Dr. Tea Nguyen (00:00.0)

Practicing medicine without insurance is possible. Imagine a private practice where you get to see your best patients every day providing medical services you truly enjoy, all without the hassle of insurance. My name is Dr. Tea Nguyen, and I'm a recovering specialist who was completely burned out from insurance-based medicine. I pivoted into direct care, where patients pay me directly for my medical services and have never looked back. If you're a private practice owner or planning to become one, 

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who's looking to be free of the grind of insurance and your craving simplicity, efficiency, and connection with patients, you are in the right place. This podcast will help you map out your exit plan and uncover the mindset needed to thrive in today's economy. Welcome to the Direct Care Podcast for Specialists. 

Dr. Tea Nguyen (00:53.718)

It's back to school season, my daughter just turned seven and she's going into second grade and it's really hard to believe how quickly she's growing. And I'm so grateful to be able to have a business, one that's free of the burdens of insurance, a direct care practice, because this type of practice has given me the luxury of time. If I hadn't left employment or left the insurance model, I don't think I would have this level of freedom. 

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over my schedule. And now, I get to flex my time so that it fits my lifestyle. And being able to spend time with my daughter is something I know that my parents never had the luxury of doing. They were working, they were working multiple jobs throughout all of my upbringing. So being able to break this generational trauma of having control in my own schedule is invaluable. There's no price tag I can put on that. 

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Now to carry the back to school theme into today's quick episode, I wanted to bring you back to the basics of what you need to know to own a successful direct specialty care practice. One that gives you time, money, and freedom, where there is less chaos and more ease and flow. So if you're new here, welcome. And if you've been here a while, this is a good story worth repeating. And sometimes you need to hear the same thing 

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over and over again. And when you become a new version of yourself, this information starts to hit differently. So let's get straight into the three things you need to know to start a direct specialty care practice. Number one, marketing is everything, or at least the bulk part of it. The more people know about your stuff, the greater the chances that the right people will become paying patients. 

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Doctors are afraid to market themselves because they think it's sleazy, it feels weird, it's something we've never been taught to do. But the reality is, if you're a doctor, you have already been marketing yourself. You do so with the relationships you create. You've been doing so when you championed yourself for a spot in medical school, in residency, in your first jobs. Maybe you've even had to apply for a scholarship. 

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I even bring this into dating. If you were trying to date somebody, you were displaying yourself, the best parts of yourself, to convince somebody that you are dateable and even to be your friend. So it's displaying your best attributes to attract the kind of person you're trying to attract. And when you do that in business, you're just doing it in a more sophisticated kind of way. You're doing it more tangibly with ads and education. And I like to call marketing 

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by doctors a way that we educate people in the problems that we solve and how we do it. So you're telling people the things that you have to offer to the problems that they're having. If you're speaking to people who have foot pain, for instance, you're going to teach them how you help them. And even before they need your expertise, you can do practical things like the things that they can do at home to minimize self-harm because not everybody needs your level of care. 

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Some might need less and some might need more. The point is to bring value to people and to bring people into your world, cultivating a relationship, which all of this takes time. And this one took me a long time to figure out, but you really aren't here to serve everybody. You simply can't. And over time, you start to develop a gut intuition as to who is a good fit for your practice and who isn't. Before I had a direct care practice, I thought that 

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I was there to help everybody. And there were many times where the patients didn't want my help. They were so unwilling to change their lifestyle behaviors and thought I was a magician. But I'm not. I am a podiatric physician who helps foot and ankle conditions. And this is what it takes to become my patient. And these are the things that it takes for you to change your circumstances. 

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And I believe quality medical care requires a level of trust, a level of partnership from both the patient and the doctor. So marketing allows you to refine who you're trying to help, the person who is ready to get your help. Oftentimes, I might get people who want my help, but they're not ready. They're not ready to make some changes in their diet. They're not ready to follow my treatment plans. They're not ready to do the things that's necessary. 

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for a successful outcome. They're not ready for surgery. So figuring out the types of patients you really enjoy taking care of takes time. And we never really got this education in our training because we were taught to take care of everybody. If they had a pulse and they had insurance, we're supposed to take care of them. And what happened in that situation? We really didn't develop the discernment that some people don't want the help. 

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that they just showed up hoping that you would have a magic pill to make all their problems go away. So marketing is everything in a direct care practice. Even if you don't have an insurance fee practice, it is still a big part of the practice. There is an intersection between your medical degree and all of the things that you've known within your profession versus the skills to tell people about what you know. And that's marketing. We know a lot. 

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to take care of people. But we don't know how to bring those people into our world. And if you're not taking insurance, you need to develop the language to know how to bring them in. So we have to market a little bit harder, in a sense, to bring the right kind of person who's willing to pay top dollar for your direct care practice. Oftentimes we have to bootstrap and develop these relationships on our own, cultivating these relationships with the people we already know. 

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And eventually we get to the point where we have to budget for this and pay for a marketing team to put fuel in the fire to get more people to recognize that we're here to help and are accepting new patients. So that's marketing in a nutshell. Number two, if you can't afford a team, then that's the problem. If you're not making enough money, it might be because you're doing eight to 12 different jobs as the business owner, as the doctor. 

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And this is pretty typical of solo practice owners. You're doing things like hiring, firing people, creating standard operating procedures. You're doing the marketing. You're doing the creatives for social media. You're ordering inventory and supplies. You're maintaining the office. You're cleaning and organizing, sterilizing, packaging. You're doing administrative duties, data entry. You're maintaining the website, updating the blogs for SEO. You're doing the bookkeeping, the payroll. 

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the taxes, the tech support, and then that's all the stuff you do at work. But when you get home, there's also to do the home cleaning, do the food preparation, grocery shopping, scheduling of other activities. And if you've got small kids like I do, you're doing the mom stuff, the parent stuff, the dad stuff, you know, these are a lot of things for one person. So you might be thinking you may not be able to afford all of these people right now, but you definitely cannot afford not having anyone to help. 

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So if you don't have a team yet, you need at least one person to help you with data entry, for example, or doing some research about the things that you do need to do. You have to keep in mind what your hourly rate is. And if you don't know, let's just put you at $500 an hour. So the activity that you do as a doctor and the visionary of your business, the CEO, must be of high value. And if it's not, you have to outsource. 

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Because when you don't outsource, that is the quickest path to burnout. When you say, don't need help, you are resisting growth because you are staying the same. You are staying comfortable. And sometimes that comfort is discomfort of seeing your revenue not growing. If you want your revenue to grow and you want to buy back your time, you need to start developing a team. And it could be as easy as hiring somebody for a few hours a week. 

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Michael Hyatt has a book called Your world class assistant that gives the idea of hiring an executive assistant. Now it might sound expensive, but it's not this day and age in 2025, we can afford assistance at $5 an hour. And if you don't know how to hire a team, you don't know how to train. This is a really great way to start where you ask somebody to help you out for five hours a week, creating a list of things you don't like doing. 

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that you know can be outsourced. Maybe it's your social media, maybe it's managing your email, maybe it is making connections within your community. Whatever that thing is that could be done remotely, allow your assistant to take this over, because you should not be doing a job that can be done for $5 per hour if your hourly rate is $500 an hour. And for many of us, a 15-minute visit with a patient 

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can sell a $2,000 package, a $3,000 package. Don't waste your time doing something that could be outsourced. This is a muscle that you can develop and it starts with one step at a time. It starts with hiring one assistant, doing a few hours of work, and then you revisit the time that you've earned back to continue to build out your team and hire for more positions. And number three, if you don't change, nothing changes. 

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Your internal belief is the limiting step to your growth. If you commit to believing everything you think, you will stay stuck. I guarantee that. If you believe no one will pay, you are right. If you believe your community won't value you, you are still right. Your belief will drive your actions and intentions. So if you believe a patient will not pay, 

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and you present a treatment option that's not covered by insurance, your tone and body language will reflect what you believe. It will show up as you not believing that they can afford it, or you not thinking that it's worth paying out of pocket for. So you've made an unfair judgment and nobody likes that. Nobody likes to be judged on ability to pay. You don't know what they're willing to pay for. You can't judge them by the way that they look or how they dress. 

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A friend told me that her millionaire father is so cheap that he would cut up an old pair of shoes to create sandals out of them. They were on vacation in the desert and he was just so unwilling to purchase sandals that he just took what he had, tried to refurbish them and she was so embarrassed. And that's the thing. You just never know what people are willing to spend their money on, what they're willing to do to get that money for the things that they value. And if they don't value it, they won't spend their money on 

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Now I know intellectually all of this makes sense, but if you're going to put up a sign for your business and expect people to just find you, you're already behind. This is the wait and see model and it's risky. It's risky to give it up to chance that the right person will find you, that they will understand your model and that they will give you the money to help them. Your medical degree is not enough and I'd advise you to be humble enough to recognize that. 

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Those who don't are the ones who struggle the hardest. Or they decide to remain employed. Because it is extra stuff to know. It's extra work to market, to believe in something different, to hire a team, know how to fire a team. But this is all stuff that you can learn. And it's readily available in books, in podcasts, in consulting, in speaking to other people who have a successful business. 

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And listen, if you want to remain employed, that's really okay. You have to decide what you want and develop the mindset to go after it. But if you want the freedom to run your business your way, you're going to need customers and the customers need to know that you exist. And you do that by telling everybody. And then you add fuel to the fire by paying for the ads to get front of those people. Doctors are losing. 

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to uneducated social media influencers because they think that their medical degree is enough, that it'll speak for itself and it's simply not true. If you don't know what it means to market, it's very simple and let me share that with you here. It means to be everywhere and having social proof that you're not just a random person out there trying to take people's money for nothing. So what you'll need are online testimonials like Google reviews. 

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So if you've already treated patients successfully and they're happy with your services, be active about asking for those online reviews. Yes, it's weird, but yes, they want to reciprocate all the good care that you've provided. So here's how it goes. A patient goes to you and they thank you for all the things that you've done for them. You say, I'm so grateful for you. Would you mind giving me an online review so that more people can find the practice, can find us? 

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And that's it. And 100 % of the time, they will say yes. That's part of marketing. That's part of doing the weird thing that you haven't been doing before. It's asking for an online review. And of course, making sure you set up a website that educates people on why you are the person for the job. Marketing is a persuasive language that gets people to take a desired action. So often I see people say things that just don't really resonate and they wonder why people don't take to them. 

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They don't show up in their office or they think direct care doesn't work. It really is all in the marketing and the messaging. So here are some examples of saying what you do versus turning it into a persuasive language that gets people to take a desired action. First up, if I were to say, cut feet, do you think that will attract the right people? Do you think people want their feet cut up? Do you think people want surgery? That's kind of a gray area, right? But if I were to say, I cut feet, 

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That really doesn't convince a person to come see me, right? But if I said something like, I treat infections, which one of those two terms sounds better? And that's kind of marketing in a nutshell, it's messaging in a way that makes sense to the person you're trying to talk to. Another thing that I see people do, I have a laser. Okay, good for you. Lasers are expensive, I get it. Versus, you have foot pain and want to avoid surgery. 

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You see how the messaging is different? Another one here. I'm a board certified doctor. That's wonderful. We know you worked hard for that, but it doesn't resonate with the right people. Versus, if you're struggling with foot pain, a doctor so-and-so has years of experience. And the last one, I provide comprehensive care for all foot problems. Okay, that's nice, right? A little bit bland, a little on the vanilla side. Versus, is foot pain stopping you? 

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from enjoying your life. So these are just examples of good marketing. Telling people what you do is not enough. Telling people you have a degree is not enough. It doesn't resonate with the right people. So knowing how to rearrange your words so that it gets people to pay attention is an art in itself. So when you understand these three points and you're willing to be uncomfortable with the idea that there are still things you need to learn, then you're already halfway there. Knowing is just part of it. 

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The other part is doing the hard thing. It's meeting with people. It's finding them. It's making relationships. It's representing yourself well online without being fake. It's knowing that you don't have to be an expert at everything. And then it's proactively reading to start changing your mind. I know your mind is not going to change after one episode. It requires repetition. It requires proof of evidence. It requires all the things. It's a system to change your own mind. But it has to start with you. 

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to be humble enough to know that there are things you were never taught in medical school, but now you have the opportunity to learn it through others or from books. You don't need a business degree to make direct care work in your favor. Join me on the Facebook side so that you can stay up to date when the next free coaching session is. There's so much that we were never taught and that's not your fault. But these are things that are really easy to learn. 

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It just takes time and it takes repetition and it takes a community to help you along the way. Take care for now. I'll catch you next week. One last thing. If you took anything from this episode, whether it's a small dose of inspiration or even an aha moment, could you please share it with a friend or post it on LinkedIn? The direct care community depends on doctors like you because no one is coming to save us. 

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So it's up to each and every one of us to keep the conversation going to a point where direct care becomes a normalized path for private practice and not some secret that we have to mine for. 

Thank you if you've already done so or if you've given this podcast a review. It really does mean a lot to me. Sending you peace and possibilities. I'll catch you next week. Take care.