Well, your toes will follow your cleats, you can position your cleats at such an angle that your feet will become straight. But your knees will probably hurt more. My feet are also normally toed out and I was able to find a compromise cleat angle where feet are already mostly straight and knees don't hurt yet. Or you can leave your feet toed out and get pedal extenders to position your feet farther away from the frame. Anyway, very small (like one degree) angle difference can make a huge difference for knees.
As for "to get out I have to make sure the foot that gets out is at the 12 o'clock position so there is room for my heals to turn in" - why do you want to turn your heels IN? Isn't it easier to turn them OUT?