D.O. or Do Not: The Osteopathic Physician's Journey for Premed & Medical Students

Episode 49: Georgeanne Freeman D.O., M.P.H. Family Medicine Physician

June 01, 2021 Season 1 Episode 49
D.O. or Do Not: The Osteopathic Physician's Journey for Premed & Medical Students
Episode 49: Georgeanne Freeman D.O., M.P.H. Family Medicine Physician
Show Notes Transcript

In this episode, we interview Dr. Georgeanne Freeman, a family medicine physician who graduated from the University of Osteopathic Medicine and Health Sciences in Des Moines, Iowa. She then went on to complete her intern year at East Tennessee State University followed by a family medicine residency at the University of Washington. Currently, Dr. Freeman owns her own full-spectrum family medicine practice called Downtown Doctor in Austin, Texas. She is also the founder of Hippo Hydrate, which provides rehydration treatments for a variety of ailments.

Hosted by Madli Vahtra 
Edited by Thomas Jasionwski

My name is Dr. Ian Storch. I'm a board-certified gastroenterologist and osteopathic physician,

and you are listening to DO or DO NOT. If you are interested in joining our team or

have suggestions or comments, please contact us at DoOrDoNotPodcast.com. Share our link

with your friends and like us on Apple Podcasts, Facebook, Twitter, and Instagram. We hope

you enjoy this episode. Hi, listeners. My name is Madly, and you

are listening to DO or DO NOT. On today's episode, we are talking with Dr. Georgianne

Freeman, who is a family medicine physician. She graduated from the University of Osteopathic

Medicine and Health Sciences in Des Moines, Iowa. Dr. Freeman then went on to complete

her intern year at East Tennessee State University, followed by a family medicine residency at

the University of Washington. Currently, Dr. Freeman owns her own full-spectrum family

medicine practice called Downtown Doctor in Austin, Texas. She is also the founder of

Hippohydrate, providing rehydration therapy for a variety of ailments. We hope you enjoy

this episode. All right. Thank you so much again, Dr. Freeman,

for joining us today. It's my absolute pleasure. I'm so excited

that y'all offer this podcast for pre-med students and medical students and others.

Yeah. So we're actually excited that you reached out to us to be on our podcast, and

I'm just curious, what about our podcast speaks to you and made you want to share your journey?

Yeah. So I found out about you in an issue of the DO Journal. So the Osteopathic Journal

had a list of podcasts that are osteopathic. And I thought at this stage in my life, as

an attendant, having been an attending physician for over two decades now, I'm now them, not

us. And here's an opportunity to share my story. And if it can help someone, anyone

in the future generations, then why I'm delighted to share my story.

That's fantastic. So we're just going to dive right in. And can you just tell us about what

your day to day looks like currently? My day begins with something physical. This

is not necessarily for everyone, but for me, I find that my brain works the best if my

body is moving first. So my favorite form of body movement is swimming. I've been a

swimmer most of my life and I swim every other day. So every other morning I get up and I

swim first thing. If I don't swim, I do some gentle yoga, just some light stretching in

my living room. And then no matter what's happening, even if it makes me late for work,

I spend 10 minutes journaling. And that looks like how I want to feel throughout my day.

I get to determine how I want to feel. I set a little projection for the day. I also plan

out what I'm going to eat and what I'm going to drink for the day. Then I get dressed.

I have some tea and I go to work. And then at work, we start with a huddle where we go

over the patient list of the day and we might make comments or get prepared for something

in particular for the patient. And then I spend about seven minutes with my medical

assistant or my resident going over whatever their homework assignment was from the day

before. They present that and then we see patients. I break for lunch at some point.

And I finish my clinic day and then I go and have fun.

What do you like to do for fun, Dr. Freeman?

I like to golf. I like to walk. So there's a common theme here, right? Like I'm very

physical. I like to play frisbee. What else do I do? I might journal a little bit. I'll

make dinner at some point. I'm recently single, so I might go on a date. That's probably my

most fun thing actually is to go on a date.

Well, all of those things sound great. That's a great way to wrap up your day. So when and

how did you become interested in medicine and decide that you wanted to be a doctor?

My father is a retired surgeon and I was always interested in medicine, making rounds with

him from the time I was nine, learning how to suture and help him with his post-ops by

the time I was 10 or 11, working in his offices in the summers. I never saw myself as being

a doctor though. I don't even remember it ever crossing my mind. It seemed like a pretty

heinous schedule, a lot of commitments, a lot of responsibilities. I was not interested.

I was not pre-med in undergrad either. I got interested in medicine after I graduated from

medical school. I was living in a rural part of the Ozark Mountains in Arkansas and I got

very sick and I didn't have health insurance and it was pretty terrifying. I started thinking,

gosh, I could be a country doctor. That's very different from being a surgeon in an

urban area and I could help people. So that's really when I started thinking about it.

And then how did you first learn about osteopathic school?

I had thrown my back out in a pretty intense ski accident when I was 19. My father recommended

that one of his partners do surgery on my back for the herniated disc, which was pretty

common back in those days. And I went to my school nurse, I was in college, who recommended

me to an Oriental MD physician who did acupuncture because I was very much a hippie and not interested

in taking medication. And he helped me with acupuncture. I never had back surgery. We

developed a friendship and he was definitely a mentor for me. And at some point when I

told him I thought I might be interested in acupuncture school, he explained that had

he known about the osteopathic pathway, he would have chosen that because you can have

the Eastern medicine and the Western medicine and do both. And so that was a light that

went off for me because that's what osteopathy is.

Right. And then what made you choose the school that you ultimately attended?

It's the one that accepted me. I mean, that's the true answer. Yeah.

Well, good, good. And so did you only apply to osteopathic schools?

No, I applied to osteopathic schools, a few MD schools. I applied to schools in other

countries. I would have gone anywhere to go to medical school. I remember applying to

Hungary, Mexico because I speak Spanish. I didn't apply to the Caribbean. I guess I

drew a line in the sand there.

Okay. All right. So how was your experience at your medical school? Did you do any special

extracurricular activities or research, just kind of a generalized idea of your time there?

I did not do research. I did not do anything extracurricular. Medical school was very intense

for me. I had been out of undergrad for a bit. My study habits were almost nonexistent.

I needed a lot of help and I got really good help at my school. I went to the Des Moines

University, the second oldest osteopathic school in the United States. And med school

was just all consuming for me. It was all I could do to really to succeed through medical

school, for me.

Did you take the USMLE?

I did not. I've always taken only the osteopathic boards.

How did you decide on your specialty?

I started off in surgery because I really love anatomy and I love to cut. And I came

out of the OR one day, this was up in Michigan, and I hadn't seen sunlight in several days

and it's really dark. I'm from Texas, so I'm used to sunshine. And it had been quite dark

for there for some time up there in Michigan in the winter. And I remember there was a

little bit of sunlight coming through this window as I was walking from the OR to the

women's locker room. And I just had this real longing to see outside. And I thought, geez,

Georgianne, you're not going to see much sunlight if you go into surgery. And that sparked me

to look at other options. And then family medicine is ultimately what I chose because

I can still do procedures, can still cut, can still work with my anatomy.

But the hours or the kind of time commitment is less dedicating, would you say?

I think that's more flexible. Now I know that I could probably create any schedule that

I want. And I want your folks to hear this. You're only limited by what you think your

limitations are. At the time, I thought the only way to be a surgeon was the way my father

had been a surgeon, which was just these 14, 15 hour days forever. Yeah, not really seeing

the sun and foregoing exercise and not taking the time to eat healthy food.

And I think that's a great point is you're only limited by what you set your limitations

to be. So how was the application process to residency and how did you end up choosing

your program?

Because I had decided, well, I wasn't 100% sure I was doing family medicine, but I was

headed that way. So I gave myself a year to do a rotating internship. I'm not sure how

common that is anymore. It's certainly much more common with DOs than MDs, or at least

it was back in the era that I went to residency. But I thought, well, I'm leaning towards family

medicine. And the thinking back then was you're probably better served doing a community standing

alone family medicine program. For example, when you're learning urology, you don't want

to have to be behind five or six urology residents. And then maybe family medicine gets to dissolve

the stone or place the stent. But if you're in a family medicine program, it's the only

family medicine residents and you're going to get to do more procedures. So initially

I thought that was a good idea. So I applied to standalone clinics or residency programs.

And I did my rotating internship at East Tennessee State in Kingsport, Tennessee, about halfway

through for several reasons I decided to transfer. And I committed at that point to family medicine.

So I went to an allopathic residency for my second, third, and fourth years up in Washington

State in Seattle at the University of Washington.

But overall, what was residency like for you? And do you feel that your experience was different

as a DO compared to your MB counterparts? My experience was different as a DO. I was

immediately welcomed as what I have always said, I felt like this queen, I had this queen

status all of a sudden, because the program director introduced me because I came in as

a second year to the program as, oh, we were so excited to have a DO because we didn't

have a DO match before in this class. And my goal is to always have at least one DO.

Now, y'all listen up and pay attention. And if you're lucky, she'll teach you a few hands-on

maneuvers that even us MDs can do to help people. And it's highly valuable, these hands-on

skills that they know, and they already are treating people holistically, things that

we seek to do here at the University of Washington. So I was treated better than an MD. And I

don't know, so that was unexpected and lovely. I've never felt, by the way, I love that y'all

address this so much in your podcasts. And I don't know if it's a regional thing. It

seems like there's a, well, it doesn't seem like, clearly there were places on the East

Coast that just flat out told people, we would never take a DO. I have never been told that.

The only time I was looked down upon as a DO was from my own father who was an MD and

trained in the 1950s and 1960s when there was still a stigma that DOs were second-class

physicians. He has since gotten over that, but he didn't speak to me for eight years.

When I applied to medical school and went to DO school, he, yeah, he wrote me out of

his will and didn't speak to me for eight years.

Well, I'm really sorry to hear that. That must have been really difficult for you.

Thank you. It was, it was awful. Yeah.

And then how, so following residency, how did you go about finding a job and what were

some of the steps that you took in order to start your own practice?

I was a national health service course scholar, so I had a list from which to choose for positions.

I chose the job that paid the most. Y'all listen up if you had fallen asleep at this

point, the worst reason to take a job is because they are offering the most money. Places offer

high salaries if it's a less than desirable job because that's what they have to offer.

So your brain may revolt at this at the time, but hopefully your prefrontal cortex will

win in the struggle over your amygdala and you'll give some consideration to this. So

yeah, that I chose that for that reason. And I'll skip over the first four jobs that I

had just untenable situations for a variety of reasons. And then I realized that I probably

wasn't cut out for corporate medicine because I kept questioning the way things were done.

I kept recommending that my employers pay me what it said in my contract. I know that

seems really outside the box and radical, but at the time, if you really stand up for

yourself, it is actually radical. And I thought I could do it better and I am doing it a whole

lot better. I opened my own practice as a last ditch effort. I was either going to quit

medicine or open my own practice and give this a try. And I was willing to fail and

I'm still willing to fail. And I'm going on my 10th year and my very successful private

family medicine practice in beautiful downtown Austin. And I enjoy going to work every single

day.

That's great. So this kind of brings me to my next question is currently many graduating

physicians are choosing employment over private practice or starting their own practice. Do

you think that this is because times have changed and what were some of the challenges

that you had starting your own practice?

I think that so many people think that they need to or have to go into an employment situation

because that's what they've seen and that's what they've heard. There are just a lot more

physicians who are employed. So it makes sense that even in my day and then in these days

as well, you do most of your rotations in larger organizations and you might not really

rotate with a private doctor, but we are out there. I'm certainly not the only one, not

even in my city. So I suggest that people do at least one rotation at a private facility

to see what it's like and tell the doctor you're interested in business even if you're

not so that he or she can give you some pearls and some information so that down the road

you have that knowledge, you have that experience and then you can decide for yourself at any

time. You can always change your mind. You can do like I did start off in corporate medicine,

have your own practice. You can go back and forth. You can do whatever you want because

as you and I know, Madley, we're only limited by our imagination. We don't have enough time

for me to describe all the pitfalls of my practice. I would say that the single most

helpful thing anyone could do opening their own business would be to hire a business coach.

I didn't know what coaching was back then, but I'm fixing to launch a new business and

I am hiring a business coach this time around because I think that that's going to be super

helpful and invaluable. That said, I had pitfalls. Yes. Did I make mistakes? No, because everything

that happened, I really learned from and I find this whole having a business very interesting

and challenging in a mostly positive way. Yeah. It sounds like you're really, really

enjoying it, which is fantastic. So as a DO, how do you incorporate OMM into your practice

and how do your patients respond to this kind of treatment? Do they see any significant

improvements? I'm so glad you've asked this question. I want everyone to know or remember

that OMT is billable. If you want the codes, you are welcome to contact me. Anyone can

contact me at any time. I'll share all the information I have about billing and coding

for OMT. OMT stands for osteopathic manipulative therapy and those are the hands-on modalities

that we do that look a lot like what a chiropractor or physical therapist would do. Medicare reimburses

even for these codes and the big payers reimburse as well, Blue Cross Blue Shield, Aetna, United

Health Care, that kind of thing. So it's not a matter when people say, oh, it doesn't pay

enough. It's a waste of my time. Well, that's not true because you can get paid for it.

You just have to know how to bill for it. So let's say somebody comes in with neck pain.

I do what an MD would do as far as workup and then at the time I'm likely to lay them

out on the table. Well, first I asked permission and I explained what I do and I might do a

little adjustment. And yes, the vast majority of people have significant relief from decrease

in pain, increase in range of motion, usually both because those things usually go hand

in hand. Remember y'all, we are also part of the solution to the opioid epidemic. I

prescribe very little pain medication because I get to the root of the problem of what's

causing someone to have pain or the suggestion to the brain of pain, which is now what we

know about pain. So if you just start off incorporating OMT into your practice, it's

not like you have to scratch your head and try to figure out how to incorporate it. You

just do. So it's a great habit to start off in. And remember I went to allopathic residency.

So it's not like things were laid out on a silver platter for me. I get med students

and I get residents who say, oh, well, obviously you've been doing osteopathic manipulation

since you've been treating patients and it's just natural for you. No, I set that intention

and I set it up that way. And even if you've been in practice for decades, you can start

tomorrow and incorporate osteopathy if you've learned how to do it at some point.

And do you find any time constraints with OMT just because some of the procedures can

take longer or does it fit into your schedule and your patient's schedule pretty well?

I don't consider it a constraint, but I do acknowledge that it's a choice that I've

made. So I have 20 minute appointment slots and my mid-level providers have 15. I would

say that out of the average 20 patients I see a day, five of them I will do OMT for.

Okay. Got it. And then I understand that you use other alternative therapies in your practice

like rehydration therapy. Can you tell us how you learned about this and really what

this encompasses? Yes. I have a high-end clientele here in downtown

Austin, well-educated people who are highly performing physically. I have some professional

athletes high performing mentally, emotionally, people who are leading the way in business,

for example, tech, things like that. And there's a lot of overlap. People who are high performing

might party hard. I'm trying to think of a more professional way to say that. So I had

patients ask me, hey, could you do a banana bag for me when I'm hung over? And I said,

I try to say yes to things, you know, if it's ethical and moral. And I did a hesitant yes

and I looked into it. And at the time there was one guy in Las Vegas started anesthesiologist

trained at Duke. I flew up to Las Vegas. I met with him. We went over science and evidence,

which there is a plethora of for IVs. I came back to Austin and started the IV business

that we still have here in Austin, Texas, really for hangovers. And people do still

come in to get IV bags for their hangovers. That said, it's a very small percentage of

people who do that. Because IV fluids cross the blood brain barrier, it's nourishing and

soothing for the brain if it's dehydrated to immediately get fluids. So how I like to

explain it is when you call 911 or you go into the emergency room, it almost doesn't

matter what you're being seen for, a bag of fluids gets hung. And there's a reason for

that because it helps with almost everything.

And then you also offer Botox and bioidentical hormone therapy as part of your practice.

Can you speak to us about how you became interested in these areas and how it adds to your family

practice?

Yes, I became interested and I got trained in Botox and fillers, which is cause these

are cosmetic procedures to decrease wrinkles and lead to a more youthful facial expression

when I was staring down the barrel of turning 40 years old and not wanting to look 40 years

old.

So I went and I got Botox and fillers for the first time. I spent tons of money, went

to this dermatologist who did an okay job, but had horrible bedside manner. I was pretty

sure the pricing was outrageous. So I just went and learned how to do it. I was right

about all those things. And I've been doing it for my patients now for over a decade.

And it's super fun. It taps into the artistic self that I have as well. Bioidentical hormones,

that's really fun. That helps folks who are going through menopause, men going through

andropause, which you may know as low testosterone, and then people who are transgendering. And

I got into that because when I opened my own clinic, my patient zero, as I call her, was

a man in his sixties who informed me that all his life he had thought he was a woman.

And I found it interesting, but I was not at all going to go down the road of prescribing

hormones for people who felt like they were trapped in the wrong gender body because that

seemed like something that might could get me in trouble. But I had a lot of time when

I opened my practice because I had maybe one patient a day, sometimes none, sometimes four.

And I started communicating with the American Academy of Endocrinology and other American

Academy of fill in the blank. And it turned out really medicine was embracing and there

was some evidence for hormone therapy. And I started feeling a little confident that

maybe it was something I could do. And this patient who is now fully feminized together,

we figured it out and I got trained. And we are a center of excellence here for transgender

medicine in Austin, Texas. We treat people all over the world and it's very gratifying.

It's really fun.

Just by the sounds of it, it sounds like you absolutely love your practice. You have a

great schedule set up, but if you couldn't have done family medicine and you can go back

and choose a different specialty, what would you choose?

I would choose surgery. And I would like to put it out there that if anyone is in the

Austin area, or maybe I would actually fly to you, if you want a second set of hands,

I just would love to be in the OR and be involved in surgery. I've actually been thinking about

offering it up to a couple of hospitals where I have privileges. Like, do you need an assist

to get back in there? And then we'll see. Do I still have the lust for surgery? Maybe.

Maybe I've lost it. I don't really know. But yeah, surgery would be my second choice.

And then we're going to switch gears a little bit and talk about the financial aspect of

medical school. Did you take out any loans? And did your finances affect your choice of

residency and things like that?

Okay. This is the question I've been most excited to talk about during this podcast.

And I love that y'all asked this. Thank you so much for doing so because I know that anyone

who's pre-med or in medical school and after, loans is a huge issue. I took loans. My father

is a very successful physician. He has a lot of money. He well could have afforded to pay

for my medical school. But as you know, he didn't speak to me for eight years because

I went the D.O. route. So I was just like anyone else who didn't have financial means

to go to medical school. So yes, I did loans. I also accepted a National Health Service

Corps scholarship. Another option for me would have been the military, but I don't believe

in war. I'm morally opposed to war. So that was an ethical decision for me as far as that

goes. So the National Health Service Corps paid for a lot of my loans. And then I had

in the ballpark of $400,000 outstanding when it was time to go and pay that money back.

And here's what I think about loans. And these are the thoughts that serve me well. I am

so grateful to live in a country where as a woman in particular, I can borrow money

and invest in myself. I could not be happier. The dollar amount never fazed me. The fact

that I took out loans didn't faze me. I don't think that I'm entitled to have something

paid for. I think that I should work for it. And at the tender age of 50, so now I'm telling

you that I'm over 50. I won't tell anyone. I'm still doing Botox. I think it's shaved

down a couple of years. But I paid back all of my loans and I'm proud of that. I'm proud

I took out the loans. I'm proud to have paid it back. I invested in myself.

And so with that being said, what advice do you have for students regarding the cost of

medical education? If you want to be a doctor, be a doctor. It took me three years of applying

to get into medical school. My plan B was to go into contracting architecture, something

completely non-medical. I would not have been a nurse practitioner. I would not have been

a physician assistant. If you want to be a doctor and you're committed, believe that

you can do it. Figure out how to do it. And then whatever means it takes financially,

just do it. Just commit.

Sure. And I just want to backpedal for just a second. So you mentioned you were a National

Health Service Corps scholar. Can you speak a little bit more about that and explain to

our listeners what that entailed?

So back when I was in the Ozark Mountains and came around to thinking that I wanted

to be a rural doctor, I really wanted to be a rural doctor. I thought that I would be

this little old granny lady who never got married, never had kids, smoking a little

corn cob pipe in her one-room cabin in the Ozarks or the Appalachians, and maybe delivering

babies at home and seeing people on horseback and very idealized view of the whole thing.

It was a no-brainer for me to apply for the National Health Service Corps Scholarship.

What it does is it awards you some money to offset some of your student loans and you

agree to go to places that most doctors don't want to go to, what they call under-served

areas. When I was walking across the stage and the woman was handing me this award, she

was representing the National Health Service Corps. And as she shook my hand, she leaned

in and she whispered in my ear, you don't have to accept this award and feel free to

talk to me after this banquet was a banquet. And I did talk to her afterwards and she really

tried to talk me out of it. And so I would just say be very careful of anything you sign.

Know that if it's the government, and I'm not an anti-government person in general,

by the way, but the government is not a human. The government is a corporation basically,

and it can change its mind and it can change where you think you might go. You might not

be able to go. You're really not going to have much control. So just be really by or

be aware of that whole situation.

Gotcha. So can you tell us one thing that has made you successful? Or in other words,

what is your superpower?

My superpower is that I was taught from a young age that if something is attainable,

I can attain it. And I've always believed that. And I have a whole lot of evidence to

support it. And the older I get, I have more and more evidence to support that.

I love the confidence that comes with that too. So you talked a little bit about loving

to go golfing and frisbeeing and you're very active. How do you strike that work-life balance?

I can't stress enough how important it is to think thoughts that serve you. If you think

that you love your job, then you're going to feel good about going to your job. And

if you feel good about going to your job, happy hour isn't at five o'clock. Happy hour

is every hour. And there's not this like release or relief when you're not at your job. And

when you don't have to white knuckle it through your job, and I'm talking about, you know,

whether you're a bricklayer or working at a convenience store or a doctor or whatever,

if you love what you do for most hours of the day, which for most of us is our job,

then you can just sashay into all the other areas of your life and show up and really

enjoy it enthusiastically, not as a, you know, just like I'm not at work. You know what I

mean?

This kind of brings me to my last question. We love to ask all of our guests, what was

the best piece of advice that you got through your education, be it in undergrad, while

you're growing up in medical school, wherever, what advice do you have and that you always

think of, and you would like to pass on to our listeners?

I love that question. And I would say that the best piece of advice that is pretty specific

to becoming a physician is that if your brain needs to know all the whys and wants to know

in a deep dive, the answer to the meaning of life and how humans work, then just pick

a course, and I wasn't meaning to down mid-level physicians earlier by any means, whatever

that path is for you, just go for it. And remember that if something is attainable,

you can attain it.

Yeah. Those are great words to wrap up with. I just want to thank you so much again, Dr.

Freeman, for taking the time to talk with us today.

Well, it's my absolute pleasure. And I think tomorrow is the first day of spring.

Right. Yep.

So I'll say happy spring.

Yes. Great. Thank you so much.

You're welcome.

This concludes our episode of Do or Do Not. Send all inquiries, comments, suggestions,

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