The Prerequisite to Direct Care

Dr. T  00:00

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  00:24

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  00:52

So many people have been asking me, How do I start a direct care practice? Where do I start, and some folks are either losing their job or wanting to quit to start their own practice. And so it feels kind of scary, right to do something you've never done before. But I want to share something with you in this episode, I have an analogy. If you were to go back to revisit your younger self, the time where you wanted to get into medical school, how did you learn or figure out how to get into medical school, there was probably a prerequisite to get in right, you had to do some level of undergraduate work courses that you think were irrelevant, but ended up being the foundation for medical school, you had to go through this checklist. And that was clear to you, you had a good idea of what you needed to do in order to apply. And then when you got in, you had to develop some new habits, right? Maybe you also learned some different skills that you need to adopt in order to succeed and get through medical school. 

Dr. T  01:54

What about the habits that you had to develop to get into residency programs, maybe a fellowship and even a job. These were skills, habits, discipline, self awareness that you needed to develop that you didn't really have at the beginning of your journey. And these things likely martyred or evolve over time. And starting a direct care practice is just like that, before you even start there is a prerequisite beyond the books. And it starts with your beliefs, the emotions, you have the habits, and these are all under appreciated, so called soft skills that we never learned in any of our training, but is necessary to run a successful direct care practice. 

Dr. T  02:38

So what are they? What are these habits, skills and disciplines that we need to adopt in order to move forward into our direct care practice? This is the topic that I'm encompassing today. But it's also in every single one of my episodes, all of these different tips and tricks are actually skills and habits to adopt, acquire, and practice in order to start showing up like a business owners showing up like the CEO who owns a successful direct care practice. So yeah, it's not easy. The concepts are very simple, it's easy to say, but it's very difficult to put it into practice, which is why you have to start practicing, you have to just get to it and get moving. And I really despise marketing that says that success comes with this one thing, or the only way or the one way, it's just such a cheap shot as something that's very complicated in business ownership, but I will try to simplify it down so that it becomes more tangible, a little bit more easy to absorb, so that you can start developing these habits that will help you move you towards a successful direct care practice. So what is it right for many of us who are taught in the traditional insurance based setting, which is basically all of our residency, right, we actually have a lot of unlearning to do. So if we didn't catch it early on, the healthcare system is totally messed up. 

Dr. T  03:55

As early as our medical training, then there is a lot of unlearning to do. Some of us are really lucky and knew right off the bat that the insurance space model wasn't going to cut it for us. And you know, props to you. I wish we were friends, because I had no idea. But here we are. So there's a lot of unlearning that we have to do if we were within the system, and now trying to get out of that. And yeah, that part is very difficult. Of course, I can tell you step by step how to open a direct care practice, but these are the actual prerequisites. Before we even get to that when you finally stop and start questioning the system that feels kind of wrong with values in misalignment. You know, patients are having to wait months to even be seen for medical care, or they're having to go to the emergency room when it could have been easily managed in an outpatient setting. 

Dr. T  04:41

You might have to pause and think like, why is the system making it so difficult for patients to access medical care get they're paying so much into their premiums, or we are paying so much into the tax dollars to offer that medical health care, right. So once you start asking these questions deeply intent fully, intentionally, I don't even know that's all Are you just gonna roll with it, then you start unveiling more problem. And it's really like Pandora's box. So I don't have a solution. I don't have a single solution for the complexities of our healthcare system. But I will share with you that I truly believe direct care can solve one physicians problem at a time, especially for the physician who is fed up with the insurance based practices. So if I can help transform one physicians way of thinking about practicing medicine outside of the status quo outside of the usual insurance based practices, then I can help that physician stay in clinical practice, instead of people leaving in droves trying to find a secondary career outside of medicine. I want to retain these physicians because patients need it, we need it, we aren't going to get older, and we're going to need physicians ourselves. 

Dr. T  05:48

We're not immune to medical problems, I hope that my physician colleagues find direct care to be a way to practice medicine and love their practice. Again, patients deserve a happy doctor. And doctors deserve to love their medical practice. And I truly believe that direct care will do that. For a lot of us. This all goes back to the law of attraction. And that is really, it's not voodoo. It's not Hocus Pocus, it's about creating energy and aligning your values in a way that brings more of it to you. So that all starts with how you focus your future, what you're focusing on. Now to get to that future. The analogy is, if you look at a light, a flashlight, is broad, it doesn't hurt anybody to turn it on, you can see stuff that you need to see in the dark with a flashlight. But the focus is very different from one of a laser beam that is still light energy, but it cuts so Windows light energy is more narrowed, more focused, and more intense, we can cut things both of these are light energies right now our attention must be focused in the same manner in an intentional way to create a meaningful effect. 

Dr. T  06:52

What that means for you is that you have to decide on the model that you want to commit to and then make choices that lead you to that end goal. Some people function in indecision, or are non committal, or they think about maybe it could just be a hybrid type of practice. Yes, you can do that. But it's not focused. When you're a hybrid practice, you have two separate messages. One message is I can bill your insurance, I'm in network. And the other message is I'm also cash. And that could be very confusing to the consumer. So yes, you can do that. But just realize the less focused you are, the harder it is to have a meaningful long term effect. So Indecision is really wasting time and not being able to hone into the focus of your dream practice or potential, it just doesn't fully materialize. So let's just think about focus as a laser beam, that cuts versus a flashlight that is broad, and not a lot of energy. So when you can focus on the one model, when you can fully commit, and you stay true to your values, what's most important to you, then you'll start attracting people with the same values. What that same energy, that same frequency, and that's how money comes in. 

Dr. T  08:05

People pay a lot of money for specialized expertise, for our focused attention on the one thing that they need to be solved. So think about how important it is to specialize in even as a specialist to super specialized as well, you can make more money by Super specializing. So think about it, if you have a car, would you just take your car to any random car shop? Or would you prefer to go to a car of your model of your make a specialist right, you might go to a random car shop. And they might put an alternative brake pad that doesn't align perfectly kind of risky, right versus going to a specially specialty auto shop.

Dr. T  08:45

So that's just an example another example of how important it is to focus. Now number two in the law of attraction, it's about managing your emotions. So being able to have a firm hold on your emotions before you enter into entrepreneurship, business ownership or even owning a direct care practice is incredibly important. You have to develop a thick skin in order to be successful because all successful people know that failure is part of the price that we pay to have success they go hand in hand failure is not the end destination. It's a stepping stone. In medicine, we're not taught to fail for good reason, right? It can hurt our patients. And that's why it's such a big deal to not make a mistake in medical school. And that's why your scores matter, you know, in how you rank in your class and all those things, which is also why it's incredibly challenging for physicians to open their own practice to do direct care, because we all want a surefire way to succeed. 

Dr. T  09:40

We want a laid out outline a protocol approach, but unfortunately, with business ownership, there isn't a prescribed path. And that makes it really scary for a lot of us we're so unwilling and so untrained to accept that failure as part of the process that we just maybe we don't even try because if we don't try then we don't fail, right? We were not scarred from the failures that we don't want to carry with us. But what I've learned along the way is that failure in the business setting is a lot more forgiving than it is in medicine. And it's necessary, failure is the best teacher. So just understanding that that's part of the process. And how you bounce back is what matters. It's how you respond to that failure, we all make mistakes, this is a guarantee, but how you respond to it is up to you. 

Dr. T  10:25

So develop the emotions that is positive, that is constructive, that leads you closer to your goal, when you experience a negative emotion, or you're just being really hard on yourself with a lot of self talk. I mean, these are things you're allowed to experience. But when you're done processing that you have to revisit and ask yourself, will this negative self talk get me to where I need to be? Or is it holding me back? Is it making me feel very afraid to even try anything else? Now I want you to think about which dialog is better for you, which is more productive version one, you failed at something and you say I suck, I'm not cut out for this, or version two, you know, that didn't turn out so well. But I think I can learn from it. And which one of the two do you think is going to help you move forward to your end goal, this is what business owners will experience more often than not more often than an employment situation. Because we are trying to create a future that has not been crafted, we are creating it on the go. So make sure that you are in the daily habit of activating the right kind of self talk and managing your emotions in the business ownership journey. 

Dr. T  11:35

Lastly, as we're talking about habits as well, I heard this saying and I've been saying it to myself at least once a day, it was from Dr. Guna. From the entre MD podcast, take a listen to her stuff, it is magical. But comfort is where dreams go to die. Just think about it. Anytime that you're comfortable. That means you're not growing, it means that you're done. And you know what makes many of us terribly uncomfortable. It's marketing, it's networking, it's putting yourself out there, it's living the extrovert life. And many of us as physicians are introverts. We like to consume stuff by reading by analyzing. And it's very hard for us to put on the business hat if we've never done that before. So if you're somebody who says I'm done with marketing, I already figured it all out my business is full my clinic patients, I'm done I'm good with. And that kind of means that you've retired from your business, because eventually people go out of your clinic, they move on, they pass on or their problem is solved, and they don't need you anymore. So you have to figure out a way to replenish those patients, and you have to have the systems in place. So you're not acting defensively, you're not acting on the day that you're empty, you should have planned for that beforehand. 

Dr. T  12:46

So developing these types of habits, and then creating systems so that it just becomes a well oiled machine is incredibly important when you own your business. So realize that owning a successful business, it's going to be an ongoing exercise, and you're going to have different stages that will demand different versions of you. So the startup phase is going to demand different things from you, versus the scaling phase, you know, when you're studying, and you just want to multiply what you already have, just like the version of you in your pre college day was not the version of you, that brought you to having your own business, you have to continue to learn to mature and evolve. So when you're going from insurance to direct care, you have to build habits that was maybe never exercised before, like marketing yourself and talking about your value. So what new habits do you need to adopt to get to that next level, from employment to business ownership, or even from the insurance model into direct care, if you were employed, and it was an insurance model, then you probably got patients coming to you because you were in network. So the referral sources knew that you took their insurance, so they sent patients to you or the patients found you on the patient portal in their insurance. And that's how they found you. So the work to get patients isn't as hard as it was, if you were to be in a direct care practice, where you are marketing directly to consumers. And your referral sources might look a little bit different. 

Dr. T  14:15

There are people who probably don't take insurance. And so they are pre screening your patients on your behalf, which is a really great way to go about marketing. But you have to learn how to put your value proposition out there, where people understand that what you offer is totally different than an in network doctor. So you have to be able to create yourself in a niche or a niche in that way. And that is just a language a messaging difference when it comes to having a direct care practice versus being employed where things kind of just come to you. So yeah, you have to work a little bit in order to craft your message to your ideal patient.

Dr. T  14:53

I talk about this in my lunch in 12 weeks course. And then I talk about also learning Each those are the first two things that you need to identify when you open your direct care practice, or before you open your direct care practice is what is your niche? And who are you talking to? These are the two things that we don't really talk about if we were employed, or are in the insurance model, because perhaps we were taught that we had to see everybody who walked in whoever carried in insurance that we took was our ideal patient. And that's kind of the difference between the insurance based practice and the direct care model. That is just one different type of mentality you need to have in order to get started in the direct care path. 

Dr. T  15:33

So in summary, law of attraction, meaning doing the things that will bring more to you more abundance, more types of patients who will pay more good stuff, so that you can craft your practice exactly how you want, it includes these three prerequisite. Number one, it's your beliefs, you have to deep down believe that direct care is going to work for you, and that you will be resourceful enough to figure out a way to make it work. It's already working for 40,000 doctors, why can't it work for you, too, if you sit in the belief that it will not work for you that patients will not pay you more than their copay, or they don't want to pay you or your community doesn't support a cash practice. And all of these thoughts that are after all, they're just beliefs. If you want to live in that belief, then you'll find yourself to be right as well. Because our ego is incredibly powerful. Whatever it is that we believe, we will find ways to prove ourselves, right. And don't forget those people who don't want to pay you their copay, they're not really your ideal target audience, if you have a direct care practice, just something to keep in mind. 

Dr. T  16:42

Number two, your emotional intelligence need to be in line, you have to develop an emotional repertoire that helps you get to your goal. That means putting yourself in a mental space that is productive. If you come from a culture that is highly critical. And your inner voice is constantly putting yourself down having self doubts, or maybe it's just very intrusive, I'm going to recommend a book down in the show notes called Positive Intelligence that's going to help you work against those sounds, those thoughts, those tiny little voices in your mind that is not productive. For me, those tiny little unproductive voices come from my upbringing for you, it could be a similar way or a bad experience that just got imprinted. This book is going to help you kind of move away from that thought and help you understand that these are just thoughts after all, and you can control what you listen to and what you don't want to hear. And I want to be clear that it's not just about positive self talk, self affirmations that you don't put into practice this, that's voodoo. But if you actually put yourself in a space where you truly believe what you think you're going to be much better off and much closer to your end goal. 

Dr. T  17:53

And then number three, establishing habits, which means you have to start getting used to being uncomfortable. There's just no way around it. But if you want to accelerate your potential, you really want to meet your future self. Or you have this dream practice that you are proud of that is highly successful, profitable, and not stressing you out. That means you have to figure out what daily habits you need to adopt, get used to being uncomfortable, and realize that each level of your practice is going to require a new version of you. And every time you need that new version of you, you're going to be uncomfortable, I'm going to add a bonus, since I'm right on it get used to saying what you have to offer in front of people who actually want it. If there are people who are unwilling to pay out of pocket for your services, stop talking to them, they're not your people. 

Dr. T  18:38

So get used to talking about what you have to offer how you can help. And that's just marketing. That's all there is to it. Now the how to start your direct care practice, that's easier. You can Google it, there's a lot of people talking about it. The Google version, you know, is the flashlight approach where you shine a light on your Google search bar, how to open a direct care practice. And you're gonna find a bunch of resources, it might be relevant to you, it might not. Or you can take advantage of my course launch your direct specialty care in 12 weeks, which are actionable steps that you can take to get started on the right path. This is the laser approach. You'll know exactly what to do every single week for 12 weeks. And I've made a bunch of mistakes so that you don't have to the course is totally affordable. And I'm also throwing in three coaching calls, which is one call per month with the first one starting this month, at the end of the month, March 31 2023 at 12 o'clock noon, Pacific Standard Time. I'm on California time so I hope you'll be able to join me grab the course. Take a look at the content, start practicing these things that you need in order to get your successful direct care practice. Maybe you're on the fence about the course but I want you to remember, indecision will delay your dream during your practice. 

Dr. T  19:52

So this is your sign, just go for it. If you don't love it, cancel it. This is the course that's going to help you week by week till you exactly what you need to do in order to launch your direct care specialty practice. I'm really invested in your success. So I hope you take advantage of the course and the coaching that I'm offering as well. That's all I have for this week. I'll catch you next time. Take care. 

Dr. T  20:15

Thank you so much for being here with me. If you enjoyed this episode, don't 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  20:34

And lastly, if you remember nothing else, remember this be the energy you want to attract. See you next time.