Dr. Mary Talley Bowden is an ear, nose and throat doctor in Houston, Texas and is board certified in both Otolaryngology and sleep medicine. Mary recently opened her own practice, Breathe MD, which offers a unique treatment approach to sinusitis, other than antibiotics, such as sinus therapy, allergy immunotherapy, and infrared sauna. Mary will discuss overcoming challenges of residency, why taking time off was the right decision, her unique treatment approach for sinus care, and how she re-entered the workplace to start her own medical practice.
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On The Madeline & Becca Podcast, we chat with leading women from a variety of industries about their career journeys and how they developed professional self-confidence.
Produced by Madeline and Becca
Episode #12: Opening a medical practice with Dr. Mary Talley Bowden
Mary [00:00:00] You just got to tough it. You just get through it and know that, it's like anything that's painful, you just got to know that it's temporary and it's, it's going to end and it will make you tougher when you get out and don't pay it forward. Be nice to, you know going forward, don't do what those people have done to you, just, but it's always like looking towards the future and knowing that it's temporary. [Music transition]
Madeline & Becca [00:00:30] Welcome to The Madeline and Becca Podcast. The mission of our podcast is simple, to inspire professional self-confidence in women everywhere. I'm Madeline. And I'm Becca. On our podcast, you will hear stories from real world influencers, women who have experienced tremendous success in their careers by building self-confidence. Thanks for joining us. [Music transition]
Becca [00:01:11] On today's episode, Madeline will be interviewing Mary Talley Bowden. Mary is an ear, nose and throat doctor in Houston, Texas, and is board certified in both Otolaryngology and sleep medicine. Mary recently opened her own practice, Breathe M.D., which offers a unique treatment approach to sinusitis other than antibiotics, such as sinus therapy, allergy immunotherapy and infrared sauna. Mary also counsels patients on the impact of poor sleep quality on their health and treats both the medical and surgical aspects of sleep apnea. Mary grew up in Georgia and attended UNC and the Medical College of Georgia. She completed residency in Galveston, Texas, and began her career in private practice before taking time off to raise her four boys. Mary will discuss overcoming challenges of residency, why taking time off was the right decision. Her unique treatment approach for sinus care and how she reentered the workplace to start her own medical practice. Here's Madeline. [Music transition]
Madeline [00:02:19] Can you tell our listeners a little bit about your early career? Were you in private practice or within a hospital system?
Mary [00:02:25] I just went to private practice. Initially when I was in residency, I thought, I wanted to do academics, but residency kind of felt like a prison sentence. And some of the personalities, I just, I mean, there are different residency programs. Summer are not kind and great people. Mine did not feel that way, I felt like, and the women were there were, the women were actually the worst. Like, the female physicians were just not great mentors. And so, I did not want to do academics after my residency experience and decided to go into private practice and joined a small group with two men.
Madeline [00:03:09] How did you deal with self-advocacy during residency with that, you know, it sounds like what was a pretty challenging environment.
Mary [00:03:19] It was tough. I mean, I, it was really, really tough. Like, I look back on that and it's a little bit PTSD. And, you know, you just you form your allies. And luckily, I had a couple of people that I really, you know, the residents, co residents and it really helped me through, and it was it was tough. I don't quite understand why many of the female physicians and academics are so tough on other women, but that's, that's a sense I got, is that it's just not very female to female friendly.
Madeline [00:04:06] And for other women who are perhaps experiencing those types of challenges in their early career, do you have any advice that you would impart on them about surviving that, that period and how to navigate those tricky situations?
Mary [00:04:21] Yeah, you just got to tough it. You just get through it and know that it's like anything that's painful, you just got to know that it's temporary and it's going to end, and it will make you tougher when you get out and don't pay it forward. Be nice to you know, going forward don't do what those people have done to you just, but it's always like looking towards the future and knowing that it's temporary.
Madeline [00:04:47] Do you think that some of the women who you knew, who you were discussing, why do you think they were so negative? Was its a, "this is we've had to be through this system and tough it out the hard way and we want everyone to experience that." Or was it just a very otherwise male dominated and, you know, the few women who were there trying to make it? What do you think contributed to that? Do you have any idea?
Mary [00:05:10] Well, I think it's just, part of it's just the nature of their personalities are hard. The women that go into academics tend to be a little more hard driven, take themselves very seriously. Have to fit in with the male dominated culture and not show any vulnerability or, or empathy. I don't know. It's just it's a different, different personality. I'm not wired that way. I think they're wired a certain way.
Madeline [00:05:41] Was your early career then? You said you went into a practice with two other men. Was that a positive experience those years? Those building years?
Mary [00:05:52] Very. They were very, they were complete opposite of residency. It was very, it was wonderful. And I, the only reason I stopped was because I had too many children. So, but yeah, it was great.
Madeline [00:06:04] Yeah. I want to ask you a little bit about that. So, did you take time away from private practice to be at home exclusively and raise your children?
Mary [00:06:14] Yes. So, I, the situation that I had was great because it was pretty flexible. And basically, I could set my schedule as long as I was keeping up and I would, I wouldn't deny people access to my services. But if I had no one scheduled, I could block my schedule and go see the kids, that sort of thing. And so, it. was very flexible. And then, I had two little boys and they were 16 months apart. And then I got pregnant again and I decided to take a year off. And then I got pregnant again and decided I couldn't, I just couldn't do it. And I had four boys in five years, so it was, and we had no family in town. And my husband traveled like ton. Like a ton. So, I just couldn't do it anymore.
Madeline [00:07:10] And did you receive any professional pushback about taking time to focus on raising your children?
Mary [00:07:19] No, I mean, I mean it was more on myself. Like, I just felt like, oh, my God, what am I doing? You know, it's like if you put in so much to get this far. Now, I'm doing exactly what my mom told me not to do. And I wasn't sure if I'd ever go back. Because once you get into that nonworking groove, it's, I wasn't sure if I'd be able to climb back into the workforce.
Madeline [00:07:46] And did you, while you were home raising your boys, did you do anything to continue to keep your connection to your field in terms of staying current or other types of things that helped you then to transition back?
Mary [00:08:03] I tried. So, because I'm in sleep medicine, I was able to be the director of a sleep lab, which was pretty easy, I could just read sleep studies from home. But, and here and there I would take CME and, you know, online. Yeah, there were a couple of years where I was just, it was just, I was knee deep in kids and that's all I could do. But surprisingly, once I started tinkering with the idea of going back, it was, it was like riding a bike. It all came back so easily. And I even, I took some cadaver courses for, to see if I could still operate. And that felt very, it was wonderfully, it was like riding a bike. It felt like it just all came back. The muscle memory was there and did not feel hard trying to catch up at all.
Madeline [00:09:03] Do you have any advice for other women who perhaps find themselves at that juncture that you were at where they're know worked really hard to have a high achieving career and are thinking about taking time off, but concerned about the ability to actually come back after?
Mary [00:09:22] I would definitely take the time off. Definitely. I am so glad I did that. Now, I do think there are some women that are wired, I don't know, I just always felt guilty when I was working. I always I mean, even when I just had one kid. And I think there's some women that aren't wired that way, they can, they can leave their kids and feel fine and there's nothing wrong with that. I actually wish I had more of that. But, if you don't, if it's bothering you, then take the time off because it's the best thing I ever did. Now I have this whole new thing that I'm doing, and I'm, it wouldn't have happened if I hadn't taken the time off.
Madeline [00:10:02] So tell us about that. Can you tell us about your decision to transition back into actually starting your own business? How did that come about and how was the timing correct and all of that?
Mary [00:10:12] You know, it took, it probably took two-and-a half years to actually from, first thinking of doing it to actually doing it, so it takes a while. And, yeah it took me a lot of money to get it started. But it's, after, I guess I'm how many months now, ten months, I'm breaking even. So, I'm excited about that. And I love it because I'm doing exactly what I want to do, the way I want to do it. I am running it. I just like doing things the way I want to do it. And it's allowed me to be, use my creativity. And I have an entrepreneurial side to me. So, it's fulfilling that.
Madeline [00:10:58] So is that why you decided to start your own business versus joining an already established practice again?
Mary [00:11:03] Yes, yes. Because I'm doing something a little bit different than a typical ENT clinic. And so, it's allowed me, I've always sort of wondered if I could do it. And so, it's allowing me to fulfill that possibility, which I wouldn't be able to do at a traditional doctor's office.
Madeline [00:11:27] So tell our listeners about Breathe, M.D., and what your practice is and your vision with the business.
Mary [00:11:37] So, we do traditional ENT, I do all the bread and butter, ENT. I'm not anti-medical ENT, but I also provide alternatives, like I'm a big believer in saline irrigations for sinus problems. And I don't think, I think surgery, I think too many people are getting surgery. I think there is a role for surgery. Like I said, I'm not anti, but so, the initial premise for the practice was to do something called sinus therapy, which is based off of what patients with cystic fibrosis, how they get treated so patients with cystic fibrosis, can't clear the secretions from their lungs because their secretions are too thick and they do a special kind of therapy where they, you know, they get percussion on their lungs, they get inhalation treatments to try to get the mucus out. So, it's the same idea, but for the sinuses and not just for patients with cystic fibrosis, but for anybody that has sinus issues. And it actually came about because I was in Massachusetts in the dead of winter visiting my in-laws. And I got a, I knew I had one sinus, it was completely clogged up. And I didn't want to deal with trying to get to the pharmacy. And so, I sat in my in-law’s bathroom and started hitting myself in the face and putting hot towels on my face. And I was able to dislodge the obstruction. And I felt immediate relief and I didn't need to be on antibiotics. And so, it occurred to me just like, well, that's basically what they do for cystic fibrosis patients. And, but then we add a spa component to it so that your, you know, you're sick, but you're getting pampered, you're getting drained. You get, you get a powered saline irrigation, you get steam, you get aromatherapy, hot compresses, massage. So, you kind of get pampered while you're sick and then you leave feeling better.
Madeline [00:13:43] Sounds pretty optimal. What about the sleep element of your practice? Can you tell us a little bit about that?
Mary [00:13:50] So I'm also a board-certified sleep medicine and we have not, well I'm building out right now, a sleep clinic. So, for overnight sleep studies, but in conjunction with that a lot of people with sleep apnea are overweight. So, during the day, we'll be focusing on helping patients become healthier and lose weight. We're also going to have a salt room, which is helpful for respiratory issues and sauna and things like that.
Madeline [00:14:25] I read on your web site that you don't contract with insurance company, which insurance companies, which means that you're able to exercise your own independent medical judgment. Can you tell us about the advantages to doing this? In my prior private practice litigation work, I dealt a lot with insurance companies. So, I know the challenges that go with having claims paid, et cetera. Can you just speak to that a little bit?
Mary [00:14:55] Yes, so it's just an easier, more efficient, if I took insurance, I'd have to hire an extra person to work on claims full-time. Because I don't have insurance to deal with, I can keep my prices reasonable, like a new patient appointment is one-hundred-eighty-five dollars. That includes endoscopic examination, which if, it actually is cheaper all around than going through the insurance company. A follow-up visit is one hundred-and-fifty dollars, which is, I mean, less than most massages. It allows me to you know; I don't have to cram a bunch of patients in to keep to make overhead costs. It's just a more efficient way to do it. And we give you know, it's really not that hard for patients to file their own claims. It's just a matter of actually doing it. I've been on the other side of that with some of the visits that I've had to take my kids to. They don't take insurance and it's not hard to do, you just got to actually do it. And I just think it allows a much more efficient and doctor, a better doctor patient relationship. I don't have to get approval from the insurance company before I do some minor thing in the office. It's also great for people that have really high deductibles because they basically are paying out of pocket anyway, unless something catastrophic happens.
Madeline [00:16:38] So, for other women who are perhaps thinking about opening their own practice, what advice could you give them about preparing and coming up with a business plan? I know, because opening a business is wearing a different hat than practicing medicine. What advice can you can you give them?
Mary [00:16:57] We'll so, there's this this thing called Small Business Development Center, which is in most cities, I think. I've loved that. I've gone to a bunch of seminars there. I will say I'm better, I'm more of a forest than trees type of person. And that's where I, that can be hard if you're trying to do business. I have a, I think the hardest part of all of it has been finding the right people like employees. And I'm finally at 10 months. I'm right, I have the perfect little setup. But I did experiment with that a little bit. So, I think you can find the right people to work with you, then that makes all the difference in the world. And then you can teach yourself a lot just online or that this place, like The Small Business Development Center. Their seminars are like thirty dollars. They're invaluable.
Madeline [00:17:57] And how has it been balancing now, being both a business owner, a doctor, and you still have four sons. I'm assuming they're a little bit older now, but.
Mary [00:18:05] Yeah, my youngest one is eight now. I, you know, they you should say, "mom, you don't do anything all day. You don't do..." And now like, "oh yeah. You're testing people for Covid." I have a little bit more respect around the house, slightly. And they don't seem to, you know. I don't get, I get a little bit you know because of Covid they were home all the time. That's when I felt a little bit like oh God. But had they been at school like we were supposed to, then it would've been no big deal because I schedule it so that I usually pick them up from school anyway unless something comes up. So, it's really not, balancing, is not that, hasn't been that hard. It's never perfect.
Madeline [00:18:52] So, can you tell us. I know a lot of small businesses have had to make a business iterations during the pandemic. What have you done with respect to Covid and testing for Covid?
Mary [00:19:07] Yeah, that was kind of weird because somehow my clinic morphed into a Covid testing center, which wasn't the plan. I just had patients asking me. Can I get tested? And then I figured out that LabCorp had it. And so, I had some swabs already with the viral transport medium. I don't really know why I even had those, but I had them. So, I started testing people. And then I was lucky because we, you know, there was a problem with shortage of the viral transport medium and but there's another way to test where you can, it's called Nasopharyngeal Lavage and you basically irrigate people's noses and then have them blow into a container. So, because my clinic is already set up for that, I was able to test people using that. So, I was able to test a bunch of people with just basically sterile cups. So, then I was able to keep testing until all the other supplies caught up. And then, another lab that I've worked with before had started testing. And I love their test method and I've got that all streamlined now. So, it wasn't on purpose, but it just essentially evolved into that, which was fortunate because I was able actually hire people during all of this and keep the business going. I still can pay my rent and also have helped get early access to testing and we started testing people March 13th, and we were allowing anybody to get tested, not just people that had symptoms.
Madeline [00:20:51] Wow, that's really early on. What is the some of most rewarding aspects of your job now that you're able to be a business owner and be able to practice medicine in this, you know, innovative way that you've created within your practice group? What's, what are some of the most rewarding aspects of your job?
Mary [00:21:07] Well, happy patients. That's you know, and I had having had four kids, I've been on the other side of the medical system and I just like I mean, going to doctor would just wreck my day. So, I like being able to provide a great office visit experience where people actually feel better and happier when they leave my office. That's probably the most rewarding. Just not wrecking people's day when they come to see me.
Madeline [00:21:32] Can you give our listeners your best piece of advice that they could apply to their own careers, specifically with respect to developing professional self-confidence?
Mary [00:21:46] I think your twenties are, and I didn't realize in my twenties, like 20s, you're supposed to work your butt off. It's gonna be painful, but it will pay off. So just take it, just tough it out and know that it's going to get better. So, your mid to late 20s should be painful. You should work your butt off. You should not sleep. You should kill it. And then stick with it and the pain is temporary and then follow your dreams. That sounds so cliché too but follow your dreams.
Becca [00:22:31] If you are interested in visiting Breathe M.D., they are located in the River Oaks section of Houston, Texas. You can also find out more about the practice at BreathMD.org. If you enjoyed listening to our podcast, hit subscribe now and leave us a review. Thank you to Nico Vettesse for composing our original music. And thank you always to our home team of friends and family for supporting us in our mission. This episode was produced and edited by Madeline and Becca. Thanks for tuning in. And remember, you are somebody.