Tea Nguyen, DPM (00:54.38)

You said it, I've said it. Almost every doctor I've ever worked with has said it at some point in their career. I didn't go into medicine for the money. And when you said it, you meant it. It felt true. It felt noble. It felt like the right thing to say, especially in a culture that trains you from day one to never appear motivated by financial gain. Because doctors who care about money are somehow less committed to their patients.

That's the unspoken rule. But today I want to challenge that, not because I think you're a liar. I don't. I think you're somebody who was handed a story a long time ago, repeated it so many times that it became an identity. And now it's costing you, literally and figuratively. Before you hit the skip button, just stay with me for the next twenty minutes, because this isn't about greed. It's about honesty. And honestly, the doctors who say they don't care about money.

Are the ones suffering the most, financially and emotionally, inside a system that is exploiting that exact belief. Let's go back to the beginning, medical school, maybe even before that, when you were a kid who said you wanted to be a doctor. I was a grown kid. I was in college by the time I decided to become a podiatrist. What happened when you told people that? They probably lit up.

They probably said something like, you're gonna help so many people. What a selfless path. Those words felt good, like we were on the right path in our career. It was a confirmation that this was the right thing to do, that we were one of the good ones. And then we got into medical school, and then the culture reinforced it. You were trained to serve, to sacrifice, long hours, sleep deprivation, delayed gratification.

All framed as noble. The system was essentially programming you and I to equate suffering with virtue. And somewhere in that training, the idea that money was a dirty motivation got baked in so deep that most of you stopped questioning it. It's still reflected today where doctors who are on social media they're getting compensated for sharing a product they like.

Tea Nguyen, DPM (03:13.442)

And doctors are so targeted, so criticized so easily compared to some random influencer with no medical background who many are freely taking their word for it. And I know doctors are just held to a different standard. And that's because of the medical culture that we're raised in, basically. So here's what nobody is saying out loud. The institutions that trained you have a financial incentive to keep you

In believing that, in believing that it's not about the money, because the doctor who doesn't value their own time and expertise is easier to underpay. Does that burn a little bit? Yeah, it should. It should make you kinda angry. The doctor who feels guilty about wanting financial security is a doctor who will keep working harder for less without pushback. Now I'm not saying

It was a conspiracy. I'm saying this is a culture you and I are a part of. And that culture shapes our beliefs, which then shapes our behavior. And our behavior right now is staying in a system that is draining. And it may be rooted in a belief that really wasn't yours to begin with. So the first thing I want you to sit with is where did you learn that wanting money was wrong? Was it your training?

Was it your upbringing? Was it in your faith? Just notice it. Don't have a judgment about it, but just recognize where it comes from. You don't have to even answer it right now, just sit with it. Now let's talk about what this belief is actually doing to your life. Because here's the thing about deeply held beliefs. They don't just live in your head. They show up in your bank account, in your relationships, even in your body, in the way it responds when people talk about money in big ways. Let me paint you a picture. You went to school for what, eight years plus residency and fellowship, something like 15 years at this point. You took on debt that was easily a quarter of a million, half a million dollars if you were married into that household with two physicians and the interest on that. And you delayed your earning years. You weren't working

Tea Nguyen, DPM (05:37.944)

To your full capacity because you were in training. And you delayed buying a home, you delayed starting a family, delayed building wealth, all in the service of this exact career. And then you graduated and entered a system where the reimbursements are declining. And it's been doing that for decades while the expenses of running said business is going up. And in this business,

There's a lot of time being spent on prior authorizations, documentations, catching up on the new billing codes instead of actually connecting with patients. And you're burning out at a rate that is now a national crisis. And yet, when someone asks why you're unhappy, the answer isn't because you don't like patients. It's really because the system is broken, because there's a financial mismatch of all of the dedication we invested in.

To know what we know in our craft to the caliber that we know it isn't matching the financial reality we're in. You're not being paid what you're worth. And you have been told repeatedly that wanting to be paid appropriately, competitively, makes you a bad doctor. And that's the lie. So the cost isn't just financial, it's that resentment that builds up when you give your all, your best youngest years.

And the system just keeps taking it and taking it. It's the Sunday night dread that Monday is just around the corner, that the weekend was too short. It's a short fuse at home because you're depleted. There's no more capacity left. It's the way that you just stop dreaming about a different possibility because it's starting to feel pointless. None of that is noble. None of that is what you signed up for. And none of it is necessary. So here's what I want to offer you in a different way to think about this.

Money is not the opposite of meaning. Money is actually a resource that enables meaning. It enables a fulfilling, rich life. Think about it practically. When you are financially secure, when you're not stressed out about loan payments, about mortgage, about your overhead, or whether or not you can pay your staff, what happens to your capacity to care for patients? It goes up. You have more room. You have more patients.

Tea Nguyen, DPM (08:04.866)

There's more creativity. There's more presence. This is where you can spend 30 minutes with a patient instead of a quick seven minute visit because the practice model simply supports it. Financial security does not make you a worse doctor. It does not make you less engaged or more money hungry. It makes you a better one because you're not practicing from a place of scarcity, like there's not enough money to go around.

Or resentment that you have a fully booked schedule of 30 plus patients a day. In the day, it feels like Groundhog's Day. It's like the next day, it's the exact same thing. Instead, you're practicing from a place of abundance and choice. So let's flip it. When you're financially stressed, overworked, seeing all of those patients, followed by all of the documentation you have to do, what happens to the care?

Your attention, your empathy, your clinical judgment gets eroded. Not because you're a bad person, but because you're human. You're not a robot. So the question isn't whether money matters. Of course it matters. The question is whether you're willing to admit that it matters and then build something that actually reflects your worth. So here's the reframe I want you to try on. Charging appropriately for your expertise is an act of integrity.

Not greed. Because what happens when you undervalue yourself? It's not making you humble, it's having you participate in a system that has decided your labor is worth less. And every time you accept that, you're reinforcing that. The doctors in direct care who are building sustainable thriving practices, they didn't get there because they didn't care about the money. They got there because they decided that financial well-being

And their patients' well-being are not in conflict. They coexist. And it's not selling out. It is solving a real problem. So what does it actually look like to be a doctor who cares about the patients and cares about financial well being? Because I think a lot of you have this fear that if you're admitting money matters, that something changes about your character, that you're a different kind of doctor.

Tea Nguyen, DPM (10:27.512)

That the motivation to take care of people shifts and it's corrupting something, but it doesn't. And I'll tell you why. The doctors I coach, the ones who have made the jump into direct care, are now building practices they love. They are fully present and they're excited to be there. Almost all of them describe the same thing. They're saying, I finally feel like I can be the doctor I was trained to be, that I'm making more money doing this.

And none of them said that the money made them worse. Not one. Because here's what actually happens when you build a practice on your terms, when you control the model, the pricing, the time you spend with patients, the services you want to provide, something changes, something shifts. That transactional feeling that was creeping up in your patient relationships goes away because now you're not rushing, you're not resentful, you're not running on empty, and you're not.

Watching the clock because you do have more time with them and you have the mental capacity to truly care for each and every one. You actually get to practice medicine the way it was intended to be practiced with just you and the patient. And then you get paid well for it. And those two things feel good together because they're aligned. So what does building a practice like this require from you? It requires that you confront the discomfort you might have around money.

The way you price your services, the way you have those conversations, you have to stop apologizing for what you charge. It's a judgment to assume whether or not a patient can afford it. And I know for many of you, this is deeply uncomfortable because of everything I just talked about, the training, the culture, the identity, but discomfort is not the same thing as wrong. Discomfort fades over time with practice.

I promise you, it does go away. Because once you have the first patient look at you in the eye and say, I will pay whatever you charge because I trust you, something changes. You realize your value was never the problem. It was the system. So I want to leave you with something personal. When I started to talk about money openly, when I started to say it out loud, what I was charging, what people were paying me, that I wanted to be well compensated for.

Tea Nguyen, DPM (12:54.25)

the years of experiences I acquired and the expertise that I have, that I was thriving in my business and in my life, there was a little bit of that guilt because of the people I was sharing that with. The people around me felt like, my God, how dare she? Crazy, right? Like what are you doing that's so special? There was all this judgment around my story. So people had their opinions about that. And guess what?

That's not my problem. Them being uncomfortable is a them issue. A lot of people pushed back. A lot of people did not want me to speak at their conferences when I reached out because, hey, this is an academic conference. We don't talk about money, right? But there were also many people who wanted me to speak about this very topic, about direct care, about the disconnection that doctors are having and why they're kind of financially stuck.

It's these conversations that are very uncomfortable and perceived as distasteful in medicine. But I had to make a decision about what's felt true to me and be in places where I would be heard. Because I see doctors stuck in this belief that they know doesn't feel quite right. It's not really aligned with what they truly want, but it's the story that we've all kind of

Said over and over again until we believed it to be true. And it's just what we kind of say now. It's not about the money. But I think you know it's not true. We need money to run businesses, to pay for bills, to have staff. So I decided to speak openly about how much I love money. Period. I love money. It gives me freedom. It gives me choices. It gives my daughter a super fun life. It gives me opportunity to travel. I'm not afraid to talk about how much I enjoy money.

Because it makes me a better person when I'm not fearful that there isn't enough. It makes me a lot more present in company when we're having a nice dinner, when we're having a couple of fancy drinks, when we're on vacation. It feels relaxed. And I deeply feel my circle deserves that relaxed version of me. And I know your company deserves that relaxed version of you as well. I hope you enjoyed this honest conversation.

Tea Nguyen, DPM (15:15.03)

If you're ready to build something that pays you what you're worth, while giving you the practice you went into medicine to have, I want to work with you personally. The Direct Care Launch Lab is an eight-week program where we go from thinking about direct care to actually building it. The link will be down in the show notes. Thank you so much for being here. 

I'll catch you next week. Thank you for listening to the Direct Care podcast for specialists.

Remember, you always have the power to choose. So what will you be choosing today? Wishing you peace and possibilities.