The Direct Care Way

How to set goals for success

January 03, 2023 Tea Nguyen, DPM Season 1 Episode 47
The Direct Care Way
How to set goals for success
Show Notes Transcript

Goal setting is more than just writing it on a piece of paper and staring at it everyday hoping it comes true. I share the 4 key things you should do to ensure you successfully hit your goals. 

Then one day, you'll find yourself empowered enough to opt out of insurance completely. 

Dr. T   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. They have chosen this path with a love of medicine. This is the direct care way.

Dr. T   0:24
By listening to this podcast, you may even start to believe that you too can have a successful direct care practice. Come listen with an open mind as I share my personal journey and how I pivoted from an insurance based practice to direct care right in the middle of the pandemic. And the valuable lessons along the way. This podcast may be the very thing you need to revitalize your medical practice. I'm your host, owner of a direct care podiatry practice Dr. Tea Nguyen.

Dr. T   0:54
We're going to talk about goal setting and what that actually looks like. Welcome to 2023. I'm going to help you with a couple of gems in this episode to get you started on the right foot. All the puns intended from one podiatrist to another. So I started the year with COVID. And I'm doing just fine. I got all of my vaccines, the boosters on time, and I really didn't know what to expect. Right now I'm not experiencing anything severe. I actually first noticed my daughter having coughs little Flamie. And then there was one night where she took a really long nap. And I thought that she would end up sleeping later. But then she went into bed and fell asleep for the rest of the night. I don't know she accumulated like 15 hours of sleep. And so I knew something was going on.

Dr. T   1:44
Me on the other hand, I was kind of having like a scratchy throat, coughing having to drink more water. So the next morning, I decided to test myself. And it was positive. And that was kind of like it was surprising. And then it wasn't because I was like yeah, I just got back from vacation. And I was trying to avoid people. It's hard to do when you're at the airport, though flight between Las Vegas to Phoenix was canceled, I traveled southwest. And so you know, there was like 2000 Plus flights being canceled. And so we had to drive to make it to our reservations over in Scottsdale. And then luckily, there was an open flight for Scottsdale back to San Jose. And we were wearing masks, we did what we could. And I still ended up getting it. So I guess we are all just kind of in it together at this point. So I'm part of the club at the COVID exposure club. But it's not really bad for me and my daughter is doing fantastic. I did have to cancel my clinic for the recommended required amount of time to isolate dealing with that right at the beginning of the year.

Dr. T   2:48
So hey, why not record all of my gem knowledge and drop it down here for you to listen to? So listen, I'm 39 and a half years old, and I have been having my body fall apart. So I didn't think much of my body aching. During this week, I thought I would have slept kind of funny. I actually took a wrong step in my kitchen, just turning on my knee popped. And I was like this is the end of me, isn't it. So welcome to my midlife as well. This started six months ago. My midlife started at the age, as soon as a clock turned me to 39. And I'm moving on to 40 this July. But anyway, I'm here having an abundance of time to rest. A little bit restless. But you know, as you know, business journey, it's not linear. Being a business owner, there's a lot of responsibility, I have to worry about what to do with my staff. Now that I don't have income coming in, because clinic is canceled. You know, that's one source of income.

Dr. T   3:46
I have ancillary income from products that we sell, but it's not as significant as if I was in the office. That will certainly change with time. But today, I want to talk to you about goal setting what that actually looks like, so that you can experience growth in your practice. Because I think it's really painful to actually step back and see and reflect on your own business and evaluate is my practice just going stale? Because I chose to not do anything different. I chose to just be comfortable? Or do you really want to expand and explore and experiment and see what you can truly make of your practice so that it works for you, rather than you working for it. I mean, the whole idea of being your own boss is to have control of your schedule. And too many of us went into the insurance space practice the insurance based model where we exchanged our services for reimbursement. And we're like yeah, that was going good until I couldn't actually provide the care I wanted for my patients.

Dr. T   4:49
And then we got strapped and then we got rolled around and then we're being read taped being told we could and what we could not do for patients and as you know, I've stepped out of that completely as of Last year, I'm 100% Cash practice at this point. And it's really important to understand the process of goal setting. And what that really looks like. It's not just you writing your goal on a piece of paper and post it and you look at that every single day. And all of a sudden, things just come to fruition, it's a little bit deeper than that, it really starts with your mind, what you think about the world does reflect on how your body responds, like physiologically, so just think about a time that or maybe think about something really scary, like, maybe you're afraid of spiders, or you're afraid of heights, or you're afraid of public speaking.

Dr. T   5:37
Now, let's say somebody tells you, you're going to be confronted with this. How does your body actually react? How does it physiologically respond? If it's a thing that scares you, maybe your heart races a little, maybe your mouth gets a little bit dry, maybe your palms get sweaty, these are actual physiologic responses from just the thought of something nothing actually happened to you yet. But it's the power of your thought. It's very well connected to your nervous system, and it produces physiologic results. That is how powerful your thoughts can be. And that includes how you set your goals, you and how you envision your future self and how you speak to yourself. It's incredibly powerful, how you think and how you actually get to your goal. So how does setting a goal, play a role in your private practice? It's the beginning of the year, and people create these resolutions. But why don't they stick? Why does it it just stick if we just write down the goals that you wanted? Put on the wall and look at it every day? And just repeat it to ourselves? Why is that not enough? Well, there really is a variety of reasons.

Dr. T   6:45
And I'm going to go over the four key elements in how to set a goal for success so that you make sure that you hit them. And you also bounce back when things don't go the way you expect them. Okay, so let's be practical. Now, let's say you are in your private practice. And maybe you're at the stage where you are considering some options to increase in cash flow so that you can get less dependent on insurance reimbursement or just want to supplement income in a different way. So let's start with how we think about things. In general, physicians in general, think about black and white, we think about either win or lose, you think about either they're, you're the first in your class, or you're the last, we think in extremes. And some of that is valuable in our clinical work, right. Because if we have one misstep, it could be disastrous for our patient. If we suddenly overdose them, they can die. It could be harmful. But when you put on your business hat, it's a whole nother ballgame.

Dr. T   7:39
You have to treat your business like a research project, which is why I love research. Because you put out a question, you create and collect data, then you share the data, hopefully uninfluenced by any financial gain on the outside. And as you know, if you read a research paper, the conclusion usually says something along these lines, more data is needed to be more conclusive. And that's how you should treat your medical practice your business. You put out a hypothesis, you start collecting data, you make something of that data, those results. And then you're like, Okay, that was just one piece of information that either led me towards my goal or away from ankle, that's how you should really enjoy this journey. So about goal setting, you're going to find people telling you yes, you have to create a goal, a big goal, right? The big picture, the audacious goal, the big thing that seems maybe nearly intangible, but you also want to break that intangible, seemingly attainable goals, and you break it down so that it is tangible, more attainable, you break it down into small steps.

Dr. T   8:44
So a basic example might be something like I want to lose 10 pounds. So what does that look like? How many pounds do you need to lose per month that's considered healthy and sustaining. Maybe it's one to two pounds a month or something like that, right? And you continue to do that you are persistent, and then you get an accumulation. And over time, you lose your 10 pounds. But that really isn't the end of it. When you go out to set a goal. It's not linear. It's not month to month, that you have gradual increase in revenue. Because we know in private practice, there are seasons, there are seasons when we want to take vacation, maybe people get sick. Maybe there is season in the work that you do. If you treat children for example, you might have a higher season in the summer months, when they're on holiday in can make appointments with their parents, for example. So really, the plan to your goal must also include the four sets I'm going to outline to you right here. I'll give you an example.

Dr. T  9:43
So let's say you want to to increase foot filler injections. That's something that I do a lot of in my practice. And so when I first started into this new service modality, I had ordered a bunch of foot filler injections, bulk in bulk because you generally get a bigger discount involved, right? And it's always a little bit sexier to get a discount, so you can make higher profit margin. So let's assume that you stockpile this stuff because you're like, it's a great deal, I want to use it. But maybe you didn't really have clients or patients lined up to actually use it. And so that product, you know, it has an expiration date, maybe it ends up getting expired, and you don't get to use it. And so that is essentially wasted capital. So what do you make of this situation? Here are your current options, number one, you default to, I failed, I am a complete failure. I wasted this money, I mismanaged my product. And I shouldn't go on to building my private practice. And we have this way of catastrophizing, a singular mistake, or a singular oversight we do in our practice. And I wonder if you've felt that because I certainly have.

Dr. T  10:59
And then you start telling yourself, this story that doesn't really exist. It's just a story. It's a black hole, you're the rabbit hole that we all tend to fall into. And we catastrophize we say we made this error, this financial error, and maybe I'm just not fit for this. Have you ever done that? And so I explore this because you don't have to think this way. I want you to think a little bit differently. Do you have to think that because you had this one financial misstep, you bought product, it went to waste, you lost money? Does that mean that you can't improve on your process? Does that mean you are a complete failure? Now maybe it's not just these injectables I'm talking about maybe it's a service or some other kind, or maybe the financial loss you had was much bigger. But nonetheless, oftentimes, we go on to catastrophize, in this one action, makes us feel incredibly bad about ourselves. And I want to ask you, do you think that's going to be productive in the way you function in your business?

Dr. T  11:59
Now, option two, you can look at this experience. And you can say, well, I did a thing, I take ownership. So here's what I learned, so that I don't repeat it. And then you set out to put some protocols in place. And maybe even ask some mentors and coaches and consultants, how to better spend your money, how to ensure that if you were to make this type of a purchase, how patients lined up to pay for it, or maybe before even buying it, you just buy it as you need to, which is what I do the patients need something, I collect money in advance, and I preorder it and it comes to me the next day or two, so I'm not having capital laying around, that's certainly an option. So you see, you have two options that are pretty clear. And a lot of people tend to lean towards to I made a mistake, and they live in that mistake. But you don't have to, you can choose to live in the other option where you're like, Yeah, that was a pretty bad decision.

Dr. T  12:57
But I learned from it. And I know the next time around, I can be more mindful about my inventory. So I don't have to waste it. Right. Now, if you chose option number two on how you want to perceive the situation, how much more productive will you be moving forward into your business. So what I want you to get from this episode is, you know, it's the beginning of the year, we all want to start really fresh, motivated, inspired, and we want to implement maybe a couple of changes that can lead us closer to our end goal. And maybe your angle is to opt out of some insurances, or maybe it's opt out of all insurances. There's a flavor for all of us here. So this is how you really want to set your goals, the four steps. Number one, when you set your goal, believe that it is achievable, this believe that success is yours, and find evidence of where it is working and who is making it work. It all starts with how you think about things because how you think about things you respond and how you react to them as well. So once you believe that it is achievable to have a cash practice, for example, then you're going to find evidence where it works. Like this podcast, I have a cash practice. I know people who have cash practices that are successful, and so on.

Dr. T  14:12
And so you find the evidence of where it's actually working and just be in a place a good mental space, or you believe it works. Because the alternative is you sitting there believing that it doesn't work, and then you're just you're fooling yourself off stage before you get on. Don't do that to yourself. Right number two. So now that you believe that your goal is achievable, you want to consider who can help you get there. Now, you might have been a little bit surprised that I'm not saying how to get there. The health part is important too. But I'm going to invite you to read a book called who not how by Dan Sullivan. And this kind of turns around the way physicians think about business physicians are incredibly smart, we are resourceful. We can digest a lot of information we can synthesize, but that doesn't mean we have to go about as Business owners doing everyone's job doing all of the tasks. Just because we can't like, for example, I went out to fix my computer, I had to replace a memory drive, I Googled a YouTuber thing and all that I spent probably four hours collectively looking for the products, researching what I'm supposed to get, figuring out how to take apart my computer, figuring out how to plug it back in troubleshooting and all of that for hours, when I could have paid somebody else to do that in five minutes, right? Time is wasted, that time doesn't come back. So what you want to really look at on as a business owner is who can actually help you. It's your end goal.

Dr. T  15:36
And maybe that looks like an executive assistant or a virtual assistant, who can take some of these tasks that takes up your brain space that, you know, maybe you're not really it's not really in your zone of genius that somebody else can do. And maybe it's their zone of genius. There are people out there who love taking notes, who are really good at taking notes, who are really good at scheduling, are really good at connecting with the community and all of these things that yeah, you can do it. What is that? How your time is best served. I mean, if you're a physician, I think your time is best served as being a physician, right? So you have to learn how to delegate by figuring out who is going to be that person, that's going to be a key player in the work in the business you're building. So yes, we can do stuff. But you have to ask yourself, do you have to be the person to do all this stuff? Or can you delegate number three and goal setting. So you created your goal, you decided that you're gonna get to it one way now that you're going to figure out who's going to help you along the way, because a business is not a one person show. Number three is preparing to respond to challenges that you will eventually experience to be a business owner and believe that you'll never encounter a challenge. That's not how it works.

Dr. T  16:47
We know challenges exist, we are built to overcome those challenges. So you know, it took me 40, almost 40 years now for someone to say that I needed to plan for setbacks. So I'm sharing that with you. And that doesn't mean to say what is your plan B, it is to say that if you are a business owner, you're a private practice owner, you're going to encounter some things that is out of your control. So how do you respond, people in business, no matter what they're generating all experience the same kind of challenges, they're just quicker to respond and get over it. So if you have not found yourself in a situation and enough challenges, it may take you some time, you get knocked down a little bit, and it takes a little bit time to pick yourself back up. That's okay, that's just experienced that you will eventually get under your belt. They're inevitable. So how do you plan for that, the more challenges you face and overcome, the quicker the more experienced you'll become, the faster you'll bounce back. So knowing how to plan for a setback. So for example, if you have a cash practice, you're going to experience rejection, patients are going to say I don't want to pay for that.

Dr. T  17:53
Or they're going to say to you, I found this cheaper elsewhere, how do you respond to that? What is your go to response, do try to keep their business and you bargain down so that it becomes a nicer offer, there are instances where you might find that to be acceptable. Or you can also respond with a little perhaps this is not my ideal client, no matter what the price point is, they're still not going to be satisfied. And so let them move on. Right. So you need to have a couple of responses in preparation for these challenges. And number four, I call number four a bonus because it's a fun bonus that you need to start doing now anyway, and that is to celebrate your small wins all of the wins. So you know, maybe you started adding a product, and your small win was I made a decision to add a product. Awesome. What's next, maybe you sold your first product. That's a great win just to break that first sell. And then maybe the next one is maybe you sold 10 of those things. Fantastic. Let's say you have your team pitch in and teach them how to sell because they're usually the last person that the patient asked, Hey, this is actually really good for me, right? And let's say you incentivize and say, Hey, if you all sell 50 products, I'll take you out to lunch, or we'll do something really nice in the office. Right? It may be you get your first refund request, make sure you have a policy in place for that.

Dr. T  19:17
But hey, if you have a refund request, that means you're selling stuff, that means you're progressing, that means you've moved along the way along the journey, and you're prepared. So selling refunds. All of that is part of the business ownership journey. Those are worth celebrating. Now, it might sound really silly to say you need to celebrate your first refund. But hey, once you get your first refund, and let's say you didn't have a refund and protocol in place, you're like Cool, thanks for alerting me. Now I have a protocol in place and I'm not worried about it anymore. So you see how you can turn these experiences around and make it really positive so that you can move forward as a business owner and focus on the thing you want to do which are maybe procedures or the doctrine Apart, as I say, then suddenly you find yourself one day wanting to opt out of insurances. Because you're totally comfortable with selling, you're making positive cash flow, it's easy for you. And then you get to a point where you're like, you know what, I'm gonna charge $5,000 for this service, and it becomes easy.

Dr. T  20:17
And you're like, holy cow. All of these experiences brought me here. And what did that feel amazing for you to say and walk away from things that didn't serve you prior authorizations, claim denials, you know, refund requests from insurances, like, ah, we needed to do a whole episode on how ridiculous that is. But anyway, right, we walk away from something that doesn't serve us anymore. A business model insurance based model that is screwing us over essentially. And now we have the freedom to choose and say, You know what, maybe I do want to direct your practice, maybe I do want to start opting out. And maybe in a year or two, I can have 100% Cash practice, just like Dr. T win, dislike a lot of us out here, the things that we're doing that we're sharing with you here. So excuse me, if you hear a bunch of us coughing and flipping in the background, the whole house is sick right now. But I hope that I was able to give you insight and what it means to set a goal and to plan for the goal. So just a quick recap on how to set a goal number one believe goal is achievable.

Dr. T  21:16
And if it is achievable, set it to be a little bit bigger, a little bit scarier, you know, that's how you grow is to be uncomfortable, find evidence where it works, believe me, they're out there. Number two, read the book called who not how by Dan Sullivan. And you'll understand why it's really important to start plugging in key players into your private practice. Because although you can do everything you probably shouldn't, that's just brain energy that is pulling away from your focus of what you truly want to do. Number three is prepare how you're going to respond to challenges, challenges, obstacles, setbacks, all these things, they're inevitable, you might as well start preparing for them and then be able to bounce back faster. And then number four, which I call the bonus, because you should be doing this right now is celebrate the small wins every day. It's kind of like even sharing gratitude. If it's not a win, it's a gratitude.

Dr. T  22:09
Like I'm thankful for that lesson. I'm thankful for this new opportunity, or the when actual when like, Oh, I got my first cash paying patient, even though they have insurance or you find a new pocket and people to serve, you know, people who don't have insurance. They're in between jobs, there are laborers, they're seasonal workers, you know, whatever, find your win and celebrate it because over time that accumulates, and then suddenly you're ready to say I want to opt out completely, and have a direct care practice of my own that is profitable, and is giving me back my life. I can't wait to see what 2023 has in store for you. Thank you for taking me on your journey.Take care.

Dr. T  22:47
Thank you so much for being here with me. 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 find my info in the show notes and send me your questions. That might be the topic for future episodes.

Dr. T  23:07
And lastly, if you remember nothing else, remember this be the energy you want to attract. See you next time