Voices in Health and Wellness

Why Aren't Doctors Taught How to Run a Business? with Dr Danielle Lewis

Dr Andrew Greenland Season 1 Episode 133

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Most clinics don’t fail because the care is bad. They fail because the business model, systems, and boundaries never get built. We’re joined by Dr Danielle Lewis, founder of Harmony Integrative Healthcare, to talk honestly about what it takes to run a sustainable naturopathic and functional medicine practice while staying grounded in excellent patient care. 

Dr Lewis shares how early exposure to holistic health shaped her clinical lens, then walks us through the real evolution of a women’s health clinic: the moment you realise you’re undercharging, the pressure of loans and overheads, and the decision to stop trying to “see everyone” and instead specialise in hormones, thyroid, fertility, and complex gynaecological concerns. We also unpack the membership-based model she now uses and why it improves follow-through, keeps patients accountable, and protects the long-term maintenance phase that so often gets missed in fee-for-service care. 

We go deep on the parts nobody teaches in medical training: market research, pricing, coaching, mindset shifts, hiring, and leadership. Dr Lewis explains her team structure, the communication systems that protect the patient experience, and the personal routines and boundaries that reduce stress. Finally, we explore multi-state virtual practice across Arizona, Maryland, and DC, including scope-of-practice limits around prescribing and acupuncture, and what that means for operations and advocacy. 

If you’re building a clinic, leading a team, or rethinking how integrative healthcare should work, this conversation will give you practical ideas you can use today. Subscribe, share with a colleague, and leave a review telling us what you want to improve in your own practice.

Guest Biography

 
Dr Danielle Lewis, NMD is the founder of Harmony Integrative Healthcare, a naturopathic medical practice specialising in women's health, hormones, thyroid disorders and fertility.
 
Now celebrating more than ten years in practice, Danielle has built a successful multi-state clinic and developed a membership-based care model designed to improve patient accountability and long-term outcomes. Alongside clinical practice, she teaches gynaecology at her alma mater, mentors future practitioners and is passionate about helping clinicians bridge the gap between excellent patient care and sustainable business ownership.

About Dr Andrew Greenland

Dr Andrew Greenland is a UK-based medical doctor and founder of Greenland Medical, specialising in Integrative and Functional Medicine. With dual training in conventional and root-cause approaches, he helps individuals optimise health, performance, and longevity — with a focus on cognitive resilience and healthy ageing.

Voices in Health and Wellness features meaningful conversations at the intersection of medicine, lifestyle, and human potential — with clinicians, scientists, and thinkers shaping the future of care.

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Welcome And Guest Introduction

Dr Andrew Greenland

So, welcome to another episode of Voices in Health and Wellness. This is the show where we explore the business, operational, and leadership side of healthcare with practitioners who are building successful clinics and redefining modern care. Today's guest is Dr. Danielle Lewis, founder of Harmony Integrative Healthcare in Phoenix, Arizona. Danielle is a naturopathic doctor with more than a decade of clinical experience specializing in women's health, including hormones, thyroid conditions, and fertility. She operates across multiple states and successfully implemented a practitioner, a membership-based model, and brings a unique perspective on the challenges that healthcare professionals face when balancing clinical excellence with business growth. So, Daniel, welcome to the show. Thank you so much for joining us today.

Dr Danielle Lewis

Thank you so much for having me.

A Childhood Shaped By Holistic Care

Dr Andrew Greenland

So maybe we can start at the beginning, if we will, rewind to the beginning of your career, and maybe just talk about your journey and what drew you into naturopathic medicine in the first place.

Dr Danielle Lewis

Yeah, absolutely. I always describe my mother as being the number one naturopath. And so I was exposed to this type of medicine without knowing that it was an official degree early on in life. And so me and my sisters all had various, you know, childhood things that we dealt with, but my mom was very adamant, I would say, about um finding more holistic ways of treating us. So I'll use myself as an example. I had eczema, really bad eczema, the type that when the seasons would change, my skin would crack and bleed. Um, and instead of her just putting me on several rounds of steroids, she did her research and I and ended up putting me on a nutritional plan that was seasonal. So she worked with my digestion, which we are, you know, now being a naturopath, I'm fully aware of the implications of, you know, how diet plays into the inflammatory process associated with eczema and any form of dermatitis, really. Um, and so I grew up with um that way of thinking about medicine. And so I knew I wanted to be a doctor, but my way of practicing or what I knew as medicine was different than kind of the conventional model we see um here in the US. And I found a person who was an astropathic doctor, had never heard of it before, and um, and started to explore that and was really drawn to the fact that it's the combination of both conventional medicine with holistic um characteristics to it, with the herbal, the herbal piece, the oriental medicine piece, Ayurvedic medicine, all of those types of things, lifestyle medicine, which is how I was, which is how I was raised. I've been getting acupuncture since I was 10 years old. I've um homeopathy saved my mom's life. Um, so that's what really drew me to becoming a naturopathic doctor.

From Undercharging To Sustainable Pricing

Dr Andrew Greenland

Fantastic. So tell us about where you're at today in 2026. What have you created? What's your practice look like at the moment?

Dr Danielle Lewis

So I'm actually 10 years in practice this year, which I I've been, it's been a part of my milestone celebrations with my social media because I think it is something to definitely celebrate, especially with being like a small, a small practice. Um, so 10 years in, I did do after I went to naturopathic medical school, I did two years of residency intentionally in a successful business because I wanted to see what it looked like to run a successful business because I know it's not easy. And then right after residency, I started my own practice. And and so it has definitely evolved over the years, I would say. Like I was definitely undercharging early on in practice. I think my new patient visits were, I think I was charging like $97 or something like that. And my overhead was low at the time, it was sustainable for me and my lifestyle. But then when student loans started to kick in and and all of it, and life started lifing, and you wanted to like buy a house and all these things, it's like, okay, either I'm seeing 100 patients a day or I'm going to change this um this model. And so I accredit a lot of my journey. And what I tell people is that if you're going into medicine and you're going to be a business owner, you have to be flexible. You have to be willing to go with the flow, kind of ebb and flow with the times. And so I was fee for service initially, and then I gradually I got coaching. Um, and coaching can be a little bit tricky because you have to figure out what type of coach you need, and sometimes that's hard to figure out. Um, but you know, I had coaching around figuring out my worth. I had coaching around um financially figuring out what I should realistically charge that would still make me accessible to my patients, but still um allowed me to pay my bills, basically. Um, and then over the years, I've kind of evolved into this membership model. And what I like about the membership model is that it um it allows my patients to be invested in their health from the beginning. So you're we're both kind of entering into a contract with each other where you're the patient is um committing to showing up and doing the work. And because they're financially committed, they're more likely to show up and do the work. Um and for and I'm and I'm committing to showing up and and providing you know high-level guidance, which I've always done for my patients through through their care. Um and so, but what that membership looks like has kind of evolved um over the years, um, especially just recently, because financially, you know, especially in the US, there are um there like uh people's financial situations have changed drastically over the past couple of years. So we have to, like I've figured out, still keeping the membership model, what that what that looks like to continue, because my big thing is continuing to be accessible to my patients since I don't accept insurance.

Dr Andrew Greenland

Thank you. Great insight. So I want to dig into the the business side of things a little bit later on because it's really helpful. And congratulations, by the way, on your anniversary. That's a landmark achievement. So well done. But

Early Vision For Women’s Health Options

Dr Andrew Greenland

thinking about that that time when you initially opened your practice, what was your vision at that point before you gleaned all these great learnings about how you were going to do things? What was your kind of grand plan when you just opened your and opened your door?

Dr Danielle Lewis

You know, I feel like you're when you first graduate from medical school, you're like this uh rose-colored glasses. You know, I want to help everybody. I want to do, I want to give everybody these kind of long drawn-out treatment plans, you know, with all this information that they've never heard before, because it's a whole different way of thinking about their health. And I have like all the information that they that they need. Um, and so I would say in the very beginning, I was just like, oh, I have something, I have options for patients, especially women's health, especially minority women's health, um, in regards to I wanted to really educate people on um different ways and and and open their minds to different options when it came to their diagnoses. So, for example, maybe so a patient that um that has been diagnosed with like fibroids or endometriosis or something like that, instead of just going the birth control route, which is typically what's recommended to manage the symptoms associated with endometriosis and fibroids along with other things, it's like what are the lifestyle things that we can do in order, like in order to give you more autonomy around your health and give you more control so you don't just feel like you're defeated and you're just treating the symptoms and you're not trying to get to the root cause of you know kind of how we got here and manage your symptoms from um a different standpoint than just going on birth control, especially because a lot of my patients that I see don't necessarily tolerate the birth control or want to or want to be on it. And so, like that was my big overarching. Like, I want to give women options, I want to give women autonomy, I want to show women that by making different lifestyle choices, they they can manage um their their symptoms and feel much better without creating other side effects.

Niching Down To Hormones And Fertility

Dr Andrew Greenland

Got it, thank you. So you said at the beginning you wanted to sort of see everybody and basically solve all the problems, and then you've kind of specialized down more to facility women's health hormones. What kind of helped you or decided helped you decide to specialize on those particular areas? What were the things that drove that?

Dr Danielle Lewis

I feel like it was partially driven by the majority of the patients that I ended up that kind of naturally navigated towards me in my last two years of school and clinical practice, and then in the two years of residency that I did, I kind of like naturally was put on those cases or those cases, like even to the point that classmates that were coming to clinic would request me to do like the Royal Women's Exams and different things like that. And then the way also my residency was set up that I was 80% of the time with an in a naturopathic clinic, and then 20% of the time in a in a conventional OB Gyne clinic. And so that was the foundation that my training ended up going in. And I'm a woman, so I was like, I can resonate with a lot of the issues that that my patients are are dealing with, and I just saw a huge need um for it. And so, you know, kind of going back to my coaching, one of the things that my coaches were like, okay, I get it. You go to school, you learn everything, right? But really, from a business standpoint, you need to niche down, you need to figure out what your niche is. Like you can do everything, but what is that one thing that you want to do well? And so then that was probably within my first two years of practice is when I had that coaching, and that really drove me to change my branding and everything, and and draw in from where my passion was and hone in on um becoming a women's health expert um and and aligning myself with that with that vision.

How Membership Changes Patient Follow Through

Dr Andrew Greenland

Thank you. So you talked about the membership model and the reasons why you've chosen it. What might it look like for a typical patient? Like if you think of a typical patient with a particular problem, how does that journey map out for that particular patient as compared to a kind of um fee for service model where they're kind of checking in erratically?

Dr Danielle Lewis

Yeah, yeah. So I'll kind of give like a side-by-side of what that looks like. So prior to implementing membership, um, I'll use uh fertility patients for instance. So I had you know patients that would come in for their initial visit. I always schedule them for the follow-up before they leave. This is on under the fee before I implemented the membership model. I would sign them up. They would usually come in at least for because at their second visit, they're usually doing uh a lab review. Um, so they would come in for the lab review, and then I would outline for them kind of what their timeline of care was going to look like, how often I want to see them, schedule them for their next visit, and then I would look up and, you know, kind of for two reasons. Either maybe they were a little bit overwhelmed by the process of things they had to do, even though I do my best to set expectations within those first two visits for my patients. Um, they maybe they're like, oh, well, I haven't done this part of my treatment plan, I haven't done that. So they start moving their appointments out. So I'm moving them out, start moving them, moving them, moving them. Um, or they're rescheduling, or, you know, maybe they're really good, they implement what they need to, and they start feeling a little bit better, not understanding that there's kind of that initial where, like in the first part of that treatment plan, when you're gun-ho and you're implementing things, inevitably you're gonna feel better. But there's the aspect of the maintenance piece of it and making sure that we're staying on track with each, because as life happens, like the holidays come around, stress events happen, like that can throw a wrench in your plan. And sometimes things, you know, I hear from people, you know, six months, a year later, where like basically everything has hit the fan and now they're kind of back to ground zero and they've come back into, and now they want to come back and see me to get back on track, versus um uh my for like my membership patients. Um, and I I won't just say fertility, I would say, you know, especially like my perimenopausal menopausal patients where things are fluctuating pretty quickly. What happens is it's like there's this understood agreement. Like I'm going to see you every four weeks, six weeks, eight weeks, whatever part of the membership that they sign up for. We're gonna schedule these visits. There's this understanding that like this is the plan over the course of the year, you've already invested in that. And I just found that these patients, like they show up, they don't tend to reschedule their appointments, and they, you know, they still have that initial, like, okay, within I'm feeling a difference within the first, you know, two to four visits. But then I just had a discussion with a patient of mine who did really well within like her first four visits and really attained her goals. And I'm like, well, now this is the this is the part where we need to sustain this. And all those habits that you've implemented that are kind of new for you. It's important for us to keep those habits and for you to use me as your accountability partner and we check in so that we maintain this because you didn't get here overnight, and so we don't want you to go back to um experiencing the symptoms and and having to start and less and starting over again. And I just find that the membership model really just that accountability piece of it and just showing up because you're invested in your health is has been a key for people getting better and staying better.

Dr Andrew Greenland

Thank you. Nice, nice contrast to explain the difference between the two. So thank you for that. So

Why Clinicians Struggle With Business Skills

Dr Andrew Greenland

when we spoke before, and also on on this call already, you've kind of alluded to the fact that there's a huge need for business training for doctors or practitioners. Um, what do you think practitioners are taught well during their clinical training and what are they not taught in this regard?

Dr Danielle Lewis

In regards to business.

Dr Andrew Greenland

Yeah.

Dr Danielle Lewis

Oh I mean, I feel like that's a load of questions. I feel like we um we learn how to be physicians really well. And I feel like we get like a like a very basic overview of running a business. So I I as far as like medical school training, I don't think that our business training is up to par. I I tell because I I teach gynecology at my alma mater, and I tell my students all the time, like if you want to do business, or even if you want to go into like the academic sector, like you need to align with people and find mentors and do, and you're going to have to like as far in regards to your business plan, a part of that needs to be allowing for an investment in coaching. And or like, I mean, there's a bunch of online, you know, in the in the world of AI and everything, there's also a bunch of like online um trainings that you can that you can do in this regard. But I I don't feel that when we graduate, we're set up to be business owners at all. I don't.

Dr Andrew Greenland

No, I agree, I totally agree. So why do you think so many talented clinicians struggle with the business side of healthcare? Is it because the lack of training during their training for this, or the lack of um investing in themselves after training to kind of take themselves to another level of developing these business skills, or do you think there are some other factors in there as well?

Dr Danielle Lewis

I think both of those are key. Lack of training, I think not knowing what type of training, because there's so much out there, right? So when you're first starting off, um it's it's difficult to know, and it's expensive. Like some of these courses are these courses, like I probably spends have spent tens of thousands of dollars on like post-school after we're not gonna discuss student loans and what that looks like um um afterwards in coaching. So I think it's um, you know, especially as naturopathic physicians, we it's not like we graduate and you you go to residency and you find a path and you walk into a career because we're not licensed in all states. And so some people like you're really a lot of times trying to set up where you're at and uh understanding like market research, like figuring out what market you're going into, figuring out what patients you want to see, who will come to you, how to get them to find you, how to build your website. I mean, there's so many. I think my initial coach that I worked with, she gave me a to-do list that was like 10 pages long of things just like get my business set up, how to do my PLLC, um, and then the and and um my business plan, if I was going to apply for loans, what that looked like, if I was going to self-finance, what financially that needed to look like. So there's a lot of moving pieces that we're just not, that we're just not set up for. And I remember sitting in my business courses and going through them, and it was like a lot of stuff was going over my head because number one, I have a neuro exam the next day or like something. So my priority and my mindset is kind of focused on that. And I'm trying to break down this is like a whole new way of thinking. I don't know if you're familiar with the book Rich Dad, Poor Dad by Robert Kawasaki. And so my dad had me read that book while I was in medical school because there is a paradigm, and I was raised in a paradigm too, where like you go to work, you earn your paycheck, you get you you invest in your 401k, you know, and you you prepare for retirement and you get all the insurances you need to make sure you're covered along the way so that you can hopefully retire one day. And so I think that that's also a big thing of it is the mindset, and I and I did life coaching around that too, in regards to my mindset around being a business owner because there's a different mindset in collecting a paycheck every day versus like, oh, I'm responsible. Like if I don't work, I don't get paid. So, how do I set myself up for getting paid when I don't work? And am I comfortable with that? Um, and you know, I probably held two or three jobs alongside of starting my business for the first three to five years, kind of on and off. And then after that, I was like, I'm going to put all my energy into my business and just live off of my business. But it took me, it took me a while to get comfortable with that. So I think mindset is another big part of it, along with just the learning the logistics of um what it means to run a business and be an entrepreneur.

Mentors, Mindset, And Staying Flexible

Dr Andrew Greenland

Thank you. I chuckled earlier on when you said that your coach threw you 10 pages of things to do, and it just reminds you of the kind of things that we do to our patients, and we give them all this information at the beginning. So I just saw quite an amusing parallel there. Um so obviously, you've been in um practice for about 10 years, you've had your 10-year anniversary, which is amazing. Um, apart from the membership model, which is something you've really kind of learned and developed, are there any other big lessons that you can think of um that you've kind of gleaned over the years that have really changed the game for what you do?

Dr Danielle Lewis

Um, I so I would say just like in life and business, who you surround yourself with is important from a business model. That includes like any employee or contractor that maybe you hire, um, who your business mentors are. I think it's important to always have mentors who are sitting where you want to be that are willing to support you and offer you. They might not coach you and hold your hand through everything, but you can bounce ideas off of them. I think that that's very important. Um I the flexibility, like being, you can't, you can't sit anything in your business and forget it. You're constantly revisiting it. Like I just recently um changed my business model within the past two months, according to like what's happening financially here in the US. So it's instead of going directly into kind of my big ticket item, I have pathways to allow people that are at a lower price point to allow people to work with me, get to know me, kind of see my style, and then we go into the big ticket from there. And so you have to be willing to revisit your business and and redo your market research and see what's going on and then adjust with the times. Um, and I will say, like, I have an amazing business manager who, you know, allows me to kind of take partial, partial, a partial part of my business hat off because she's kind of that person who's always, you know, doing market research, telling me where it's like she's patient-facing, and so she's listening to the patients, they're bringing that back to me. And then we make those adjustments so I can focus more on on patient care. And I, you know, I've heard several of my colleagues be like, Well, I can't afford a VA or I can't afford, and so they're doing everything themselves. And I would say that's probably the third takeaway is um you like you once you get to that level, there's only there's only so Much that you can grow with doing everything yourselves, you're going to have to start hiring people around you that to do what they went to school for or what they're trained to do, so that you can focus on you know being a doctor, you know, and a business owner, but have but have that support. So I would say those are probably my biggest lessons over the years.

Dr Andrew Greenland

Lovely, really good gems. I like that. Thank you very much.

Team Structure For A Virtual Clinic

Dr Andrew Greenland

So you've mentioned uh team members just now. So what does your team structure look like today?

Dr Danielle Lewis

So I have so I'm most I'm now like 80% virtual, 10% in person. I am licensed in Arizona, Maryland, and DC. And so I see patients in all of those states virtually. Um, and then I go back and forth to Phoenix about once every eight weeks to see patients in person. Um, I do have like one practitioner who is there to do in-person stuff when I'm not there, like acupuncture and stuff like that, that I can't do virtually. And then I have a virtual assistant, and her primary job is making sure my phones get answered, um, kind of doing the day-to-day monotonous stuff, like making sure labs are in chart notes, um, things get fast, um, kind of like those daily tasks. And then she also helps with my uh with my marketing um piece, my my social media, I would say more so than marketing is what is what she does. And then um I have a office manager who is like she patiently, she's she basically is the liaison between new patients, especially, and help um educating patients about my paradigm and getting them on the schedule. Um, and then um my branding, she manages my well really me, she manages me too, and my and my virtual assistant, um, and is is like my my background person. So she runs like my day-to-day operations, my financials, my billing, all of those types of things.

Dr Andrew Greenland

Very impressive. And with that, how has your kind of leadership style changed over the years as you've developed and growing your team?

Dr Danielle Lewis

I had to learn, you know, like I've I've definitely have gone through a couple of medical assistants and virtual assistants. This is my first time having an office manager too. And so I would like I'm because I'm a very laid-back, easy-going person. Um and I think like I don't feel like I become a new person when it comes to business leadership or anything like that, but I had to, I had to get clear on what my vision was and what um what type of environment I wanted to offer to people. Because if I'm if I'm not clear on that, then how do I how do I train the people who work for me or around me what that what that looks like and the type of environment that I want my patients to come into. And so I would say that I'm very um I'm very direct. Um, however, I I like to meet my employees where they're at, but I've also had to learn to um to when something's not working to let it go, you know. So like whether that's like the person who maybe is working for me, you know, like if we're just not seeing eye to eye or this just isn't working, or like you're just not subscribing to the vision of my practice, like it's okay. Um, you know, like we're just not a good fit and it's time for us to part ways. Um, if part of my coaching was to if somebody who's working for me is maybe not showing up in the way that I want, then I need to reassess my leadership style too, or my management style. And so, you know, that goes back to like definitely having more touch points, like, you know, getting together, having meetings, even if it's like a five-minute meeting to make sure everybody is clear, everybody feels supported, all those things. And then we move through our week, making sure I have clear, like I there's a lot of spreadsheets and Google Docs going through my practice to with check-in points, things that they need from me to make sure I'm getting them what they need to support them on their job, and then making sure that um my expectations, those KPIs are, you know, are um are aligned and we're all on the same page versus kind of being like, this person's over here, this person's over here, which I would say over the years was kind of the case. It was like I was here and this person was here, and then it took me a while to realize it because we weren't really communicating it well, versus now I'm big on communication, regular communication, regular meetings. We have these docs that we all check into, um, and and then and then making sure that we're all kind of assessing each other and including them assessing me and what they what they need for me to make sure that at the end of the day, my number one priority is the patient experience. Whatever we have to do in the background to make sure that patient experience is equivalent to the value that they're that they're perceiving that they want to receive, then then that's then that's what's matters. So I would break it down to definitely communication, regular meetings, and being and and organizing, but still within that being flexible in regards to this isn't working, let's change this. Um, but tapping into that and making sure we're addressing that on a regular basis.

Dr Andrew Greenland

Thank

Leadership Systems That Protect Patient Experience

Dr Andrew Greenland

you. I think you may have already answered this, or ask it anyway, because there may be some other things that are play. So, what systems have had the biggest impact on reducing you know your personal stress and improving efficiency and the practice and the way you run things? I guess a lot of what you were just saying around staffing and the interactions and the touch points may be one aspect, but is there anything else that you've kind of discovered on your travels?

Dr Danielle Lewis

Um goodness gracious, therapy? Just kidding. I'm not kidding. I think you have to you have to learn yourself, you know. I think that it's important for you to really dive deep into the values that you've set up for your practice and be clear on the type of practice that you're running. Like I I had to tell myself that I'm not emergency medicine. Like that's kind of an ongoing, ongoing thing. And so being clear, so like my patients, if they send a message, it's clear that I will get back to you within so many days. And um, and I, you know, you're not gonna get an answer right away, but it's it's like setting up expectations um for things, me personally um setting boundaries too within that. Um, and and having this, I would say the specific kind of online systems is like within my EMR, there are tasks, like I create tasks. So if I'm shutting down at the end of the day and nothing, I have to tell myself, nothing's gonna get done after this certain time of the evening, right? So let me send these tasks and they'll be seen in the morning. I can set levels for how critical or not critical those tasks are, and that's and that's tomorrow's problems, right? That's tomorrow's issue that we can because I'm not emergency medicine. Um from a health standpoint, I would say having a morning routine is very, very important. Like pouring into my cup first before I start into the day with my business and my practice is really important. So I have a dog, so I get up, I feed her, I walk her, taking care of her makes me happy. You know, those types of things. I have my tea that gives me energy because I don't tolerate coffee, but I have like my teas that I have, open my blinds, I see the sunlight, I've got a little bit of sunlight from walking with my dog, and then I kind of do a morning meditation and or and or prayer, and and then I ease into my day instead of just kind of jumping right into my day. And I feel like that really helps to set the tone for how I interact with my patients and my employees, um, and allows me to be able to be present and have the energy, the mental and physical energy to get through, you know, some busy, some busy days without feeling burnt out at night. Not that it doesn't happen, because you know, Mercury always goes into retrograde, I feel like it and life happens. I feel like last week was one of those weeks where like everything was happening. Um but you know, my goal is always to start my day off in a way that sets me, sets me and my team up for success.

Dr Andrew Greenland

I

Boundaries, Routines, And Reducing Stress

Dr Andrew Greenland

love it. I have my own morning routine as well. I'm completely with you on that one. Now, one challenge that's unique to your experience is operating across states with very different naturopathic regulations. So, how can you explain to us how Arizona differs from some of the East Coast states and how do those differences affect patient care and your kind of business operations?

Dr Danielle Lewis

So, Arizona has, when we talk about scope of practice, that means like what I can do legally under my license in that state. And so Arizona has one of the best scope of practices, and that's where I was trained, and that's where I worked for solely for um about 13, 14 years. And so in Arizona, I can basically be considered a primary care physician. I can prescribe um with very little limitations, and the stuff that I can't prescribe, I wouldn't want to prescribe anyway, like opiates and stuff like that. Um and I can do acupuncture in that state. I can um I can run labs and those can be billed through insurance. There are um insurance won't cover my services, but if somebody has something called like a health savings account, then they can use that to pay for my services and for their supplements and if they have a copay on their lab, stuff like that. Um, in Maryland and DC, the scope of practice isn't as broad. So, for example, I cannot do acupuncture in Maryland or D.C. I can only do that um in Arizona because I did not actually get a separate degree as an acupuncturist. My degree fell under my naturopathic doctor license that I received from Sonoran University in Arizona. Um, and so I cannot do those um in DC or Maryland. Um I can I can run labs in DC and Maryland, and insurance can be billed for those labs. You can still use your HSA to pay for services and code pays and supplements in DC and Maryland. Um, however, in Maryland, unlike DC and Arizona, I cannot prescribe medications. I can't modify medications, any of those things. So if somebody comes to me and I feel like according to their labs, they need to, they need to be put on thyroid medication. I have to refer them to an endocrinologist or a primary care that prescribes those and manages those for them. And I become more of like an advocate or a liaison person for them. In DC, I can prescribe, but we have a very limited formulary that hasn't been um updated in several years. But I can do because I do prescribe hormones and I can prescribe those at least in DC. And so the challenge has been, has been kind of like I have to know where my patients are, because it's where they sit now, where I sit, as far as um what I can and cannot um do for them. Um and it's like it's turning on those different parts of my brain. So like the first year it kind of drove me crazy a little bit because I'd have to be like, where are you from? Oh, I can't. And then it's like I'm so used to being able to manage medications myself in Arizona that it was a little bit frustrating. But, you know, I'm starting to settle into it. I'm figuring it out, I'm learning how to educate my patients around it. They, you know, they're they're frustrated by it too, but they understand. Um, and you know, and I'm also a big advocate. Like I've testified before, you know, the Senate and House of Delegates and everything in Maryland to try to expand our scope of practice to include licensure in the state of Maryland. So I'm also going to advocate for what I want too. So that's a work in progress, but um, it's it it just takes once again being being organized and teaching my my staff too when somebody calls, I need to know what state they're calling from so I know what I can and cannot do for them under my license in that state.

Dr Andrew Greenland

That's

Working Across States With Different Rules

Dr Andrew Greenland

really helpful clarification. Thank you. So as a business owner, you wear all the hats, or you probably managed to do a bit more delegation now, you've got a very good team behind you. But what's the what are the biggest time drains for you even now in 2026 that take you away from the things that you like in terms of running the business?

Dr Danielle Lewis

Um, chart notes. The inevitable chart notes. I'm sure you understand that. I feel like that when I go online and my doctor groups, it's like, how can we be more efficient with chart notes? And you know, we have EMR and stuff like that that was supposed to make us more efficient, but I don't know. There was a research article that came out that I totally agree with after EMR had been our electronic medical records had been around for like four or five years, and it was like it's not it's not helping us to be more, to be more efficient, more legible, but not necessarily more efficient. Um, and then I my Office Magic gets on me all the time about this because she's like, I mean, I like to talk, I like to educate, I like to do all those things, and I'm learning that it can be overwhelming from my patients. Um, and it's a lot, it's a lot of energy from me too. So over the years I've had to learn how to still be personable, but you know, efficiently guide the conversation, the direction to get the information that I need in order to better serve that patient. Um and then just like the the the behind the scenes business management, the operations. I mean, even though my office manager does some of it, there's a lot of it still lies on me, the financial piece of it, uh managing that, making sure that I'm staying organized with that so that you know I can pay my taxes and pay my bills and you know, put money aside to grow the practice and and then forming, especially being on the East Coast, I'm new out here, right? So it's like net, you know, networking and um meeting people. Like I had an event this past weekend that was lovely, but it was a lot of work to like get it set up and get people to come out and do the marketing. And for me, like my part I play in the marketing now is I have to get my my um social media person videos. I gotta do videos, and I don't necessarily like doing videos and everything and taking the time to do that. You know, even meeting up with you is like it's I have to kind of do the one, two, three tactic of like, okay, Dr. Greenland hit me up about this podcast. I should do it. Should I not do it? Like, not to overthink stuff and just being like one, two, three, let's talk. Let's talk. You and I had our discussion, it was lovely, and then you invited me on. Um, but even stuff like that, because I've definitely done podcasts in the past that took up a lot of my time, which you did not, I appreciate you. Um, but um, you know, and they never got played because something happened with the sound or something happened with um, you know, they just did not decide to to air it because their business went a different direction from what we talked about and the podcast. And so I would say that the management piece of like the networking and growth and being the voice of your brand and everything can be can be very time consuming.

Time Drains, Marketing, And Staying Visible

Dr Andrew Greenland

For sure. It completely resonates with that. So at this stage, obviously you've got a very well-developed business, but is there anything that still keeps you up at night? And is there anything that you wish you could have a magic wander solve by tomorrow morning?

Dr Danielle Lewis

Yeah, I mean, if I could um oh gosh, that's a load of questions. That's a good question. Keep me, well, sorry, keeping me up at night. I mean, I I just I care so deeply for my patients. Sometimes, like I get some pretty complicated cases where like I give the treatment plan and I worry about them until they come back and tell me if they're doing better or not. And I worry that I'm gonna wake up to a message saying that I gave them the dumbest treatment plan ever or something like that. I don't know. It's just like the pressure I put on myself with my patients. Um, I worry that my messaging to like, especially as I grow my social media, that you know how well received my messaging and like people are people gonna understand how passionate and how much I want to help. Is that coming through in my messaging? I would say those are like my my big things, which is which has held me back from doing a lot of marketing in the past, but I've really pushed through that this year, I would say, this past year. Um, and then my magic wand, I mean, if my magic wand, if I could just have naturopathic and functional medicine, when people talk about um preventative medicine, you know, in the conventional world, a lot of times that's vaccines and stuff like that. And I'm not an anti-vaxxer, you know, for all of them. But like, but you know, that to me is not preventative medicine. I want preventative medicine to be like lifestyle. I want people to recognize that by like making, like by working with a functional medicine doctor or naturopathic doctor, and really honing in on like the lifestyle and and the implications of stress and just learning to breathe and doing these things that seem you know supporting their emunctories and detox pathways and stuff like that, like the value in that, and if that would become kind of mainstream medicine, that would make me very happy. Like if I could wave my magic wand and just like have you know the government and and people in general, when we talk about empowering them around their health, understand that what we have to offer is preventative medicine, I think that the world would be a much better place.

Dr Andrew Greenland

Sure.

Worries, Preventative Medicine, And Next Steps

Dr Andrew Greenland

And finally, what does the future look like for you? What where would you like to be in 12 months' time, either sort of personally, professionally, or with harmony? Where do you see things going?

Dr Danielle Lewis

Um, I would like to um bring in another practitioner. I want to um definitely do that. And I so I who to do the more of my my membership and my one-on-one care, because I want to move more into like group, um, group care, educational courses, more like webinar or online courses so that I can educate more than one person at a time. I feel like it's time to kind of move to like that broader scale of um, you know, speaking engagements, maybe even um corporate engagements where I can be in front of a room of people, um, whether in person or online, um, to have a larger, a larger impact um and and really serve that educational piece that is has been a passion of mine since the beginning.

Dr Andrew Greenland

And with that, Daniel, I'd love to thank you so much for joining me today. Joining me today. It's been a really interesting conversation, great insights. Thank you so much for sharing about your journey, your approach to business, what you're doing clinically, and I mean your perspective on where you were looking to take things. It's been a really enjoyable conversation. So thank you so much.

Dr Danielle Lewis

You're welcome. I appreciate you having me.