Tea Nguyen, DPM (00:54.446)

Welcome back. If you're new here, I'm so glad you found me. So have you ever heard of the word burnout? Burnout gets treated like it is a resilience problem with the individual. But oftentimes it's an operation problem. It's the way that you run the systems in your practice. And that's what my lecture at SOMI Doc's third annual mastering private practice course is about. If you own a private practice or you're planning to, I highly recommend taking advantage of this course and many other lectures within it to help you optimize your bottom line without the chaos of trying to do everything yourself.

The links to getting your tickets will be down in the show notes. And before I ask you to spend your time with me, you should be able to size me up. And that is what this episode is going to be about. This is a snapshot of what you're going to learn from me. And these episodes are designed to help give you practical tips that you can use right away and help you decide if I'm the right guide for you in the direct care model. As always, I will give you the next.

Clear step if you choose to work with me. So there are three reasons why anyone should not listen to me, and I want it to be crystal clear so that you know the perspective that I'm coming from, the experiences that I have, and whether you find value in that or not. So the first reason to not work with me is that I'm not perfect and I'm still evolving. I'm not a finished product. I'm not selling you a guru story of how I created a perfect life that had zero mistakes and went off riding into the sunset like a romanticized success story that we were all taught to believe is a common occurrence. Unfortunately, my life is quite average, and I would even say probably below average because I came from immigrant parents who came with little.

Tea Nguyen, DPM (02:53.294)

Absolute no resources. They were literal boat people from Vietnam escaping communism, the war, and they were shoved on a boat that could have easily capsized. That meant that they had no personal possessions and it was just the clothes on their body, and no money, no job, not even the skills of English, because they came here from Vietnam to the States.

They were very lucky in the sense that they did have some sponsors that helped them get started with the life here. So they knew how to survive. And my job as a first generation born here is to actually thrive, not just perpetuate the idea of survival mode, because we're not in survival mode anymore. We actually have better resources now, but the whole point of them taking the risk is so that their children can.

And their children can have better opportunities and better lives.

Tea Nguyen, DPM (03:56.12)

So it's my job to ensure that the life that I live isn't always in survival mode, that I'm actually taking the steps necessary to thrive. So I have been able to do that. And the pivots that I've made is what makes my story and any story worth hearing and living through. So it's actually the ups and the downs that create a beautiful story. It's not the linear path where

Everything was perfect and the trajectory was a straight line going upwards. No, it's the ups and downs because we are humans, we are fallible, and my practice is still changing, it's still evolving. So what I teach is current and it's tested in real time. I have my clinical practice where I think of a theory, a hypothesis, I experiment that If it works, I share it with you. If it doesn't, I say, hey, don't do that because I've done that. And then you get to learn from other people's mistakes. Now, as of this recording, I can't say I have 30 years of experience, right? I've only had eight. And if you've been paying attention to the healthcare landscape, medicine is very different today than it was even 30 years ago, even 10 years ago when I was just getting out of fellowship.

In the beginning of my practice, I was taught to take all insurances, and that would promise to fill up my schedule and thus should equate to more revenue. And the reality was that it just kept me busy because each patient transaction undercut the true value of the services I was providing. And in many instances, what I was getting reimbursed was so low or denied or non-existent.

That I was technically paying to have people in my office. Now, with the decline of reimbursements even more now in the past couple of years, this is not sustainable in this economy. So over time I learned that being selective and being intentional about what I was attracting into my business is actually what helped increase my revenue.

Tea Nguyen, DPM (06:12.47)

Opting out of insurance actually increased my revenue. And I know that sounds a little bit crazy if that's the first time you've heard this, or it never even passed your mind. But I remember when a doctor was telling me once I let go of my lowest paying contracts, I let go of those insurances, I actually made room for more money because new opportunities would show up. And I didn't believe them because I was scared because I was taught to take everything, you don't refuse people.

Because of their ability or inability to pay. That's not the right thing to do. That's not ethical. So there was a resistance to me believing that if I let go of the lowest payer, that I would actually make more money. There was an internal conflict about that too, where hey, I didn't become a doctor for the money, right? And there's a little bit of a white lie in that statement. I chose medicine because of the potential for making a lot of money. That's why I gave up.

The best years of my life to learn medicine, to go through the hardships that I have endured. And I know many of you feel the same too, that your expertise should command a higher dollar. At some point, but over time, what we're seeing in the healthcare landscape is that the more you know, the more experience you're building in the practice of medicine, the less you're getting paid. And I think that's just ridiculous. So that's my opinion, of course.

So that's my perspective on the direction of healthcare at this time.

Tea Nguyen, DPM (07:46.264)

But in order for your practice to thrive, this is a necessary realization. If you're somebody who feels like you're always busy, but your bank account is not reflecting the time you're putting in, then it's likely because of a systems issue where you're taking too many insurances or you're doing too many things and it's not the right thing. It might be low-value work, it might be trying to put out fires every five minutes, it might be the internal systems structure.

That you have or don't have in place that needs to be refined. This is not a you issue. This is not something that is wrong with your type of issue. This is something that's totally correctable. And you can learn from others. And I myself am still evolving as to what those systems look like. But hey, you don't have to listen to me solely because I'm not perfect. There's another reason why you shouldn't listen to me. Reason number two. I have interests outside of my clinical practice.

I don't have a full-time clinic anymore. I know that I enjoy it at a particular dose. I know that my two and a half days are perfect for me. And that doesn't make me less of an expert in what I do. It makes me fully aware that I'm not a traditional practice. I value my freedom. I like helping people, and I like being paid to help people.

And I think my generation and the next generations understand that there is this delicate balance between work and life. Maybe in other generations, people make their work their entire identity. And if that's you, that's totally okay. But that's not for me. And realizing this, I've chosen to step back in my clinical hours so that I can entertain and make room for other interests, like hanging out with my daughter on her field trips or taking longer vacations or spending my off days coaching other doctors or having spa days with friends and going on dates and things like that. That's my thing, but that doesn't have to be your thing. Because I have operational systems in place that don't require me to be in the clinic full time, I like what I have. I love what I'm building. It works for me.

Tea Nguyen, DPM (10:07.212)

If you're somebody who doesn't want this kind of practice or this lifestyle, you don't have to listen to me. And I still have one more reason why you may not want to listen to me. Number three, I'm still young in my practice. I have eight years under my belt. And it's still evolving. My interest straight out of fellowship in twenty fifteen looks dramatically different than what I actually have today.

Because life happens. And here's the thing: I still remember the fears, the doubts, and the feeling, the burn of mistakes I've made as if it just happened yesterday. I still live with those. So it's not a remote memory. It's still part of me. And that also means that I'm close enough to know the pain that I had to endure. And I want to ensure that other doctors who are in the thick of it.

Don't have to go through the same thing. I can sympathize when somebody is drowning in their work. And that's not the time to just lecture them and tell them, hey, they shouldn't have jumped in the water in the first place. Helping somebody can be as simple as extending a hand to acknowledge they're in a predicament, that they're not alone, and meeting them where they're at and guiding them to shore. So I'm eight years in.

And my practice is stable. Of course there are times where I want to continue to pivot. And then there are other times where I say, okay, no, everything's totally fine. I don't want to do a thing that's different. It's working, leave it alone.

Tea Nguyen, DPM (11:47.692)

If you're somebody who finds yourself in a similar situation where you've got your good days and you've got your bad days, you're not manic. This is just business ownership. This is just how it goes. This is the rhythm. You write it out when it's tough. And hopefully you have a supportive network to support you along the way and that there are people ahead of you who can assure you you're on the right path.

even when it feels hard because business ownership is incredibly lonely, especially if you're a solo practitioner like I am, but that doesn't mean you have to write it out alone. Doing this long enough I've realized that none of our problems are that unique. We all have fears, we all have doubts, our insecurities, limiting beliefs.

Tea Nguyen, DPM (12:37.644)

And we were all trained in a similar manner to believe that there is only one way to thrive in private practice. Back then they told us it was insurance, and I'm telling you today, it's actually without insurance.

So the whole premise of this podcast is to prove the point that you can thrive without insurance.

Tea Nguyen, DPM (13:00.28)

That has been my mission for the past four years and I foresee that to be ongoing for the next several years moving forward. But if any of that resonates with you, then you're in the right place.

Now, sometimes what I say doesn't always make sense. I've had doctors tell me that the things that I've shared with them didn't quite click with them until years later. When they finally opened their own practice and went through the motions, learned their lessons their way, and then they would come back and say, Now I get it. You were right. And I just had to learn it my way. And here's what's predictable about human behavior.

Most of the new things that you hear about don't always make sense the first time. That is completely normal. New things come with fear, judgment, skepticism, especially amongst doctors who were trained

To be over prepared.

To make sure you don't make a ton of mistakes, there is a regimen to the work that we do, right? Now some people will choose to skip the shortcut for two reasons. Either it doesn't make sense to them yet, or the new path is too uncomfortable and they don't want to do it. They're trying to find alternative pathways to get there.

Tea Nguyen, DPM (14:23.222)

And I realize sometimes people just need to learn the lessons themselves. It's kind of like kids. If you have kids, I think you would understand this. You tell a kid not to touch the stove because it's hot. They touch it anyway, right? And now they're scared and now they understand. And even as adults, sometimes you say, Don't do that. People do it anyway. And they spend a lot of money on these mistakes, but now they can say, Now I get it.

Tea Nguyen, DPM (15:01.102)

So I realize some people just need to learn things their way before understanding the shorter path is actually quite accessible. That it was just the fears, the doubts, those limiting beliefs getting in the way. But if you're somebody who wants to get there faster, there is a step-by-step instruction manual to have a thriving direct care practice all available to you. I've condensed it and it's available in a course, or you can choose to do one-on-one with me.

If any of this is resonating with you, this podcast is the most robust snapshot of what it's like to work with me. If you like the straightforward style, you like clear directions, and you want to grow even when it feels uncomfortable, but you want that accountability, I am here for you. Here's the one thing that I will say that seems obvious to me and maybe not to others. Direct care is the most effective way.

To thrive in private practice in this day and age in this economy. Now, burnout can happen when there isn't a clear system in place, and this applies whether you take it in turns or not. And I will always argue that there is less of it in direct care because you cut out the middleman. So when there are less hoops to jump through, things are simpler. So that makes sense.

Of course, when we talk about burnout, we also need to mention moral injury, which is a systems problem. But if you leave the systems of insurance, there is still a risk of doing too much of the wrong thing within your business. And too often, I see doctors who are business owners, they care deeply about taking care of their patients, but don't realize that the systems aren't set up to allow them the freedom to step away and have peace of mind when they're not seeing patience.

Tea Nguyen, DPM (17:03.948)

How do I know? Because I've been there. If you want to hear more about ensuring that you have operations in place to prevent burnout, check out the lecture where I share with you three simple systems to ensure your practice thrives without you adding more busy work. The links are all in the show notes. And I'm so curious if this episode resonated with you.

Tea Nguyen, DPM (17:29.88)

Let me know what you're working on, and it might be the topic for the next episode. Thanks so much for joining me today. I'll catch you next week.