Interview with Brenda Herrera FNP-BC By: Ahmad Sultan

Ahmad:

Wonderful, so thank you once again for having this interview with me and I will begin with my questions. So based on my research at least, You Matter Primary Care, it opened around June 2022. So what would you say makes this clinic different than the other adult primary clinics that are here in the

DMV area?

Ms. Herrera:

Yes, well it's nurse practitioner owned and I know there's not many nurse practitioner owned practices, although it is increasing. Also, I was trying to make the appointments longer, probably like an hour, usually an hour long. Sometimes 30 minutes fits something quick, like a sick visit. In order

to provide more time for the patients to get listened to, to be able to hear the whole story and not be rushed like the average primary care clinics that are 10, 15, max 30 minutes. And that way I feel like we're much get a big, you know, a broader view of the patient's health in general and also their problems. And we're able to take care of more things at once, so then it's actually less turnover with as far as appointments. So we're able to, I feel like, give a more thorough approach. Also, I do memberships, which is like, it's not a direct primary care clinic only, it's kind of a hybrid. So I do take insurances and I also offer monthly memberships for patients who are uninsured. And I do a lot of social work in the background to help these patients who are uninsured because they need a lot of help, not just for the visits with me, but like with labs. I offer discounted labs and also I try to help them as much as I can with the imaging and specialist visits. So I feel like that is a more unique approach to primary care. I just, I did the regular standard clinic. I worked like that for seven years. I worked in a hospital as well for at least one year and I felt like it was just a lot of, I mean, in the healthcare system, unfortunately it is broken and we do give, you know, less time for patients. So I feel like this is trying to continue to make it as I can to give it a better approach to care. So that's what I offer in my clinic. I feel like that's what makes it stand out. 

Ahmad:

Yeah, definitely. Especially because nowadays, like even when I go to the doctor's office, it's like we have 10 minutes maximum and I can't even fully deliberately say what I need to say. And then if you try to communicate with them, then they're not going to be able to talk to you for like two more months. So that's kind of the But it's really nice to see like clinics like this. So I wanted to kind of focus in when you talked about being a nurse practitioner, because that's like one of the unique parts of owning a clinic. So why did you choose to become a nurse practitioner? Like what would you say is like the advantages and challenges of pursuing this pathway? 

Ms. Herrera:

So I, at first I'll be honest, I wanted to be a doctor. I wanted to be a primary

care doctor. But then I just, the reality and the time and the financial restraints, along with my with my family, it was just for me, I felt like it was a faster way to get to being a provider. That's why I wanted to be a nurse practitioner. And also, I like how nurses are more a little bit more like holistic, and that they try to help patients in different ways. So I know a lot of we focus on like I said, for my uninsured patients with social work, and nurses take on many hats, which I love about nursing. And we're able, that's how I'm able to help my patients even further. I have a different connection with patients, sometimes that isn't as emphasized in the medical, I guess, in like the medical doctorate programs that RNs have with patients. So I feel like it's just a way that I can provide that type of care, but still be a provider. That's what I wanted. It's like the best of both worlds, as much as you can be in a healthcare system that's so complex. So that's what I like about being an MP. And that's why I decided to take that route. 

Ahmad:

That's, that's really interesting to hear. And yeah, it does make

sense. Because sometimes even, because I remember I talked with this other doctor, and like, even for them, like, they got into medical school. But then, of course, the cost nowadays is like, it's so high that like, sometimes if you want to go still do like, they're actually a nurse practitioner as well.

So that's why I asked that question. Um, now I kind of want to focus in on the clinic. So because I want to but I do want to open my own clinic. So um, how could you kind of like briefly explain how you originally had this idea to like opening up the clinic, like in terms of logistics and stuff?

Ms. Herrera:

Well, it was a very, like a long decision I had been making through over time, I first I started as an RN when I was in nursing school, I actually worked as a medical receptionist to begin with, when I was 18. In order to just get the experience of working in that clinic, and I already knew I wanted to work in an outpatient environment. So I got to know more like the inside and throughout like how to work in a it was a pediatric office, but it was still like primary outpatient primary care. So I did the receptionist part, I also did some billing. I was a bone density tech, I did medical records. So I felt like I learned a lot about the different departments that are, you know, make up a primary care clinic. And then I was a finally I was an RN and then I was a MP, the private provider. So I was like multiple, you know, did multiple roles. And I felt like I wanted to and I always had kind of like an idea in my head whenever I worked at different practices, like I wish I did this, or I wish they provided this, you know, and so I knew I wasn't going to find that type of practice that I was looking for, unless I did it myself. And so that's why I tried, you know, I was like, well, I know the supplies, I know exactly what supplies we need. I know that I, you know, as far as like how to run it through the background, like the administrative, you know, details that I have to do, and then it is a lot of work. It is very demanding and is exhausting. But if, you know, if not, if it's not there, it doesn't exist, then the only the only thing you could do is try to make it exist and, you know, create it. So that's why I felt like I decided to do that. And I'm still somehow, I feel like I'm keeping afloat. It is very complex just as a role and even in the system to survive like this, to be like a different type of clinic where I can still accept insurance. Because that's where a lot of people now are, a lot of providers are trying to get out of this system because it is broken and they're making their own rules and they're just doing direct primary care where it's just a paid membership. And I love that, but it's also sometimes not realistic for some patients because imagine they're already paying an insurance premium, which might be $300, $600. With this economy, with all the prices going up, I feel like it's harder. It's, you know, a higher class of income that you would need to be able to be, you know, be a direct primary care patient. And so I try to, that's why I'm trying to do this hybrid where I'm, you know, taking insurances and also memberships. But it's a lot of work. And as far as like, you know, logistics, it was just through, because I had already been working in different types of medical offices, outpatient offices, that I knew what I needed.

Ahmad:

Well, wow, that's really sweet, actually, because it's really nice to hear that even, because whenever I go to like private clinics, because like my optometrist, for example, is a private clinic, like they don't accept insurance. So like, it's like, whenever we go on like a visit, it's like $1,000, just like fine check. So it's really sweet to hear. And I kind of want to focus in on more logistics.nSo recently, I attended a seminar, it was about how a lot of clinics started using AI to make the workflow much more easier. Have you considered that for your clinic?

Ms. Herrera:

I definitely have. I mean, I try to stay on top of all the, you know, technological advances that we have that helps with health care, because I'm just a one person show. So I need that extra help. I do use AI to make like medical, like, I would say, letters of medical necessity, or like letters to insurances to help get approval, when I want to phrase it in a certain way. And I don't have the time to, you know, come up with all everything that I need to, and I just basically give it like the details I need. And it's right there in one second. I do definitely use AI to do that. And as far as I also do it for, you know, letters to employers, just things whenever I just need a formal writing, it helps a lot. And scribing, I'm thinking about it, it's just expensive. That's the only other thing. It's like the price in order to incorporate it into my EMR, unless it would be free, I would definitely take it if it was free. But it's not, I'm just kind of, you know, since it's a small practice, it's just myself. And remember, nurse practitioners, we get 70% of the compensation that a physician would get, even though I do, like a lot of work, and I may take care of a little bit more things during a visit, I still get 70% of what a physician would make. And so it's still and also with the insurance rates, reimbursement rates that are going even lower. And I'm still trying to stay with the same amount of number of patients. So I don't, they don't feel rushed. And also, I don't get burnt out. And I can actually feel like I'm helping my patient. So it's a lot of like, careful balancing with all that.

Ahmad:

Yeah, thank you for sharing that. And I kind of want to this next question is kind of like focusing on your journey, right? So what would be one thing that you would change that you think would have made your life so much easier when you're starting a clinic or even when you started your medical journey?

Ms. Herrera:

What would I change? I feel like I wouldn't change a thing because it got me here. But as far as like, I feel like maybe I would want to have taken a longer time in picking the first place I worked, because I felt like it was kind of like a boot camp. Sometimes there are better types of like, new nurse practitioner programs, even like residencies, which I tried to kind of create, because I was trying to do a fellowship for nurse practitioners, new nurse practitioners, to slowly kind of like their first month from graduation, they still feel like not ready yet, or maybe they didn't have the best clinicals and they want to and they're going specifically into primary care or they want to own a primary care practice. That's why I was doing my fellowship to try to offer that I haven't gotten much people like signing in basically signing up for it. Right. And so that's why it's on pause right now. But regardless, I would have wanted to kind of taken a longer time in selecting it because I felt like I didn't get the help that I was told I was going to get from when my interviews, it was a different kind of picture. I even try to like shadow each provider my first day before I decided made my decision. And it seemed okay. So it was just, you know, I just wish I had picked a place where maybe it was a better transition where they wouldn't just put, you know, all they did is give me 15 minute breaks, basically, in like the morning, one 15 minute break in the morning, one 15 minute break in the afternoon. That's only kind of like help I got to adjust to my schedule. This is a brand new EMR for me. I was brand new. I felt like certain places like they do a better transition into like the world because it's so overwhelming. Primary care is you have to know a little bit about not a little bit, you have to know a lot about many, many conditions. It's unlimited what you're supposed to know. And we're supposed to stay on top of all the information. So and you're supposed to, you know, it's you can't mess up and practice. If you do, it's people's lives. You don't it's just a lot of a lot of a very like, stressful beginning. So that's why I would have liked to pick a better place maybe to start if I had but that's why I wanted to try to provide them my fellowship for new students.

Ahmad:

That's really, that's really sweet to hear, actually, and creating opportunities like that only makes the next generation of students at least have better experiences because 30 minute break for a 12 to 15 hour shift is not a lot. 

Ms. Herrera:

Yeah, it was a 15 minute. Yeah, 30 minute break total. Yeah. And then this

post my lunch, but still, it's just like, you would have wanted a little bit more time. And I would havewanted a little bit more orientation. Yeah.

Ahmad:

Okay, My last question is, it's kind of directed to me, actually. But I'm currently in high school. I'm, I'm thinking about doing like pre med, like trying to become like a nurse protection, nurse practitioner, or like a physician in the future. Yeah, what would be the one advice that you would give that, like, would help like high schoolers, college students?

Ms. Herrera:

Well, I know it's very competitive. So you want to make sure that it's, it's definitely your, your, your, it's a big decision, because it's, it's, you know, you have to hang in there. And it's a long journey. So you want to make sure you really want to do it. You're not just in it for like compensation, because it's not going to take you far at all. Once you're in there, you have to have empathy, you have to have the drive and motivation. So you want to make sure that you really have those, you know, that in you in order to be able to start that journey. And then also, just like you're doing is getting volunteering, that's smart, you know, getting experience, I feel like now schools offer so much, like so many certificates. Now, before you even graduate, you can be a medical assistant, I think, like, EMTs, you know, there's so many things that you could take advantage of in school, and also, free college courses, right, AP and trying to take as much as you can, as you but also not overwhelm yourself and be realistic with what you can handle. But trying to take advantage of like, I did bio, AP bio, and my senior year, and I got to skip bio 101, 102, because I got a, you know, at that time, you had to have a four out of four for your AP classes. Now it's three out of four. So I feel like now, you definitely take advantage of that volunteer like you're doing. And just make sure you still keep aligned with what you look into yourself, like, do I still want to do this? And this is still my what I, you know, my passion, and just check in on yourself, you know, every, every once in a while, so you make sure you're still on the right track. There's so many healthcare professions as well. It's nice, you have that variety, you know, especially if you want to go into primary care, definitely, you have to, it's a lot of work. And we don't, now we have a shortage in physicians for primary care. So it's very, it's much, much needed. That's why MPs and PAs are kind of taking over a little bit the primary care field, just because of the lack of primary care physicians. So you definitely need it. And, and yeah, that's what I would say for advice.

Ahmad:

That genuinely helped a lot. And yeah, that's all the questions that I have for you today. Thank you so much for taking the time to speak with me. I truly appreciated it. And I'm confident that our readers from our blog will definitely benefit from this. 

Ms. Herrera:

Yeah, and I think I just want to correct myself. I had said 70% MPs get, I think, an 80% 70 to 80% compensation for that position.

Ahmad:

Okay, thank you so much. Have a good day. 

Ms. Herrera:

You too. Thanks.