Tea Nguyen, DPM (00:53.592)

Hey there doctors. Welcome back. If you're new here, welcome to the show. I'm here to help you think like a successful direct care owner. So here is where I will start. I've been having a lot of conversations with doctors. And I don't know if you realize the perks of direct care. One of them is that you get to have more time with patients. And that can start well before the patient is even in your room. It can start right on the phone when they call your practice.

Now, a lot of us in direct care have started our practice with simply a cell phone. We use Google Voice, which is a separate number from our cell phone number. It's free. You can register that right now and have a totally separate number, especially if you've got a different area code. You can use Google Voice for that. So that is our business number. And when people call us, they're usually coming from like our friends, our colleagues, our inner circle. So what do we do? We answer the phone.

And we know who they are and they're asking, when can I see you? Right. And then eventually you start building a list of strangers who have heard about you through the grapevine and they also want to book with you. Now, for those of us who are already in the direct care space, we answer our own phone calls. It's not that big of a deal. But for others who are new to the idea of connecting with your patients directly on the phone.

Maybe you've got a feeling about that. Maybe you have a judgment about answering your own phone call. Like it doesn't feel like you're running a successful business yet. Or maybe you're embarrassed to answer your own phone call because maybe you haven't done it before. Or you're measuring what success is supposed to look like and you're new in this practice model and you don't quite feel successful yet. And so you're kind of afraid to show up.

You're afraid to answer the phone. You're afraid of what people are going to think about you starting a new business with a new business model. And that's really okay because all of us were trained in a system where medical care requires a couple of different touch points before you actually see the doctor.

Tea Nguyen, DPM (03:11.064)

The patient makes a phone call. The person who answers the phone call, maybe it's the front desk receptionist, maybe it's your office manager, a virtual assistant, or something before it gets to you. And you're used to this. You're used to this version of healthcare delivery. Direct care is totally different. You can choose how to set this up. You can choose to have a phone tree if you wanted to, but I'll tell you, those of us who claim the direct care model, we are saying we are direct specialty care doctors, we love answering our own phones. We love the surprise when the patient calls our phone and says, I didn't expect to get the doctor directly. What a pleasant surprise. And then you move on and say, yes, I built this intentionally so I can spend more time with patients. Now I want to take a step back because I know the impression of what success looks like probably looks like this.

You think of a doctor who owns a practice who has many other healthcare professionals in their practice, maybe a PA, an NP, a medical assistant, another doctor, and so forth. So there's a lot of volume in that model, right? So success on the outside might look like a very busy practice. They may have a really nice space, large real estate, for example. They may have a large payroll, but what you may not know is what their profit margins are. And I've met doctors who've made millions of dollars, but their profit margins are minimal. Like they'll spend 900K and so ultimately their profit margin is 100k. And I've met solo practitioners who you would never know are making half a million dollars in one exam room with nominal expenses. And yes, those are direct care doctors. So what you see is kind of like the illusion of the assumptions you might have of what success should look like, but you never really know what's happening on the back end. So here's what I want to invite you to consider. Look at the growth of your practice in a little bit of a different way when it comes to something as simple as answering your own phone call. Instead of thinking that you're not successful yet, or you're not good enough, or something's wrong with you because you're not busy, you're not seeing

Tea Nguyen, DPM (05:33.304)

hundreds and hundreds of patients, you can look at this situation as if it was the whole point that you are removing the noise that got in the way between you and the person you're trying to help, the patient. The whole point of direct care is to connect with why you chose medicine in the first place. And you can start connecting with them on a phone call. Answering your phone call is a big deal for patients and in a good way. I remember when patients would call my cell phone and I would answer it, not realizing they were trying to get a hold of me through the business. So I wouldn't have a formal introductory welcome message like thank you for calling Pacific Point Podiatry. This is Dr. T. Like I would I would just answer like hey who's this what do you want? And patients would pause and they would say I'm so sorry. I didn't mean to call you on your cell phone. So already people are assuming to not access the doctor. And for me, I ended up saying, no, that's okay. You can call me anytime. This is my number. It goes directly to me. Sometimes my assistant is available and sometimes they're not. Doesn't matter. How can I help you? And they're not thinking, this doctor is not successful. Why is she answering her own phone call? How embarrassing for her. Nobody thinks that. Only we think that. We think the worst case scenario, right? Because we are just mean to ourselves. We are cruel.

about our own growth. And I want to remind you that you're allowed to grow. You're allowed to start with where you're at today and be in a different place a year from now. But it starts with starting at ground zero. It starts with where you are today. You've got patient number one. And one day you'll have patient number 1000 in your direct care practice. So realize the stories you're making up in your mind aren't always real. There's no reason to be embarrassed about

Designing a practice that you are intentional about where you can reconnect with a patient. Patients love talking to the doctor. They want that connection. They're tired of the phone trees. They're tired of being passed around on the phone from one department to another and not feeling heard. That's what makes people frustrated. By the time they get to the door, they're like, I've called you 10 times and was transferred another 30.

Tea Nguyen, DPM (07:57.664)

And no one's answering my question. And what is this experience even? And I'm paying so much into my insurance deductibles and premiums and so on, right? So we remove all of the noise and now we are able to connect with the patient, answer their questions, and get them on our schedule because that is how we intentionally built this practice. We're not trying to answer the phone where hundreds of people are calling. We just want the few to make this work. Now, if you go back and think about where does this attitude or embarrassment comes from, something so simple as answering the phone feels like a judgment that you're not good enough. Well, it's how we're trained because we were trained in a system where things were convoluted, they were kind of messy, there are all these widgets or parts that are kind of like sewn together, and eventually the patient gets to the doctor and hooray, right? They eventually get there.

Whether it be in your medical training or in your real life experiences as an employee, or if you run your own practice, there was a model of how a successful business is set up. You hire a bunch of people, they answer questions about insurance, you've got a billing department, accounts receivable, and so on. So we were trained to make things complicated when in reality, this is like what I call the Marie Kondo. of medicine where you're removing all of the clutter. You're keeping the things that bring you joy. And a lot of the stuff in the healthcare landscape with the insurance model does not bring me joy. And therefore I had to cut them out. But I also had to learn new business skills like answering the phone appropriately, answering those, do you take my insurance calls and so on. Direct care is a simplified version of how you can deliver medical care and get paid really well. So our medical background doesn't really teach us how to simplify. It actually continues to complicate.

Remember back in the day before insurance, if you're old enough to remember, before there was insurance, there was a patient who needed a doctor and then doctor who can provide the care. And they exchanged chicken eggs or something, and then eventually it became an exchange of money. And then down the road the doctors abdicated the business side of medicine to corporatized medicine, health insurance. And then now we've forgotten how to collect payment. We've forgotten how to answer phone calls.

Tea Nguyen, DPM (10:20.29)

We've forgotten the basics, but now we're coming back around to simplifying because the current system is totally broken and it's no longer acceptable to deliver medical care in that way. It is okay to say to yourself and to the people who want to work with you that you're still figuring some things out. That doesn't mean you know medicine any less. It's just the logistics of your practice that you're figuring out. You're figuring out who to hire, how to answer the phone calls, the scripts the payment methods, the forms, like all of those logistical things that you did not learn in medical school that was not required to pass an MCAT or your residency training and so on. Right? Those are two different skill sets. You're still figuring out the business of medicine. And that is okay to be in. There is uncertainty. And give yourself grace that you're learning through it. Be honest about it. That doesn't mean you know medicine any less. You have your degrees, You have your credentials. You've secured the bag. It's just the delivery mechanism that is new, but not impossible to learn. So it is okay to say, I'm still figuring this out, especially if you're in the early process of opening your practice or contemplating opening your practice. So this conversation came up when I was talking to a doctor and I asked him, why don't you answer your phone? And there was this hesitation, and I can feel it.

Because I've talked to enough doctors to realize there is a judgment about not doing the thing that seems pretty easy. Answering your phone seems pretty easy. Scheduling your patient's appointment is pretty easy. I'll walk you through how I work with my patients. The patient comes to the office. I don't even have a waiting room. I have this little two-chair area. And then just a few steps through the front door to get to the exam room. I have like a 500 square foot office space right now. Two rooms. One room is storage slash my office slash sterilizer machine and all the stuff we do in the back end. And then one exam room. That's my current setup right now. So patients are seen on time one at a time. So the patient walks into the exam room, sits directly on the chair. We do the exam, we have small talk for about 15 to 30 minutes, maybe an hour if it's a new patient. At the end of that visit, I collect the payment. I will say your balance today is $275.

Tea Nguyen, DPM (12:43.544)

Do you want me to charge the card on file? They say yes or they give me a new card. And then from there, I'll ask them, Do you want me to book your next appointment or would you rather call? Literally everything happens inside the exam room. They're not having to leave the exam room and go to the pit station, the centralized area where the medical assistants are. That's how I was trained. That's what I observe, that's how a lot of practices are run. Or the patient goes to the front desk, they check out, they make payments and so on. Everything is done efficiently within one exam room from start to finish. Payment is closed, appointments are booked, everybody is happy. We move on to the next patient. And I've been doing this for so long that to me, I think it's normal. But then when I share this with other doctors, it's new for them. They're like, wait, what? Do you do stuff in the exam room?

Yeah, I do everything in my exam room. I do surgeries in my exam room. I do the appointments. I collect payment. I don't skip a beat when it comes to taking care of the patient. And that's because it was intentional. That's how I'm able to be efficient. That's how patients are able to get what they need on time. And that's exactly how I like it. And when I go to my doctor's office, that's how I would like for them to have it, but everyone does it their own way, right? There's no judgment about

How you run your business. The point of having your own business is that you do it your way. Now, this is my way, and if you don't like it, that's okay. You can decide what you like. Maybe you do want to have a front desk where they can make a payment and check out in the front, and you create a system around that so that it works for you. And that's the point. Do what works for you. But if it's new to you and you have a judgment around something that's new, that could be an invitation for you to see. things differently because there's a lot of versions of what success looks like. Success could look like having a million dollar practice. It can look like having a $200,000 practice. It is totally up to you. But don't chase success because you think it's just the singular number that you have to chase. Some people can make all the money in the world and have zero freedom. They have no time for their family. They have no time for self-care.

Tea Nguyen, DPM (14:54.968)

To me, that's not success. That is just hustling until you die. And that's not the life that I want to live. So decide how you want to live your life and stay focused on that. Everyone's gonna be doing something a little bit differently, and you can draw inspiration from that, but don't use it as your metric to measure yourself up against. Some people started decades before you have. Some people have different advantages than you. Don't worry about it. Focus on what you need to do and realize a quiet clinic.

That's not seeing hundreds of patients a day could be as successful as one that's very busy. We all get to define what success is on our own terms. And you don't have to believe every thought that crosses your mind. Challenge it. See the flip side to it and start flexing that muscle where you can see how things can work in your advantage because you're being intentional about what you're building. If you're a doctor who's ready to step into this new role to become the owner of a successful direct care practice,

My information is in the show notes. Let's book an introductory call to see what your next steps are. Just follow the links down below. And as always, I look forward to chatting with you again next week. Take care.