Meet the happiest nurse practitioner in Alaska!

Christine Sagan opened her clinic in a broom closet. She says, “I never thought in a million years that hundreds of thousands of dollars would be just rolling in.” Here’s how she did it . . .  (download/listen to MP3 below):

Christine Sagan: I’m Christine Sagan. I’m a family nurse practitioner and I live in Anchorage, Alaska. So before I came to Breitenbush retreat I was pretty miserable. I had for about six years not liked my job and I didn’t think there was any way out. I thought on the outside everybody would think it was a great job. I worked at a holistic health center and I had flexibility. I worked three and one half days per week. I kept justifying and minimizing my situation thinking that I was comparing it to everybody else and thinking it’s not that bad. But it was that bad in lots of different ways and it continued to take a toll on my mental health and my ability to show up. So after a change in contract and a pay cut, I decided that I was done with that place and was looking for solutions and I Googled around and I found Pam.

So I was really looking forward to Breitenbush just to get out and have fresh air and super excited to be off the grid and not deal with WiFi and just kind of disappear and get back in touch with my own thoughts and not have all the busyness and distractions. When I showed up here it was one of the largest groups. It was 54 people. I really didn’t know what I was getting into or what to expect and it was super-humbling to hear everyone’s stories.

Starting as a nurse at the bedside 17 years ago, there was definitely a hierarchy in the hospital—like this is the doctor and they tell you what to do—and it always put doctors on a different pedestal, but when I heard their story I was like, “Oh, you’re just like me! Oh, you’re human. You have the same crazy story I have!” And all the sudden when I took that barrier down about who they were and who I thought they were in the medical system and I had compassion, I realized that I could have my own compassion for myself and for the other doctors I worked with and I realized that we were all really were the same going through the same thing. We just had different tolerances for B.S.

I came to the retreat in May and it was pretty solidified by then. I had been working toward it, but I was still scared. I was 10% there and there was no way by the end of the year I’d have any plan in place. So I felt mentally solidified that I could exit. Didn’t matter really where I was going to go. I was actually okay if I didn’t even have a clinic. Just leaving was victory for me. So I just got even more excited. I almost feel like I came out of the winter and it was spring and there was this renewal of spirit, of like I can do this and I’m going to be okay and I’m making too big of a deal out of stuff and I’m just going to do the next right thing. So I continued to find opportunities to grow and that next six months I was out.

Someone from the hospital approached me who invited me to use space at the hospital and I could build it any way that I wanted and there was a budget for it and I had to sign a lease. At first I was a little fearful of it, then I thought, well, I’m going to work and it will work out and it will be okay. I’m not going to worry about it, I’m just going to work.

So the space presented itself which got more exciting. It was like okay I’m really working toward this. I put it out there and started sharing with people and patients. This is my idea and they started shoring up support and helping me come up with designs and websites and someone did all my photography and I talked to my brother and was like I need a name and he came up with a name and that resonated with me. It was exciting—like birthing a child.

My boss eventually found out that I was exiting and I don’t think he knew much about the details other than that I was going to leave so he fired me. And I felt pretty happy and at peace with being fired. It was like that’s so cool, I’m really free! I didn’t quit you. You had to quit me. What was really funny is the last official day of the contract would have been the 31st of December and my last day of work was December 22nd and I had planed on working through because in my mind I was like I need revenue because I don’t know if I’m going to have that many patients. So the last day was the 22nd on a Monday which is really random and I decided to give myself the gift of Christmas and not work for 4 days and I decided to open my clinic Vitae Integrative Medical Center on December 28th. The funny part was that my boss offered me my job back the next day with even more of a pay cut. He knew I was fearful and vulnerable and I called my dad and he’s like, “Why would you work for this person?” and I was like, “Okay. Right!” and I kind of just got back to that spiritual sense of being able to ask my higher power, “Am I doing the right thing?” And I remember sitting in the break room and my boss had texted me, “Hey are you signing the next contract?” and I just sat for a moment and I heard this loud NO!  And I was like, “NO!” And he got more angry at that. Oh wait I have a voice! I can say NO! And it’s a complete sentence.

I would tell my patients, “Oh by the way, in a month I won’t be here.” And they were so excited! I thought, wait a second, are you guys all in on the secret that you were just as unhappy as I was in this space? Nobody told me. So they were super happy and people offered to work for me and I had all sorts of crazy offers. Since my space wasn’t open, they offered me a closet for $200 per month. I said, “I don’t have anything right now because I wasn’t planning on being in a closet.” So they gave me a Pap table, they gave me a desk, I got a computer. And people showed up on time and I had a full schedule (because peoples’ insurance was paid up) so the 28th to 31st I had 40 patients and they showed up at the closet and they knocked on my door and I let them in and checked them in and out and I took payment.

I kept thinking this is so funny because Pam always said, “Do everything yourself” and I thought no, no, that’s not going to be me. I’m not doing that. But it was a wonderful blessing because it was humbling and I was able to just show up and I heard their stories about why they showed up and followed me. I had no idea they were going to follow me. That was my biggest thing. I don’t even know. I’m going to go out there completely blind and I don’t know who will come. I don’t know if anyone really likes me enough to follow me. Are they attracted to the clinic or to me? And that was such a weird mind trip. It’s almost like a popularity contest. Who’s going to stay and who’s going to go? But it was shocking that I had 40 patients the first week. What was really cool was that the three months I worked in the closet (and they would make jokes about the closet, it was just so humble and sweet) the money from insurance came through exactly on the mark that I opened my new space that cost more and I had enough revenue to pay all my bills and my staff.

Pamela Wible: So what has this done for your personal life and your sense of wellness?

Christine Sagan: So I would say that at points during the stress and the unhappiness it polluted all of my relationships. So it was sort of this, I’m unlovable and I’m not going to try. And my husband and I did talk about divorce quite a bit. I feel like in the last year—because my spirit has come alive with who I am—it is easier for me to show up and say what I need and mean what I say and be able to make amends and just be real and not be afraid all the time. So I feel like our relationship has really blossomed and we’re doing really well. So it’s kind of an interesting gift when you have yourself that all the sudden your relationships get better.

Also I started traveling as a young person and that’s one of my happy places to go and see the world and when you’re working all the time you took little breaks but I decided I’m just going to go see the world! So it’s kind of funny. I opened on December 28th and on like February 20th I’m like I’m tired. So I forwarded my phone to my brother and I went to Hawaii and took my kids for ten days and just played. We played and we didn’t have to do anything. And I thought oh that was too easy! So in May my kid finished her first year of middle school and I said, ”Let’s go on a trip” so I took her down to Nicaragua which is really random into this roadless island and I had learned how to dive when I was 18 and  hadn’t dove since my 20s so I taught her how to dive and I got to dive again and it was just kind of like this youthful rebirth like, “Oh, okay I can play and have fun!” And again I didn’t have to ask anyone to be on call. I didn’t worry. I was in Nicaragua and I couldn’t log on to the Internet and I got to just go to bed and walk on the ocean and just have quiet time and realize there is so much more to life than working. So I’ve continued to make goals of what’s the next trip.

I feel like it is just the perfect balance of work and rest and fun. It’s intense being in the medical field. You’re taking care of people and I feel like I have myself and there are great outcomes and they enjoy being there but at the same time I still need rest from hearing people’s stories all day and really caring and being empathic. Same thing other people have said (see Dr. Kayla Luhrs interview), I’ll tell people, “I’m going to go to Mexico next week” and they say, “Oh great! Where are you going? Go to this place and here’s this and they’re constantly excited for me and want me to have fun and be rested and practice what I preach and I come back and say, “Oh I learned this,” and they’re like, “Oh great!” It’s like having an extended family and everyone cares about you and they want you to be well so you can show up.

Pamela Wible: Do you feel like you’re living your dream?

Christine Sagan: Yes, I feel like I’m living my dream in terms of I’ve been consistently happy and now it’s like this obligation to the medical community so in my own little way I meet doctors who are on their own and I’m encouraging them or encouraging people to go out on their own and try to create collaboration  and community and and just having the heart to show up and not be exhausted by it. I just have this joy of giving it back and moving it forward.

Pamela Wible: Can you talk about salary potential?

Christine Sagan: Okay. Money. So this is interesting. When I first came up with my business plan I really meditated on what’s my mission, what’s my vision, what are my values and what am I doing. Over and over again I would make sure that was really ingrained in what I was doing and really prominent on my website—this is my mission. Part of that is that I wanted to attract who I wanted to work with. And a friend of mine who is wise said, “If your bottom line is money, you won’t be successful.” So I thought, “What else is your bottom line?” She said, “Think about what your bottom line is?” Wait, the bottom line is people. If their needs are being met I don’t have to worry about my needs being met. They’ll be met. So I had this trusting approach. I’m not going to worry. It’s all going to be okay.

So I have never not had a full schedule. I kept getting more and more booked out so I had to stop taking new patients. Then I decided to hire other people to help out. So I’ve hired a part-time doc and I find their same story. I say, “What’s your story?” They tell me their story just like everyone else has shared their story and then I think I want to provide something that is safe. Not everyone wants to be on their own so I’ve had other people come to work in my space so that produces revenue. Part of what I want to do is work smarter and not as hard and so I have recognized other revenue sources. For me I chose to take insurance because I feel really strongly that people are paying for insurance and insurance should be used and we should bill insurance for the services at top dollar.

I went to a talk and I used to feel bad about making money because it is almost like you have to sell yourself and whatever you are selling and so I remember listening to this talk and I thought oh, okay. What I decided was that I am now unapologetic about my worth and what insurance is willing to pay and what I’m going to charge my patients. I feel if I lessen what I am worth it doesn’t really make any sense for me. I might feel anger or bitter and resentful or something. I charge what I charge and I get paid for it by insurance and then patients get better. They are invested in their health and they show up and they are willing to cash-pay me, they’ll do whatever. So all of my bills have been paid. I’ve always been ahead of schedule. Everything in the office I own. I own every computer and every desk and I’m not in any debt and I never had to take out a loan. It just came and everything is moving forward as awesome as it could.

Pamela Wible: Would you say you could make two, three, four times what you could make as an employed nurse practitioner?

Christine Sagan: Yes. Yes. So what’s funny to me is that it ended up in the end (because of course I’m just going through the motions and I have no idea what the bills are going to be) so at the end of the year I made five times what I made before.

Pamela Wible: In your first year?

Christine Sagan: Yes. And it was funny I was like, “Oh wow! I just compressed five years of my life and I lived it in one. Now I have so much more freedom to retire early. And it’s just funny because my bottom line was never money—that was never my goal. My goal was to make what I made or at least pay my bills or not go into debt like that was my basic goal. I never thought in a million years that hundreds of thousands of dollars would be just rolling in. But it allows for the freedom to not be worried and then to dream bigger like okay, whats next?

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Pamela Wible, M.D, is a practicing physician who has devoted her life to preventing medical student and physician suicide and helping healers heal to live their dreams in medicine. She is author of Physician Suicide Letters—Answered.