 (29:15)
That’s so true. And I can tell you that it’s not uncommon at all. Like you said, when patients come in here, they’re nervous, they’re coming to their doctor’s office. There are things that bottled up that they need to release. And in primary care we talk about everything their social history, their family history, mental health concerns, stress, marital relationships, concerns there. So it can provoke a lot of anxiety when you’re in a doctor’s office. And we see that actually fairly often with our patient encounters. That’s why, in fact, when you look at blood pressure management that we do most commonly in the primary care setting, we never go by that one blood pressure that you’re measuring our doctor’s office, because most times it’s high than their baseline. One of the things we did was this is obviously a very inviting environment, and I’m very thankful to the team that worked on this project, because we definitely wanted natural light, we wanted openness, we wanted the rooms and the decor to be very inviting and relaxing. We’ll turn on music for folks when they’re waiting, so that certainly is a huge benefit in terms of architecture. But the other thing we’ve done, and this is what I was mentioning to you, is when folks come back to us, when they come for the nutrition appointment, for their yoga appointment, the second time around, the third time around, we just notice that ease, like they’re more comfortable, which wasn’t the case.

Speaker 1 (30:34)
That the first time that we met them. And then you sort of meet them on a recurring basis. You get a chance to be able to just have a social talk about how things are with their family or with their job. And that ease is so important because then people know that they can really confide in us with any concerns that they may have, whether it’s their health, whether it’s their emotional health, their mental health. And that opens up a lot of avenues for us, for medicine, that small.

Speaker 3 (31:02)
Talk is where actually it’s not just small talk. That’s actually where a lot of things can come out. Because when somebody starts to feel welcome and comfortable and you’re making that small talk about what’s going on in their lives, that’s where the little snippets come out of like, oh, I started doing this, or I stopped doing that, and then the light bulb comes to like, oh, could that be a trigger for this? Could there be an allergy situation here? Have you tried to remove this from your diet? Or did you realize that maybe that’s a stressor, things like that may be popping up and you learn from that. But again, that was the traditional way of doing medicine many, many years ago. And we sort of lost that art. I guess that’s sort of the art part of medicine. There’s a science is a big part of it. It’s what we think about. But there’s an art, especially to primary care, in terms of dealing with people good bedside manner, understanding, being able to interpret, being able to communicate, being able to read between the lines. I believe, again, I’m just outsider looking in here, but I believe you’re more equipped to do that in a setting like this than you would in a traditional setting.

Speaker 3 (32:01)
Your traditional, mainstream, large, institutional setting is what I mean by that, because I think people just feel and I know for being in that position myself, because we’ve all been patients, you just feel a little bit more pressured for time, and you’re trying to get it all out in like, 30 seconds. And it’s really hard to do that and really get to the underlying cause. It also sounds to me like you’re not just prescribing medicine, but you’re prescribing lifestyle changes. I think we’ve talked about that throughout this conversation, but maybe we didn’t hit on that directly. But that’s huge because a lot of lifestyle changes do matter, and I think medicine has gotten away from that. We believe that just prescribe. What’s your symptom here’s? The pill. And let’s move on to the next patient quickly. I got to get through the numbers. I got to get through my day as opposed to what are some of the things that maybe people are doing that contributing to their own illness? Can we start to make differences there? Can we mitigate? Can we remove things? And obviously that’s what you’re doing with getting people on the yoga mat and doing some exercises, trying to get them moving and breathing and prescribing nutrition as opposed to just pills.

Speaker 3 (33:07)
And it sounds like that’s a big part of what you’re doing here.

Speaker 1 (33:09)
Absolutely. I mean, I can tell you that not a single patient leaves the clinic without us talking about exercise, nutrition, mental health management, sleep relationships, stress reduction, work life balance, all really critical aspects for preventative health. But each one of these topics is huge. I mean, you could spend an hour conversing, so it’s almost impossible to be able to do it all in one go. And that’s why it’s important that we work as a team, and we have professionals that are experts in those different areas, and we work together as a team that patients engage with and provide that team based approach so that patient can get that full spectrum of help that they desire. The other aspect is we meet as a team on a regular basis too. So we share ideas. We kind of talk about scenarios that in some cases that might be challenging, whether it’s weight management or whether it’s certain mental health concerns that we may have about patients. And we sort of work as a team to determine, okay, what is the best treatment plan, if you will, that we can develop cohesively as a team of professionals that can help meet the patient’s needs.

Speaker 1 (34:18)
And like I said, we also collaborate with other specialists, other practices in the area, so that if it comes to having to refer, then we certainly would. But that gives us a multidimensional perspective. When we hear that perspective from our dietitian, from our fitness instructors, from our mental health counselors as to what their impression of the patient’s concerns may be and then how we work as a team to kind of develop a roadmap moving forward.

Speaker 3 (34:46)
Speaking of the team that you were mentioning, that you’re building a team, you’re not the only one here. Obviously, you’re building a specialized team, a sophisticated team. You kind of referenced this earlier when we were doing the tour, and we were talking in the fitness wing of the business where you had different people on staff. Now that you’ve been in business for a few months, obviously you’re continuing to build in this location. What types of folks do you have on staff now that are able to provide different services? Maybe just touch on that again, and then maybe where are you going with it? Are there some key positions or areas that you’d like to see filled to be able to allow you to better offer the services that you want to to your patients?

Speaker 1 (35:25)
Right. So, myself, I am the physician and the medical director of the facility. I have two nurse practitioners on our team that are family nurse practitioners that are trained in providing family medicine care. We have a fitness instructor that specializes in fitness consultations to develop exercise plans for our patients. We have a yoga instructor that really works on yoga instruction and training, a registered dietitian that provides all the nutritional care services at our center, and a mental health counselor that provides mental health counseling. We will also have physical therapy here at our center so that patients have the ability to be able to get access to physical therapy right here on location.

Speaker 3 (36:10)
And in the future, do you plan to add any additional types of medical people or experts that you don’t have currently or any other physicians? Is that something that you’re thinking about?

Speaker 1 (36:20)
Yeah, I mean, I think that that would be ideal that we could have a partnership with physicians that could provide extended spectrum of services, particularly in the realm of preventative care. So some of the things we notice for sure that our patients require and would benefit from would be gynecology services, for example, for preventative women’s care and other physician specialties that would be partners with us that can help with the integrated health approach. Certainly that would be a great addition to the team.

Speaker 3 (36:52)
Dr. Asher, as we wrap up, what final words of advice could you leave for entrepreneurs listening to this?

Speaker 1 (36:59)
Really?

Speaker 3 (36:59)
That’s what you are. You are a physician, and you’re a medical provider, but you also started your own practice, and so that means you’re a business owner now, and you’re an entrepreneur, too. People out there listening, they want to start a business, and maybe they’re like you. Maybe they work in a profession that doesn’t always have a lot of entrepreneurs. Most physicians are not starting their own businesses anymore. Most are working as employees in the system. And so maybe somebody out there is in a similar position, or maybe they’re in a corporate job or something, and they just want to start something new and different. They have a passion. They have an idea. Maybe your thoughts are along those lines, or it could just be some practical advice. I mean, you’ve been in business now for a few months. You got a long way to go but you’ve learned some things already and you’re doing like you said earlier, you’re juggling and managing everything. Marketing, finance, accounting, hiring, training, the facility, construction, you have all of that. And so maybe just something is on your mind with respect to that.

Speaker 1 (37:58)
Yeah, I think it certainly starts with a vision and being passionate about your goals to accomplish that vision. It does take a lot of drive and a lot of dedication to make sure that you see it come through to fruition. So patience and making sure that you give it time to be able to come to full life is important. One of the things I’ve experienced really in my journey is spending the time to be able to talk to people. I spent a lot of time meeting and talking to other practitioners that had ventured out and set their own private practices because you get a lot of useful information just knowing what were the hurdles, the impediments, the challenges that folks had faced when they had ventured out to start their own private practice. I thought that was a very, very helpful approach. The other aspect is due diligence. I mean, you definitely want to spend the time, whether you have a financial advisor or somebody that you can work with, to look at planning, projections, budgeting, just penning the time to be able to prepare and plan. Sometimes that weight can be hard when you’re ready to ambitious and you want to see it come through as quickly as possible.

Speaker 1 (39:14)
But no, spending the time preparing, planning is very critical. There are a lot of challenges and hurdles that come along the way. Especially you talked about construction. That was an area that I really didn’t have a whole lot of experience with, especially commercial construction. And so what I say is that I did trust in people. So when I did my due diligence in finding the right teams, then I found ways in which I could appropriately delegate responsibilities and work and then trust in people that can bring through your ambition or your vision with the project. Sometimes it can be overbearing to have to deal with a lot of responsibilities in a project like this. So finding ways in which you can know what are the areas that you really need to delegate work for and what are the areas that you need to be more hands on is important. It’s that balance, right? And I think the ultimate reward really has been the team that I work with that are so passionate about this project and they’ve given me all the support. So having the right folks that you can work with and then the patient relationships that we have developed that pulls us through.

Speaker 3 (40:29)
Yeah, that’s some great practical advice there and some great information for people listening. So thank you so much Dr. Asher, for being on the podcast. Thank you for having me into your facility. Wonderful facility here, giving me a behind the scenes tour. I know that listeners and viewers are going to really enjoy this, so thank you so much.

Speaker 1 (40:47)
Thank you.

Speaker 2 (40:50)
Hey, everyone. I hope you enjoyed this episode. Please do me and the Pittsburgh small business community a huge favor by giving it a rating on your favorite podcast app. It really helps others to find the show so that we can continue to build our community. If you haven’t subscribed yet, please do. And if you know someone who should be on the podcast or you’d like to connect with me, you can reach me@proprietorsofittsburg.com or at 412-36-8247. I’m Darren Volano, and this is the proprietors of Pittsburgh Podcast. Take care.