Tea Nguyen, DPM (00:53.76)

Is direct care right for you right now? You've been listening to the podcast. Maybe you've been Googling things like cash pay practice, boutique, concierge, direct care. I know there's a lot of names, but you know that running a practice less dependent or independent of insurance exists. And you're wondering if this will fit your situation, in your specialty, in your market, and in your life. So I put together seven questions that you have to ask yourself.

Which will help you decide on whether or not direct care is right for you right now. And even if the answers are not yes or no, it's fuzzy, you're unclear, and you want to get more clarity around that, you can contact me on my website. The link will be down in the show notes. So let's just get started. And this is gonna be a quick episode because this is my third attempt to recording this topic. I don't know what happened. It was recorded, it fell into the abyss of the internet land never to be recovered. So I'm gonna try to be a lot more concise this time around. When I ask the questions, you're either going to answer yes or no. And the results are if there are more yeses than no's, because seven questions, it's an odd number, you're gonna have more yeses or more no's. That's going to help you gauge on whether or not you're ready for direct care. That doesn't mean that if you have more nos than yes, that it's never going to be right for you. It may just mean that you have some more planning to do.

And that's why I have all of these workshops. I even have a course that guides you along the way to setting the foundation of your practice for success. It'll help you minimize the mistakes a lot of us do. And I've put it all together in an easy-to-follow curriculum. So you can choose to have that to shorten your path to a successful direct care practice. The first question I like to ask doctors is this: Do you offer or could you offer services that aren't typically covered by insurance?

Or something that patients already expect to pay out of pocket for. This is relevant to people who recognize that aesthetics care is not covered by insurance and even regenerative medicine, things that help patients avoid surgery, functional medicine, integrative medicine, naturopathic medicine, there's a lot of niches that isn't typically covered by insurance. So is there something that you already do or can learn to do to build your

Tea Nguyen, DPM (03:14.222)

Cash practice because that's usually the easiest path out of insurance. So the answer for you should either be a yes or a no. Do you already have it or are willing to learn it? So we're calling these services non-covered services. And for a lot of specialists, we know that the options we can provide patients extend beyond what insurance allows. And so I've found when I work with doctors, this is the easiest way to start building that confidence to having money conversations with patients and letting them know.

The thing that they want, the thing that we recommend as doctors, is not covered by insurance. Or you can set a better price if they paid you directly. Because we know that the insurance rates oftentimes are hyper-inflated and consumers are catching on. They are recognizing that they have a lot of power in asking what cash prices are. And so if you're set up as a cash practice, as a direct care practice, you can serve that population. Question number two: what is your financial runway? Can you manage a change in your income in the next six to twelve months while you build this practice. If the answer is yes, because you have savings, you have a working spouse or a partner or other income resources that can cover your needs, that would qualify as yes. You would answer no if you're saying no, I am the primary income for my household and that would be too much of a risk. 

Then I would say that would lean you more towards no, not right now. And so that means that you can build into that and have a safety net before you start to build a project that is going to take a lot of your time and your resources, but ultimately it's going to set you up for a practice of freedom where you can make an unlimited amount of dollars. So there's no cap when you build a business. The only cap is your willingness to learn the things that's needed to build it. Question three, if you have a partner, are they in alignment about this idea of yours? This is a little bit tricky, but let me help clarify. If you have a partner, will they support you through thick and thin?

And I would hope that the reason why you have a partner is because they are there for you through thick and thin and vice versa, right? This is a relationship. You're meant to grow together. So if your answer is yes, you're on the path of possibly direct care could be for me soonish. If your answer is no, they are not available financially, emotionally, all that stuff. And sometimes that does happen, I would suggest you solve that problem somehow, some way.

Tea Nguyen, DPM (05:37.902)

Whether it be through open conversations, therapy, even, whatever you need to do to ensure that your household is a supportive environment for your growth. And I say that with the deepest compassion because I was in a relationship where I could not receive help. I didn't know how to ask for help. And so I felt like I had to do everything myself. And even though I had a supportive partner, the support I needed wasn't really articulated. And that became a problem. So ensuring that your partner's on the same page is healthy for your relationship and for your business because your business is going to take away a lot of your resources, your energy, your focus. And having somebody who understands that and you have an open communication with them with clear expectations that this is something you're building. It doesn't just magically happen with an income in the next quarter or two. It could take a year or two, depending on how you build this thing. So it's important to ask yourself, does my partner align with where I want to go in my life?

Yes or no? Pretty simple. Now, if you don't have a partner, even better. The question then is do I support myself through thick and thin? Because you are your biggest advocate. You have to be your own cheerleader and you have to be really excited to take on this path. That's the only way to sustain yourself in building something this crazy, this insane that only less than one percent of doctors are choosing. So be honest with yourself with that question. Question number four, your market. You want to think about your city, your neighborhood, where you want to practice.

And ask yourself, are there other cash pay practices or health-aligned services that are already available? Now that doesn't mean that the practice needs to be a direct care practice exactly like yours, the one that you envision in your specialty. It could be things like med spas, concierge medicine, boutique fitness centers, private pay therapies, high-end dental. I simply observe as to where people are spending their money. Do they have nice cars? Do they have an iPhone?

Do they have nice purses and watches? Like how are they spending? What's important to them? What is a ridiculous spend that they're spending on anyway? Because you see the thing is people have freedom to spend. They have freedom to spend on what they eat, on what they wear, on the cars that they drive, in the house that they live, and they can definitely choose where to spend their health dollars, even if they have insurance. They're spending anyway with insurance, right? In the premiums, the co pays their deductibles. And I know when I ask this question, doctors kind of jump to conclusions as to open.

Tea Nguyen, DPM (08:02.754)

This would never be supported. Patients don't even want to pay their copay. And you're right, some patients are unwilling to pay their copay because there's this level of entitlement where they're already spending a lot on their healthcare and they expect a lot in return. But the reality is insurance is a business model. They take lots of your money and they're very cautious or careful about how it is spent. That's how insurance companies make money. It's not always aligned with what doctors want for their patients.

And that's why if you're somebody who really wants to advocate for your patients, leaving the insurance model makes sense because then you have the freedom to have these conversations with patients as to what is available, what things are gonna cost, and you were their advocate without any restrictions. So taking a look around as to what's already available, where people are spending money is going to help you decide if a cash practice is going to work for you.

Also pay attention to neighboring cities that people are willing to travel to. So when one day you become the expert at what you do, people fly all over the country for that kind of care. And we live in a world where social media is available at people's fingertips. And if you show up a lot, they're gonna recognize you as the expert for that thing. And so a lot of what makes a direct care practice successful is your marketing. Half is your skill set and probably more than half is your marketing. Now if you're the best at what you do but nobody knows about it, you're not gonna have business.

But also if you're everywhere and you don't deliver your results, your business is going to get hurt too because eventually your reputation will come out that you're not that good. So it's a balance between the two. Your medical degree is not a marketing degree. They need to go hand in hand. And so that is something that you can learn. Question number five, time flexibility. The question is, do you have the patience, do you have the time to allow this business to grow the way it needs to grow? Just like you can't rush a baby to be fully developed sooner than nine months. The baby's gotta do what the baby's gotta do.

Time's gotta happen. It takes time for things to grow, for things to line up, for things to make sense, and for systems to be put into place for it to start growing in a sustainable way. So yes, you have time flexibility, you are time aware, you know it's going to take time to build this. And a no would be, I need income right now, like yesterday. If you're pressed for money, I don't recommend that you take the direct care path without thoughtfully thinking about

Tea Nguyen, DPM (10:22.562)

Or being realistic of your expectations of building this kind of practice. Can you make money the first day you open your clinic? Yes. But you have to have a plan because it's not going to be consistent right out the gates. That takes time to build. Unless you buy into a practice that's already established, that already has a funnel, that already has a reputation. If you're building this from scratch, this will take time. It's gonna be a little bit messy. You're gonna tweak what works, you're gonna let go of what doesn't, and ultimately all that takes time. So you might be thinking about

Maintaining your current job, putting aside money, saving some money, investing in some money, but ultimately realizing that time flexibility is a big part of building this kind of practice. Question number six, do people like you? Do they like you enough to refer to you? If you've been practicing for a while, you may already have patients, colleagues, referral sources who say you are the person for this thing. And if that's a solid yes, you're on the path to direct care. If your answer is I'm not sure,I haven't been in practice long enough, or truthfully, it's a no that you don't hear a lot of referrals for you. That could mean that we have some building to do, meaning you have to build your brand, your practice, your people skills. And I know a lot of us are introverts. We are nerds who really like to learn. We love to solve problems, but socially, we're kind of on a spectrum, right? There's a lot of introverted introverts. I fall in line around there.

And then there's a lot of extroverts who love to connect with people, who love to be out there and boisterous and connect, and they're just easy to get along with. So there's this whole spectrum of personality types that makes us who we are. But when you run a business, you really need to tap into creating connections in an organic way, in an authentic way that feels genuine to you. That doesn't mean you go out there and you connect with people and you over exert yourself and you pretend and put on a fake face.

No, it just means that you have to learn how to connect with people so that they can like you enough to do business with you. And that's what these small businesses all have in common. They build through word of mouth. They build through the work that they produce. And I have an inkling that most of you who are listening here today, you're likable. You're a people person. You may have limits. You may not like to be public facing on social media on a mic or with all the attention on you. But I bet that you're so good at what you do.

Tea Nguyen, DPM (12:45.518)

People already think of you for the problem that you specialize in. So automatically, I'm just gonna put you guys in a yes bucket for now. But if you're honest with yourself and you're saying, I don't really get a lot of referrals, then that's something we can build on. So don't rule this out just because of this one question. And the last question here is very important. If you answer no to this question, then the rest of the quiz is negated. If you answer yes to most of these questions, including this one, you are on the path to direct care. You are almost ready.

To launch it. So what is the question you have to ask yourself? Are you willing to learn the business side of medicine? Because direct care is not just being excellent in your clinical work. It's having those awkward pricing conversations about customer service, about running a small business and ensuring systems are in place so that it can run without you eventually.

But in the beginning, you have to put these pieces together. So be honest with yourself. Is this something you're willing to learn and willing to recognize that your medical degree is not a marketing degree? That people just don't show up because you are a doctor. Those days are gone. There's so much more competition now, there's so much more access. So you really want to think about: can you put yourself out there and tell people, I have a business that solves this problem? If your answer is maybe or yes, put yourself in the yes bucket.

Because now you're on the path to direct care. You're ready. But if you answer no, I don't want to have anything to do with running a business. I'd rather let somebody else take care of it. I just want to be the doctor. That's going to be a heavy no. And if this question is a solid no, it does negate the rest of the questions I asked. And it simply means that you're not ready right now. And for some, not everybody, but for some, employment remains a great option where the patients just show up and your schedule is full. You get to be the clinician, but you're trading the ability to focus on just being a clinician for not being able to have control of the way you practice. Somebody else decides the types of patients you see. Somebody else decides what you're gonna get paid. Somebody out there is going to decide what services you can and cannot offer, whether it's directly or indirectly. So there's a trade in all that we do, right? You have to decide which one of those hard things feel right.

Tea Nguyen, DPM (15:02.998)

long term. All right, tally up your answers. If you have more yeses than no's, you are ready for a direct care practice. You may not feel ready, you may still feel a little bit shaky, like you still need to learn a little bit more, like you need to see a little bit more evidence, or have a little bit more trust in yourself. But all those things you can learn along the way. You don't have to be ready with everything today because it all starts with your willingness to learn the things you need to learn.

To be the owner of a successful direct specialty care practice. But if you're somebody who has more no's than yes, this is not the end of the road. That just simply means right now is not a good time. And over time, you can start building your financial runway or learn how to be more people-ly when it comes to business relationships, putting yourself out there, for example, marketing, knowing how to put together a lean team. Those things are easy.

And you have so many resources to help you with wherever you're at, wherever you're stuck at right now, so that you can take the next step forward towards your future destination. So listen, I know this quiz is not validated. This is just for fun. This is just to gauge the temperature of where you're at with things. So I hope that you found this to be helpful. And if you do, please share it with the doctor because more doctors deserve to know that direct care exists. I hope you enjoyed this episode and that it gives you some clarity.

On whether or not you are ready for direct care. Until we meet again, take care. 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 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.

Tea Nguyen, DPM (17:23.446)

And four, 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. 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.