3 Things Not To Do In Your Direct Care Practice

Busy doesn’t always mean profitable. In this episode, lets break down three common mistakes that quietly sabotage direct care practices: undercharging, neglecting the full patient experience, and underutilizing simple technology. 

Learn how to shift your pricing, create meaningful patient touchpoints, and stay top of mind—so you can build a practice that’s both sustainable and fulfilling. 

•  Ethical Selling replay available for a limited time:  watch it here

Transcript

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Tea Nguyen, DPM (00:53.88)

Today I'm diving into three critical mistakes that can silently sabotage your direct care practice, keeping you stuck, being underpaid and overworked. If you find yourself doing any of these three things, you might be leaving money, time and impact on the table without even realizing it. But don't worry, I'll also offer some practical tips so you can know exactly what needs to change in your business.

All businesses will go through some growing pains of experimenting, researching, and learning. And I say that because these are the things that I have mistakenly overlooked because I didn't know better and I didn't have anyone looking over my shoulder. So you only know what you know and you don't know what you don't know. And now you will know better also. So how to avoid these common mistakes and set up your practice for real success. Also, I don't want you to feel bad about it. I just want you to recognize if this is something that you're doing to acknowledge it and then we can start moving forward. So what are they? The first thing here is that a lot of doctors, myself included, tend to undercharge. It's very common to under price to attract more patients because we have the mindset that if we price too high, people won't come. Here's what really happens though. If you don't price appropriately, and it's not your fault because none of us really know the price of medical care. We only know the contracted rates that we get paid after the service is rendered. So right now we are moving towards transparent pricing, which is what direct care offers. And that allows people to shop around. When people can shop around, there's price competition. But before all of this, nobody knew the price of anything. And so when we wrote an order, we never knew the price.

We never knew patients didn't follow up because we never knew the insurance covered it or not, or if there was a big out of pocket expense that made them divert the care and so on. But if you don't price correctly, if you don't learn the correct pricing for your practice now, here's what happened with underpricing. You end up attracting lower invested types of people who then hang out with the same types of people and they refer their circle

Tea Nguyen, DPM (03:12.322)

which are also lower invested types of people. And then suddenly you find that you're busy, but you hit a financial plateau. You've got people on your schedule, but you can't pay the bills or you can't take home a decent income. When you compete for pricing, this is the strategy to lose because nobody wins in a price war. How low can you go? And it turns out bigger industries can go really low.

Whereas the small folks like us, as solo practice owners or small business owners, it hurts us the most to not be able to make a decent profit. But then as you can see with businesses like Amazon, they are a big business entity with a lot of resources, a lot of tax benefits. And so their profit margins per item is really slim, but they're playing the volumes game also. And you can see at times the quality will also depreciate. So unless you function like Amazon, a business entity of that magnitude, pricing wars just don't work. It will hurt you and it will hurt the patients you're trying to take care of and you won't be sustainable. But when you focus on the quality of your care, you're intentional about what you do and who you do it for, and you can charge more, that's when it really works out in your favor. Over time, you start charging in a way that attracts the people who value that.

They value your time, they value your expertise. People who want to save time, they want to solve the problem faster will always find a way to pay for that because time is more valuable to them than money. That doesn't mean that only rich people will invest in a direct care practice. That does mean there are people who are out there whose time is valuable. They need to get back to work, they need to make their money, they need to do whatever they need to do outside of your clinic hours.

where time is important to them and they will spend the money for that. If you can move them from their problem point from point A into the solution end of point B, if you can condense that for them, make life easier, save them from making mistakes, that is worth paying for, that is premium pricing that you can do. And once you start witnessing that there are people out there who do value what you do and are willing to pay at that price point, they bring more of those people into your practice.

Tea Nguyen, DPM (05:37.698)

And that's what you want to grow in a direct care practice. So how do we overcome undercharging? The first bit is just knowing your value. If you don't value the work that you do, then you may never be able to feel confident in selling your stuff. People can read, body language, discomfort, lack of confidence. If you can't convey the value and you don't really have conviction for what you offer. If you're kind of wishy-washy about what you offer, they're not going to feel totally confident in investing. So you have to be really clear and you have to believe what you sell. that's step one. Step two is recognizing that if you're going to offer care on a one to one basis, that automatically is already a higher priced value. If you look at other industries, anytime you're speaking to a lot of people, teaching a lot of people, they are able to price it lower because they're helping a lot of people. They're providing a lot of value. But anytime you move up the ladder, to VIP level care basically, people know that's premium service and therefore it's going to cost more inherently. So if you're gonna have a practice that's one-to-one, realize that is a high touch point type of care and through that you can charge more. But also not just putting a price tag to say I'm gonna cost more, but knowing how to convey the value of that. And I talk a lot more about how to price appropriately in a free masterclass called ethical selling.

And if you want access to that, I will provide the replay link down in the show notes for you to review at your leisure. And you will learn so much more in how you can deliver the value of your services in a way that feels aligned and allows you to be profitable. So it's free, you can go check it out while it lasts. Link should be down below. All right, the second thing to not do in your direct care practice is neglecting the patient experience.

The patient experience starts when they make the phone call. Is it easy to call your office? How is the experience on the phone call? Whether you're using AI or you have a real person now, and then at the visit, how is their experience from getting to the door into the exam room? Is there a lot of friction points? Is there a lot of confusion or any interference with them getting the care that they need? Most doctors will stop there. After their visit, they're done. They forget about it, set it and forget it.

Tea Nguyen, DPM (08:02.68)

But if you're doing that, you're missing a really big part of the care. It's the follow-up. And something that was advised to me was to always call your new patients the following day to check in, to see if there was any area of confusion that maybe they didn't have a chance to ask or ask exactly that. Were there any questions that came up after your visit? So you can do this yourself. You can have your staff do this. When you provide a secondary checkpoint, it does make the patient feel truly care for, like you remembered them. And things do come up after the visit where they say, I forgot to call, but then they don't want to call the office to ask that one question. But if you just add this to the patient experience, they'll remember you and then they'll remember to refer to you. What typically happens in the medical office is the patient is waiting to get onto the exam chair. They're in a waiting room. Maybe it's crowded. Maybe they're not seen on time.

Maybe they're starting to feel a little bit more anxious because not a lot of people really want to be at the doctor's, right? And so they're not being seen on time, they're waiting and waiting. And then people feel disrespected for their time because their time is just as valuable as your time. And so this anxiety starts to build up. They finally get a little bit of relief as they get into the exam chair. They're like, finally, it's my time to see the doctor, ask the doctor questions, get on the road to healing.

And then they get there and the doctor spends a few minutes staring at their computer, not really being able to connect with the patient. Patient feels a little dejected. They leave the office and they go to Google to clarify the questions that they either forgot to ask because they were all pent up or whatever their experience was, right? It wasn't a pleasant experience for them. And they did not want to continue the care. So they just went to somewhere else. And oftentimes there's someone else lives in their phone.

It's Google, it's a Facebook group chat, it's somewhere else. And that can be frustrating for both parties. You as the doctor want to give the best care. But if you don't make time to be intentional about what the patient actually experiences, you don't follow up with them. You're leaving an opportunity on the table that shouldn't be missed in a private practice like a direct care practice. The whole point of our practice is that we have a low volume of patients that we can service.

Tea Nguyen, DPM (10:24.866)

And that is what makes it really special. It's kind of like indie music or going to the farmer's market. It's like a special niche for a select people. And you really want to think about the intention of what you're building and make sure the patient's experience is as seamless as possible and that it's positive and that you close up any loose ends through the follow-up. Now there are other things to consider. We're talking about the macro, the big picture. What does your office feel like? What does it look like?

What are they experiencing? I had seen an office where there was lint all over the vent and made me think, did I actually want to get a procedure in this kind of office? If their lint trap is gross, I don't even want to think about what their sanitation process is. It may be fine, but visually, me as a patient, as a consumer, I have questions when I see things like that. So think about all the details that goes into your practice too. If there's...

spider webs and dead bugs in the corner of the windows, we got to get those cleaned up. Your staff can do it. You can do it. Pay somebody to do it. If it smells weird, some patients are really sensitive to smell. I go to this one facility and they have a Glade plug-in in almost every socket of the building and it's nauseating. And I don't know if they're trying to cover up the smell of feet or something, but there's got to be a better alternative. So smell is really important. It does trigger memories and it can also trigger allergy reactions too. So all the details matter. Macro, what it looks like, what it feels like, what it smells like. Just visit any high-end hotel, you'll get the vibe there. They are very intentional about the client's experience. You should also be intentional about your patient's experience. And the micro are the touch points where you show the patient you care through something like a follow-up call or even mailing a thank you card, postcard. Yeah, those things. You know snail mail? Do that.

Not a lot of people are doing it, so if you do that, you will stand out. So patient experience is a big deal. We don't have to get it all perfect the first round, but tweak it here and there. Maybe get your staff involved and ask them, what do you think would be really nice for the patient? What are they complaining about when they call? What are they frustrated about and how can we fix that so that the next time around we reduce those stresses for the patient? After all, they're going to a medical doctor's office. A lot of people get really stressed out, know, white coat syndrome.

Tea Nguyen, DPM (12:52.526)

We want to minimize that. We want this to be a pleasant experience so that they talk about us in their circles. The last point here that I'll share with you is under utilizing technology. If you're not sending out emails to educate, you're missing out on a huge opportunity to helping paying customers. So even if it feels like newsletters or emails is something that people don't read, they definitely are. Every single time your name shows up in their inbox,

That's a touch point. They don't even have to read your stuff to remember you or to have you top of mind. This is something that you can outsource. You can pay somebody to do it. You can put your finishing touches on them if you like. You can even offer some seasonal specials or just say, happy holidays, some feel good news. People really do look forward to seeing good news from time to time. So this is one of the best ways to stay connected in your network of patients who have seen you or people who are interested in you.

It's a digital connection to help you stay top of mind. What I like to do is prepare 12 quick healthy recipes that gets distributed once a month by email. Occasionally I'll throw in some updates about the practice or maybe some awards that we've won or maybe a new technology that can benefit them. Everyday tips like that. That is something that can be done within 30 seconds and it's very simple. You can use all of your knowledge as a marketing strategy.

By providing some valuable everyday tips. And maybe you think about more seasonal things like holidays or traveling or kids going back to school as a topic that's relevant to your specialty. Those are always really fun for patients to read. And even if they don't respond, I'll have patients tell me that they really liked the emails that I send out. You just never really know who's reading. But for you to do this, you have to get into the habit of providing value communicating to your patients or your patient list so that you can remain top of mind. Now, some people have hesitation around this. They say, what if they don't want to hear from you? Or what if I'm like too much in their inbox or something like that, right? Well, it's just like anything else out there. They can choose to ignore it or delete it or unsubscribe. And you don't need to have your feelings heard about that. You got to do the work. They can decide what they want to do that information on their own free will.

Tea Nguyen, DPM (15:18.22)

Right now in healthcare, we are dealing with a significant amount of a trust recession, it's called. And a newsletter is one way to restore it by providing some useful information directly from the doctor, the doctor who they already know and trust. That is your avenue to continue educating people so that you can keep your community healthy. And that is a really great way to bring people back into your practice and start generating more income, more revenue that way.

You can start these newsletters with something as simple as MailChimp or Constant Contact. There are so many others, but these are low price or free if you're going to trial it out for you to start getting into their inbox. I currently use something a little bit more sophisticated called Go High Level because I also have my coaching program and my clinical practice. All the emails are housed there and with the added layer of HIPAA security.

But if you're just writing a basic non-patient specific topic, you don't have to have that added layer of security as long as it doesn't identify any of the PHIs. The key takeaway here is that if you want to stand out, you have to be intentional. If people are going to be spending money at your practice, your space should reflect that. And I feel like my business is my nesting space. It's sharing a part of me. So I want people to come to the office and feel calm and cared for. I had actually gone to another doctor's office one time and it was cluttered. It felt gross. There were stacks of old books, old papers all over the desk. There was nowhere to really sit. And I felt kind of like, I don't know, curling up in a ball because I didn't want to touch anything. I didn't want to mess anything up. And he was charging a lot more than I was for my office visit and he was doing okay. So, you you want to think about like Maybe don't do that. 

Don't have such a chaotic space because it's really hard to focus and heal in such a space. So be intentional. It doesn't have to be high end or super expensive or anything, but clean is kind of the bare minimum and intentional. Like you want their anxiety to be calmed at ease. I myself am constantly moving stuff around in the office, rearranging the chairs, the cabinets.

Tea Nguyen, DPM (17:43.136)

equipment and so on just so that I you know clean up the dust bunnies that might be hiding or even some of the dead bugs that creep into the office. I live close to where there's a lot of nature and forests and things and we get some interesting creatures in the office. But it's something that I get into the habit of making sure that things don't just pile up for no reason. If the item doesn't have a specific purpose for the day it does not belong in the office. It goes into the back room or somewhere else or I sell it.

So if you're somebody who is going to charge people money or a lot of money, your space should reflect that. It's a subconscious thing. They're going to associate you with having a nice place, with having nice services, and therefore I have to pay a nice dollar to get that. All of that in order to make them feel safe, that they chose the right place to get their care. So those are the three things not to do in your direct care practice that a lot of us end up doing and that's okay. But let's move forward, right? Don't undercharge.

Don't neglect the patient's full experience and follow-up and making sure you take advantage of the technology available right at your fingertips. If you get a good handle on these three things, you will have no problem making a healthy profit in your direct care practice. Hey, docs, I'm finally ready to share some exciting news. If you've been listening and thinking, I want a direct care practice, but I don't want to do it alone, then keep listening because I have something special for you. If you've been exploring the idea, of building a simple, efficient, and profitable direct specialty care practice once and for all, one of the biggest challenges is simply knowing where to start. Most physicians were never taught the business side of medicine. So when you start thinking about direct care, you're left trying to figure out things like, how do I actually structure this? How do I price services that feel right? How do paying patients actually find me? That's exactly why I created the Direct Care Society Launch Course. It's a 12-week self-paced program designed specifically for specialists who want to build a sustainable direct care practice. walks through the four pillars for success, such as discovering the right model, finding the right patient, pricing it right, and installing the right system for a lifetime of freedom from insurance. So if this is something you've been thinking about, you've been listening for a while,

Tea Nguyen, DPM (20:08.93)

and you need one final sign to take a bet on yourself. Well, here it is. This is the step-by-step framework that details the four pillars to success. And I'm officially opening it up for you, but you gotta act fast. Here's the catch. I'm offering a substantial early adopter discount to the next 20 doctors who go through the program in exchange for your feedback. My goal is to make this one of the most practical and effective programs available for specialists who want to launch.

and sustain a direct care practice. So I need your feedback. Over the past few years, I've had the privilege to help many specialists just like you successfully launch their practice. One doctor said she made more in two days in her direct care practice than being employed. Another doctor was suddenly let go from her employment position and was able to open in under 12 weeks to see patients. And another doctor who said this is why he went into medicine in the first place.

and he has already seen his practice grow in so many ways, making a profit in his first month. This is a program that I wish I had when I opened my practice many years ago. It's everything I've learned since then now organized into a clear, self-paced course you can go through at your own pace. As an early adopter, you will have lifetime access to the course materials and updates, and I will continue to work with you until you see your first cash-paying patient.

This program is designed to help you avoid many of the common mistakes physicians make when trying to build a direct care model and move forward with much more clarity and confidence. I'm doing this intentionally so a small group can go through the material, implement it, and help shape the future of this community. Changing the experience in medicine starts with you. If you're ready to stop waiting for medicine to change and start building their practice made just for you, follow the link below to get started.

I'm excited to be part of your journey. I'll talk to you again next week. Take care.