As a kid, I aspired to be a farmer, a priest, a writer, a professional basketball player, a trial attorney and rich — in no particular order.
“So what did you end up becoming?” I can hear some bosses, current and past, asking me.
It’s good to have goals. Goals keep you going in a positive direction and maybe out of mischief. It’s something to shoot toward.
Christi Hay set her sights on one thing and one thing only: becoming a doctor. A pediatrician, to be more exact.
“I wanted to take care of kids,” said the 45-year-old professional.
Hay was 10 years old when she set her goal. She was in the doctor’s office at Kaiser Permanente when she fell in love with the caring and confidence displayed by the physician comforting her mom.
“I was sick,” she said. “My mom was asking questions. The pediatrician said, ‘You want her to be perfect. She is going to be fine.’ That always stuck with me. I wanted to do what the doctor did.”
Four years at Stanford University, a masters in public health at the University of Michigan, medical school at the University of Virginia, a residency at Children’s National Medical Center in Washington, teaching pediatrics at George Washington University’s medical school, two jobs and two kids later, Hay has her own pediatric practice.
Her one-woman show sweeps around the Washington area in her banged-up Honda Odyssey. She makes her rounds of house calls — no typo there, “house calls” — to her patients, or the “kiddos,” as she calls them.
Hay runs her five-year-old boutique practice, called Palisades Pediatrics, from an office in Foxhall Square on New Mexico Avenue in Northwest Washington. It is just her and a part-time office manager.
“I do all of Washington, D.C., and the area close in — Bethesda, Potomac, Arlington and McLean,” she said. “My practice is intentionally small. My families call me directly or email me.”
She makes house calls for under-the-weather children and newborns “so families don’t have to pack up a sick kid and come into the office.” That’s pretty handy if you are a $500-an-hour professional who is going to burn several hours running to the doctor’s office with a sick child.
Hay charges a flat administrative fee of a couple hundred dollars per patient per month. My math tells me she grosses about $36,000 or so each month for the 180 patients she sees. She said she plans to limit her total patients to 200.
She is not shy about turning a nice profit. Her income at two previous jobs, one at Children’s Hospital and another at a private practice in Northwest Washington, were well under $100,000 per year.
“The plan is to make more money than I did at those other places,” she said.
She works just about every day, and last week she made two house calls on Sunday.
Most of the families she serves have two or more children. The patient base varies economically, socially and ethnically. She tends to single-parent families, educators, business owners.
Her big selling point is customer service. “What I have learned, as part of my start-up, is that they all say, ‘I want one person who is easily accessible and provides high-quality care.’ ”
Hay started her business out of frustration with her previous job at a traditional private practice in upper Northwest Washington.
“I was seeing 20 to 25 patients a day . . . 10 minutes for a sick visit and 15 minutes for a well visit. I probably got about five minutes with a sick patient after they filled out forms, got their vitals, temperature, blood pressure.”
She quit after three years and wrote a business plan while vacationing with her husband in the Caribbean. He runs his own consulting practice and helped her sort out her priorities.
“Pediatrics should be pleasant — for me, for the kiddos I was taking care of and for the families. That wasn’t happening at the traditional practice I was in.”
She credits her four years as a biology major at Stanford, smack in the middle of Silicon Valley, with sparking her entrepreneurial gene.
“Once I was able to figure out what was important to me, I was able to write a business plan based on what the business model needed to look like.”
First off, she wanted a lower patient count. A typical pediatrician carries as many as 3,000 to 4,000 patients. Hay wanted a cap at 200.
“I knew I needed something small,” she said.
She wanted a minimal staff.
She wanted minimal interference between her and the people she was caring for, which partly meant direct phone-call access for the patient.
Lastly, “I knew that I needed more time with the patient to foster and develop the relationship.” Her time with each patient at home or in the office lasts between 30 minutes and an hour.
She also had “this really goofy idea that I would want to see a patient at their home. I thought that would benefit myself and help me with the home dynamic.”
That presented the question: Did someone really want their pediatrician in their kitchen?
Hay said it works. It helps the family minimize the headache and bigger exposure of coming into the office with a sick child. It also helps the child, who Hay said is more comfortable in the familiar surroundings of home.
“It brings a different type of energy. Less threatening. They want to show me their room, their toys, their books.”
It wasn’t easy finding her patient base. Hay advertised in Washington Parent magazine to get her name out. She also cold-called physicians who deliver babies, asking them to consider recommending her as a pediatrician. She tapped her network at Children’s Hospital, too.
She bought mailing lists with Zip codes and names of families and sent postcards to people in the area informing them of her new practice. She is on several neighborhood email lists and has been helped by word-of-mouth.
Hay’s patients range from newborns to 21-year-olds. The age of their parents “is all over the place. I have some parents in their late 20s, new parents from the mid-30s to early 40s.” She even has parents in their 50s and beyond.
Hay has a broad approach to medicine, starting with an emphasis on getting kids to read (she started the reading room at Children’s Hospital), eat well, exercise and stay away from tobacco and carbs.
“I am really interested in how you impact behavior,” she said. Most of that comes from her two years at the University of Michigan School of Public Health.
She calls her patients “my community. The people I take care of.”
“So far, so good. I am going on year five and still consider myself a start-up. I love it.”
I know the feeling.