Dr. Ariana M. DeMers's Start to Her Ortho Practice

Dr. Ariana M. DeMers stepped back from surgery, discovered orthobiologics, and started a one-day-a-week cash clinic in a rented room with a high school receptionist and a Square reader. She built it on one-hour appointments and word-of-mouth, proving the model worked without the overhead of traditional surgery.
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So you do this 9 months. What's going on during this 9 months? You're working 2 half days, 1 day of surgery. What are you doing in the interim? Because I would imagine that was like kind of strange to have that much time because when was the last time you ever had that much time? Like never?
Yeah, college.
So what'd you do?
College.
College. Yeah.
So yeah, I was taking care of myself. I was running, I was working out, I was working 40 hours a week, which was amazing. That was so amazing. But I was kind of panicked because I didn't know what to do. I was like, what am I going to do? What am I going to do? That was kind of my mantra. I'd run every day and be like, what am I going to do? I have no idea. And so I kind of— a light bulb hit and I was like, I need to do orthobiologics. I think that is going to be how I change my patients' lives, that this is going to be the next new thing. And this is what I'm going to do. is I'm going to focus on orthobiologics. And so I started looking and I started trying to get really smart on how to do orthobiologics in a really, really good way and focus on that only and more of a non-operative clinic. Because I was doing a lot of surgery, I was feeling really exposed, and it was really clear to me that nobody cared if I felt exposed or not because no one had checked to make sure I was actually above water. And so I started looking and I couldn't really figure out how to get smart on orthobiologics. I searched, I looked, and I found some education with the Interventional Orthobiologics Foundation, IOF, and I started to go to the conferences. And my first IOF conference, my brain exploded. I was like, oh my gosh, Oh my gosh, there is this whole other world and whole other way to care for patients and to get really good results without surgery, without invasive procedures, without high risk. And oh yeah, by the way, without downtime. And there's a ton of research. In the orthopedic world, we have been ingrained, it's been ingrained in our head that there's no research, there's no data, there's no evidence that that works at all. It's pixie dust and magic.
Yeah.
Okay, uh, we don't—
and this is, this is like 5, 6 years ago when basically in the world of orthobiologics it was kind of like— I, I liken it to the Oregon Trail days, right? Like there was, you know, nothing but pioneers. There's a bunch of people out there just kind of trying to find their way through. Like this was real at the beginning, at the real beginning stages of, of orthobiologics, right? I mean—
It was in the beginning. There was a lot of very smart people doing lots of really good work and research. It just wasn't in my realm. I did— I was not aware of it. I didn't know it existed. It does exist. It is real. People all over the world are doing amazing research, and this has been a real thing for a bit. It just wasn't in my realm. And so I was like, oh my God, this is the best thing ever. Yes, I'm all in. And that's what I did. And I started a cash practice. I was a little bit nervous, but I did it one day a week. I said, okay, well, we're gonna do this and I'm gonna do it one day a week and see how this goes. I rented one room and I had my nurse, who was the one who was on maternity leave, she joined me one day a week. And I didn't even have a lobby. There was a lobby of the building that we were renting. And so I had a receptionist who I'd hired. She was just out of high school and she was very smart, but, you know, This was humble beginnings, and so she would make the appointments on her cell phone, and she had a little laptop, and she would like meet the patient at the door and be like, "Oh, hello! Hi, how are you? And let's sit here in this lobby and let me get your information, and then let me take you back to our treatment room. The one one we only had one. So you know that she'd bring her back, and we do the treatments, and we do all we do the interview." you. And then at the end of their therapy, I take their credit card. I had a little Square reader that I hooked up to my phone, I think, and took their money.
Right now there's a bunch of doctors short-circuiting in their brain about all of this. Like, where's the big machine? Where's the massive computer system? Where's the EMR?
Yeah, it was the craziest thing. I was like, oh my gosh, this This is really like, you come, I take care of you, I see what the problem is, and I take a long time and you pay me for my time and my expertise and we hang out and talk. Like, my appointments were 1 hour long. And so we would just get— I would get to know them, they'd get to know me, they trusted me that like I had some treatments that sounded really interesting and helpful with low downtime and potentially they could avoid surgeries. And we did the treatments. And then they paid me the money and then they got better and it was really cool. And this is word of mouth. And I did it one day a week and I did it for a whole year. And then I'm like, I think this might work.
Actually work.
I think this might be viable. And so I was very busy. And so I actually quit my 40-hour-a-week orthopedic surgery job that was quite lucrative. And I opened up my orthobiologics clinic. In 2019, right before pandemic. It was great timing, but it worked out because I had my ability to make changes. When the pandemic hit, I just switched to telehealth online services. And when, you know, when we were shut down and nobody could have surgery, people were still having orthopedic problems and they could come to my clinic and they could have injection-based therapy. And get better, and I could help them and hone in on the why and spend time with them when nobody else was. And so it has been so rewarding, so amazing. I love my job. Am I working hard? Of course I am. I think that's kind of still ingrained in me, but I love it.
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