The Direct Care Podcast For Specialists
Learn why and how to start an insurance-free, hassle-free Direct Specialty Care practice that lets you provide care your way for your patients without middlemen.
The Direct Care Podcast For Specialists
Kingdom Healing Institute with Dr. Adetoun Abisogun Musa
Dr. Adetoun Abisogun Musa is a neurologist who focuses on epilepsy and practices with her husband Dr. Hussein Musa in San Antonio, Texas. Offering evidence-based therapies and holistic care.
Clinic https://www.thekingheals.com
YouTube @kingdomdocs
IG @thekingheals
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Dr. Tea 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. Tea 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. Tea 0:52
Today, I have Dr. Musa who practices in Texas, in a neurology clinic, but she has a very cool niche that I'm really excited to share with everybody here. Let's welcome Dr. Musa.
Dr. Musa 1:05
Thank you so much for having me.
Dr. Tea 1:08
Could you give us a little introduction about yourself and how you came to have your direct care practice?
Dr. Musa 1:14
Absolutely. So I have always been interested in Neuroscience. In fact, I majored in Neuroscience in college and initially thought, well, maybe I'll be a Neurosurgeon, but once I realized that, really, I'm not too much into the procedure, but the diagnostic depths of neurology and localization, I decided to pursue that as a career. Fast forward, after training at Yale, as a Neurology resident, and also in Clinical Neurophysiology as an Epilepsy Fellow. I moved to San Antonio with my family, and I started as the Director of the Epilepsy Center of Excellence here at the VA. And it was pretty rewarding, but it's a large healthcare system. And it turned into a bit of a machine. There are a lot of pros, but there's some cons to working in such a large healthcare system, and one was just not having that deep relationship that really I was looking for with each patient, I wasn't seeing any sort of transformative experience. In most of my patients. I really prided myself in very high quality care and excellence that a lot of doctors are perfectionists, but it's just it, it was kind of more of the same thing over and over again, and became kind of a routine type of cog in the wheel situations. So after some time, and some reflection, and honestly some prayer, my husband and I decided to step out in faith and, and start this direct care practice.
Dr. Musa 3:06
And in this practice, what we do is we combine conventional medical therapies, which would be just, you know, regular medications and what you would call evidence based medicine with Holistic therapies. And the holistic therapies are, in fact, research based or evidence based, a lot of people have different definitions of what holistic means. And really, what that means to me is treating the patient as a whole. So we're speaking to the patient. And we are not only concerned about the physiological aspects of their disease process, but the social ramifications if they're suffering psychologically, if their newest neuropsychiatric complications, and even if the patient is comfortable, any spiritual issues as well. And that is something that we have time to do in the direct care practice. We certainly did not have that time when working for a large hospital system. And I've seen a lot of turnaround and a lot of testimonials for my patients because of our approach.
Dr. Tea 4:19
I love that. So you decided to go from an employed position and open your own practice. How was that transition?
Dr. Musa 4:28
Well, it was definitely a leap of faith. I would say that there were some ups and downs and I think that it's definitely a learning curve. It can be a steep learning curve to some people because working in an employed position, and you don't necessarily have to think outside the box, you just kind of show up to work. You have a full panel of patients or a growing panel of patients with the direct care model. You really have to put yourself out there, you may even have to understand that there's an element of sales as well. And you can't be afraid of public speaking and networking. And just finding out what else is out there, how you can apply it to your practice, and how to communicate what you're doing and how it's different and how it's needed and wanted in the community.
Dr. Tea 5:26
How long have you had your direct care practice?
Dr. Musa 5:29
Since May 2023
Dr. Tea 5:31
Such a baby, it's almost coming year.
Dr. Musa 5:35
Yeah, almost a year.
Dr. Tea 5:37
Beautiful baby. Okay, how's it going within the first year?
Dr. Musa 5:41
So the first year, when we had our Grand Opening May of 2023. And before that, we had more of a soft opening. But I think as far as networking, we had some successes, and probably some failures. So marketing for direct care, I think really, is just networking, speaking engagements and finding your target audience, and then just speaking to them directly about what it is that you're doing and what you're offering to them. There are a lot of digital marketers out there. And even the traditional marketers that go from practice to practice, but we had the most gains from really just going out there and and speaking about what we're doing to the people, which is, I guess, direct consumer marketing. So yeah, it has actually made us into, I would say full time marketers, we aren't hiring anyone to do our marketing for us. There's also the social media aspect that helped her practice grow as well. And I think really just growing credibility, I don't think we've increased our patient panel per se directly from live things like Facebook or Instagram, but the clientele the patients that we have currently, they do look at our Facebook posts for factoids and knowledge and just reassurance that, you know, we know what we're talking about. And we're, we're real doctors.
Dr. Tea 7:30
Who would you consider your target audience who's ideal for your practice and who's not so fit for your practice.
Dr. Musa 7:37
So as a double board certified Epileptologist, and Neurologists, my target audience are patients who are looking for a neurologist, typically they're Googling neurologists, and they cannot find an appointment within a timely manner. So these patients are typically looking for a neurologist and they say, well, they can't see me for another six months. The symptomology usually includes hard to control seizures. And those patients, typically they cannot wait several months to get their problem addressed because of the risk of injury. And, and also just the risk of even more severe accidents or car accidents, that type of thing. So they typically want to get seen as soon as possible. Within the realm of chronic pain, I treat migraine as well, those patients typically don't want to wait. So really any neurological disorder where patients are looking for fast access. I've also had a lot of success with target audiences of people who are suffering from dementia, or mild cognitive impairment, memory impairment can be very anxiety provoking for patients. And it's not so much that they cannot wait for a neurologist, but they may have actually been to a few neurologists, and they're looking for a second opinion or alternative means of therapies to improve their memory, or at least reduce the progression.
Dr. Tea 9:21
You have so many key points and how you're targeting your ideal person. Because I think what we are seeing in the traditional model is that the appointments take forever, six to nine months to deal with something that should be managed a lot sooner. These are people who are seeking more time with their doctor to address the root cause of their issues, or they just have a level of complexity that demands more than the seven to eight minute visits. And you mentioned holistic care and consumers generally think all doctors are relatively the same. They think everyone's the expert and so if you go to an in network system versus an out of network system to them, they don't quite know the difference until they have that personal experience. What are you doing in the way of your marketing to stand out from insurance alternatives?
Dr. Musa 10:15
Well, one thing that I'm doing is a lot of education. I love teaching. And I currently hold faculty positions at UT Health Science Center. And I have discovered that part of marketing is helping people understand the product. And part of a lot of that is really explaining it very well. And so what I do are speaking engagements to retirement home residents, I do that I do the same type of speaking engagements to home care councils and other types of interest groups that are involved in caregiving for patients with dementia or autism, people who are suffering from epilepsy, and through that education, it, it first of all, it increases the credibility of the one that is educating the audience because they look to you as a credible source of information. And it piques their interest. And it also, I think, provokes a lot of questions in those target audience members. And in order to answer those questions, they are led to either call the clinic or find out more, maybe sign up for an informational session, and then that turns into an appointment.
Dr. Tea 11:44
How are you getting these speaking engagements? Who are you seeking out? How do you approach them? How do you secure them?
Dr. Musa 11:51
Well, I kind of just fell into it, to be honest, I was I did a lot of networking early on. And I started meeting people, usually, like, we'll say, people that were in charge of these homecare councils or different long term care facilities, medical directors, that sort of thing. And I would just talk to them and they would say, hey, you know a lot about this topic, you should come and speak to our association. And, once speaking engagement will turn into additional speaking engagements, and then it just kind of snowballed from there.
Dr. Tea 12:31
So you're saying it's easy?
Dr. Musa 12:35
I don't know if it's easy. I mean, people would call it luck. Other people would say, well, it's fake, where you're just, you know, had some blessed encounters. I think that looking back now I understand the importance of high level marketing and, and just really trying to market to people who have a direct connection to the clientele or the patients that you're trying to service. So yeah, so I would say anyone, anyone that is a neurologist out there, and there's thinking about doing direct care, you really have to put yourself out there, you have to be social, even if you're an introvert, I'm an introvert myself. And it doesn't, you don't necessarily have to act out of character, and just play on the giftings that you already have. So if you like teaching, then try and get as many speaking engagements as possible.
Dr. Tea 13:29
You mentioned a keyword that I think a lot of us can relate to. We are kind of introvert, we're like introverted nerds at the same time. So how did you get yourself more comfortable with public speaking? Do you have resources or tools? What was your guidance?
Dr. Musa 13:46
I think I've been trained to speak publicly for a very long time because of my faculty position at the University. I did a lot of didactics and lecture series, and it just forced me to just get out of my comfort zone. My advice, you can be faculty or not, but just put yourself out there, try and find some libraries that you can speak at. I've been speaking at libraries as well. Special Interest Groups. And if your MD or DO or professional degree is enough to pique people's interest and say, Yes, you can come speak, it doesn't take that much effort. You just have to be kind of persistent with the emails and calls. And then once you get that speaking engagement, I know that it's going to sound a little snowball because more people will hear about you. I also recommend recording all of the speaking engagements as well. You can put it on Facebook Live, and that also gets people interested in what you're talking about if you get to increase your exposure and other people will invite you to more and more speaking engagements. Don't say no to them unless you're, you're really busy. I try and do as many as two per month. Maybe like every other week, you can, you can do more or less depending on your schedule. The more you do the, the easier it is. And also you start to build a library of PowerPoints. And you don't necessarily have to reinvent the wheel, you just pick whichever presentation you want to do, and you show up and you do it.
Dr. Tea 15:35
What has been the biggest challenge for you?
Dr. Musa 15:38
The biggest challenge has been overcoming the mindsets of having to use my insurance or just not really understanding what direct care is, which is why I do a lot of these speaking engagements. The mindset of Well, I have insurance. So I don't understand why I have to pay for this appointment. I've gotten very good at convincing and converting patients who call for appointments. One thing I didn't mention is really the probably the most effective marketing, besides networking, speaking, etc, would be Google Ads. I don't know if I'm allowed to say, Google here. But that's where I get a lot of random calls from people who are looking for a neurologist and maybe they've been to a neurologist, but they can't find one for six months or more. And so I answer these calls, but they're, they're in this mindset that I'm going to use Blue Cross or Aetna. And so the way that I overcome that I say, Well, you know, typically, it's going to take you six months to see a neurologist. When you do get to see this neurologist, the appointment is going to be maybe seven minutes, if they're generous, it may be longer. A lot of times with complex neurological issues or second opinions, it's going to be hard to delve into the root cause of the issue. And our practice is different because we are prescribing medications, but we want to get to the root issue, we treat the patient holistically. And that's been proven to really help patients overcome whatever that chronic illness is. And that does convert a lot of patients. Some patients will say I'll keep looking, and they do call back and make the appointment after they look.
Dr. Tea 17:35
That's so good. So now that you're coming up on your one year anniversary, do you have any regrets about not taking insurance? Or do you want to go back?
Dr. Musa 17:48
I don't have any regrets. What I, No, taking insurance, I've done this before I had a private practice. I think back in it was 2017 - 2018. And it requires so much overhead to chase down the insurance reimbursements, you have to see more patients and it's just the quality of care goes down this direct care model, it is a slower growth curve. I think that the acceleration or the growth, you're going to have to be patient. But honestly, if you have kind of a safety net, or if you've taken up a business loan, or if you've saved money, just realize that the growth is going to be slower, but the rewards are going to be so much greater because you have patients that love coming to your practice. You actually care about the patients because you're spending time with them. I remember my patients names now because I don't have a 2000 patient panel or something crazy like that. And no, I really don't regret it. What I'm actually looking forward to is doubling or tripling my marketing because I know that if I cast a wider net, I'm definitely going to get more patients. The proof of concept is there.
Dr. Tea 19:23
Is your model cash fee for service or is it membership?
Dr. Musa 19:29
Its cash and membership. So typically when somebody comes over and signs up for the appointment, we tell them that it's a $600 initial consultation fee. This consultation fee includes the initial appointment, any diagnostic workup that we do, and a follow up appointment. So they'll pay the 600 they come back for their follow up. No payment is due on that second visit, that second visit, we're able to go over any results. And counsel the patient, we asked them how the treatment plan is going. And I found that probably about 30% will say 30 to 40% of those patients convert to members during that second visit. So it's important to touch base with them the second time, that's what I found.
Dr. Tea 20:28
How did you decide to choose a membership over fee for service?
Dr. Musa 20:33
I found that people who are suffering from epilepsy and sometimes migraine, it's a lot of, they require a lot of hand holding, initially as we're changing their management plan, especially if they're coming from another practice and we're switching medications or cross tapering. It does require a lot of follow up. And so just having them come back, A La Carte, sometimes it's just not, it's not the best fit for those patients, especially if they're having active disease or active seizures. There are some people who have very well controlled seizures that only come twice a year. So then we just use the A La Carte Model. And then there are other patients who are in our dietary therapy clinic. So that's part of our holistic approach. We are, I think, actually the first ever, medically directed dietary therapy clinic for the ketogenic diet and modified Atkins diet for the treatment of epilepsy. And I work with a registered dietician, I've launched a program like this in a large healthcare system before. And I found that, because it's such a large machine type of model, it's hard to get people to remain compliant on the diet. And so because I have the time, I've implemented coaching into our dietary therapy, and with that coaching element, the membership model really just goes hand in hand.
Dr. Tea 22:20
What has been the biggest reward for you on this direct care journey?
Dr. Musa 22:24
I think the biggest reward is that. Honestly, I don't know if it sounds weird, but just the love I have for my patients now like I, I really, really, I really care about their well being and, and I can tell that they're so grateful, and they're so appreciative that they are in a clinic and seeing a doctor that is listening to them. I get a lot of patients with mystery complaints. And you know, a lot of neurologists will get second opinions like that. And to be able to have the time to actually figure out what's going on is very rewarding.
Dr. Tea 23:01
So for the doctor who is on the fence about direct care, they're not sure which direction to go, how would you advise them?
Dr. Musa 23:08
Well, I would say to do research, and these podcasts are a great resource. I would also say, to just to reach out to anyone that has started a practice and I would be happy to receive any emails or even phone calls, other doctors that are on the fence and needing some extra guidance. I would also say to prepare for launching your direct care practice because the growth is slower than what you would see with an insurance model. And then, and that's it really, it's a it's really been a journey, but it's been a very enjoyable journey.
Dr. Tea 23:51
Any last tips or advice for the listeners?
Dr. Musa 23:55
If you're suffering from burnout, and you find yourself going to your patient appointments without empathy or compassion, it's really important to reevaluate your situation and to re-enter and revisit why you became a doctor. If you become a doctor, it's for to heal patients to see patients improve. And whatever model that you're in is not facilitating that. Then consider the direct care model.
Dr. Tea 24:29
That was so perfectly said thank you so much for your time. I'm gonna put your information down in the show notes for everyone to find and connect with you. For everyone who's listening. Thank you so much. I'll catch you next week. Take care everyone.
Dr. Tea 24:42
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. Tea 25:02
And lastly if you remember nothing else remember this be the energy you want to attract See you next time.