The Transparent Podcast
The Transparent Podcast
Dr. Dawnnmarie Risley - Psychiatry, Healthcare Insights, and Preventing Child Abuse
Check out Dr. Risley's book here: https://www.drrisleychilds.com/book
Discover the captivating journey of Dr. Dawnmarie Risley, a board-certified psychiatrist who unexpectedly found her calling in psychiatry after initially pursuing a career as an OBGYN. We discuss how her family's history with psychiatric disorders guided her passion, leading to fascinating experiences in psychiatry and unique insights gained from working within the prison system. As we hear from Dr. Risley, she shares her expertise in identifying behavioral health issues with those she interacts with. She discusses the feasibility of starting a private practice while maintaining other medical commitments, offering a refreshing perspective on balancing personal and business aspirations.
Join us as we explore the intricate landscape of psychiatry within the broader healthcare system. Together with Dr. Risley, we tackle the challenges of segregated care, the frustrations of electronic medical record systems, and the critical role of scribes in improving physician efficiency. Understand the financial implications for clinics dealing with incomplete EMR notes and dive deep into the complexities of the healthcare insurance landscape. Through this conversation, we illuminate the often-overlooked administrative demands faced by medical professionals. We also underscore the necessity of a strong support team in managing patient care, highlighting the collaborative nature of healthcare.
Beyond the realms of psychiatry, the episode embarks on a profound discussion about child safety and abuse prevention, underscoring the critical need for community awareness and proactive measures. We learn about Dr. Risley's mission to combat child molestation and her journey of writing a memoir which aims to empower and heal. This episode highlights her dedication to these pressing issues and emphasizes the importance of persistence and passion in business endeavors, offering valuable lessons for anyone looking to make a meaningful impact in their field.
Hi, my name is Nick Ford and I'm the host of the Transparent Podcast, where we believe in bringing transparency to the world of small business, and I'm joined today by Dr Donmarie Risley and Dr Risley, I'll let you introduce yourself.
Speaker 2:Yeah, I'm Dr Risley. I'm a board-certified psychiatrist and I've worked with Nick for many years as a contract psychiatrist and I've taken about the past year and a half off to regroup, be a mom and I'm getting ready to go back to work as a contractor.
Speaker 1:Awesome, and so just tell us a little bit about your background in psychiatry, what inspired you to go into the medical field and that specialty.
Speaker 2:Well, I did not go into medicine to be a psychiatrist. I went in to be an OBGYN and delivered 80 babies 40 as a sub intern during my fourth year of medical school and in Denver, loved every minute of it. It was exhausting and I started questioning whether or not I had the stamina for it. During internship I delivered 41 babies as an intern and about the third Saturday that I had on call driving, I was sitting there waiting for the light to turn green and that jug handle and I said this sucks. And I was exhausted and I thought that internship was one of the lighter internships that were available and if I didn't have the stamina to do that, how was I going to have the stamina as an OBGYN? And so I started really looking at what is the lifestyle going to be. I still had a passion for OB. I enjoy treating women, um, but the lifestyle was really what made me change and, well, made me start looking.
Speaker 2:And then during my residency, or during my internship at residency, the um geriatric psychiatric department was brought down to my training program and I loved it and, um, I remember someone telling me that way back when what, when you get called at three o'clock in the morning, what are you going to be most interested in and what is going to least upset you? And waking up at 3 am to a patient who is manic chain smoking wraparound sunglasses I just found that so fascinating. You look at my background, though. Um, way back when I was in college, we had a sociology professor who gave us the task of why are you in college? Like, what is it about your background that makes you a candidate to be in college? And really, I was only the second one in my family who got a college degree, and I got the highest level degree, a doctorate level degree and when.
Speaker 2:But when you take a look about, why am I a psychiatrist? It's really. Why am I not a forensic psychiatrist? Because I was raised by a psychopath. My husband coined the term cluster B, saturated when it comes to my mother. My one brother has chronic cannabis use, the other one alcohol abuse and very heavy in the narcissism my father was. You know, my entire family was just saturated with psychiatric disorders and so forensics was really, and I have done a lot of forensic work. The only reason why I'm not a forensic psychiatrist, why I didn't do a fellowship, is because I crashed my parachute while I was just before I was about to apply. Oh my goodness.
Speaker 1:Oh, wow so.
Speaker 2:I crashed it and I could barely even get you know I had a head injury, and so you know, then I was just making money, and then I said okay, well, we're not going to go into forensics, but I realized I didn't need the forensic um background. Yeah. I didn't need the fellowship in order to do forensics, and I've done most forensic work.
Speaker 1:Yeah, cause I I mean when we were working together and I I handled most of california. Um, out of college, you know, I went. My first job was in recruiting and I dove straight into the west coast craziness, uh, with all the county department of mental health and working with all the psychiatrists. And you know psychiatrists would work in private practice but they could go into work in the state prisons or go into, say, hospitals, and so you know, I'm sure it helps to have that forensics. You know specialized training, but you can still go, do you know?
Speaker 2:the big thing, the schizophrenia. Schizophrenia and bipolar disorder is bipolar disorder and depression is depression. So you know those symptoms remain the same across, no matter where the patients are located. Where it comes into play is really understanding the cluster B saturated persons, the malingering, the secondary gain. That's the kind of thing that you really wanted to pay attention to in the forensic setting and it's rampant there and I was fortunate enough that one moonlighting in the prison system taught me a lot of that. But also, you know, just the sheer experience that since early childhood I learned that one of the most prominent things I learned was when, when I get really comfortable, with a patient really comfortable that it becomes uncomfortable then, I know I've got a psychopath in front of me and you just have to really be aware of that.
Speaker 2:internalization, those little alarm bells start going off and I and I've applied that in life whenever I felt that with someone I got a second guess that yeah, that's yeah.
Speaker 1:I had, I had experiences with with, you know, doctors that worked in in the prison system and you know they started doing telehealth at one point and you know some doctors that thought that was great because then they didn't have to go into the jail or that or into the prison. But then it was like, okay, now these people could get out one day and I'm the psychiatrist of record and I don't know what they're going to go do when they get out of jail and I've never actually met them in person. So some doctors had that concern. But when I, you know I've worked with a lot of psychiatrists and psychiatric nurse practitioners that had private practices. So, like those clinicians that want to start their own, you know, private practice, those clinicians that want to start their own private practice, do you think that that's feasible to do that while they have a full-time job at a hospital or a full-time position somewhere else and be able to start that on the side? Or how have you kind of seen that play out?
Speaker 2:You have to have support and business takes time to grow. So either you have a big stash of money already set aside that can sustain you during that time, or you're working overtime, or you're working part time with one and part time with the other. I found you know for me with the book writing, because I wrote a book in the past year and a half there was no way I could work and do that at the same time right the emotional toll that I had on the book itself because of the content.
Speaker 2:um, that definitely would have interfered, uh, with my um practice. Uh, I'm at the point now where I feel to that, and it's, the book is finished, we're just in, yeah. Congratulations. We're in the weeds right now to publishing and that. But I'm also being going in as a contractor again. I'm going through a whole different aspect of what outpatient would be to you know, entering a forensic facility again which mostly deals with very ill patients Right Psychiatrically they're psychotic.
Speaker 1:And so that You're going to a state hospital. Right, that's where you're going to be going, okay. Yes.
Speaker 2:Yeah.
Speaker 1:Yes, yeah, yeah. So you've had a lot of different experience within different settings because, you know, for people who don't know or aren't familiar with, like psychiatry, there's, you know, outpatient, which is, you know, seeing patients in a clinic, and then, you could be county outpatient clinics where it's you know those are.
Speaker 1:You know patients that are referred into the county system, and so that's one demographic, or there's the like. I had one psychiatrist that left the county LA County Department of Mental Health to go work for a very high end celebrity clientele private practice in LA. Good for that person. Yeah, he was getting paid Like he said he was going there to get, and he's going to make $400 an hour for each patient.
Speaker 2:Very nice.
Speaker 1:I was like, wow, how did you get that deal? So yeah, there's lots of different ways.
Speaker 1:So when you yeah, I was like, well, he quit no-transcript. Do you? When you would see things get implemented, you know whether it was like a new EM? Let's talk about EMR. When you see a new EMR system get implemented, would it have been better to get buy-in from, like all the people, the individual contributors, like the clinicians and the you know daily users of that system, or was it better that the executive team just made a decision with you know, in a closed room?
Speaker 2:Uh, you know, I've never been consulted about which EMR we should use, ever. Um, I've had to use a lot of different ones and, uh, most of the time those emr systems have a lot to do with gathering data and have far less to do with actual the practical implications for psychiatry. Uh, when I go to larger, when I've gone to larger places, they never put in. They always separate the psychiatry from the general medicine. You know you can't separate psychiatry.
Speaker 2:We are physicians, this is, this isn't just. Your brain is not separated from your body. So there's always because they separate those and, uh, the institutions generally do not buy the psychiatric part. It makes my job harder and more difficult because, you know, even in dictation, if I say Alanz or uh lorazodone, I think it comes up Las Vegas or Lanzapine, and you know it's something crazy. It always has these weird things that come up with the names of the medications, and it just doesn't comprehend those, and so it becomes very cumbersome.
Speaker 1:That was one of the worst things I dealt with. So you know I was on the recruiting side and you know I was having to be the middleman between, like the psychiatrists that were working on assignments with me in the facilities and one of the worst things that would happen would be I get a call six weeks into a doctor that was on an assignment and the clinical director would be calling me and they'd be like Nick, I just went into the system and Dr X has not put in a single EMR note since they started. So we need them to come in and enter all of their notes and they're not getting paid for it because they should have been doing it as they went and and sometimes they'd want to just have them leave after they did that. Because can you talk a little bit about what would happen if you did not enter your EMR notes from the facility standpoint One?
Speaker 2:of the. The problem is is that there's not always enough time. So they say, yeah, we'll give you 30 minutes for follow-up, but what if I'm spending 25 minutes with the patient and I only have five minutes to write all that in? One of the biggest helps that I ever had was I was in private practice and we were a private group within a hospital, and I hired my husband as a scribe. He was very familiar with the vernacular he's a hunter and pecker, but he was quick at it and he is an intellectual, so he understood what I was teaching him to put into the chart and I barely had to do any follow-up notes.
Speaker 2:Having a scribe is crucial. It took a long time for me to even be allowed to have a scribe, and because I wasn't allowed to have a scribe, initially I was in the hospital till 11 o'clock at night, but once my husband came in, we were in and out of there and always out on a reasonable time, and everything was on time, and so it pays to have doctors have an adequate scribe. I even had medical students. The medical students had already been trained as scribes, so they were excellent too.
Speaker 2:I had them before I had my husband, and that made a world of difference, and it was also double served that I was able to teach the patients how to present, or teach the students how to present better. It was really mutual. And then there were times where I was observing them, interview patients and then I scribed for them.
Speaker 1:So we went back and forth and they got to see those subtle differences in what makes a good note for the patient right, yeah, and the issue that I would have was that typically you can talk more about this, but typically this clinic or the you know county, or especially if it's like a private practice or something they couldn't bill for those patients if they didn't have the EMR notes in, is that right?
Speaker 2:Yeah, that is yeah, I believe. Yes, absolutely yes, so they can't bill for that. Yeah, so I think it's probably the ones that are not getting the notes done are the older generation that are used to paper, and I grew up coding when I was in high school, so I was learning how to code.
Speaker 2:So, and even though I didn't own my own computer until 10 years later or more, I think I think it was even more than that, maybe 12 or 13 years later I still understood how to use a computer, but it's really it's. I don't think they get very much input from the physicians themselves and the people who are using it to make things efficient for them.
Speaker 1:Right, you know, when I was before I started transparent staffing actually kind of during the time I was starting transparent staffing in January 2021, I was an employee benefits broker and so I learned a lot about the medical insurance, health insurance world. You know, working with all the different carriers and you know there's really like a big five. There's five main you know medical carriers that kind of run everything I mean even the other healthcare insurance companies. They run all of their claims through those um networks you know. Blue.
Speaker 1:Cross Blue Shield, uh, cigna those. So I just learned that it's all kind of um, not transparent to be punny about it, but it just you know it was very um to be punny about it, but it just you know it was very um, it just didn't work very well. It was very difficult for the patient, as me, as, like a patient that's trying to, you know, like we have, we've had three babies in the last seven years and that's expensive and you're an ob-gyn, you know how much it probably costs to do a c-section um and or just to have a baby um, and so can you talk a little bit about from the, from a physician's side of the you know fence, how, how does that impact you when you're like, if you're trying to run a private practice and build insurance companies, what is that like?
Speaker 2:well keep in mind. I used to do family practice work as well as, uh, psychiatry. I was doing family practice in the interim between deciding to do OB to psychiatry and what I found was most practices required about three people per physician. So you need the nurse or the med tech or whoever is going to put the patient into the clinic, take the blood pressures, take the measurements, et cetera. Then you need the biller and then you need the person who's doing all of the follow. You know the scheduling. So you need a minimum of three per person.
Speaker 2:So that becomes very expensive and, yeah, so for psychiatry it used to be really easy. Psychiatrists would just send over the bill and then they would get paid whatever they had wanted. They made it far more difficult for that and I have not been part of the billing in a long time when I was in my private, when I was in my last private practice, interestingly, I found Medicare and Medicaid to pay more than yeah, they paid and they paid on time, whereas Blue Cross they were a pain in the neck even to get medication. They came up with more reasons why not to cover medications and it was so much easier with Medicare and Medicaid patients more just because my life was easier, not having to put in all of these reasons why it is that I want to prescribe this medication to a person yeah, well, and that's something prior authorization.
Speaker 2:It's the bane of every psychiatrist yeah, I think of every doctor. They hate that I'm actually. I have surgery next week and you know they. Oh, we have to do prior auth for tramadol. Well, how much is the medication? Oh, it's 30 bucks. Well, let me just play cash, Okay.
Speaker 1:Yeah, for real, in the big picture of things.
Speaker 2:this isn't a $700. That's why. But you also have to look at how much is the pharmacist participating, Because when you have a patient who refuses to pay $5 for a medication, it's like wait a minute, I see you with your fingernails. Am I paying for your medication or am I paying for your fingernails? So it's a mess.
Speaker 1:It's a mess the whole system is a mess. The problem with the health insurance part of it is they're all publicly traded companies. They're all trying to make a profit. That's the big problem and people think that the cost of health care service, like the cost for you to treat a patient, has not gone up nearly as much as those companies are profiting off of administering claims like they're making, if you look at the number of doctors, that, or the number of health workers, whether it's doctors, nurses versus the number of administration has skyrocketed, and that administration is what has driven up the cost of healthcare.
Speaker 2:And you know, maybe insurance shouldn't be publicly traded.
Speaker 2:Because, you're not serving. You know I pay for an amount of money for you to guarantee me that, if in case, I'm happy. And another thing is third party. Do we really want 30 party pain system? You want we pay for what you value, like I've. I've said this for a long time you pay for what you value. If you value your health, then you're going to go. How can I be motivated to remain in good health, whereas if you say well, someone else is going to pay for it? Look, look at obesity, not just on the rise, it's here. Obesity is the norm. When I was a kid obesity was the rarity.
Speaker 2:There were maybe three kids that were obese. But now I go to my child's school and the majority of the kids are morbidly obese. What are they putting in their mouths? Are they exercising? They're not taking care of their health.
Speaker 1:Yeah, you know when I I follow politics way too much and so I followed, you know some of what. I didn't follow him too much, but Robert Kennedy with his stuff about just the ring poison in our food and that the food companies are basically working with the pharmaceutical companies to poison us and then sell us the drugs that are going to fix the what the poison did. You know, and it's not that far fetched, cause like when I, you know my wife is very into looking at ultra processed food ingredients that are in the food that our kids eat, and you can look at the list of ingredients and half of the stuff is like a chemical, it's not even a food, and so you know it's not that far-fetched to think that these gigantic companies that you know, the, the food companies, own so much of the market because they just buy up every smaller brand that comes up.
Speaker 2:Obesity really came Diabetes and obesity really shot up with two things Number one, the introduction of genetically modified corn, and number two, putting high fructose corn syrup in just everything and those two things have you know that high fructose corn syrup is horrible for the liver, it raises your blood sugar, it makes you more susceptible and insulin resistant.
Speaker 2:The more insulin you need, the fatter you become, and so on, and it just keeps growing exponentially. So, um, and they have huge influence. And what is wrong with getting back to the earth and what we need for?
Speaker 1:Eating actual food.
Speaker 2:Actual eating, actual food. Yeah, I'm actually. You know I have a long story about fertility with Whole Food Plant Place Diet. That might be another podcast for another time.
Speaker 1:We can do another one. We can definitely do another one. Yeah, I diet.
Speaker 2:Diet changes what you put a lot I imagine, and when you look at health care in general, the three things that cause hospitalization are complications, complications secondary to smoking. Okay. Complications secondary to obesity and complications secondary to alcohol or drug use.
Speaker 1:Yeah, I mean it makes sense All across the board you want to look at schizophrenia.
Speaker 2:I'm reading articles right now about early cannabis dependence or early cannabis use. Increased risk of schizophrenia methamphetamines rampant in the hospital system it's really bad in california alcoholism, if, if, and you know, we come at free will. I, I'm very um libertarian on this point. We we come at free will. Yeah. But you have to know what the consequences are.
Speaker 1:Yeah, people aren't educated on what's in their food and those things.
Speaker 2:Yes, but we also have to do that prevention. You know, as a DO, as an osteopathic physician, everything is about prevention for me. So the difference between an MD and a DO we look at. You know MDs don't do manual medicine, dos do. But we also learn our medical aspect of how can I keep this from happening versus how can I fix it. And I've seen that in medical staff meetings all the doctors will say, well, how can we fix this? How can we fix this? How can we fix this? And I'm the lone person that's sometimes the only DO and I'll say I want to know how we can keep it from happening. To begin with, Like what can we get prevention?
Speaker 1:But I mean, you know this is like getting too far in the weeds probably at this point. But just like the pharmaceutical companies make money off of selling drugs to fix problems, so they're not gonna want, I would imagine, the high up people, they're not gonna want to do too much to try to fix the things that are just creating more administration, more money, more. Exactly Is there?
Speaker 1:money laundry going on Probably Um so we, you know, we probably never know it's you know but we can do our part to try to bring awareness to what the problems are and I think if government got out of medicine we'd be a lot better off. Yeah, I mean what the capitalistic, you know, non-regulated, you know it's, there's two sides to every coin.
Speaker 2:But I mean speaking of like well, here's the thing Everyone keeps talking about capitalism and that capitalism is bad. We are no longer in capitalism. Pure capitalism is beautiful, it's. I have a product. I sell it to you. Someone else can make the same product or a similar product they might. They might make it cheaper. What we have right now is a fascist society. When we have big pharma going in and doling out plenty of money to our senators and to our House of Representatives and we have our congressmen congresspersons making millions of dollars when they only have a salary of $200,000, we've got a problem.
Speaker 1:Well, that happened during COVID. You know, they all walked out of the meeting where they found out about COVID and immediately were buying pharmaceutical stock. I mean, they knew what they were doing, you know.
Speaker 2:Yeah, but it's more than that. It's more than that they're also getting. They also have Pfizer walking in and offering them, taking that, all the things that doctors are no longer allowed to have. All the senators are. So they're taking the senators out to dinner. They're taking them on trips. They're taking them, they're sponsoring them. They're giving them plenty If we actually had our representatives with patches, just like on a car yeah, nascar drivers, we would have trans.
Speaker 1:I love that, right. I love that. I love that and we need to have that they should have to post it on their website who their sponsors are the ones that are.
Speaker 2:They're the ones that are are making the laws, so they're doing what they want and, yeah, that is where we've gotten out of control in our country that those there's too much money in.
Speaker 1:There's just too much money in politics. They're not represented, yeah, and they're just. I mean, we just saw with this last election they're blowing hundreds of millions of dollars on ads and they're all funded by different sources that have their motivations and why they're giving them money because they want them to do things that are going to help them, obviously. But, speaking of capitalism, when you think about just running a business, like I know, you're writing your book right now and I'm sure you're looking at all the ways to market it and advertise it and how to grow the sales, and you're doing speaking engagements, which I can't wait to see more of that next year and through the rest of this year.
Speaker 2:Me too, it takes about six months to get any.
Speaker 1:Yeah Well, so I'm, that's super exciting. And so you know you're, when you write a book, you're, you're marketing yourself Like you're, you're a thought leader, you're an influencer, you're an author, um, you know. So you're completely building something from the ground up. What do you?
Speaker 2:think about like that process and how that's been like doing something from scratch, like that, versus like if you wanted to just do a different kind of business and, you know, buy a franchise, or you've thought we've talked about you wanting to get into, like real estate, real estate yeah, I'm getting a real estate investing because it has numerous tax benefits and tax sheltering and I really like more of my money to go to where I want it to go to and not to the IRS, wherever the IRS wants it to go to.
Speaker 2:So it's really about putting money and you know, the government encourages, encourages that that's why they have laws to allow that.
Speaker 2:So it's really yeah, they want you to do that to invest, and do you know what I want to do with that? Um, as far as writing the book, it was, uh, it was something extraordinarily different. I had never done. I've. I've written plenty. I've. I've only written research articles in college and medical school, um, not since then, uh, but I do look things up, and you know. So, as far as researching, I have that background. Um, this was like giving birth at times.
Speaker 1:Is that painful?
Speaker 2:My healer told me. He said it's going to be like giving birth and it really is this torturous, hard, exhausting, exhilarating, amazing journey and it was really something crucial to my healing, I believe, and knowing that I've already had two people who have told me, you know, I started listening to some of your videos, or I've read pieces of your book, and you know I know actually three people, um, you know, I want my sister to read this, or I want, or this is now starting, for you know, I'm remembering some things as a kid and it's making me feel less ashamed. I don't I? You know?
Speaker 2:I was ashamed about that. I've never talked to about it before and here I am now talking about it, and so you know it's really less about me being the hero in my own story and it's more about putting an end to travel station, Like that's my end. Goal is that?
Speaker 1:Yeah, that's something you know. I don't know how much I've shared with you, but I am pretty involved at our church and so I do like the operations stuff there. I'm the operations minister and so I do all of our policies and you know, maintaining the building and you know all the business administration type of things that go on that have to be done. I mean we're a fairly large church administration type of things that go on that have to be done. I mean we're a fairly large church and so that's super hyper-focused for us. Like protecting the kids in our youth ministry and our children's ministry, so like they are very proactive about. Like our child safety policy and we just rehauled that completely and brought in an outside consulting group to help us with how we wrote that and built that and how we're going to educate all of our teachers, bible school teachers and leadership Because it's so important.
Speaker 1:Like those kids that have gone through that, like you, you know your experiences that you've gone through it is life altering. It'll change their entire, the whole trajectory of their life and so you know it whole trajectory of their life and um, so you know it's top of mind for me and you know it's a tough position to be in, like being over that, because it's a lot of responsibility. Um, and you know, youth ministers or children's ministers um, that's been amazing being on the inside. Youth ministers or children's ministers um, that's been amazing being on the inside working with them. They have just completely dedicated their life to what they're doing and they're in it for the right reasons and they want to do what's best for those kids and, um, part of that is protecting them from people who we don't you, you know, talk a little bit about like with child molestation, you know, talk a little bit about like with child molestation who are the most likely people to negatively impact a kid in their life, like someone that most likely be a predator their parents right
Speaker 2:yeah, it's, uh, their fathers and their stepfathers. It's about 30 percent, a little more than 30 percent, of the fathers and the stepfathers who are molesting, more often than not, the daughters, and we always think that it's the boogeyman or, you know, it's somebody's we get we get the headlines that the kid was stolen at the bus stop, but that's not. That's the rare, that's the exception to the rule. The rule is that it's happening in our own homes. 90% of the kids who are being molested know their, they know their perpetrator and they know them well. It's their grandpa. If it's not their father, it's the uncle, it's their older sibling who is also being abused. It's the grandfather or the uncle, or it's the older sibling who is also being abused. It's the um, it's the grandfather or the uncle, or it's the family friend and, uh, they almost always know their perpetrator yeah, and they're threatened or they're coerced.
Speaker 2:They're um manipulated probably believe that. They believe they're going to hell. They believe if they talk or they're threatened, that someone's going to harm them, or uh, it really takes everything out of someone's, of a child's, soul yeah, it's so sad it's so sad, but what's saddest is that and where my book comes in is my book is hitting that head on, because we look at the churches and, yes, has the Catholic Church perpetrated a lot of child molestation?
Speaker 2:Yes, absolutely, for I don't know how old the Catholic Church is, but for as long as the church has been alive, it's been doing that.
Speaker 1:It's happened in all kinds of places.
Speaker 2:It's happening all the time it happens. Child molestation happens where children are. It happens at day. My perpetrator just closed his daycare center in December, Wow, so you know they go where they're going to find children. They're going to be Boy. Scout leaders. They're going to be teachers. They're going to go wherever it is located for easy access to children and where they can. And you know even what was the physician's name for the Olympic team.
Speaker 1:Yeah, I know you're talking about.
Speaker 2:yeah, I'd rather not even give him his name, you know because why give? Him any more notoriety.
Speaker 1:Don't give him any more airtime.
Speaker 2:Don't give him any more airtime exactly.
Speaker 1:I think I'd love to talk deeper into this in another podcast, maybe next year. I want to get back to kind of the your book. So I know that a lot of that is part of your book and part of your journey. But talk a little bit about like did you write the book entirely by yourself or did you have like ghostwriters or anything like that?
Speaker 2:No, um, you know, those ghostwriters are expensive. I think they're somewhere between $25,000 and $50,000.
Speaker 1:I've looked into it. It's expensive.
Speaker 2:Initially, what I did was I had a good friend from college who had helped me write before. He would help me write my personal statements for residency and he wrote this beautiful. He helped me write this beautiful personal statement. It began, he came into. You know, the agreement was that I would make him dinner and he would help me write. It turned out two dinners that took for that one. But he came in and he said epiphany, we have to use epiphany. Because that's the first thing that I thought of and that was not something that I would think of. So it took me a while to find my friend and I finally just said I think this is his address in San Francisco and I knocked on his door and I left a note and I sat down with him and I said we have to start with epiphany, have to end with revelations. The same thing. And we and I did, and um, but when I, he is such he chooses to remain anonymous. But yes, that's an amazing writer.
Speaker 2:I was producing so much he couldn't even keep up with it and he kept the biggest contribution. The poems are his. He wrote the poems. He wanted to put some beauty into it, so the poems are his and I thank him for that. But the rest of it, um, is all mine and it's really. It was. How was I going to write it? And I had gotten a? Um. There was a coach, which is what I've now learned. Is is is basically a vanity book.
Speaker 2:Um people want to write a book. They get this, they pay a coach and then they pay for the marketing themselves and that, um, she said one thing to me. She said get words on the page. And so. I started just throwing words on the page and then I dictated it and I got someone to type it all up for me. And then it came to OK, I see where this is. I know the story I want to put in the beginning.
Speaker 2:Yeah in the beginning, yeah, and then because when you write a memoir it's kind of boring to write it. I was born on this date all the way over, and so I organized it where it was that transformation part. So there were really two major transformations in my story. One was when I left for medical school and I got away from him. I got away from my stepfather, and my classmates were supportive and they became my family. And then the other time was really um cutting off my mother was the next transition and allowed me to heal.
Speaker 1:Yeah, well, that's um, I'm sure that's a journey from there until you know, and then I'm like that's, um, I'm sure that's a journey from there until you know.
Speaker 2:And then I'm like, okay, february, I wrote the book now. Yeah exactly. I got to improve it, okay, I think I can rewrite this better and you know it kept growing from there and I think I've had I think I've had five different, five versions. You know I've gone through the rounds five times and now it's just the formatting has been the most difficult. And the formatting has been what I've been doing for like the past eight weeks.
Speaker 2:And when I get off the phone with you. I'm going over to the formatters place and saying okay, you've had some trouble too. Let me tell you where it needs to improve, but we're almost ready to publish in the next day or two.
Speaker 1:That's amazing, that's so. That's such a full circle thing, like your whole life journey is probably in that book, kind of you know it's in the book.
Speaker 2:Yeah, and there's still plenty that's missing. I mean, I could probably write a whole nother chapter once this goes through and we see the impact that you know. The fourth one will be you know what is, what's the aftermath and and where have I come since I finished writing the book.
Speaker 1:Yeah, well, you know, I think that that's um, I've wanted to write a book for a while and I looked into it. I met with a guy that, uh, I'd wanted to write a book about my grandfather and he was been my biggest mentor for my business, you know he you know, from the age of 18, maybe younger, I'd wanted to start my own company and the reason was because of him.
Speaker 1:He owned a life insurance company pretty big life insurance company in Dallas, texas, and he had about 300 employees that he owned with a 50 50 partner, and so I saw him do that. You know he had he sold the business when I was either very young or maybe even before I was born, and then did consulting and things like that. He had a consulting business after that for a little while. But I looked at him and thought and kind of joked with him like well, if you can do it, I mean like it can't be that hard. I can do it.
Speaker 1:Um, you know, he's a very special person. He actually, uh, unfortunately passed away recently and so that's sad, but I have such great memories, I learned so much from him. There's so many things I'll take with me for the rest of my life because I watched him and he was in a worthy ideal that I could follow behind and kind of look to, and so I would love to write a book about him. But, like you experienced, I talked to this ghostwriting, their publishing company. He has ghostwriters. They have different levels of like. You know, you could write the book yourself and they'll edit it and publish it, or you get a ghostwriter, which costs, yeah, like $25,000, depending on how long it is.
Speaker 2:Yeah, the only thing that I've not done for myself is the formatting, because it was just something so specialized and we tried to format ourselves and it was just coming out a big mess and Microsoft Word is not the friendliest thing, and then you put it into an Adobe PDF and then it's all screwed up. It was getting screwed up. And so yeah, so I have someone doing that.
Speaker 2:Look get words on the page. That's the first thing, and I'm already thinking, you know, you know lessons from my grandfather, something in business like you can figure this out and, and it sounds like your grandfather was really encouraging and, um, and it sounds like your grandfather was really encouraging, um.
Speaker 2:Most recently, I was at a uh, I was at a real estate, um convention and I walked up to this one gal who I've been following and I said this time next year I want to be where you are. She said this time next year I want you to be further than I am that's amazing I love her attitude that, no, don't limit yourself, Be even bigger. You know, be bigger than yourself.
Speaker 1:Yeah, I think you know, when I think about people who have succeeded in business and people who have failed, it's the people who acted on their dreams, like they had a dream that no one else saw, or they had some kind of vision for what they wanted to do with the business.
Speaker 2:And they were the ones who came up with the plan and had goals and acted on them and um forward to success. That's the thing you know, I've failed many times over with this book. This book was not right, so it's like the first version. Well, I think I can do that better. And there comes to a point where you're saying better is the enemy of good enough. And I got to the point where I said OK, this book is good enough. It tells what it's going to say. It has the impact.
Speaker 2:The only thing is I need you know I need somebody to do the formatting. So there was a point where we did the formatting ourselves. We failed, fortunately, you know, god closes the door, he opens the window. There's someone right in my neighborhood that said, by the way, I do formatting. Great, because how much is it going to cost, you know? I got half of my pocket.
Speaker 1:That's a specialized thing I got money to decide for you.
Speaker 2:So you know we're doing that, and so that's good. You know, sometimes you have to give some things off, but the only person, nick, that can tell your story is you, right, the only person who can talk about your grandfather is you, and so yes there are other ways to help yourself with that, and there's so many other things that are out there that are assistance that cost you very little money.
Speaker 1:Yeah, and I you know that that one of my favorite pieces of advice that I've probably done a poor job of implementing. But one of you know one of my leaders, sales leaders. He, you know, was talking to us about how to build connections with companies that we wanted to sell our products and services to, and he said just go help them. Help them for free with something that you are skilled at and build a relationship with them and you'll become a trust partner and then maybe they'll buy from you at some time in the future. But just help people and you build a relationship. And that's how I started my business.
Speaker 1:I had a lady that I connected with in Thomasville, georgia, which is all the way South Georgia, basically on the border of Tallahassee in Florida, and she just posted asking, you know, that she wanted help with job post writing and needed a little bit of help with recruiting and that she was seeking help. She just posts on LinkedIn. And I messaged her and just said, you know, I hadn't started transparent staffing, but I'd wanted to for a while, I'd had that idea behind it for a while, and so I reached out to her and I was just like hey, you know, I can help you with writing some job posts and give you some pointers on recruiting and like what job boards to use. And she was. She responded within an hour and was like can you talk this afternoon, right? I was like okay, yes, sure. And then uh ends up I'm talking to the owner of the company that afternoon. He owned four companies, including a real estate uh holding company that had 500 rental properties.
Speaker 1:I mean, this guy was amazing to work with and he was so kind and you know, by the end of the week we had a contract in place for me to do recruiting for multiple companies of his and it was a good deal for him because it was, you know, discounted compared to what I would charge now. But for me he let me be kind of an internal recruiter, so I had no costs, I just had, you know, I charged a 10% fee and now I would charge a 25% fee. But now I have administrative costs, I have to pay for my time, I have to pay for job boards and but that let me get started and I they'll be hold a special place in my heart because they allowed me to start my company, uh, and in my heart cause they allowed me to start my company, so leveraging is helpful.
Speaker 2:So yeah, you know asking for a piece of the pie or for information or help in some other way. Leveraging can be a way to get what you need or what you want without the upfront costs.
Speaker 1:Absolutely yeah.
Speaker 2:I'm learning that about real estate yeah, and I'm.
Speaker 1:We can have a I'm learning that about real estate. Yeah, and we can have a whole other podcast about real estate, because I've done some real estate investing.
Speaker 2:Let me get a little better at it.
Speaker 1:first, you can't really see it, but right up there. Yeah, it'll get there. There's a picture of the cabin in Blue Ridge, georgia, in the North Georgia mountains, that I owned. We had an Airbnb and that sign says, uh, the mountains are calling.
Speaker 2:Oh, yes, beautiful.
Speaker 1:Beautiful.
Speaker 2:My biggest regret in real estate is I did have two houses before and I sold them, and that is my biggest regret. So, um, don't sell what you have.
Speaker 1:Yeah, Real estate will always go up, especially if you have a low rate mortgage. Uh, my, my college roommate owns a mortgage broker in North Carolina. He was on the podcast too. Keep that low-rate mortgage, Don't sell it, Rent it out or do something else with it. Don't sell it. It's going to keep going up. Real estate will always go up over time. But what do you think? My favorite definition of success is the progressive realization of a worthy ideal, and you know that was Earl Nightingale. He's a Tony Robbins from another generation and he, my granddad used all of his teachings, all his like content. But just what do you think separates people who succeed from the people who ultimately fail? But just what?
Speaker 2:do you think separates people who succeed from the people who ultimately fail? Most people give up when success is around the corner. So you keep getting up. You be on nimble feet, pivot when you have to Find out what is working, what is not working. If it's not working, step back, see if there's a different way. You can keep doing it, but keep on going and keep moving forward. This, this wallpaper in back back of me. I could wallpaper my whole room with rejection letters from medical school.
Speaker 2:And yet today you called me Dr Risley. So, um I, I, I did lousy, I took the MCATs four times and then I finally got in. I I've had to repeat boards, I've had to repeat things I've had, but I keep getting up. So, no matter how much, how many times you fail, don't give up. Only give up if you really recognize that this isn't something that I want to do anymore, like I recognize with OB that it was something I didn't want to do anymore. I, I delivered babies. It was fun. But I found a passion and a niche that fit me better and so I gave up the OB part and went into psychiatry. But but I still became a doctor. So it wasn't that I failed or that I gave up. It was something that I found that my dreams when I was 16 are no longer applying when I'm 30. So it's okay to change and change your goals, but don't give up. If that's what you want keep going.
Speaker 1:You mentioned this in another way, A quote that Earl Nightingale quoted. It's not his quote, but he said that we're all standing in our own acre of diamonds and most people stop digging right before they hit the diamonds.
Speaker 2:That's right, yes, and we've all seen that little cartoon with the diamonds. Yes, exactly.
Speaker 1:Yeah, and it's you know. For me, I think, the three things I would say is one have goals. If you don't have goals, you're a ship without a plan, without a captain. Have faith, and to me, faith is another word for just believing. Like if you don't believe what you're going to do it will succeed, and be willing to be tenacious about achieving that goal, then you're going to fail. I mean and it goes back to the first point Like if you don't have a goal, you don't have anything to work toward, you don't have a plan.
Speaker 2:I like what James Clear says about atomic habits. It's pretty interesting.
Speaker 1:I'll have to look at that.
Speaker 2:It's a different shift about goals versus doing a little bit extra every day. Yeah. And it's uh, it, it. I think it's something that I'm shifting in, because I've always been goal oriented, and then if I don't make that goal, but what ends up happening is is that I end up um sacrificing pleasure to achieve this goal and. I've sacrificed pleasure my whole life. Um but when you try to just do a little bit, a little niche, a little bit extra, yeah, it's, it's um.
Speaker 1:I I think about I call it laddering. You have like a big goal and then you have ladders going in between, so um, but yeah, so if you had one point to share, like, can you give us a little bit of a um, your elevator pitch about your book and where we can find it and how to how to find your content?
Speaker 2:Yeah, well, it's. Uh, it's called the offering a physician's journey through abuse, psychedelics and the freedom of forgiveness.
Speaker 1:Excellent.
Speaker 2:Uh, yeah, it's um, there's plenty of humor in it, so it's not all dark. Uh, there are light places in it and it is a positive outcome at the end. So it's really about standing up for yourself, for freeing children, for freeing women from the burdens that they've had, because most, yes, boys have been molested too, but it's most often um fathers against daughters, uh, and it's really. I think you can compare it to a rewriting of lot, okay.
Speaker 1:Oh, wow, okay.
Speaker 2:Yeah, so uh, I'm on a God given mission to stamp out child molestation.
Speaker 1:Well, that's a worthy goal.
Speaker 2:And to let people know that they can heal.
Speaker 1:That's awesome.
Speaker 2:Yes.
Speaker 1:I love that. That's where you are in your life and your journey to do something that's so worthwhile that I mean anyone could agree is a worthwhile pursuit. So I love that you've pursued that and that your book is coming into being published soon and I'll share a link to your website.
Speaker 2:It'll be available on all the major, and I'm publishing through IngramSpark and through Amazon, so it'll be available everywhere, awesome.
Speaker 1:Well, we'll have links to the podcast. Well, thank you so much for being on the podcast. You were an awesome guest. I'm sure we'll stay in touch for many years to come. So thank you so much.
Speaker 2:You're welcome, take care.
Speaker 1:All right, thanks, dr Risley. Bye-bye.
Speaker 2:Bye-bye.