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
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,
and even let us know if there's someone you want us to interview to do or do not podcast
at gmail.com. Don't forget to like us on Facebook at Do or Do Not Podcast for updates.
If you enjoyed our podcast, please share it with your classmates and administration. We
have plenty of more interviews lined up and we're excited to share them with you. This
is Tianyu Shea. Thank you guys so much for listening to Do or Do Not.