Sam Pappas was born to two Greek immigrant parents and was raised with a respect for the wisdom of the ancient Greek world. In the birthplace of modern medicine, Sam’s forefathers always stressed the importance of “a cultivated mind and a disciplined body” for maintaining good health. The lesson stuck with Sam.

The more time Sam spent as an MD, the more he observed that the advice doctors typically offered their patients was lacking. “A friend of mine got me started looking at research in the integrative health world,” he explains. “I was looking at this data and thinking, ‘Man, this research is confirming what my grandparents said.’ I go back to Greece occasionally, and I see older people thriving. I took a deep dive into the literature of Greek medicine since I have always been fascinated by warrior cultures. I was also fascinated by health through a historical lens. So I started to teach myself lifestyle medicine.”

Sam’s colleagues were less than enthused about his studies. Many dismissed the idea of integrative health and encouraged him to focus on prescribing pills and getting the patients out the door. There was enormous pressure to treat as many patients as possible, as quickly as possible. This didn’t incentivize the behavior—spending time getting to know your patient—that Sam has found so important to improving patient outcomes.

“I spent more time with people than my peers did,” he explains. “I asked them about diet, stress, work, meaningful friendships, spiritual outlets, etc.” And the patients responded. Within a year or two, his reputation had spread across the area with mothers in North Arlington singing his praises as their doctor of choice online.

“I spent more time with people than my peers did,” he explains. “I asked them about diet, stress, work, meaningful friendships, spiritual outlets, etc.”

After some time, Sam ended up in charge of a practice, where he was named a top doctor by the Washingtonian magazine. He had a long waiting list of patients who knew him by reputation only. And yet, for the medical establishment, there was only one metric that mattered. That metric was money. “They were shaming me and comparing my daily patient visits for a month to the average of other doctors. I saw 14 patients when others were seeing 30,” he recalls. “I would counter that I have the best outcomes, my patients have fewer hospitalizations, my patients were raving about me, I was a Washingtonian Top Doctor, and other things that I thought would be metrics a doctor’s practice would want. But obviously, those weren’t the key metrics they wanted.”

Seeing the writing on the wall, Sam began to put together an audacious plan. He’d start an integrative health practice, out of network, with concierge services. Patients could choose to pay a flat annual rate of $2,500 to $3,000 a year and get full access to Dr. Pappas in-person or remotely via Skype whenever they needed him.

Sam’s hospital was shocked and claimed the move came out of nowhere. Sam’s wife, Joyce, was nervous. “She was very worried,” he recalls. “She felt that going ‘out-of-network’ was risky and wasn’t sure concierge services would be attractive to patients. But I assured her that I know how to take care of people and that my work ethic and sweat equity will make it work. I told her, ‘If we do this, they will come. I don’t know how it’ll all work out, but I want you to partner with me.’”

Joyce was trained as an ICU nurse—a “fantastic” one at that notes Sam—who had given up her career and plans for medical school to move to New Jersey with Sam and raise their kids. But she was also blessed with incredible organizational skills and a head for business. She became the co-founder of Pappas Health and today takes care of the back office and operational side of things. “I’m more of a 30,000 foot kind of guy,” explains Sam. “Joyce is hardworking, knows finances, and is very much synergistic with my approach. She’s the one meeting with all of our business advisors and professionals and handling all office matters. I’m really blessed that she can do all of those things and allow me to serve our patients.”

Today, along with Sam and Joyce, Pappas Health employs three other staff members. The practice is small but thriving. Sam estimates he has about 1,000 patients in total, not to mention a few thousand more who subscribe to his emails. The practice fuses traditional medicine with Sam’s passion for integrative health which ensures that patients receive the best of both worlds along with a hefty dose of one-on-one attention. “I say that we are both high tech and high touch,” describes Sam. “We use tools like telemedicine as well as email. Many people in the concierge world will spend an hour with you and tell you to take a pill. We’re the opposite. We’ll text and email you, see you regularly, and take deep dives into your biochemistry. It’s a unique mission. I’m proud to be the only Washingtonian doctor that has a focus on both traditional medicine and integrative health and wellness.”

Sam’s faith in himself, as well as his hypothesis that his ability and reputation would follow him to his new practice, proved correct. Since Pappas Health was launched in 2016, they’ve never spent a dime on advertising; all of their clients have come to the practice via word of mouth. He even counts many doctors as clients; some of the formerly skeptical doctors see the better outcomes Sam is able to produce and have come around to integrative medicine as the best way to care for themselves. “Initially other doctors thought I was crazy,” Sam laughs. “But then the patients realized that I was simply recommending lifestyle changes in most cases. Things like exercise, taking vitamins, and changing the diet. The other doctors were scratching their heads, but the patients were coming in droves. We got better results for them, and I quickly became a doctor to many doctors.”

Sam started considering medicine at a young age. His mother saw something in him that she wanted to encourage; something that led her to believe he was cut out for the field. “My mom was kind of like a GM for a sports team,” Sam laughs. “She would remind me that I like to communicate, that I was a good student, and that I should consider this field. So I was pushed in that direction in a very loving and nurturing way.”

Through it all, Sam’s mother continued to push him. “If I came home with a B, she’d say, ‘Is this the best you can do?’” recalls Sam. “She was a great role model as a leader.”

Sam is an identical twin, and his brother, Tom, had other talents. The two of them were inseparable throughout childhood and adolescence. They even shared a bedroom up until they went to college. They were best friends. “We were attached at the hip,” smiles Sam. “We’d always go out together and we had many of the same friends. We got along very well and looked out for each other. Basically, we were thick as thieves. I was the oldest by 15 minutes but was always more shy growing up than Tom! And since Tom was more outgoing and we had a lot of common friends, we were very synergistic. Basically, we grew up in a wonderful environment. We also never complained because as twins we attracted a lot of attention!”

Sam, Tom, and their younger brother, Bill, grew up in New Jersey, where their mother stayed at home with them, and their father went off to work at his produce business. Their Greek heritage was a huge part of their upbringing. Both parents came to the U.S. as adolescents when Sam’s mother was 13 and his father was 17. The boys were raised attending the Greek Orthodox Church, which was very central to the community. They attended Greek schools, learned to speak and read Greek, and would even take trips back to the motherland for vacation.

Sam’s father had been a semi-professional athlete in Greece who played soccer on a small 1st division team in Athens before moving to the U.S. Once here, he started in the restaurant business and worked his way up the ladder like so many other Greek immigrants before eventually switching from restaurants to produce distribution. “He said, ‘I’m going to get a truck and start selling to these Greek businesses’ since they had a cultural connection,” Sam explains. “His love of history and geography meant that he connected with all these people from different parts of Greece. So he had a wonderful business but put in a lot of blood, sweat, and tears. In the summer times, my brothers and I were a part of that business. It was a relationship business, so I really got an appreciation for the importance of relationships from him.”

Sam’s mother, meanwhile, came over with her parents in 1960. Sam’s maternal grandfather was a huge influence on him growing up; he was, in Sam’s words, a “larger-than-life” figure, who told them stories of picking up a gun to defend Greece during the civil war. “From him we learned about our history, our culture, and the importance of stories,” Sam affirms. “I would say I grew up with one foot in the Greek world and one in the American world.”

Both academically and athletically, Sam thrived. He was competitive, and both the twins were driven to try to best each other in the classroom and on the field. “It came easy to both of us, but I was always a little bit better,” winks Sam. Their father passed along his love of soccer and would take the boys to see the Cosmos, a team in the North American Soccer League. When they were younger, the twins played soccer and baseball, but as they grew older they developed a love of basketball thanks to the influence of their coach and mentor, Mr. George. Mr. George ended up moving from their middle school to their high school where he continued to cultivate their skills and push them to be better. By 10th grade, Sam was named all-county and one of the top 10 sophomore basketball players in New Jersey. He was also voted the best player on the team.

Through it all, Sam’s mother continued to push him. “If I came home with a B, she’d say, ‘Is this the best you can do?’” recalls Sam. “She was a great role model as a leader. She was tough, but I learned a significant amount from her. We had some really formative discussions. My dad was more of a quiet leader so early on I saw different leadership styles. He led by example, but she was hands on and would push and cajole. She was the disciplinarian and would exude tough love. So we were pushed to excel and as a result we all had high expectations for anything we did.”

By junior year Sam had gotten his first job outside the family business. “I don’t remember ever being paid by my dad,” he laughs. “I think the payment was free room and board!” At his mother’s encouragement, he went out and got a job at McDonald’s and learned firsthand the rigors of the food service industry. Then, she pushed him on a possible healthcare career. “She asked me what I thought about healthcare,” Sam remembers. “I said, ‘I’m interested in it, just because I love biology, I love sciences, and I love serving.’ So she said, ‘I recommend you go talk to some doctors.’ I was so impressed by them and that calling.”

Through his conversations with doctors, Sam found out about an opportunity working in the State Medical Examiner’s Office in Newark. He worked on the second floor there and processed body parts and fluids for examinations in cases with autopsies. “I was the low man on the totem pole, but I became a fan favorite of the doctors there,” Sam says. “I was a young kid who was interested in medicine professionally and would ask questions and help others out. It was a very moving experience. They loved me, and the science part was really cool.” He continued to work there in the summers throughout college. The doctors there were proud to learn he’d gone on to successfully get his M.D.

“She asked me what I thought about healthcare,” Sam remembers. “I said, ‘I’m interested in it, just because I love biology, I love sciences, and I love serving.’ So she said, ‘I recommend you go talk to some doctors.’”

Sam’s parents’ combination of leading by example possessing a strong work ethic, and pushing them to excel paid off. Tom and Sam were both accepted to West Point. Ultimately, though, Sam decided the military wasn’t for him. By then, he had decided to become a doctor, and becoming a doctor in the military meant a commitment of 16 years of service. Instead, he headed for Lehigh University in Pennsylvania, and the twins were separated for the first time in their lives. The transition was a tough one. “We had a clean break,” says Sam. “As a result, college was not easy for me. I learned it was tough to fly solo and not have my brother for support and encouragement! My best friend was no longer with me.”

But Sam buckled down and focused on his studies through college. He didn’t have the typical partying experience a lot of kids have since he knew he needed top grades to go on to medical school. His intensity paid off. He was accepted at several schools but fell in love with Penn State University in Hershey, Pennsylvania.

“Once I was in Medical School, I became a lot more balanced,” Sam says. “I realized it was okay to be in the middle of the pack and get a 90%. All of my peers were very smart.” The second half of medical school involved doing rotations with different specialties. But unlike most students, Sam decided he wanted to travel. He was able to work in different parts of Pennsylvania and also went to the prestigious Cleveland Clinic for six weeks. “That was my best experience,” Sam nods. “It is a great hospital, and someone there gave me the best advice—the Cleveland Clinic doesn’t have a lot of hands-on work for residents but nearby Case Western Reserve has one of the best residencies in the country.”

Sam considered everything carefully but ultimately decided to return to Cleveland for the Case Western residency. It was destiny calling for it was here that he met Joyce who had been working as a critical care nurse. They had planned to stay in Cleveland for some time, but soon after they married, Sam’s mother fell ill with ovarian cancer. Thinking she had only months to live, the couple relocated to New Jersey where she happily lived for six more years.

Sam took a job at a community hospital where he did both clinical and academic work as a teacher working with medical residents. There were only four faculty members (larger schools have more like 100) so he became a “jack of all trades.” He taught, saw patients, and helped with administration. It was there that his interest in integrative health began to be piqued.

After about four years there, Sam accepted an opportunity that quickly turned out to be the wrong move for him. A mentor of his had offered him a position at the University of Medicine and Dentistry of New Jersey. It would be a significant pay bump and more administrative work. “I thought it would be awesome, but it was perhaps the worst decision I have ever made,” admits Sam. “Within a month I knew I had to leave. I learned that I left for the wrong reason—I left something rather than moved toward something. I made plans to leave after one year when my contract was up. Looking back, it was the worst year I have ever had professionally, but it was a fabulous life lesson. I also learned a lot about my health. When you’re not happy, you have a long commute, you’re overworked, and you never seen the sun, you can’t be healthy.”

While planning his departure, Sam spoke with an old friend, Patrick, from medical school who invited him to come to Arlington, where he was running two successful practices and looking to expand. In 2004, the Pappas family relocated to the DC area, and the new job was a much better fit. “I warned Patrick that I was a little different. I liked to spend more time with patients and practice integrative health,” recalls Sam. “Patrick was okay with it as long as I billed for my time. So he gave me a lot of freedom.”

The partnership went well for a time, but ultimately Patrick began to have personal issues that were interfering with his work performance. The hospital where the practice operated offered to buy out the practice under one condition; Sam was to be in charge. The two parted amicably, and Patrick decided to go his own way. It was as Sam became more enmeshed in the large hospital system that he began to chafe against the counter-productive metrics being pushed by the administrators which then pushed him to launch Pappas Health.

As a leader, Sam says he believes in “we.” “I’m very much hands on and very much believe in getting to know someone and connecting with them,” he reiterates. “I don’t micro-manage. I get to know people and put them in my family. Whatever I’ve done, I’ve always been able to connect with people. I’ve learned to give people goals and get out of the way.”

To young people entering the working world today, Sam advises an appreciation for adversity. “Cultivate a biography of meaning,” he encourages. “Serve others. Have mentors and learn from them.”

“I’m fascinated by leadership and strategy,” Sam says of the future. “My next chapter is going to be about that. I’m still learning, I’m 50 years young, and there are a lot of opportunities. My twin brother and I are avid readers, and we’ve been talking about putting together a website, cultivating some of our readings from health, to history, to religion. I think we need to share wisdom. The dynamism of the future with the traditionalism of the past. Looking forward and back. It’s an exciting new chapter.”