Thinking Outside The Business Box With Dr Jalan Burton

Apr 16

Transcript
Welcome to Dula Tips and Tits, the podcast where we cut through the noise and get real about what it takes to build a sustainable doula business. I'm Kaylee Harrod. I've been a doula informally for 14 years and full time for seven.
Around here, we don't sugarcoat stuff. We talk autonomy, owning your worth, creating a business that works for you. No fluff, no burnout, just the honest truth on how to be your own best boss. Let's get into today's episode.
Today's episode is our first guest episode that we have had in quite a while. It is a person local to me, Dr. Jalan Burton, who is just magical in what she does as a pediatrician, her philosophy and framework for how she shows up as a pediatrician is awesome.
And as a small business owner, I think she can be inspiring in terms of innovation, ways to kind of think outside the box and not feel like you're trapped by what society tells us your business is supposed to look like.
So enjoy this episode and I will see you in a solo episode again next week. Hello and welcome back to Dula Tips and Tits. We have another guest today and I'm very, very excited for this guest because she's not only local to me in the D.C.
area, she's like seven minutes from my house. So she's very local to me personally. Dr. Jalan Burton is here with us of Healthy Home Pediatrics. And is it OK if we call you Dr. Jay on the podcast episode?
That's great. That works for me. That's what I hear everybody calling you. So I feel like Dr. Jay, I would love for you to take a minute to introduce yourself and tell us a bit about who you are and what you do.
Thank you. Thank you. I'm so excited to be here. I got to hug you recently. that you are local as well because, you know, I love hugging folks. I'm a big hugger. So my name is Jelon Burton and I am a pediatrician, wife and mother of three kiddos who we just got to talk about also overlapping with kids.
Yeah, somehow go to school together and we didn't know. We didn't know that our middle schoolers, my oldest is in eighth grade and then I have a four-year-old and six-year-old and DC public schools, you know, all of that jazz.
And so I call myself kind of a reluctant entrepreneur, but it's been such an amazing ride to see problems, know that my brain loves problem solving and putting puzzles together and then just addressing the needs that my community has and the needs that I have for like what I want my life to be.
And so, you know, I'm really excited to chat with you because I think we both have kind of like, hashed out ways of practice that work for us and our families that I do not think when I was in medical school, I had any exposure to.
So all of this is really new to me. I guess it's been going on six years, but I couldn't see myself practicing any other way. So, yeah. Yeah, it is kind of magic when you land on something that you're like, oh, this is my thing, right?
But then you're like, five years ago even, I didn't have this full vision. And I'm sure there's a five year in the future version that's different than even what we envisioned now, right? In all the good ways is my, what I'm manifesting for both of us.
Yeah, yeah. But I love that you said, you know, when you were in medical school, because I think my imagination as someone who is not a doctor and has not gone through medical school is that when you're doing medical school and you kind of pick your specialty, there's like certain ways that that specialty is acted out, right?
So like you're a pediatrician, when you become a pediatrician, what are the traditional things that you think of, private practice, et cetera? So when I was in medical school back in the day, when I was in medical school, all of my mentors worked at inner city urban clinics, right?
As a black woman, that is where everyone worked, right? A lot of the, I guess I'd say white academic folks would work in the hospital, then within pediatric you'd have the sub-specialists like the surgeons and the endocrinologists and the different people.
And they all worked at hospitals as well. And so one of the things, so I have a background in public health as well, but one of the things that I went into medicine knowing is that like medicine for me was always a part of my social justice practice.
So the reason why I went into medicine is because I saw how people treated my grandparents. I saw how disrespectful they were, you know, older black couple from the South and then, you know, moving on.
to the North and I remember being in visits with my grandparents and as soon as people heard, oh my granddaughter is a doctor, their tone would change, their verbiage would change, the respect that they gave them would change and it was almost like this deference and I just thought that was completely unacceptable like I didn't like it and since I have always been very interested in health disparities and the racial aspects of medicine again as a black woman it's like how could you not be when you see the impact on your family.
I remember just thinking I needed to step back from this like one-on-one interaction with patients and really look at this broader systems that were causing you know high blood pressure, high cholesterol, diabetes, stress, alcohol abuse, like all of these things that I was seeing in you know, communities that I came into contact with, if not in my direct family, but with others.
And so for me, you know, we were talking a little bit before you started recording about like our paths and my path to entrepreneurship, it was really based upon the variable care that I got growing up.
Nobody asked me if I wanted to be a doctor and I've known I wanted to be a doctor since I was three. So the fact that like none of these doctors that I saw knew this little girl in front of you gets great grades and she wants to be a doctor.
And I never saw the same doctor growing up, right? Because my dad, who is one of my biggest supporters, he's our nanny now, he watches all three of us. Oh, I love that. Yeah, he's the bomb. We call him Grandie, Granddad and nanny put together.
So my dad worked at an international trucking company and was one of the managers. And my mom was a stay at home mom, which is like, you know, no, a whole lot of black stay at home moms, but she was, and she was our volunteer lunch lady sometimes.
But my dad, his company would switch insurances very often, right? And so we would have to see different doctors every time we switched insurance. And as a kid, it's like, wait a minute, what do you mean we can't go back to, you know, that clinic that we went that had the nice books, but now we have to go to a completely different one down the street.
And so to know, to like learn in college that that was not the norm in anywhere else, other than the United States was like, wait a minute, hold up, let me backtrack and like look at things. So I ended up getting a public health degree from Columbia University.
And that's where I met my husband. And my husband does a lot of research on social justice movements, propaganda. He's a big abolitionist of like, you know, a lot of our prison industrial complex here in the United States.
And so talking to him about like my training, it was like, he's like, you know, this is excellent. and I'm like, what are you talking about? This is just the pre-med track. And he's like, no boo, no, no, no, no.
He's like, this is not cool. Like this is, and so reading really helped me being exposed to a lot of different communities and different theories really helped. And so for me, it was like at the end of residency when I was applying for jobs, and then when I got my first job, it was like, I want something more for my family.
I do not want to be a burned out doctor that has no time to be there with her kids, right? Looking at the way that the United States spends so much more money, so much more of our gross domestic product when compared to other industrialized countries, but then our outcomes are terrible, right?
Like to me, those are things that are just unacceptable. And those are things that I feel deeply committed to addressing. And In 2022, I got a grant from Johns Hopkins and then before that I had gotten a grant from the American Academy of Pediatrics and I really looked at like, what were my neighbors experiencing, right?
Because yes, I learned about health disparities and things like that in medical school, but I'm like, things have gotten a little bit better. And then you look and it's still the same, if not worse, right?
And like the pandemic made it even worse. And so we've got health disparities, we've got physician burnout, physician suicide is on the rise and at epidemic level, we have high staff turnover, right?
Like no one can keep front desk staff, no one can keep nurses and just increasing chronic disease. So I just was like, I can't keep doing what everybody's doing and think I'm going to get something different.
And so for me, when I got my first job within two months, I just looked around and everybody was burned out. All of these women, black women, white women, all of these women who had trained me when I was in medical school, right, had all these additional responsibilities, but no one had additional accolades, right?
Like no one was now promoted to an assistant professor. No one was the director of the center, right? But these were all the people doing the work and doing it in an uncompensated way. So when I got there, I'm like, okay, well, what research projects are you guys on?
And they're like, we're seeing patients. And I'm like, okay, no, like I'm not doing, you know, uncompensated work for y'all. So for me, it was really about like, loving myself enough to say no, and loving my family enough to say no, and being like, this is not going to work for me.
So I went and worked for a few years for the DC Medicaid program for children with special needs. And I was supervising nurses and supervising social workers who did house calls. And then I would go to these big meetings at healthcare finance, where we're talking about like millions of dollars, right?
And we're talking about how many kids are ending up in the emergency. room, how many kids are ending up in the urgent care and how many kids are not going to their primary care doc, right? And then I'm seeing the primary care docs triple booking, because patients are missing appointments, right?
So like, I go in in the morning working in my little clinic, and I would have three patients in like the nine o'clock appointment. So if all three of those families show up, it's bad, right? So I'm hoping my patients don't show up when actually you want them to show up.
So you can keep them out of the urgent care. So you can keep them out of the emergency room. So little old me would be in these meetings being like, y'all should pay me to be the doctor for, you know, kids with Medicaid here in DC, and I will keep them out of the emergency room, like, give me the equipment, I will go in, I will do house calls, I will check their medications, I will do all the stuff that these nurses and social workers can't do,
I will bridge that divide. And everyone said, no, no, no, that's not the way we do it. Nope, that's not the way we do it. That's not how our payment systems work. And I said, let's figure it out. And so since 2019, I've been figuring it out.
And it is amazing how I can keep kids out of the ER. I can keep kids out of the emergency room. It's amazing how I can get kids asthma under control, how I can be there for newborns. We share that. I love meeting a newborn family.
I love being able to be there so you can call me overnight when you have a question so that you don't end up in the ER exposing that baby to flu, COVID, you know, men and girls, like all those things, because you just need me to see the baby on telemedicine at night.
Like, excuse my headscarf. I'm in my baby's playroom, but hold on one second. Let me see the baby. Baby's breathing fine. Call me first thing in the morning. Yeah, it's like those simple things. And I still believe that like, they should still make me that, right?
They should still make me that. They should pay off my loans. I'm going to be speaking with some DC council members today. Like, I don't, as a private practice doctor, I do not qualify for any of the loan repayment, even though I'm here in Ward 7 doing this work, doing, you know, working on health disparities because I'm not in a nonprofit, I don't qualify.
So that's part of what I'll be talking to the DC council members today, that like, if you want people working in these communities helping to address health disparities and making things better, they got to be able to do it in a small and local way.
It can't be these big, like there is a place for these big, you know, big, huge clinics, but most patients really want a doctor who lives in their community and knows them well. They want a beautiful office where they don't have to sit and wait for an hour and they don't want to be rushed.
You know, like people literally want the basics. Yeah, yeah, literally. Well, and also, I mean, first of all, that's just, that could be our whole episode right there. So many things about this. But I think like two of the things that I was thinking as you were talking is like the disparities that we have.
So we are a family, a mixed ethnicity family. And so we've always lived in black communities really intentionally because there's a lot of whiteness just inherently in the U.S., right? And so we intentionally expose our children to a lot of awesome blackness because they're going to get exposed to whiteness as the norm because of how our culture functions.
And that's not okay, right? But also we feel as a family that we are a safer on lots of levels and be introducing our children to what should be their norm by intentionally doing that, right? The result of that is part of me starting this work is the biases that we face, right?
Like we were pregnant as a multiracial couple with Medicaid and people assumed my husband wasn't the father of the baby. Like that's the assumptions we got that I'm like, we're newlyweds. having our first baby like why is your assumption that I'm also sleeping with someone else like you realize that's what you're saying right like and why would I bring him to my prenatal appointments if he was not the dad like what is happening and so even just that's that like groundwork right is kind of the passionate place that we both share for different reasons I'm not a black woman and so I don't have that personal experience and I even as I experienced alongside my family it's not the same right and I when I'm by myself I have all the privilege of being a white woman in the US and so but part of what I think about when I think about like you know community based health work and that's very much there for doulas as well is that what we end up doing in the systems we have right now is is working against you know stress chronic hypertension chronic illnesses that could be handled well if life changes were made etc and then the people who are addressing those are also dealing with those health issues because of how they're asked to address them right and so I'm like when we think about birth right we're putting a black woman in a scenario to protect a black woman in labor and then both of them are coming out of that with trauma and so we're maybe keeping the black woman who's in labor a little bit safer but the black doula is carrying that on her shoulders right and that that is not a sustainable way to do that and it's not it's nobody's fault that that's how that's happening right but because like you said like part of it is a lack of imagination part of it is that the systems that we've built financially benefit right and so the people who are being financially benefited are not motivated to make those changes which is a whole another podcast episode right um but I but I also think like when we think about big clinics right part of the issue because like as a parent I'm like oh I go to urgent care way more than I go to my primary care doctor why because it's easier to get into it's faster they're lovely And you can almost have them be sort of like a primary care.
Like if you go to the same urgent care all the time, you know, the doctors, right? And you're like, I think my kid has the flu. Can you test him for it? You're like, Oh my gosh, Jabari, you've gotten so tall.
You know, like there's, there is that relationship in part because the primary care practices are failing at that. And so we're not ending up in the ER all the time, but we can barely see our primary care doctor because it takes so long to get in with them.
And because of that, we don't have the relationship and the trust to be like, should I be worried about this? And we end up troubleshooting a ton of things on our own, which is not the best scenario, you know?
And I will just say that urgent care and ER docs, they are looking at things in a different way than I'm looking at it, right? Like, of course I don't want you to be sick. Of course I want you to like get well, but I don't have to do it as quickly as they do.
Right. So like, you like the likelihood of you getting, for example, antibiotics, when you go to your primary care doc versus an urgent care, you're gonna get it at the urgent care, right? Cause they can make sure, like at least if I give her the antibiotic, if she does have that thing, then it can go away.
But for me, it's like, okay, I can see you today on telemedicine and I can write that prescription just in case you go pick it up just in case, but do not start it until we talk tomorrow and she's still having those fevers, right?
So the exposure to antibiotics is so much more when you go through your primary care doc. And I will say to advocate for my colleagues that are still in these clinics with all of the red tape and stuff, like I remember being there and we were trying our absolute best to fight against the system, but you can't in a lot of places, right?
Unless you have leadership that is really has your back, sees you and embraces your full humanity, right? Like my team always talk about like, we are fully human and we all have lives and we're not gonna be connected to our computers and our phones other than me, right?
Cause I'm the person that has to pick up the phone when people call because they're sick, but like, I don't remember, well, I guess I've had some amazing bosses, I will say when I was at DC Medicaid, Dr.
Renique Shields Harris was a phenomenal supervisor. She respected my humanity, but after that, I don't know, like, you know, definitely got written up for too much pumping time by a pediatrician. Like, what is that?
Like, what is that? Yeah, like that's totally against the law, right? Like totally illegal, but I need my job. So I'm not gonna talk back too much. I'm just gonna say, okay, from now on on my invoices, I'll make sure to let you know which pharmacists I called and which medications I refilled while I'm pumping for my special needs child.
You know what I mean? Like, like stuff like, like, you know. which I wish nobody had to experience, but I had to experience it and so, yeah. Yeah, well, and I wanna also clarify that we adore our pediatrician, right?
Like our pediatrician is amazing. She's great. She's built wonderful relationships with our kids. It's just incredibly hard to get seen, not because of her, right? But because the system is not working well as it's currently set up.
And because she's good, she has a higher show up rate and a higher retention rate, which means it's harder to get in with her. I'm sure that doctors that aren't as good, you can get in faster, right?
It's really tough. Yeah, it's, yeah, yeah, exactly. So part of what I wanted to talk to you about is how you practice medicine, because I think what is awesome about getting to be sort of establishing yourself in your own practice is having the freedom to make it yours.
Now, One thing that I talk about on the podcast all the time is that there's a little bit of like lived experience necessary with that, right? So like, I've been teaching childbirth ed now for seven years, right?
And I was in a scenario that I got trained by an awesome woman who has been a doula and teaching childbirth ed for ages. And then she was going to have me, I did shadow one of her classes, but then she was gonna have me like co-teach with her as my first class.
And then she had a client go into labor and she was like, surprise, you're doing the whole class by yourself. Like, oh, awesome, wonderful, great, okay. But I went in there like none of these people know that I've never taught this on my own before.
And I had taught, I used to be a professor. So like that piece was there, you know, but I remember teaching it. And as I was going being like, will I maybe describe this differently next time? You know, because it takes some time to be like, yeah, I talk about your water breaking like this.
This is my rhythm for talking about comfort measures, right? And that comes with doing it. And so as a small business owner, there is some stuff that you have to just try it out and see if that way works for you and then tweak it, right?
There's no way to have every single thing exactly how you want it when you start because you don't even know what you don't know, right? But I think having an understanding of the broad range of how people do this work and do like patient centered care is so helpful to even start your imagination of what this could look like, right?
Like I'm sure you've met doctors who are like, what do you do and how do you do it? What, that sounds awesome, you know? And so I would love for you to describe like, what do you think is like really unique about how you show up in this space as a pediatrician and how do you see that really positively impacting your patients, aside from being just like an amazing doctor at Children's National or at one of these.
you know, bigger groups that we have in the D.C. area. Mm-hmm, yes. So I always apply to every single grant scholarship fellowship award that I possibly can. I think that's because of the oppressive amount of student loan debt I have.
Like, it's always like, if I want to take this course, you better get a scholarship for it. And because there's just so many opportunities out there to learn. So when I was working for Medicaid and thinking about starting my practice, and I guess I was in a private practice as well then too, but I knew I was not going to be able to work under that system where you had to see like 35 people per day.
I got some funding from the American Academy of Pediatrics, and they had funding for early life people, like early career physicians. And you could choose any topic you wanted. And I said, I want to do this on alternative practice management.
styles. And so I was able to call people all over the country and email them and even talk to people internationally, like, hey, I'm working on a project with the American Academy of Pediatrics. Can I ask you some questions about your practice?
I'm also thinking about, right, like starting a practice like this and full transparency, right? Like, I'm not going to call anybody and pretend to be a researcher and then, you know, switch it up. So and so I would let them know this.
And so I ended up calling doctors all over the country. I ended up talking to patients all over the country. I ended up talking to a friend who was in the UK and like getting her prenatal care and baby care, everything in her home, right?
So I'm hearing about all of these different ways of practice that I was never exposed to before. And all I had seen was, again, like an academic center, right? Like you go to the academic center and you get seen in the clinic.
I saw like a community federally qualified health clinic. I saw private practices and that's it, right? And each one of those had their own challenge. So I never saw like a membership-based practice until I started making those calls.
And I kept hearing about concierge medicine and direct primary care. And I'm like, what is this? Like, I never heard about this, but it was so cool. Most of the doctors were in the Midwest. Most of them were white men, middle-aged white men and older white men.
Most of them, their wives were their assistants slash office managers. So as many times as I talked to the physician, more times I was speaking to their wife who was their assistant, which I think is very telling, right?
And it was just like, I just kept getting brought back to this. And I was like, you know what? Let me try this. So my philosophy, because that's what your question makes me think of, has always been one of what do I think would work better for busy families in my area?
And it always went back to families want to be healthy. they wanna establish a new legacy of health for their kids. They don't want their kids struggling with the same thing their grandparents and parents dealt with.
I have a lot of families struggling with obesity and high blood pressure, the parents and the parents are like, we wanna do something different. You tell me what to do and I'm gonna do something different for these babies.
Like all of us, we want to do better by our babies. And as someone who had her first child in medical school and was like waddling around and like going after hours to birth, like my husband would be like, babe, you need to come home and sleep.
And I'm like, no, there is a mom having a natural birth and it is after hours and I'm the only student here and everybody's teaching me what to do. So I'm staying. And he's like, but baby, you are eight months pregnant.
I do not care. And he's like, okay, babe, I'll see you when you get home. Let me make sure you got enough lunch. You write. And I'm like going to the breastfeeding center and taking classes, like on my off days, right?
Like I'm doing integrative medicine lectures on my off days, because like, none of this is happening during traditional hours. But if I don't see it, I will never be a student again. And I won't be able to see it.
Right? So all of it was like, uh, it was like, I need this for my own baby and my own life. And I need it for these patients that have, that are not getting people who are doing this in the hood where we live.
Right. And so I think, especially being a mom before I graduated school, and I ended up at home with our oldest for nine months. And I will tell you that is harder than any residency that is harder than being the intensive care unit.
It is harder than anything I have ever done being at home 24 seven with a exclusively breastfeeding newborn in like Arlington, Virginia. Um, so my philosophy has always been one of like, I went to medical school and they, I mean, I went to residency and they'd be like, well, this is true.
And this is true. Like very dichotomous, very black and white. I'd be like, y'all, everything is gray. It's covered in crumbs. It's got a schmear of poop. And like, this is what it is. Right. So like, if I can't give people real things that they can use at home, what the hell am I doing?
And so all of those experiences just made my medical school, my medical school and my residency experience completely different. Um, I have always had good patient outcomes because I am willing to sit those extra hours after hours to listen.
Um, I've always listened to my nurses. I love me a doula. I love me a midwife. I love me a nurse. I love me a doctor that takes extra time with people. So I've always like tapped into community. So like all those things that make me a good entrepreneur.
and a good pediatrician, like I had already been doing it because of like my upbringing. So like residency was pretty easy for me, like I'll say, in the sense that like, I have good patient outcomes because I'm a good team player and I listen really well to people.
Now, am I quick on my feet and can I do calculations in my head? No, did I get yelled at a lot of times because I can't do that? Yeah, but guess what, I still passed. And guess what, my patients have a really good outcome.
So, you know what I mean? Yeah, so my philosophy I think has always been one of collaborating and partnership because it doesn't, it does harm when we give people things to do that they can't do, right?
Like it hurts them when we tell them, take this medicine six times a day, you know, good and well, they can't, they cannot take it six times a day. So go ahead and figure out a different medication. that they can do once a day.
Cause I will tell you as the parent of a special needs child and being neurodivergent myself, taking meds even two and three times a day, it is hard. And I know how people miss appointments. You know what I mean?
So my practice, what we do, we decrease so many of the barriers, right? Like we schedule people's appointments for them. And guess what? Since I'm a house call doctor or they come to my house, they show up, right?
Like they show up for these appointments. I was like, I don't know, in the last six years, I had two patients who were really overwhelmed and I knew their situation, who missed an appointment. And that's in six years, right?
Because they sit there on their floor in my scrubs, playing with the baby, I'm gonna hold their newborn. I might even put a baby carrier on and hold their newborn while they sit, I'm gonna make sure they get food, right?
So like, that's how our work kind of overlaps. I think sometimes I try to do a little dueling for families. Yeah, so I think it's doing the things again that my community has shown me that they needed.
So like when my patients, for example, I think in year number two of business, I think it was like, yeah, 2021. And I was still referring people often to lactation medicine. And one of my patients said, why are you even sending me to them when you told me everything that they said already?
Can't you just be my lactation consultant? And I'm like, let me see what I can do. And then I applied for like, you know, a hundred hour course, took extra lactation, you know, education. And now I can do a lot of that stuff internally.
Like, of course I love lactation consultants and I want everybody in the prenatal period to have someone they can call if they need them, but I can manage most of it by myself. You know what I mean? I have patients now that are like, we need you to understand more about functional and integrative medicine, like as it relates to like ADHD and like autism.
And I'm like, okay, y'all, let me go and figure out what courses I'm about to take and like, let's figure it out together. So it's really collaborative. It's really accessible. You can send me a text message.
And just remember, if it's after four o'clock, I'm not going to see your text message. So if you want me to check it, if there's a picture, you call me on the urgent line and you say, Dr. J, log into the system so you can see this picture.
I look at the picture. I tell you it's okay. We'll talk again tomorrow. You know what I mean? So I'm constantly trying to figure out ways to provide lower barriers. And one of the things that I'm so excited about is our group visits, which we've been hosting since we launched our community space, which, you know, you've been to community spaces.
I love it. We're going to start offering like developmental visits to community members because so many people are like, my pediatrician doesn't have enough time to like sit and talk to me about these developmental, you know, these developmental milestones, but I want extra screening.
And I want to be able to talk about it. And so like now, in addition to my patients coming once a month based upon their age to our office, we're gonna be offering all those screenings online to anybody, like to people who want a consultation and they can come to our group visits.
And I'll give them a report that they can then share with their pediatrician that's like, I mentioned a few times I was worried about X, Y, and Z. I went and saw this community pediatrician and she did these screenings with me.
And here's the report that you weren't able to do. I get it, you were busy, but like she really thinks I should go to speech therapy or she really thinks I should go to see the genetics doctor. So she said, you can call her, but like here's her report.
Yeah, and I think both sides of that, like so both sides of that, what I mean is you said, you can call me and be like, look at the picture and I can look at it and be like, everything's fine. I'll talk to you tomorrow.
That is like, I'm really freaking out about this thing as a parent. I don't know if everything's fine. So like for me, one thing I get is pictures of diapers that are like, is this poop look normal? Is this pee normal, right?
Or like mucus plugs during the beginning of labor, you know? And I think the ability to be like, oh, this looks very normal. This is what breastfed poop should look like. It means your milk has come in, right?
Like that kind of stuff versus like, oh no, that looks like a dehydrated baby diaper, right? And that is actually something that we're concerned about. That reassurance when it's just like boringly normal, that spit up looks normal.
It's our first time ever spitting up. Don't be alarmed, you know? Like she's okay. It's because your milk volume has increased and no, she's not puking. She doesn't have a stomach bug, you know? And on the other side, having someone who takes them seriously and says, yes, you're right.
You do fit the description of someone who needs this genetic testing. You do fit the criteria of this kind of speech pathology or this OT or whatever it is. And I think what this system that we're talking about that kind of fails.
folks, right, is the fact that like you bounce around to different pediatricians your whole life, you don't have a coherent health history then in a lot of ways, right. And so you don't have someone who's like, you know, I've known you since you were six months old.
And this thing has always been an issue, right. And so that also makes people fall through the cracks. But when we think about like whole person care, like you were talking about your good outcomes, right.
And I'm like, I as a doula, I don't love that we clarify, we like kind of quantify so many good things about doulas around C sections and interventions. Because I'm like, there's a lot of that that we do not have any control over, right?
Like, yes, I think we prevent unnecessary C sections in the sense that we like often have tools for like helping a baby who's having trouble navigating the pelvis get through, right? Like we have extra tools.
In a scenario where your kids a little stuck, I have a higher likelihood of getting that baby unstuck. than if you have nobody trying to do that, of course, right? But I think for me, it's more important that at the end of this road, you feel like an intact person and your family has been set up for a good kind of on ramp to family, right, to parenting.
Like I want to work myself out of a job and I'm not going to keep you from having an emergency. I can't do that. None of us can do that, right? But what I can do is make sure that you're well supported.
If an emergency happens, I can bring the tools to reduce trauma in that scenario and help you process. And so for me, I think like the fact that families are thriving three, four or five years out from having a baby, that's my success story.
You know, like it's not how many C-sections versus vaginal deliveries I've had or how many, you know, like that to me is less of, I mean, yes, I enjoy a good like things when as I planned them, you know, but I don't have as much control over that.
What I have control over is making sure that you are taken seriously, making sure that you're listened to and telling you like when you have a doctor saying, I'm not worried about that being like, no, you and I both know that this is a concerning sign because of your history.
So it's not ridiculous for you to go in and have the baby monitored in this scenario. That is what you need to do. And quite frankly, there are two babies I know for certain are alive because I made people do that, right?
Because I was like, you're going into triage anyway. And if your doctor's like, why are you here? Just be like, screw you, right? And my thing is, call me. Like the doctor in the ER is asking you, what's up?
Like, there's my phone number on that. Like have that doctor and actually I call ahead, right? Like we don't, I don't know how to say that. Like I'm calling the specialist ahead. I'm calling the emergency room ahead and I'm giving them my cell phone number because I know that mom does not remember what I told her and she's going to, you're not going to make her feel like crap and she's going to forget the paper that I told her to print out.
the portal. So no, let me call you and let me tell you what I'm worried about. And oh my goodness, it just means the world and the specialist, the urgent care and the ER is always like, thank you so much for calling.
No one calls us, right? Like, yeah, just thank you so much in advance. And I'm like, yep, it's built into my practice. You know what I mean? Into what I do, because I know that it means a lot. Yeah. And in those scenarios, people do fall through the cracks because of how the system overloads the doctors who are doing it.
Right. So for me as a doula, I'm like, I want to know, like you have a weird blood clotting thing. Okay. I want to know about that. Not because I am a doctor and can do anything about that, but because if something comes up that that should be remembered by the doctor, I am going to be one more annoying person reminding them of that.
Right. Because I know that in an emergency, sometimes those kinds of details get missed. And so I want to say, I want you to know, I want you to remember you're wheeling her to a C-section. She hemorrhaged twice already in two different pregnancies.
It's her third pregnancy. please have every single hemorrhage medication in there with you, right? That stuff I'm just always going to do. And that protective piece then keeps those emergencies less emergent, right?
And that's the same for you. Yes, you're keeping people out of the ER and the urgent care. But when they go to the ER, you're also making that ER visit productive and less emergent because people aren't just like, why are you even here?
I loved when our kids were little, I really loved having a doctor who we could be like, well, I don't know why I'm here, but my doctor told me. Don't blame me. It's Dr. Castro who wants me here, not me.
Because it's so helpful as a new parent to be like, well, Dr. J knows what she's talking about. And she's the one who said it's this serious. It's not my hysteria. That's not what this is. So we could talk forever.
We need to wrap up so the episode doesn't go for hours. Is there any last stuff that any last stuff I can't even, I shared with Dr. J before we started recording that I went to bed this morning at 3 AM from a birth, which was lovely and beautiful and wonderful.
And also, I'm working on little sleep as we record this. Are there any last notes? Also your kids are home, like my kid is home. Right. And I'm trying to ignore the noises I hear and hope that you don't hear them.
Are there any last thoughts that you have about what kind of finding your own way has meant for you? And I know that's super personal. Like it's you can't say, like if a pediatrician does what I did and what I'm doing now, you're going to feel X.
I do not ascribe to that thought because I'm like, what works for me and my family might not work for you and your family. But I think hearing how it has benefited you and how you feel and are impacted by letting yourself listen to your needs and be directed by those, I think is powerful because there's a lot of fear in trying to invent something that is not what people consider the norm, you know.
Yeah, all of that made me think about how in the beginning of my practice, I don't know how comfortable I was about establishing the culture and the vision of the business, right? I remember in the beginning, not doing things the way I have been taught, but just like setting things up, right?
Team hiring and things of that nature, and so investing money in coaching was phenomenal and super helpful. I did a two-year intensive program for women service providers where we talked about team and hiring and operations.
finance and mindset issues, right? Like I met so many like money mindset and visibility mindset resources. But one of the things that I think has meant the most to me is just being like, being comfortable about like, I'm a culture, like this is the vibe, like I set the culture for the practice.
And so it makes me think of our, so two terrible instances of the practice. So we are extremely committed and it says it on our website and it says it in our applications because I got burned, right?
It says it like, we are committed to inclusive and culturally responsive care. Like I just thought, and you know, 2022, 2023, people just know this, right? Like, you know this, you know, I'm anti-racist, you know, I'm like committed to, you know, but then you get like the homophobic staff member who sends a homophobic email out and you're like, wait, is this really what we're doing?
Like, okay, and now I have to spend thousands of dollars on a human resources lawyer. Like I have the bomb, HR lawyer that represents so many of us in the birth worker community in DC, amazing black woman.
And she helped me feel comfortable about like, putting my vision statement into my application, right? So it's, do you agree with this statement and do you agree to take training on it whenever we say as a team, we need training, right?
Like I didn't have those things or like having to let go of a racist staff member who like, oh my goodness, I just, I live in DC. I don't really deal with a lot of overtly racist people. In my training I did, sometimes I do in public and I'll quit to check somebody, but like not someone who's sending emails on my behalf, like not this person making several of my black patients feel like crap.
And then when I bring it up to her, cause like, everybody's got biases. I've got bias, you've got bias. As long as we're willing to reflect on it and intervene on it and change, cool. You can stay on the team.
We can figure this thing out. But when I brought it up to her, it like the demeanor changed instantaneously and we get the pouched lips, we get the talking down to, we get the husband in the back of the screen in our meetings now, like, and me who has not felt like this in years, in tears, right?
Like being scolded by another person. It's like, wow, okay. So let me lead with like our team commitments, right? Like we are a culturally responsive, like we are committed to constant improvement. I'm like reading them, right?
We are committed to demonstrating excellent, culturally responsive care, joyful interactions, treating ourselves really well, flexibility and culturally responsive team culture, right? Like those 10 things out of like bad experiences, I will say, I'll call them learning experiences, right?
So now I lead with that, right? Cause I am the culture bearer of this practice. So anyone who comes in as a patient, anyone who comes in as a consultant, a contractor, an employee, you have to agree to those things from the jump and you have to know that we are going to repeat them over and over, we're gonna do training and education on them, we're gonna have awards based upon them, like all of those things.
So I wasn't super comfortable in the beginning with that. And I think over time, finding your own way is like realizing who you already were and being able to put that into words and practices and policies and statements, like our one page executive summary is like in every single thing that we do, like application, your 30 day evaluation, like all of it.
And finding my own, it's just been so cool. Like, I love an operations manual, like I do. If you know, I've always loved a good checklist and I'm like, give me an operations manual, give me an Asana project, boo, put some people on there, put some deadlines, let's get some, like, I love that.
I might be like 65 and retired and like go back to school for like operations management. You know what I mean? You're a VA now for people. All of those things, right? Like those are the things that you find over time and what it's meant for me is just like challenging myself and pushing myself and taking courses.
Like I'm taking an Asana course, like hours just to like learn how we can make it work better for our team. So like, you don't have to email me and you don't have... to ask me a question because it's already there.
It's in the Asana, click that button. You get a little unicorn that does a little happy dance when you do your thing. I love that about us. I love the unicorn. She's so cute. And like we're moving on.
So that's what it's for me, just like, you know, and then my neighbors, like, it just, it's nice. They're like, come look at her office. Like she built this in her backyard. Like come to my garden. Like she built this in her backyard.
You know what I mean? And my babies literally knock on the window when it's over. They tell me to come in the house and go home. They're like, mommy, are you done with your meeting? And I'm like, yeah, go with it though.
Your meeting is supposed to be over. They're so cool, right? Like my patients have been so gracious. They're so wonderful. They're just so happy. They're like, Dr. J, I know you are gonna be in the preschool drop off.
Call me back as soon as you get done. Bam, I'll call you in the parking lot. And like that is what it means to me for it to like in my life and work in their lives. And it also just, freakin dope outcomes.
Yeah, yeah. I love that so much because that clarity feels scary sometimes, right? Like it feels a little like, but what if people don't fit? What if it doesn't work? Well, what if people don't like it?
And actually, there's so much freedom in that clarity. And you draw in the right people because you're super clear about who you are. And if you if they don't fit that, they're gonna be like, no, thanks, you know.
And that I mean, I, I love that. And I think talking about yourself and your business and the way that you function has to be something that both draws in the right people and pushes the wrong people away.
Because that is what we want it to do, right? As small business owners, we don't want the people who are not for us. We don't want them to have us like it's not good for anybody, right? And the more you do that, the more it feels initially like, I'm gonna lose clients, or I'm gonna lose customers or they're, you know, what if that's the only family that wants to hire me in May?
I'm like, no, there are plenty of people. There is not a scarcity of folks for you. There's not a scarcity of people. There is not. And it is a dream to work with your dream clients. Like, it's so much fun.
They're so amazing. I love the farm and the view. Right? Like, you're like, they love me. I love them. I feel good about what I do. Like, that is the dream of doing this. Not that there's never hard things, but that you can be like, I know that there's like so much mutual respect here in this relationship.
And it is benefiting both of us. And that's glorious. You know, it's really, truly lovely. So this has been wonderful. Thank you for having me. Thank you for having me. I feel like we can talk about this stuff all day.
And we'll just have to keep on having conversations, right? No, I know. We should just hang out every now and then and then put a recorder between us. You know, I'm always like, please come to my office so that I'm not in here.
But I'm like, I'm like, this space is so big. I'm like, work with me today. You have your own side, I'll have my own side and then we can like eat lunch together. I'm like please come. Yes, yes we need to orchestrate that because we're way too close to not make that happen.
It'll be during our children's mutual tournaments and whatnot now that we know they're in these same things. And all the same things. It will happen. Thank you. Yeah. All of Jalan's information, Dr. J's information will be in the show notes so you can check out her stuff.
She has amazing resources and also has cool stuff coming in the future. So she is someone to know about and to be following as her world expands and as she has more stuff for families. If you are here listening, we will have our normal episode on Friday like we always do and I will see you then in that episode.
Yay. Yay, thank you for having me. Thanks for joining us for this episode of the doula tips and tits podcast. If you learned something today or had an aha moment, we'd love for you to share that on Instagram and tag us at hara doula so we can celebrate alongside you.
If you found this podcast helpful, we would so appreciate you taking a second to leave a rating and a review on your favorite podcast app. That helps other doulas find us as we do this work together.
This podcast is intended as educational and entertainment. It is not medical advice or business advice. Please consult your own medical or legal team for your own needs around your health and your business.
We'll see you again soon.

ASK A QUESTION!!! My plan is to start Friday Q&A (we need a new name, I know!) but first I need your questions! Submit them using the form below:

https://www.harroddoulaservices.com/ask-me-a-question

In this episode, we dive into the beautiful truth that there’s no one “right” way to run a doula business—and that’s both the magic and the overwhelm. Reflecting on the many conversations I had with doulas throughout 2024, I was reminded just how uniquely we each show up in our work. That diversity isn’t just okay—it’s essential. It’s what makes this profession vibrant, validating, and sustainable when we give ourselves permission to build a business that actually fits us. We also touch on burnout (again), because while I thought I’d covered it endlessly, turns out I haven’t—and it’s too important not to keep bringing up.

Quote from Dr J:

“So when I was in medical school back in the day, when I was in medical school, all of my mentors worked at inner city urban clinics, right? As a black woman, that is where everyone worked, right? A lot of the, I guess I'd say white academic folks would work in the hospital, then within pediatric you'd have the sub-specialists like the surgeons and the endocrinologists and the different people…. I remember being in visits with my grandparents and as soon as people heard, oh my granddaughter is a doctor, their tone would change, their verbiage would change, the respect that they gave them would change and it was almost like this deference and I just thought that was completely unacceptable like I didn't like it and since I have always been very interested in health disparities and the racial aspects of medicine again as a black woman it's like how could you not be when you see the impact on your family. I remember just thinking I needed to step back from this like one-on-one interaction with patients and really look at this broader systems that were causing you know high blood pressure, high cholesterol, diabetes, stress, alcohol abuse, like all of these things that I was seeing in you know, communities that I came into contact with, if not in my direct family, but with others.”

Meet Dr Jalan Burton:

Dr. Jalan Burton, or Dr. J, as she loves to be called, is a pediatrician, public health champion, wife, and mother of three with over 15 years of experience in pediatrics, lactation medicine, children with special needs, public health, youth development, practice management, and managed care. She is the CEO, Lead Physician, and Founder of Healthy Home Pediatrics where she helps families optimize their health, happiness, and peace. She is also the CEO and Founder of Harmony in Practice where she helps women in health care and wellness build joyful, profitable, scaleable, and sustainable businesses and brands.

Some of Dr J’s favorite kids' health websites are: https://kidshealth.org/ (for general kids' health info) and https://amaze.org/us/ (for tween and teen puberty and sexual health information).

CONNECT with Dr Jalan on TikTok or Instagram

https://www.healthyhomepediatrics.com/

https://www.instagram.com/healthyhomepeds/

CONNECT with Kaely on TikTok or Instagram

https://www.tiktok.com/@doulacoach

https://www.instagram.com/Harroddoula/

If you like this episode, don't forget to share it to your Instagram stories and tag me @harroddoula

Doula Tips and Tits is produced by Kaely Harrod of Harrod Doula Services

It is sponsored by The Doula Biz Blueprint Self-Paced Class for Doulas Launching Successful and Sustainable Businesses!

Music by Madirfan: Hidden Place on Pixabay