The Direct Care Podcast For Specialists

Stuck or Scared? What now?

Tea Nguyen, DPM Season 4 Episode 225

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0:00 | 13:21

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You already know more about direct care than you think. So if you’re still stuck researching, listening to podcasts, or waiting for the “right time,” this episode is for you. 

I’m breaking down the real reason many doctors never make the transition into direct care — and it’s not lack of information. We’re talking about perfectionism, fear, people-pleasing, and the internal voices keeping you stuck. If you’ve been craving more freedom, simplicity, and connection with patients, this conversation will help you take the next step. 

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Tea Nguyen, DPM (00:54.156)

You've been Googling, you've been on social media, you've been listening to this podcast and many others. You've probably already talked to other doctors who have had direct specialty care practices. So you've listened to people like me. You probably know more about direct care than you want to admit to others, but you still haven't made the move. Why is that? That question is what this whole podcast is built on, and today I want to give you an honest answer.


One that has nothing to do with business models or billing codes. In working with specialists making the transition from the employed insurance-based model into a direct care practice, I see the same thing stopping doctors every single time. And it's not what you think. You didn't go to medical school to become a data entry specialist. But here we are. Here's the thing: you know direct care exists. You've thought about it seriously.


So the question isn't what is direct care. The question is what is actually stopping you from taking the next step because it's not information. Having information is not the same thing as taking action. The voices that are keeping you stuck, traditionally called saboteur voices, this concept is taken by Shazad Shamin, who is the author of Positive Intelligence, the program and the book, which has given us the ability to label.


what's really going on inside of our mind because it's you inside of your mind in the beliefs that you have that's actually holding you back. There's four very specific things that might resonate with you. And I wonder if you've said this to yourself or you heard a whisper of it somewhere in your conscious or subconscious. The first is I'm a doctor, not a business owner. Or maybe you've been told, stay in your lane. It sounds like humility


But it actually functions like a cage because you have been shaped by what others expect you to be. This is a judgment from other people, or maybe from yourself that you're a doctor. You're here to help people. You're not here to build a business, to make a lot of money. Maybe some of you do want to make a lot of money, but there's an underlying current that overtakes that desire that you truly want in your business and in your life that sounds like.


Tea Nguyen, DPM (03:17.816)

Doctors ought to stay in their lane. The second voice that you might have heard, where I've seen doctors say to themselves, is I just need to see more data, I just need to see how it's working for others, I just need to collect more information, another case study, another testimonial, one more webinar. Maybe this course will do it, maybe that conference will do it for me, or maybe it's a certification. This is labeled as the hyper rational, obtaining data.


To make it feel like you're doing the due diligence and it permanently keeps you in the research mode because over time that becomes the crutch of inaction. It feels like action. It feels like you're doing all of the right things, but then you hit a tipping point where no matter how much more you learn, you're in the exact same place you were a year ago, four years ago, because you're collecting data, you're learning.


And it's wonderful. I'm not saying you shouldn't learn the things. You absolutely should. It's just like medical school. You gotta go through your medical training before you have hands-on experience. But at some point, you stop being the consumer of information and you start putting things into practice. And in business, the only way to really learn is to get your hands dirty, is to do the work. You've got the data, you have the brains, you have the insight, but now you need to take


Action. The third thing I hear from doctors say to their inaction is that they feel they need to stay in network because without it, patients would be abandoned or they wouldn't have access to medical care. On the surface level, it sounds like a devotion to your patients. You care deeply about the people who need your access. And we can't argue that. There are just some people who need their insurance to get their medical care. I'm not arguing that at all. I'm not saying that it's so black and white that it's one or the other. It's only partly true though. And that's why this argument is very effective. If you find conversations online on LinkedIn, for example, and as soon as I say or any of the direct care doctors talk about direct care, there will always be an argument about, well my patients need an in network doctor. That's very true. But that doesn't mean


Tea Nguyen, DPM (05:43.874)

We have opted out and abandoned the patient. We have opted out for a different reason. We have opted out so that our business can sustain itself. It doesn't mean we're abandoning the patients. The patients still have the choice to use their insurance or not. Many will choose to use their insurance and it's their right to. If they have the option, why not? And then there are the few who want a direct care doctor, who need more time to get the care that they're looking for that hasn't been served.


Through the insurance model. And that's the reason why direct care exists. We exist to fill a gap. We're not replacing insurance. That would be kind of crazy to expect everyone to pay out of pocket. No, it fills a gap. And you have to decide if that's the gap you want to fill. And some doctors don't. Some doctors want to stay in network because that's their niche, that's what they want to do forever and ever, and that's okay. But then you have to accept.


What comes with that? The volume, the low reimbursements, the possibility of not being able to pay yourself or pay your staff or pay your bills. That all exists because we know the trajectory of reimbursements. It's just going down while the cost of business is going up. And the fourth thing I hear from doctors is they say something like this I can't launch my practice until I have my website perfected, until I've perfected the prices, until I've got all of my legal stuff.


Airtight until the branding is done, right? It sounds like you're doing all of the right things. It sounds like movement. It sounds like the professional thing to do. And hidden underneath all of that is actually perfectionism, is the fear of showing up messy, of being seen, of not getting it right the first time. And so we kind of mull over the imperfectness of our logo.


Or the color just doesn't feel on brand or it's not resonating with you. This is the stickler. This is the person who needs to have it all right before you even get started. So to recap, these are the four things I hear over and over again from doctors who are stuck in indecision or they feel like they're making a decision, but it's really a protective mechanism from you moving forward. So being told to stay in your lane, that's a judgment.


Tea Nguyen, DPM (08:09.56)

Right? Somebody is judging you for stepping out of your lane, being hyper rational, needing to collect more data, needing another case study, needing to talk to more people, despite you having all of the information already, being the pleaser, feeling like you have to be there for everybody, feeling like you have to take insurance to take care of all the people, because all the people is proportionate to how you feel accepted and loved and are giving to others.


This is the need to please. And then the fourth one, being a stickler, making sure that everything is perfectly aligned before you even start. These are the types of thoughts that initially are disguised as a protection from the unknown. For a moment, it keeps you safe, but the problem comes when it is long term and it controls your next move. That's how you stay stuck.


You continue to believe to stay in your line, you continue to think you need more data, you continue to think that you're abandoning your patients if you opt out. You continue to think things need to be perfect before you start. Those are the things that are holding many doctors back from moving into a direct care practice because it takes a direct care mindset to understand that it's not really about intellectualizing every movement. These are mechanisms to help you avoid pain.


The pain of not knowing what's next. There's a lot of pain in the uncertainty in the future, a lot of discomfort in that, then the current discomfort that you've grown accustomed to. So thinking like a direct care doctor means that you recognize that voice. You recognize it's actually holding you back and then challenging it. Because if you don't, it's like running a new program with an old operating system. It's just incompatible.


It's at war with one another. It's a constant struggle to get to the next place. So the next time you hear one of these voices show up, don't argue with it. Don't try to think your way through it. Just name it. You can say it out loud. You can give it a name. You can say, that's just the the pleaser talking. And you don't have to identify with it. You can step


Tea Nguyen, DPM (10:27.788)

Outside of that and say, that's just the voice, I don't have to believe it. To overcome it, you gotta start with naming it. Is it a judgment? Is it being hyper-rational? Are you trying to be the pleaser? Are you being the stickler? Once you name it, once you identify it, once you know what's happening, then you have control of your next step. Then you'll have control of your future. Because now you can course correct and say, Okay, I actually do have enough information. I actually don't want to stay in my lane. I want to do something different. I have enough data. I can take the next step in learning how to market, learning how to sell, learning to have ethical conversations with patients about their options. I can do this messy. My website doesn't need to be perfect because the people who know me, they're gonna call me anyway. They're not even looking at my website. They don't even care about the shape of my logo. That's not important today.


What's important today is that I choose to do this despite these voices that are trying to hold you back, to keep you safe, to keep you from changing, because that's just safe. What I see from the doctors I've coached is that they don't believe in themselves enough because nobody has told them they have enough. We've always been told we're not enough, that we need another certification, that we need another course or another module or another achievement in order to feel enough. And then we gain all those things and we feel the exact same. We have a moment where we feel good about those achievements, but it wanes quickly until we're on to the next goal. So my invitation for you today is to recognize within yourself you have everything you need to take care of a patient. Maybe you're a doctor who hasn't been told enough times that you have exactly all that you need to take care of patients really well.


Direct care is just a payment method. It's just a model that you can easily learn if you're committed to learning it. If something in this episode landed, if you heard yourself in any of it, realize that you don't have to take the next step alone. I created the Direct Care Launch Lab, which is an eight-week program where I work personally with specialists to move from thinking about direct care to actually building it. Not someday, right now. The link will be in the show notes.


Tea Nguyen, DPM (12:51.276)

If you're ready to meet the version of you who makes this happen, come find me there and let's get started today. Thank you so much for joining me. I'll catch you next week.