The Direct Care Way

More on burnout, unscripted

May 16, 2023 Tea Nguyen, DPM Season 2 Episode 66
The Direct Care Way
More on burnout, unscripted
Show Notes Transcript

This is what happens when I go unscripted. 

Grab an adult beverage and just hang out with me for a bit. You might be hearing my washing machine in the background as I spill my guts. 

I talk about my experience with functional medicine. I don't know where I was going with this, thought I'd share it anyway :D

Dr. T  0:00  
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  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  0:53  
Hey, there, I have a fun update. The last episode I recorded on about burnout was about how the insurance based system really is designed to squish out all of our energy to see as many patients as possible while reimbursing as little as possible, ultimately, to save all the money for themselves. It's not for the betterment of our community. We know that now. But I also wanted to talk about symptoms of burnout. There are doctors in I wonder if you're one who may not know exactly what the symptoms of burnout are. And I've had doctors who came to me depressed, maybe confused about what they're doing in their practice in their life questioning if they even chose the right path, having a lot of doubts about the decisions, they're making any essentially demonstrating signs and symptoms of burnout. 

Dr. T  1:50  
But because this wasn't part of our regular vocabulary, we may not always know that what we're currently experiencing is a transient phase, in our practice in our life in, I'm going to share with you how I've started to recognize my own signs and symptoms of burnout. And maybe you can relate. Or maybe you have your own story as well as to when you first experienced burnout. And when you finally labeled it, and then was on your way to finding a treatment for it. I certainly hope that if you've ever experienced burnout that you got professional help for it. I'm not a mental health expert by any means. And as you know, these episodes are designed to entertain and educate. But if you're having a hard time with coping with life circumstances, please do reach out to your local resources on professional help. So with that, recently, I have been experiencing a lot of exhaustion. And I think you know that this is pretty typical. If you own your business, and you're a high achiever, you like to feel accomplished, you do a lot of things to feel accomplished. 

Dr. T  3:00  
And for me, that's exactly how I am. I love to write articles, I get the most dopamine release, when I accomplish a task, like writing an article for a digital health newsletter, or even the various outlets that I'm currently participating in payment therapy feels like it's writing in it feels really good once I complete a task. However, in the last five years, for as long as I've had my daughter and my private practice, I felt kind of like I was in the same place over and over again, it was one thing to opt out of insurance. But another thing to feel like I'm kind of chasing an imaginary endpoint, the feeling of once I get there, then I will feel better than I will feel secure. You know, like all of these things, we tell ourselves, the if then type of stories, you know, and they call this the destination fallacy, where you will only believe that you can achieve happiness, if you hit this marker in life, you reach that destination. And I found that that's not the best way to live. If you only live for the outcome, then you never have the opportunity to enjoy the journey. And the journey could be decades of our lives. 

Dr. T  4:15  
So if we're just waiting around for, let's say retirement age, then those decades that built up in your lifespan don't have a lot of significance. You're just kind of buying time or wasting time until you get to that point and then you get to that point and you're like this is it and then you'll feel like all of your life has been wasted. And that's a feeling that I never want to experience. So going back to what's been happening lately. You know, I put together these free resources for you so that you have an idea of what's possible. It's the seed that I plant and continue to water it so that you know it's very possible for you and then I offer coaching, private coaching and group coaching to make sure that you are traveling the rightpath because it's really easy to get in your own head and get stuck there. 

Dr. T  5:04  
And the doubts that we allow fill up in our mind, I like to say that the thoughts that you have in your mind need to be managed like a garden, if you let the negative thoughts persist, it's kind of like ignoring a weed where it will just continue to grow. So you got to check it, you got to pull the weeds, you got to recognize that it's there, in order to have a healthy garden, a healthy garden of thoughts. So I decided to take some functional test functional medicine tests to further evaluate some of my physiology. And if you're not familiar with functional medicine, I wasn't familiar with it until more recently, but these lab test is a typical or non traditional, I should say. So when we ordered test as surgeons and physicians, we're really looking at like CBC, the BMP, the CMP, stuff like that, right. Those are things that are taught in our medical education and reinforced throughout our careers, especially when we're having to order tests for a patient who might have some kind of illness or even preoperatively. 

Dr. T  6:06  
We want to get a baseline. Other tests that I've never been taught about in any part of my education was neurotransmitter test and a hormone test, I had the luxury of living in Santa Cruz. And I'm surrounded by a lot of functional medicine experts, people who are in a variety of different fields from MDS to nutritionist to those focusing on women's health, natural pads, we have an abundance of a variety of different types of health care professionals. So I got an inside lift, just seeing how we all work together. To help our patients, I decided it was time for me to explore alternative medicine, or a different route, because I was experiencing fatigue that was that felt a little bit more abnormal than usual, actually have baseline low blood pressure. And motivation has always been very hard for me, which is why I have to put myself to task in order to feel some level of accomplishment, some level of productivity when at baseline, like right now I'm laying in bed recording, my thoughts in I started to also develop some external symptoms, like some eczema that developed on my hand, it started as a small patch between my two fingers on my right hand, and over the year, it spread to the entire surface of the palms. And I thought this was just because of the more frequent hand washing and alcohol sanitizers I was using throughout the pandemic, or even the gloves that I had switched back and forth with I thought it was just some cheap gloves, and getting a delayed sensitivity to it. 

Dr. T  7:41  
But then I went to my lovely, lovely friends, medical doctor friends who prescribed me some topical steroids, which was helpful in the beginning. But then I wanted to dig deeper, I wanted to know why this was happening to me. And it was very hard to not see that my stress and diet had some influence to this skin manifestation. So that's when I started to decide to explore some functional medicine tests on my own and wanted to incorporate some more of a lifestyle component to my practice, because I see a lot of patients who either they've already gone to a functional medicine doctor for overall wellness kind of a checkup, they had some other issues like bloating, fatigue, just general feelings of not feeling like themselves. 

Dr. T  8:28  
And I thought, hey, it's my time to learn about adding modalities that can help my patients at least point them in the right direction, if the standard labs that I ordered doesn't reveal anything significant. So I took this lab test, I took the kind where you peed on a bunch of strips throughout the day. And I took some saliva test as well. I had a spit in a tube. And I sent that out. And to be honest, I didn't think anything of it. I was kind of surprised to even get any results because I was like, what, what on earth can you find with the urine samples, or this small amount of spit that I put in it to bray like I'm just not that educated in that arena of medicine. And then about a week and a half or two later, I got the results. And it was a really extensive result. It was about a 17 to 19 page summary of all the different things that they tested for and when you get something like that it can feel really overwhelming. And that's how I felt. I was like, Does this mean I have Alzheimer's, there was some note about possibility of Peri menopausal and, you know, all the worst case scenarios started to creep up. But I did notice something that was significant that I could kind of understand which was my dopamine levels were really low in dopamine is related to your motivation. And it can even suggest some level of depression. 

Dr. T  9:45  
So I was like, Well, who at this age doesn't experience some of that right? But it was significant enough for me to want to dig deeper. And so I spoke to a professional who suggested that with the labs that she saw on me, too. To explore supplements, and they were not pushy at all, they were very helpful and kind and thorough, and even walk me through some of the pathways that could result to the current symptoms that I have, including the eczema I have on my hand and their frequent bloating that I had for the variety of foods that I do eat, I just couldn't put my finger on what was the one thing that was bothering me. And that is probably because it was a variety of things, just the general lifestyle that I currently have, the stress that I experience, you know, and all of that can lead to dysfunction of your immune system. And your gut health also influences your immune cell. And this is scientific stuff that we don't again, we missed out learning throughout medical school. And so luckily, we're lifelong learners. 

Dr. T  10:44  
And we continue to learn as things come up. And so that's the phase of life that I'm in right now and trying to explore the sources of my exhaustion, general fatigue, I am getting cold a lot more often, the symptoms on my hand, the bloatedness, the general overall feeling of I don't feel like myself, and I believe it has to do with everything, the way that I eat the way that I manage my stress, or I'm not managing it well at all physical activity. I know I'm not at the prime of my well being. And yeah, having these two businesses is a lot of work on top of my daughter taking care of her and having to rearrange my schedule to accommodate hers. And it's a lot and so if you're somebody in a similar position where you don't think it's just the kind of life that you have, you know that there's more to it, you know that there are things that you might be able to implement an add on, then I think getting a functional medicine test might give you a little bit more answers, because it's definitely done that for me without even telling the clinician my symptoms, like I have this random eczema developing, she found that the histamine levels was elevated in it suggested that it might be related to my diet, maybe some gut dysfunction, and to explore that further. So how does this have anything to do with burnout? Because burnout is really complex burnout, whether it be from work causing you a lot of stress that is unmitigated, or is not addressed in a healthy way it can contribute or accumulate and cause physical manifestations such as adrenal fatigue or adrenal insufficiency, and were to have hard time saying, but adrenal insufficiency enough to cause some clinical symptoms, but also enough for you to seek treatment for and there are natural treatments for it. 

Dr. T  12:32  
The clinician also offered to see a professional who can prescribe them pharmaceuticals, such as an antidepressant to help increase those levels of dopamine, which will also help increase norepinephrine, but I just don't really think I want to do that right now, I have some personal history of using Lexapro for depression, but it really just turned out, it was my environment, that was a complete radio show. And so once I removed myself from those circumstances, I didn't have to take those medications anymore. But you know, I just wasn't very excited to get a prescription. And I know a lot of folks this day and age with all the resources that we do have, we can do more to help ourselves in the various chemical pathways are influenced the way we feel. And so this is this is just talking more broadly about when you can't find answers in the conventional system in the conventional way of medicine, then you got to look for alternative options. 

Dr. T  13:24  
So this rabbit hole that I'm taking you through has a lot to do with the opportunities we can give patients when I only knew about conventional lab testing, I missed out on helping a lot of people, because those people sought out functional medicine doctors, and now that I'm incorporating more of that into my practice, looking at the patient in a holistic way, trying to help them manage their stress, address their diet, even hydration, and just general well being it has opened the doors on the different ways I can help people. Plus, I get to spend a lot of time with patients. And what I have all that time I get to discover what's really important with them. You simply can't do that in a seven to 15 minute visit a lot of appointments, I have ranges from 30 to 60 minutes. And that gives me opportunity to listen to what matters to the patient, how often are we examining patients just to have things written down in our chart in our specific sections, and to meet metrics to appease the insurance companies so that we get paid and that is a wrong way of taking care of patients instead now and get to look at the patient on a whole listen to their story. 

Dr. T  14:31  
And by listening to their story, I can really dig deep into the things that matter to them and provide a personalized plan that will be more effective for them. So by listening to patients, giving them the time to talk about themselves, I can create a treatment plan that they can buy into and that'll give them the small little wins that will help them in their healthcare journey, not just in trading for me as a podiatrist and they're finding a problem but really to help them in their overall wellness and their mental well being too, because that's incredibly important in the journey of healing. So in this episode, I share a kind of off topic, but very relevant talk on functional medicine, how I've used functional medicine to help myself and to show you that there are other tools that you can offer your patients in your direct care practice that will lead them on their way to a healthier glow, rather a healthier lifestyle, things that we can influence. 

Dr. T  15:28  
Despite our genetics, despite our circumstances, we can help guide them towards a better path of healing, not just their specific medical condition that they saw you for as a specialist, but as a holistic doctor. And direct care provides you time with patients to understand that in the depths that matter, and plus the people you start attracting are going to really appreciate the doctor that shows up in that way, which means you can definitely charge more for your time. And for your knowledge.

Dr. T  15:57  
This might be one of those episodes where you're like what on earth where did this take me but once in a while I'm gonna take you along the journey. Tangent Boulevard, we call it just so that you can open your mind a little bit to something new that maybe you've not heard of before. So I hope I did that for you in this episode. That's all I've got for today. I'll catch you next week. Take care. 

Dr. T  16:18  
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  16:37  
And lastly, if you remember nothing else, remember this be the energy you want to attract. See you next time.