Tea Nguyen, DPM (00:53.878)

It's July. Happy birthday to July babies. I'm a cancer. And I just wanted to let you know that I do celebrate it all month long. So next week will be my birthday. It's on the 16th. And thinking about my birthday got me thinking about where life has taken me in the past 42 years. I'm going to turn 43. So where has life taken me today? And that's what I want to share with you right now. That if I had a time machine, these are the three things I would tell myself.

Before going into a direct care practice. Now, back in the day, when I opened my practice, I had left an employed position. It paid me all right. I was comfortable. I was saving up money for an exit plan ultimately. But I just couldn't find a job that was really made for me. I always felt like I was squeezing myself or making myself small or trying to impress somebody somewhere out there, essentially not being who I truly was. And I was somebody who craved

Autonomy. I craved creative freedom. I just want to do things my way. And I want to take care of patients the way I think is best for them. But when I was employed, that was really hard because my assignment was to show up, to take care of the patients on my schedule. I really didn't have a lot of freedom around that. And if I wanted to do a certain type of treatment, but the practice didn't want me to do that, then my hands were kind of tied. So it was a whole thing.

So that's the the very short version of my life, my time with employment. And that practice was close to a hundred percent dependent on insurance reimbursement. Maybe they had a couple of cash pay for certain things that wasn't covered by insurance, but predominantly it was heavily dependent on insurance. And so with that came a lot of restrictions with the time I spent with patients or the time wasted on trying to get the paperwork lined up in order to see the patient.

So if they had like an HMO plan, you know, the back office would have to make sure the primary care doctor approved the visits. And I know you know the story. It just goes on and on. So anyway, I wanted to share with you these three things that I would be telling myself if I had that time machine about going into direct care. Yes, there are a lot of things. These are the big top three takeaways for you so that you can put yourself on the right path sooner, which means

Tea Nguyen, DPM (03:17.89)

Future generations are going to be able to build this practice a lot sooner, a lot faster, with more efficiency because now you've got the resources, whereas I didn't. So, what are those three things? The first one is if you're going to have a cash practice, you need to stand out, you need to be different. And what does that mean? That means that the stuff that you're selling, the services that you're offering, needs to be financially sound. And we know that when we left insurance, that that model is not financially sound for a variety of reasons.

You're seeing a lot of patients and reimbursements are going down and the cost of running a business is going up. So the math does not matter. You see lots of people, you get paid less every single time, and you have more work to do, right? That's the insurance model. In the direct care practice, you need to be able to have one clear big ticket offer. That is something that took me a long, long time to figure out. I thought I was just transitioning out of the insurance model and simply having a different method of payment.

Which is kind of true, but then you realize there's actually a lot of nuance when it comes to leaving insurance into a direct care practice. Here's what's really different. With insurance, it's fee for service. So every time there is a service, you've got a consultation, you need to order an x-ray, you have to do a procedure. Those are all itemized care. That's how insurance decides what they'll pay you, what they'll reimburse you. Whereas in a direct care practice, if you continue on with that model, first of all, it's

Expensive, it's exhaustive, it's a lot of mental brain work to decide what each and every one of your services is going to cost. There are some things in which you can do that for, but it's going to be energetically expensive for you to run that way because you're giving the people, the patients, the freedom to kind of pick and choose. You're functioning like a restaurant that has over a hundred menu items, and now the patient is confused. Or they think the best way to do something is to select something from.

This category, something from that category, and they're not walking away with a proven plan. They're not walking away with a perfect recipe. So that's kind of the problem with fee for service, is that there's too much variability. And if the patient's coming to you for help, they want to know what you think is the best thing to do is. And if you make that offer very simple to take, you're telling them this is what I've done in my years of experience.

Tea Nguyen, DPM (05:38.892)

It is all built into this one package. You make it more convincing to buy. You're not overwhelming them. There is fewer confusion. It's just the one recipe. And this is what I love about direct primary care, the DPC model, is that they have one singular offer. It is a low monthly membership offer. And I've known specialists who also do this monthly membership option, where if you want the care, you're either paying annually or monthly. For specialists who do a lot more.

Or don't find that the annual membership really makes a lot of sense. Maybe you're a proceduralist, you're a surgeon, or you simply don't want to have that type of care. You want to solve a problem and then be done with it. Then you want to think about, again, not fee for service, but one big ticket offer. So if you're providing a service that has an endpoint, you can resolve pain, you can change a deformity, whatever that looks like, then you can have again one offer that is clear.

Easy to follow. Everything that's needed is in that package. And that makes it worth your time to invest in and sell repeatedly. Because now you've made life easier for them, the patient, but it's also very easy for you because you just got the one thing to sell over and over again. And of course, over time, in a direct care practice, you can raise your prices because hey, inflation happens. The cost of things that are required to run a business goes up. Whereas if you're in the insurance model,

You can't raise your prices. Their rates are determined by somebody else. So that is the first thing I would be telling myself if I had to do this all over again. To have at least one big ticket offer. Too many options, very confusing for both your practice, the workflow, and for the patients. And you want to eliminate things that are confusing, overwhelming, which leads people to walking out of your door along with the money in their pocket. All right, the second thing I would be telling myself is to learn how to hire, but also giving yourself grace that you may not get it right the first few times. The only way to be a good hiring person or the human resource department, especially if you're running a solo practice like I am and many other direct care specialists are is to have practice at this. So give yourself grace. The only way to get better is to do a lot of hiring. And in the beginning, I honestly didn't know what I needed. I just knew I needed somebody at the front desk. I needed a medical assistant.

Tea Nguyen, DPM (08:07.126)

And sometimes you have an employee that is just not a good fit in the sense that they're not growing with you. In your practice, you will grow, you will expand, you will refine. There are things that just move with time. The practice that you started with is not going to be the one that you stay with for the rest of your career. It will continue to change. And the thing is, if your staff doesn't change with that, they're not flexible in that, they're not willing to learn new things.

That could be a problem to your growth. So being able to recognize when somebody has reached their capacity and giving them the grace by letting them go to find a better fit for themselves is part of learning how to hire people. And I know there's a lot of guilt around hiring somebody, and that person is dependent on you to provide their paychecks in which they provide for their families for. But here's the thing: if that person does not fit your practice,

Or doesn't grow with you, or there's just a lot of resistance to them making the workflow easy for everybody else. Now you're just trying to accommodate that person. And that's going to cost your practice so much more than stress and time. It will affect your bottom line. It will affect your staff morale. And it will affect the way you show up in the way that you're being soft with your boundaries, where firm boundaries need to be have because you are the CEO of your business. So if you find somebody who maybe they were a good fit in the beginning but over time they were no longer a good fit, don't force the square peg to fit in a round hole. It just will not work. That's not to say you can't adjust somebody's job description from time to time. If they have the flexibility to do so, they've got the skill set to do so, they're willing to be there. That's totally fair. I'm talking about the higher that you feel guilty letting go of because you feel some kind of moral obligation to them. But here's the thing, when you own a business, you have to be able to learn when to let somebody go and allow them the grace and the freedom to thrive somewhere they will actually fit instead of forcing them to fit into what you need. Because if it doesn't work for you, it's probably not working for them either. So give them that gift of freedom and let them go about their way to find a job that is right for them.

Tea Nguyen, DPM (10:32.364)

So that you can find the person that's right for you. So I feel like hiring is a lifelong skill set, but you can learn it. You learn as you go. You may not get it perfect. Again, give yourself grace. Point number three, be so mindful about how you spend in your practice, in the way that you lease your office, your equipment, the way that you pay your staff. This is something that can be slow. You don't need to have all of your equipment all at once.

Remember, early in your practice, you're having conversations with patients. They're asking for an expert opinion. You may not need to perform surgery on the first day you meet them. In your buildup phase, you're having lots of conversations with people. And if they need something, schedule another appointment. Say I need to order that. Come back at this date. When I opened it, I ordered everything. I thought I needed to have the entire supply ready to go because I wanted to be.

Prepared. Like I would be very hypervigilant and over prepared because I'm an overthinker and it has cost me a lot of money. So I'm telling you this from experience. You don't need to have everything ready on your first day of opening. You can just order as you go. I have a lot of injections, a lot of supplies that I do for surgeries that I don't necessarily have all at once. I order them as I go. That allows me to be in tight control of my supplies so that things don't sit around.

Going expired or going wasted or unused. In my practice, I tell my staff just to have inventory for the next month or two. I don't try to overdo everything all at once. When it comes to leasing equipment, again, you don't need to purchase all of the expensive ones up front. You want to look at equipment that you can lease for a low monthly fee with a short lease contract, maybe about three years or so.

You'd be surprised at how long five years really feel. I mean, imagine how often you have to update your iPhone. Technology keeps changing, right? So don't lock yourself in an old equipment over five years. That also goes into leasing your office space. Now in regards to office space, you don't need a lot of space in the beginning, especially if you don't have a wait list of patients waiting for you. You can simply start off really lean by renting a room from another healthcare professional or in another space.

Tea Nguyen, DPM (12:52.92)

Where it's low commitment. I don't know if you notice this, but I'm a very low commitment kind of person over time. I wasn't like that in the beginning. In the beginning, I thought I needed to have everything perfectly lined up and that had cost me a lot of money. But now that I can look back, you know, they say hindsight is 2020. I can see that I could have been more judicious. I could have been more mindful. But I do know five years is way too long to lock yourself in a property that you're not certain you would grow out of. And honestly, there's no certainty with anything, right?

So making sure you don't overcommit in the beginning is very important. And making sure you are acutely aware of every dollar that's coming in and going out of your practice is definitely a skill set that we didn't learn in our medical training. But you can learn it now. You can start learning about it today because it's just so easy to overspend. And there are just so many businesses out there who take advantage of doctors. But if you set yourself up to not be one of those people,

You're gonna be way better off. So, those are the three things that if I had a time machine, I would be telling myself about going into a direct care practice. So, to recap, those three things would be number one, making sure I have one clear big ticket offer. That is what's going to make me stand out as a cash practice. That is the thing that's going to secure my cash flow. And doing it this way means it's actually less effort over time because once you get the ball rolling, people start to know about you, they tell their friends, then it's just an easy way to tell people what you do and what it costs. The second is learning how to hire, giving yourself grace that you may not get it right the first time and that's okay. You gotta learn what you gotta learn. But making sure you hire slow, but fire fast. And fire fast, not in a abrupt kind of way, but compassionate way. Let them find their space so that you can find your person. And lastly,

Being mindful about how you spend, paying attention to the money going out and the money that's coming in. When you're building your practice, the money coming in is not as free flowing as the money going out. So be aware of how you're leasing your space. I think five years is way too long unless you own the building. And that would be a thing that I would say to myself, consider owning a building. Because of course, retrospect, right? I spent just as much leasing rent, whereas I could have just been paying mortgage to myself, but

Tea Nguyen, DPM (15:09.09)

Hey, now I know. Making sure that you're not just buying a bunch of equipment thinking you have to have it all at once. You can take your time, build up the capital, purchase it, lease it, you know, you decide, but be mindful of how you spend your money. If you're a doctor ready to take the next step and you want to work with me, follow the show links down below and I will catch you next week. One last thing. If you've been listening and saying to yourself, I want a direct care practice, but you're overwhelmed and you don't know where to start, keep listening because I've got something for you.

Most physicians were never taught the business side of medicine. So when you start thinking about direct care, you're stuck on questions like how do I actually structure this? How do I price services that actually feel right? How do cash paying patients even find me? That's exactly why I created the Direct Care Launch Course. Just like your treatment plans, success starts with knowing what to do and when, and navigating the doubts and fears that inevitably creep up along the way. The Direct Care Launch Course is a 12 week self paced program with

Built specifically for specialists who want a sustainable direct care practice. It walks you through the four pillars. First, finding the right model, membership, or fee for service. Second, finding the right patient. Third, pricing it right, and fourth, installing the right systems for a lifetime of freedom from insurance. Over the past few years, I've had the privilege of helping specialists just like you launch their practice. One doctor said she made more in two days as a direct care specialist than she did as an associate.

Another doctor was let go from her employment situation and opened up her cash pay practice in just under twelve weeks, with no prior business experience. And another doctor turned a profit in his very first month just by following the structure I laid out in the course. This is the program I wish I had when I opened my practice years ago. Everything I've learned since then is organized into a clear, self-paced path you can move through at your own pace.

It's built to help you skip the common mistakes physicians make building their direct care practice so you move forward with clarity and confidence instead. And right now, listeners get an extra bonus. You will receive an additional three months of live coaching calls valued at $3,600, which will be included at no extra cost because this is a summertime special. That information is not going to be seen at the checkout link because it's a surprise bonus just for you.

Tea Nguyen, DPM (17:31.17)

All you have to do is follow the link down in the show notes, and if it's still available, that means you will also get the free live coaching calls. Changing your experience in medicine starts with a proven plan that has already worked for others. This is the kind of practice that'll last you a lifetime. I'm so grateful that you're here learning about direct care. If you're waiting for a sign, this is it. 

Follow the links below, and I'll talk with you again next week. 

Take care for now.