What you need to lose in order to gain

Dr. Tea  0:01  
Owners of a direct care practice are more likely to experience higher job satisfaction than the insurance based practice. And it's no wonder why direct care is independent of insurance. Patients pay the doctor directly for their expertise. The doctor gets full autonomy in how they care for patients and how they get paid. We've chosen this path for the love of medicine. This is the direct care way. 

Dr. Tea  0:26  
By listening to this podcast, you may even start to believe you too can have a successful direct care practice. Come listen with an open mind as I share my personal journey on how I pivoted from an insurance based practice to direct care, right in the middle of a pandemic. And the valuable lessons along the way. This podcast may be the very thing you need to revitalize your medical practice on your host owner of a direct care podiatry practice, Dr. Tea Nguyen.

Dr. Tea  0:55  
Fun story. I remember when in high school, I got offered a job it was $16 an hour working at a makeup counter in Macy's, this was exciting times because minimum wage was about $8 an hour. So I was making big money. I took the job. And in just one day, I said no way. The mall I went to with dead, there were no people. So I couldn't even push for sale because there was nobody there. And there was no mental stimulation, no real professional growth. And it was just something I could not stand. I had friends who would gladly take up these jobs. But I couldn't find it in myself to do it. And I felt a little bit, I guess entitled is the word. Because I have immigrant parents and you just kind of take the job that you need to take to bring home some money. But I was a little bit more privileged in the fact that I could say no, I can choose a different job. And I wanted a job that didn't make me feel I was actively mentally dying. And so I quit. 

Dr. Tea  2:09  
Another job I took was I was a telemarketer. At the time, I didn't really know what that meant. They just said you just got to make some calls. And I think in three days, I just stopped showing up to work. It was an awful job. Yeah, so you're wondering why I'm sharing this. I will also welcome to episode 25. What a great number 25. The quarter of 100 Oh my god, yes, they did some math. This is a special number. So why am I sharing this story? Well, it's because you don't always know what you want.

Dr. Tea  2:47  
Until you do it until you do the things that you think you might be interested in. So I always look at people who say things like I always knew I wanted to be a doctor, I always knew I wanted to run a business and I cannot relate. I didn't decide I wanted to go to podiatry school until the end of my, my last year of college. And I didn't think I would own my own business until I actually did it until I really didn't have a choice. So you know, the the stories that I share with you there, they all kind of parallel each other. And it also was in line with my pediatric career as well. Like I took the job as an associate, I had the honeymoon period lasted for a year or so. Probably less. I think I was in denial for a while. Yeah. So then I realized I was just lying to myself that I was conditioned from the beginning to take a job, make the money, keep your head down, get the experience.

Dr. Tea  3:54  
 Don't stir the pot, you know, heck even be a people pleaser so that people will like you. And maybe they may decide that you will be paid more Who on earth taught us business skills because clearly I missed that class as well. I felt really embarrassed. I feel embarrassed sharing the story because it's like, I clearly have so much more to learn. So I got to the point in my private practice where I I just hated the volume. I was at how a 15 minute appointment easily turned into a 45 minute appointment. And then there was after our charting, Billing Coding staff, hiring staff training, protocol adjustments, having to answer a family members questions who chose not to be at the appointment but wanted a phone call afterwards. So that easily doubled my own time. And I couldn't build because this was state funded insurance and then because they paid so little practice management companies have told me you need to break up these visits into different visits, you know, one problem per visit and so Oh, I wasn't really solving their problem in adequate time. And that really frustrated me. I was like, There's no way this is normal, that I can't answer all of their questions in one visit, that I can't do it thoroughly. 

Dr. Tea  5:12  
And I just didn't want to live that life anymore. So I looked at my insurance payer mix, I looked at what I was being paid, and the energy I had left in the entire transaction, then I had to really do a quantum leap into my future self, and ask myself, is this sustainable? Can I keep going at this pace? And as you can see, the answer was a strong No. And so the next question really was okay, now what, what do I do now? So I love sharing these stories, because a lot of doctors asked me, what did it take to learn the business skills to opt out? And to sustain a direct care practice? So how did I get there mentally? And then what were the steps to get there, someone had once told me once I start opting out, especially the lowest paying insurance. Once I get rid of that, that's going to make more room for more money. So people who will actually pay will come in because right now they're being blocked, or the appointment times were far out, because most of the appointments were consumed with low paying insurance. 

Dr. Tea  6:24  
That was most of my referral base. And then, when someone said, once I get rid of my lowest paying insurance, even though they were the keeping me most busy, I just, you know, the math did not compute. I was like, how am I going to see less and make more. And then I was also afraid that by opting out, I was going to be abandoning patients. Now the reality was, I never abandoned patients, patients chose to go elsewhere. So I was much more attached to my patients than the patients were attached to me. And you might have witnessed this yourself when when a patient changes their insurance. When patients change their insurance. What do they not hesitate to do? They're gonna find another doctor in network. So the patients who made me feel like I abandoned them, by sending me nasty emails and saying, You don't take my insurance. 

Dr. Tea  7:21  
Therefore you don't take me. That is a perception. Patients were always welcome to my office, they were always welcome to make appointments, they just had to pay in exchange for that. And then I started having patients who were excited to see me, they were excited to pay. And that left me feeling like I'm onto something, there are people paying me 1000s of dollars, and they didn't bat an eye for it. They saw the quality of care they were receiving. And it was really wonderful to not feel like I was pitching a sale. Like I wasn't trying to be sleazy about my services, I wasn't pushing for things that didn't work. I was practicing evidence based medicine, I offered a lot of alternatives, what people were already asking for, I provided thoughtful care, appointments were long, up to an hour even. And with all of that, there's a cost for admission, I wasn't making it mean more than what it really was that when I was opting out, I was abandoning patients I didn't, I didn't make it mean that way. It was just that I was disassociating myself from insurance contracts, so that I can give patients one on one attention with longer lasting treatments without any insurance interference. 

Dr. Tea  8:39  
So that's what patients are paying for. I went out of network so that I can focus on what's best for the patient rather than what insurance allows. And this has restored my love for medicine, and love for business, I had to see it for myself, by opting out of this insurance. It was really just my disassociation with the insurance contract, it didn't have a whole lot to do with the patient, the patient was always welcome back. They just had to pay for it. And when I saw patients paying for the services I was providing at my rates, it gave me more confidence. It really made me understand that patients are choosing their doctors and those who choose their doctors by going out of network paying out of pocket, due value, what the doctors have to say, and they are more adherent to recommendations. Therefore the outcomes are improved. The quality of life is better, and you can continue to have your practice. Because you enjoy what you do. It's rewarding. 

Dr. Tea  9:40  
Sometimes you might hear something that's just too good to be true until it happens. And then you're like, that's awesome. And that's what I experienced. I don't think people telling me that this was going to happen with enough I really had to experience it for myself. So people telling me you have to opt out of your lowest paying insurance To see what you can get to make room for your ideal patients, you know, I would have never really known if I just sat in that feeling of discomfort that I'm afraid to abandon patients, because that's not true, you're not abandoning patients, patients have chosen to not see you anymore. And that's okay. Sometimes you just call it a go. And so one foot in front of the other, I started making these changes, I started listening to what I was saying out loud, and have it reflect back on to me. And then I started to realize my thoughts are kind of silly, they're self sabotaging, they weren't real, I actually gained a lot more than what I had lost. And to me, it's worth it now. Because I see what I can do, I can see how people benefit with what I offer. And I'm really happy that I can continue to have my business be profitable. And so medical care is just it's so much more rewarding on this side. So just some stories I wanted to share with you today. Here's some things I want to leave you with number one, let go of an old idea so that new ones can serve you. 

Dr. Tea  11:02  
So the idea that you have to see a lot of people to make a lot of money is really not true, you can see fewer patients who pay more, and you have to do that if you want time freedom. But if you choose to continue to see a lot of patients with really low paying insurance, how on earth are you going to get more time in your day back, or even your energy back, there's only 24 hours in a day, we all have the same number of hours. So it's really about prioritizing how you get paid in order to stay profitable, and to reserve or preserve your energy. Number two, sometimes you got to do it messy. And did I get nasty emails from patients saying I didn't warn them, I was opting out. Yeah. And then I was able to move past it. Because once I started seeing patients handing me over cash, their money, checks, credit card payments, 1000s of dollars, even without a second glance, then I really understood what I had to offer was really valuable to people. And so I continue to refine what I offer. And I continue to refine how I offer it, and I continue to refine who I serve. 

Dr. Tea  12:09  
So if you go back to Episode 24, I talk a lot more about why it's important to know who you serve, so that you can get clarity on who you don't serve. And number three, the hardest $18 I had to earn does not even compare to the easiest $2,000 I have made. And if you want to know more the details about that. I'm going to invite you to my website, the link is down below, I offer one on one coaching on where I show you exactly how to easily make more without using any paid ads or Click Funnels or anything doing what you already know how to do. You don't have to necessarily even opt out just yet. So I invite you to come learn. I'll show you everything, the nitty gritty details of what it takes to go from insurance to direct care, or maybe even a hybrid. But I'll show you how easy this is once you start changing the perspective of what you're going to lose and really look at what you gain. I invite you over link is down below. Have a great one. I'll catch you next time.

Dr. Tea  13:16  
Thank you so much for being here with me today. If you enjoyed this episode and want to hear more, please like, share and subscribe so more people like you can have access to another way of practicing medicine, that direct care way. Let's connect by my info in the show notes and send me your questions. It might be the topic for future episodes. 

Dr. Tea  13:36  
And lastly, if you remember nothing else, remember this. You are in control of your life. See you next time.