Medical practice, partially by treating COVID-19 patients, tracks growth path

For many medical practices, 2020 was a lost year in terms of growth, particularly in new patients and elective surgeries — normally high-margin sides of health care.  

But Docs Outside the Box, a St. Petersburg holistic medical practice that combines Western and alternative medicine, with a focus on personalized treatment, is an anomaly to that notion.

The practice grew revenue 25% in 2020 over 2019, from $1.2 million to $1.5 million. Also, the pair of founding physicians — Drs. Leah Teekell-Taylor and Lana Garner — project to surpass $2 million in revenue in 2021 and are in expansion mode. They are looking at bigger offices, new disciplines and new markets, including possibly entering Tampa or Sarasota. The practice has 15 employees, including two doctors, one acupuncturist, two physician assistants and a nurse practitioner soon to come onboard. “Culturally, the world wants more from health care,” Garner says. “Because we supply so much more — we have grown.”

What else is behind the surge? A big reason is the doctors, sensing opportunity amid chaos, took on the challenge of seeing people with COVID-19. In total, it’s seen about 1,000 COVID-19 patients since the pandemic began. Of those, only two have had to go to the hospital. (Treating COVID-19 patients took its toll on the practice’s workforce: four employees left at the beginning of the pandemic due to fear of the virus.)

Starting with doing COVID-19 tests, Docs Outside the Box’s shift to treating COVID-19 patients soon became an unintentional marketing tool. Patients were distraught other doctors wouldn’t see them. They were being told not to come into doctors’ offices because they were contagious.

“We had 70- and 80-year-olds crying,” Garner says. “They were coming out of the hospital having had nothing done for them. And then we treat them and they do fine.”

Turn it around

While Teekell-Taylor, 61, and Garner, 52, didn’t start out 2020 with a plan to shift their practice so dramatically, they have always been somewhat counterintuitive when it comes to practicing medicine. The do-it-different approach is mostly why they founded Docs Outside the Box, in 2015, in the first place. They wanted to spend time with patients and empower them to make their own medical decisions, while offering the best of both Western and alternative medicine. 

“We’re not going to give someone who is really sick an herb and tell them to go home,” Teekell-Taylor says. “We push them in the right direction, but then they’re in charge.” 

In a pre-COVID-19 world, first-time patients were sometimes surprised when they came in, says Teekell-Taylor. They were shocked to find a doctor who actually touches them during an examination. Their intensive appointments last for at least an hour — significantly longer than to industry norms. To wit, a 2018 survey from Mobius MD, a medical dictation app, found only 11% of doctors spend 25 or more minutes with their patients.

That all came to a screeching stop in March, when COVID-19 turned into a health care crisis. Their preventive patients canceled their non-urgent appointments once the state was shut down. The doctors worried they or their employees would bring the virus home. 

“We stood here going, ‘what do we do?’” Garner says. 

Garner and Teekell-Taylor regrouped. They ultimately decided to turn a bad situation into an opportunity.

First, they reworked office space they previously sublet to chiropractors and turned it into an urgent care exam room with a completely separate entrance from the primary care waiting room. Then, they quickly prepared to administer COVID-19 tests. Garner, who calls herself a “prepper,” says they had “more swabs than the state of Montana.” On March 21, a Saturday afternoon, they called for new signage. It was up by Monday. 

At first, they worked with LabCorp and Quest Diagnostics to process results. For a time, they were getting those results back within three days. Soon, three days turned into two to three weeks. So they partnered with a private lab and implemented antibody and rapid COVID-19 testing as well. 

Then came the groundswell of COVID-19 patients. Treatment Docs Outside the Box physicians and staff provide for COVID-19 patients includes acupuncture, herbs, homeopathic remedies and emotional work and diet changes. Garner adds the practice’s quick adjustment to COVID-19 had a lot to do with their continued growth at a time when others were stagnant.

“We are treating COVID-19 in the outpatient setting, which added 5-20 new urgent care visits a day,” Garner says. “When we see a new acute COVID-19 patient and they are super sick, we will nurse them back to health with daily visits to our clinic, if that is what is needed.”

With all the extra work, the practice is looking at expansion options, both in St. Pete and new locations. They’re on the hunt for a larger office space that can encompass three parts of their practice: primary care, urgent care and a pediatric portion of the office they hope to launch. 

A career change 

For Garner, Docs Outside the Box is her third career. She was an architect and then an artist. When she was plagued by health issues, including foot pain so severe she couldn’t wear shoes, a visit to a holistic clinic prompted an epiphany. A voice inside her head told her: You’re going to work here. So she started working at $10 an hour bagging supplements. Eventually, she worked her way up to helping to run the clinic.

Whereas Garner’s process felt predestined, Teekell-Taylor says she “fell into it.” She started out as a cardiothoracic surgeon only to transition to urgent care once she started having children. But she wanted out and eventually went back to surgery.

Garner, who previously lived in South Carolina, and Teekell-Taylor met through Garner’s identical twin, who lives in St. Pete. They developed a rapport with each other, and in 2012 Garner joined the practice where Teekell-Taylor worked, to bring in a holistic medicine component. “I was a babe in the woods to what she brought down,” Teekell-Taylor says. 

Soon, they developed a business partnership and decided to spin off on their own. 

Flip side

Before COVID-19, most of Docs Outside the Box’s patients had a similar story: They’d seen doctor after doctor, but couldn’t find anyone to solve their problems. 

When Teekell-Taylor and Garner hear that, they flip it around on the patient. “We’re going to help you solve your problems,” they say — a belief that’s gained prominence in medicine in the past decade or so.

But in the late 1980s, when Suzan Walter started the American Holistic Health Association, the word holistic had a negative connotation. “Back 30-odd years ago, you were ridiculed, you were made of,” Walter says. “When I was in the corporate world, I would chat about it on breaks with coworkers. They thought it was kooky. Now it’s

mainstream.” 

Docs Outside the Box see between 250 and 300 patients a week. Patients who want a more rigorous experience can elect to have an intensive appointment. Beforehand, the doctors look at the patients’ lab reports, their medical records, their imaging. But they spend the first 12 minutes of the exam just assessing their body.

“We believe the body is always talking,” Garner says.

They perform muscle testing, pulse diagnosis and palpate the body. Then they talk about what they see with the patient.

For many patients, it’s a breath of fresh air. 

“They’re getting knee-jerk treatment,” says Teekell-Taylor. “If this, then this, see you, bye. There’s not enough time in the structure of their other doctors’ appointments to sit and get to know them.” 

The two doctors also see their practice as a safe space for patients who want to embrace both Western medicine and alternative medicine and don’t want a doctor who will snub one or the other. 

“St. Pete is very accepting of alternative medicine, but you’ve got to go to your cardiologist who is going to say bad things about your acupuncturist, and your acupuncturist who is going to say bad things about your cardiologist,” Teekell-Taylor says. “There is no meeting of the minds.” 

They pride themselves on a treatment process that can cure even the most stubborn of chronic conditions. A recent patient, for example, came in crying almost every week because of persistent migraines. Doctors had put her through a battery of standard tests, like a brain MRI and monitoring of her brain waves. 

Teekell-Taylor and Garner tried some natural approaches with her, like a coffee enema, which cleanses the colon. Nothing worked. 

Finally, Garner asked her, “Are you eating Nutrasweet or any artificial sweeteners?” The answer was yes. Well, stop, Garner told her. She did, and the migraines went away. “You eventually find what it is, but it takes a while,” Teekell-Taylor says.

Walter thinks this kind of work, what’s happening at Docs Outside the Box everyday, is as important as ever in the era of COVID-19. What if holistic doctors could cure underlying conditions before they ever became a vulnerability for the virus? 

“We’re realizing now that the people who are getting the sickest and being hospitalized or dying is because their underlying health is poor,” Walter says “Their innate immune system is not functioning as well as it should. It breaks my heart.”