Transcript:

 

Dr. Tea  0:01  

Practicing medicine without insurance is possible. Imagine a private practice where you get to see your best patients every day, providing medical services you truly enjoy, all without the hassle of insurance. My name is Dr. Tea Nguyen, and I'm a recovering specialist who was completely burned out from insurance based medicine. I pivoted into direct care, where patients pay me directly for my medical services, and have never looked back. If you're a private practice owner or planning to become one who's looking to be free of the grind of insurance and you're craving it, simplicity, efficiency and connection with patients, you are in the right place. This podcast will help you map out your exit plan and uncover the mindset needed to thrive in today's economy. Welcome to the Direct Care Podcast For Specialists.

 

Dr. Tea  0:53  

Today, I have Dr. Stephen Lewellis, dermatology. And guess what, guys, he also has a podcast, The Direct Care Derm Podcast. He has gone out of insurance and owns Above and Beyond Dermatology. And who doesn't love a dermatologist? Come on, let's be real here. Welcome to the podcast. 

 

Dr. Stephen Lewellis  1:15  

Thank you very much. Tea I, as I was saying, off air, I'm a big fan, and it's always fun to finally be chatting with someone who I think we've talked in other forums prior, just kind of back and forth on LinkedIn and things like that. But it's great to be on your show. You are an inspiration, and the people you talk to are as well. You're leading the way. And what people need is examples, and that's why I'm here, and that's why I want to talk to you and reach your audience with what I'm doing. Everyone, we're all doing it a little differently, but I think what we can all agree on is that we're a whole lot happier than we were when we were stuck in a box.

 

Dr. Tea  1:53  

Oh my gosh, happier is an understatement. So let's talk about you, because I spent the last two years talking about me. It's your turn. So how did you decide to venture out to own your own practice? What was life before? What did you hate? What's the gossip and what's going on? 

 

Dr. Stephen Lewellis  2:17  

Life before was four years of being what, unfortunately is a fairly typical job or life. I had a job for four straight years after residency, and it was pretty typical. I worked for a large integrated health system, two different ones back to back, and that paid the bills, and I got to take care of patients, and that was nice. And I got a I had a nice relationship with my staff at both places that I was at, but it certainly wasn't something I looked forward to each morning. I still had a lot of work dread, unfortunately, and I thought maybe that was just going to be my life in medicine, just how it was for me, and I eventually, I think, got unhappy enough with work that I started looking around and noticing things about the hospital system that I was part of, that I wasn't a fan of. And I started speaking up and banging my fist in meetings and saying, What's going on here? Why are we? Can we pay a little attention to the patients and the employees and the staff, and not so much just the spreadsheets? And eventually, I have a feeling that got me fired. One day, they just said, you don't work here anymore. Essentially, it was without cause, but it was out of nowhere, and they just, I had a feeling for political reasons, let me go, despite really good reviews and good, you know, relationships with my staff and I certainly couldn't point to anything wrong that I did. So that launched me before I thought I was ready on this path, and I'm very grateful that they had the foresight to do that, because I'm so much happier now, and I look forward to Mondays. I was just saying that to a friend on the phone this morning, and that's never happened in my life, even before having a job, med school, residency, high school, anything like that. And now, despite not having a big paycheck, I look like I get excited about Mondays. I love the weekends with my family. I have two young kids, and I love being with them, and then I love going to do what I do for the patients that I serve now. And it's, it's truly just because it's aligned with what I was meant to do as a doctor, and big paycheck or not, that that stuff will come, and I know that will come down the road as long as I take good care of people. But it's really a joy to be doing what I'm doing. 

 

Dr. Tea  4:40  

How long have you been open now?

 

Dr. Stephen Lewellis  4:42  

I incorporated in November of 2023 that this abrupt termination that I was talking about was August 8 of 2023 so I pretty much hit the ground running. I just said, I'm not going to get it. I'm never going to have a job again. I don't want this. This clearly wasn't working out. I am. I think a few of. The US throw around the word unemployable in the best way possible, and I will take some blame for how things turned out, and try to have you know the ability to reflect and understand what I was doing that wasn't aligned with my position, right? I was an employee, there's a lot of benefits you get as an employee, but there's a huge amount of trade offs too. And I was kind of wanting to have my cake and eat it too, because I'm a doctor, and I can't just look at things and say, well, whatever. I just have to see the patients sign the charts. So there is that always going to be that conflict of when you put a doctor, when you make a doctor, an employee and their bosses, especially when their bosses are not doctors, it is never going to be a natural fit, and there's always going to be this, this friction and intention. So that's what I was always that's what I felt that I was fighting with and dealing with. And I can't have my cake and eat it too. I can't tell the CEO not to buy another hospital, because we're all still reeling from the last hospital you bought, even though I know your big bonus depends on how many hospitals you buy and how big you get. So that, yeah, you kind of get it. I needed to be my own boss. And, yeah, that was about, that was November of 23 and I've just been. I saw my first patient in the house in, I think, June of 2024, I was seeing patients virtually a little bit before that. And I do like I like you said, I do the podcast as well. I like to work with industry colleagues. I like to just leverage myself in any ways that I can that are aligned with who I am and how I take care of patients. So not all of my time is spent doing direct patient care, and things are still evolving.

 

Dr. Tea  6:48  

I think it's really cool that you and I are sitting here with our medical degree saying we're going to do whatever we want. It doesn't matter. So for me, I love the diversity of what we bring to medicine. I get to be here on the podcast. You've created your own, you're creating your culture, your environment, to help others do the same thing. And I really feel like this pathway allowed me to show up the way I show up best. I was not the person I really am proud of when I was working 60 hours a week, 80 hours a week, but today I can show my daughter that this is what doctors look like. We can literally do whatever we want with our time, because we own it.

 

Dr. Stephen Lewellis  7:33  

We own, yeah, we own the means of production. That's something I I've always said to myself and other people, and they want us to not realize that they I think they want us to not realize our value, the value of our credentials and and not realize that we can do it without all these, these layers and layers and layers of support and administration, just because of how complex everything has gotten. And that is, I think there's a lot of there's something inherently deceptive in that, in kind of passing down that and just letting it become fact for especially for young doctors coming out, how am I going to start a private practice? All I've heard is how hard it is, and I'll just go get a job, and that's what these systems rely on. So good for you for being able to be that example for your daughter. And now I imagine sometimes you have easier weeks, and sometimes you have harder ones and fewer hours, longer hours, etc, but you're at the end of the day, you're not coming home and getting angry at the kids when you're not when you shouldn't be, because of stuff that happened at work or because of this misalignment, and that certainly I find that in my life, I'm not perfect at home, but I'm not bringing home nearly as much baggage every day as I used to be. And like I said before, I'm excited to go to work in the morning, which is so so so different, and not something I ever thought I would experience.

 

Dr. Tea  8:59  

Did you know you were going to open your own practice when you had that sudden termination?

 

Dr. Stephen Lewellis  9:04  

I think about a millisecond after it happened, I figured I just wouldn't have a job. I didn't need to have a job ever again. I had, if it was I'm still grateful for the jobs I had and the experience I was able to get in terms of understanding and learning just how to take good care of people after residency, you know, take care of people on independently, and be the one the where the buck stops with me, and just getting good at that. And then once I got good enough at that, I could start looking around at the things that bothered me about the systems, and also thinking about, Okay, well, running a business is a pretty big deal. And yeah, and there are difficult things, and you got to decide insurance, not insurance, hybrid, all this stuff. But I had the bandwidth for that. And I was practicing a lot. I was Dr. Una, who's the founder and CEO of EntreMD, which is a business school for doctors. And she always talks about intrapreneurship or being an. Entrepreneur when you have a job, and that's how I treated my jobs. I treated my staff like I was there, like I own the clinic, and that they were, that I was responsible for them and the culture, and we were a little team, and we were very different from the other teams that were also dermatologists at where I worked. And they would tell me that, and I think they appreciated that, that I ran things a little bit differently and stood up for them, and took the time that we needed to be a team and have meetings that weren't just lunch meetings and you know, stuff that if I had asked for I probably would have been said, No, we don't. That's not what we do here. So I think being an entrepreneur was really helpful. And yeah, I just, the minute it happened, I just said, I'm gonna I'm ready. I wouldn't have been ready four years ago, when really two years ago, but I was ready. And I'm glad that they cut the cord, because my loyalty is a is a big deal for doctors and nurses and all this. So we tend to stay much too long out of loyalty to others and maybe fear. 

 

Dr. Tea  11:07  

So you saw your first patient in June of this year, 

 

Dr. Stephen Lewellis  11:12  

first in person, patient like you're the exam chair you see behind you. I didn't even know if I was going to see patients in person. I thought I could do telehealth for a while, while I'm figuring this out. And I was doing that for a while, and I had a patient who i i took care of via telehealth, and she said, I I want to, I want to see you in person. I got something, I want you to look at, whatever, or just, you know, I want to, want to do telehealth anymore. And I said, Okay. And then I literally bought a chair and put it in the room, and, you know, you gradually accumulate supplies, and there you go. And it's not quite that simple. You get it. There's some other compliance things you need to, obviously, just cross some t's and dot some i's, but that's how I'm running things, and that's, again, in the service of just creating access for people to dermatology, it's and and serving patients. And I'm really glad she challenged me to do that. And now I love seeing people in person. I also do telehealth. I go to people's homes if they want me to. I just do whatever is best for them within the constraints of what I feel like I can do in a sustainable way. And I love that. I also go to various areas around the state and see people through other other people's clinics, and just try to get creative, because dermatology is it's not okay to me to say the next appointment is six months or nine months or whatever, even four months or three months, that is like my business card has four core values on the bottom, and access is one of them. And access to me means definitely, never tell a customer that the next opportunity to serve them is six months away, and especially Don't say it like, you know, what do you expect? What do you expect? Of course, it is. Of course, in six months it is dermatology, if that is a sign of an insurance dependent business, if they have that sort of customer service, because they know their patients are trapped, they have nowhere else to go, you are in network for them. So the insurance company is going to feed you patients all day, and you don't have to take you don't have to treat the patients who are there well, because you're just going to have a steady flow of them regardless, because of the nature of the system. So my practice, even though I do take some insurance, and we can talk about that, I treat everyone very everyone the same, regardless of how they're paying. And I do not think that six months is a an okay amount of time to say when, when someone calls you, so that I try to see people within a week or two, and if I can't do that, it's my job to increase capacity or close my practice to new patients. It's not just about making more and more money and decreasing the time of the visits indefinitely.

 

Dr. Tea  13:54  

Let's talk about the logistics. You mentioned that you're taking some insurance. What was your decision point to choose to take them or not take them. What was the process like for you?

 

Dr. Stephen Lewellis  14:04  

Yeah, it started out much like you have, you are and you have committed to which I respect that a lot. I said, screw this. I just cannot. These places don't respect me. These companies do not respect me. They're not aligned with how I want to take care of people. In my opinion, they don't have they don't put patients first. So I don't need I don't need them, and they certainly act like they don't need me because of the way, the way they negotiate, and the the amounts they pay, and the ways they kind of abuse us and take advantage of our goodwill and our desire to take care of patients and the amount of paperwork and authorizations and just games, games in service of us doing unpaid labor to save them money. And I did that for a while, and. Then I found this kind of middle ground where, in Wisconsin, at least, and I think this is happening everywhere, there is a groundswell of activity in a cottage industry arising from this of employers, finally, and that's what's going to move the needle. Doctors can clamor all they want, and we can have great direct care docs popping up, and that's really important. But what's going to move the needle is the customers and the employers, because they have the customers given that just we tend to get insurance through our employers. So there in Wisconsin, there's these employers that are finally saying, this is a huge line item. We are paying 1000s and 1000s, millions, or whatever, if four premiums and they're going up 10% every year, and the broker gets to keep the broker just almost assumes that sort of raise every year, and they just take it for granted, and they don't give us a better product. It's usually a worse product every year, and the deductible goes up, and the co insurance goes up, and every and everything really gets better but it's just this kind of trade that no one questions. So employers are now doing things called self funding of their health plans, where they will send their money, instead of to UnitedHealthcare or retina, they'll send it to a company that is actually aligned with independent doctors and says, we get it like you're paying way too much. These places are inflated and their service isn't good. Outcomes are not great, all of this. So we'll contract with Dr Lewellis, for instance, and he'll give us transparent prices, and we know he spends a lot of time with people and takes good, really good care of them. So if you go to Dr Lewellis, you're going to have zero $0 co-pay and $0.00 co insurance, because we know his price is reasonable and we don't need to pass it on to you. And you're going to get a good experience with him if you get in his tier zero or something like that. So I have contracts with a few groups like that, which I love. It's amazing to know that my patient will be taken care of if it's a medical dermatology thing and they have no co-pay, no no nothing at all. They just get to use their insurance. So I do some of that, and then I'm now a member of what's called the independent physicians network. I'm experimenting with that. With that comes a number of commercial insurance plans, just because you're it's sort of like a group purchasing organization, kind of, we're all independent, but we they get to, there's, there's now someone to, I'm not negotiating with, with Blue Cross, right? Someone is negotiating on, on behalf of all the physicians, these independent physicians. So I'm given that a whirl. We'll see where it goes. I'm fine with it so far, and so it's a mix, and then if, if, and I take Medicare and Medicaid out of principle right now, we'll see how long that lasts. But I think that's important, and I do direct care, just like you. If they don't fall, if it is in any of those boxes, I tell them a reasonable price, I'll even negotiate, and we go from there.

 

Dr. Tea  17:41  

I bet you the listeners are really interested in learning about this Health Share, where you are connected to employers. So do they pay you directly, or is it still going into a pot?

 

Dr. Stephen Lewellis  17:54  

There are a few different ways, but the most common way is that these companies are called third TPAs, or third party administrators, and they are so they are going to pay me directly based on the rate that I negotiated with them. So they usually will go still using the standard CPT codes and things like that, just because that's already so ingrained. So I'll say these are my most common CPT codes. I bill, you know, em, stuff, 992, that kind of thing. And common procedure codes that I do, and this is the price that I would charge for them. And then we negotiate back and forth on that, or they usually, what they say is, oh my gosh, that's great, because that's so much less than the big hospital, like in the big integrated health systems, the dermatology department there is charging us, so we don't even need to negotiate, because your price is great. So, and it's also a price I feel good about. So if it's that I send the claim to them, and they send it, they send me the check. And it's not like, well, we that you build $200 but because of all these little things, we're going to send you $84.73 no $200 and they send me a $200 check, because that's what we negotiated. And some of them are like that. Some of them are a little more opaque, but nonetheless, it's still better than the alternative. But yeah, the best kind, in my opinion, is where I go right to them, they I know what. I know exactly what I'm getting. We agreed on a price, and we can renegotiate that. And I also know the patient is not seeing a copay. That's good for me because I don't have to collect it, and it's good for the patient because they don't have to pay for it. They're already paying their premiums, stop having to pay so much, and deductible and all that. So I know that no matter what I bill, their employer is taking care of that, not them.

 

Dr. Tea  19:45  

I think that's really cool. It's another tool that we can definitely use to give more access to patients. Essentially direct care is exactly that doctors get less independent on a crazy Corporation, but still allowing access and some sanity at the end of the day. And I. Like how you said negotiate, but really the word is loosely negotiate, because we know that these big companies are not negotiating. They're saying you take it or you walk away. And,

 

Dr. Stephen Lewellis  20:10  

yeah, we don't need you. Yeah, that's what that means to me. We don't, I don't need you. And that's why would I say I need them if they don't need me? So good points. 

 

Dr. Tea  20:20  

So tell me the progress you went from opening last year telehealth. You saw your first inpatient here recently, this year. What is the logistics of your practice? Do you have people working for you? Are you solo?

 

Dr. Stephen Lewellis  20:36  

Yeah, totally, on my own right now that is not recommended. I'm not advocating for that, but I think the most common term for what I'm doing right now is a micro practice, probably, and that's just because I've enjoyed the independence of that. I do everything, especially because I do, I take insurance, I and I believe in just again, serving, serve the people. Just help people, and that the value will accrue to me, you know, in spades in the end, and I just trust that. So I don't nickel and dime people right now over like prior authorizations and stuff. I don't blame anyone who does, and maybe I will do that at some point, but I'm just learning all the jobs. So I'm the receptionist, I'm the biologic coordinator. I do the prior auth, I do the billing, I do that. I see the patients. But that wouldn't work if I was seeing 30 patients a day, right? I see very low amounts of patients. I spend quality time with them, and I'm also doing a lot of other things with my time. So currently it and again, it is evolving, but currently I do all the jobs, but again, not I don't recommend that. And I'm going to gradually grow and gradually delegate things. And I also have some plans for 2025 in terms of collaborating with another person in my area and starting a clinical trials unit as well, which is something that's desperately needed in central Wisconsin. So a lot of fun stuff that's in store, and that will certainly turn into something that looks more like a, you know, something that has a receptionist, a medical assistant, a nurse. Maybe I'll hire a billing team if I do continue taking insurance, all of that kind of stuff. But right now, I'm doing it all.

 

Dr. Tea  22:16  

I heard you say, if you continue to do insurance, does that mean that there is flexibility? What's gonna happen for you?

 

Dr. Stephen Lewellis  22:24  

 for every day that I have no commit, I don't have, I don't feel any obligation to any beyond any contract that I signed, I will honor contracts that I signed. But those aren't like 10 year contracts. It's and they're also things that you can give notice, and it's not working out, give 60 days notice, or whatever is in the agreement, and everyone moves on. And I believe that if I'm not happy, they're not going to be happy with the product that I'm delivering their members. So there's no reason for us to stay, to stick together, but I'm enjoying it right now, and every it can be reevaluated on a daily basis, and eventually, if I had to forecast it, because I'm not the type of doctor who's going to see people in five minute increments, unless I really staff up. And I could see that model too. I I like physician assistants and nurse practitioners in dermatology. I do not like the abuses that have brought us where we are when a doctor out of purely out of greed, has 10 satellite clinics and PAs and NPS at all those clinics and rarely sees them. That is not okay, in my opinion. But if you're all under the same house seeing you're all there together, it's a team. I do not need to see every mild acne patient that walks in the door, nor should I be. And that's about access to that's why they're six month wait lists. I tried to introduce that model at the place that I got fired from, and the other doctors were just like, No, we don't. We don't. We don't do that here. And that's so and but I could see myself doing that. So anyway, if I don't, if it's just me, eventually I'm going to have a core of patients who are who are very loyal to me and really appreciate what I do for them, and I do specialize in I like treating chronic inflammatory diseases where people need a lot of longitudinal care, but I'll take anything that walks in the door and that eventually I'm going to run up and against those constraints instead of I'm either going to have to say, Okay, it's a three month or six month wait, or I'm going to have to say we're taking we're kind of closed, or we're taking fewer patients, or we're only taking direct care because we haven't the market will satisfy that. So I don't, I don't have any kind of like, I'm never taking it for one year and then we're done, or I'm happy with how it's going, and when I'm unhappy, I will reevaluate and pare things down as needed.

 

Dr. Tea  24:46  

I really like how you said that things are movable. We don't have to fully commit long term month to month, even I just did an episode about not signing on a five year lease. So you know, it's good to know that life is flexible. (Yeah) and you can certainly choose how you want to practice with insurance, a hybrid concierge completely out, totally up to you. (Yeah)

 

Dr. Stephen Lewellis  25:08  

I totally agree with that. Then I guess what I'm doing right now is called hybrid. And you mentioned concierge people often when I describe how I take care of people, and even say that, you know, I do direct care, if, if there's, if they don't align with the insurances that I accept, people will often say, Oh, so you do concierge. And there's, there's a specific definition of concierge within healthcare, and that's not what that's not what I do, but it feels concierge to my patients. I give a concierge level of service, but it doesn't feel concierge in terms of what they're paying, and that is important to me, and that is at least what I'm doing right now. But yeah, my patients feel like they. I do think they feel like they're at the Ritz compared to when they go down the street to the dermatologist they saw last month that they weren't happy with, because I take care of them.

 

Dr. Tea  25:59  

You mentioned the Ritz, and I was thinking, what's the alternative motel eight?

 

Dr. Stephen Lewellis  26:03  

Yeah. I mean, I had to, I had to campaign. I had to beg to get a Keurig in the waiting room because they don't care. They don't need the patients who are sitting there. So if those patients think, I think there should be, I think this place should be a little nicer, and I think my doctor should spend a little more time with me, and I shouldn't wait so long for an appointment. Get out of here. Next person, next one up. When I got fired, we had like, 1000 people on our referral queue as of the couple months prior to that, when last time they told me what, the number was that that pay that business does not need the people sitting in that waiting room, and that's how they get treated. So the bar is so incredibly low, and that's not a slight on the doctors. The other doctors I work with were great. They take great care of people, but it is the system that is causing this. It's Charlie Munger, show you the incentives. I'll show you the results. And the incentives are to see more and more and more and more patients, and you don't get paid based on whether the patients are happy. You get paid based on whether you prescribed a medication, or what the complexity of it was, or whether you froze something or cut something out. And that's how you get paid, if you're if you're insurance dependent, so that's, yeah, the bar is really low. But I don't, I don't just try to skip over the bar. I try to leap over the bar, and that's pretty easy right now.

 

Dr. Tea  27:28  

Are you doing marketing, active marketing, right now, or do they come through the insurance pathway?

 

Dr. Stephen Lewellis  27:33  

Both I things about marketing. I just stopped by a local radio station this morning for a program called Wellness Wednesday that a local station puts out, and they've had me on a couple times. I go on the local news for the last few, kind of six months or so. Once a month, I did a three minute live spot on the 4pm news once a month talking about a kind of dermatology issue, of my choice, and they would interview me about it. So that's all kind of earned media. It's not, I don't pay for it, but they i i work for it. And I had to get those, you know, get those opportunities. I do some in print. I do some print marketing, because I think that's undervalued right now. So I really enjoy print marketing within my local community, so people will see me in kind of a magazine or something like that. I do a little bit of digital marketing, just experimenting with it, but not a ton. But now that I have got some friends behind here, I get a couple of lasers that probably combine those things that cost more than I paid for my house, so I need to pay for those, and I need to put them to work. And that is the way I think about marketing within dermatology. People know what a dermatologist is, and lots of people need one. So I don't need to put a huge billboard saying general dermatologist like but if I have a specific device that is very good at doing a very specific thing. I need to tell the people who are needing that thing about it, and that's to me, that's marketing. It is very specific marketing to your ideal customer avatar, not just like spreading it everywhere and hoping, hoping someone walks in. And I also care a lot about repelling people who aren't going to like me, so I never get a chance for them to give me a one star review and give me a headache and attract people who are going to love me and that. And why not? I don't want to to. I don't know if everybody vibes differently with different people. And if I can put myself out here in forums like this or my own show or the news, someone will be like, oh, yeah, that's I gotta Yeah. He seems like my kind of doctor. Someone else will be like, talks too much. You don't like his voice, stupid hair, or whatever, like that. Then they just get to sort of self-select before they call my office, because I don't have a lot of resources to have this huge triage process and all that. So I. I think that's kind of one of the ways I think about marketing. And yeah, so I do some, but if my budget is not I'm a very lean practice right now. I don't, I don't see a ton of patients. I'm just, I got bills with these devices and stuff and and so then marketing is very, I try to be very specific about it, very strategic about it so that I'm not wasting a lot of marketing dollars. 

 

Dr. Tea  28:46  

The doctors that are listening right now to you, they're probably inspired, because I know I am. (Thanks) What would you tell them about owning their own practice?

 

Dr. Stephen Lewellis  30:33  

Do it so that that's the cheap answer. If you are happy with what you're doing, don't have shiny object syndrome because you're listening to Tea and I, but you're you're listening to us for two reasons. You're not happy with what you're doing, or you're doing kind of like what we're doing. And you want to have, we want to learn from people who are doing it alongside you. So if you're in the first camp of you might be like, I was an employee doc who's just like, what's there? Is this? It? I'm not super happy, and I feel like I am not very aligned with what's going on here. And yeah, the money's good, but that's about it. That is the person who I'm saying do it. And it doesn't mean you have to do it right away, but just start planning for it, start learning, start building a financial cushion that's huge. If I didn't, I would have been a pretty financially conservative person. My wife and I both don't want to be living paycheck to paycheck and being house poor and having three houses and boats and all this stuff that we can't sustain. So this would have been much more traumatic. It was already traumatic, but it would have been so much more traumatic had we been like, Oh crap. Like, where's the next paycheck going to come from? That is the size of the old one, so I will gradually work up to that paycheck and far surpass it, I have no doubt, but that's a long game, and those results will come because I'm playing the long game, and the I have the ability to do that because we, we were, we did it. Did build up a financial cushion. And that's important if you want, especially if you want to stay independent and not take on a ton of either investors or a lot of debt. I mean, I finance things. I finance the devices and stuff. So everybody does it their different way, but do it and reach out. Talk to Tea, talk to me, talk to there's a lot of us out there, and there will only be more over the coming decades, because of what the big systems are doing to push us out and make us miserable and hurt our patients and all of that, so that the water is warm, it is wide open, and the patients are waiting. They're desperately waiting for you, they're desperately waiting for a doc like Tea who's going to be like, I got this. I'm going to take care of you. This is how much it's going to cost. You're going to get way more value than you thought you would then, then, then it feels like you should get that amount of money, and we're both going to be happy. So my wife said, I don't she doesn't say this, but I think she would say, I talk too much, so I always picture sitting on my shoulder saying, shut up. But she's a very nice person, and she doesn't actually say that.

 

Dr. Tea  33:08  

Who doesn't like a doctor that likes to talk? It's very engaging. I'm sure your patients love you so much for that, because you're right. Seven minute medicine not working anymore.

 

Dr. Stephen Lewellis  33:17  

It ain't for me, at least. And yeah, I joke that now in my new job, I will have patients looking at their watch and being like, I gotta go. Am I ever gonna get out of here? And that's obviously what I need to do, I want to be mindful and respectful in my patient's time, of course. But I think people do value, you know, having a one hour consult slot. If they have a big thing going on. They've been suffering from something for a long time. They've seen a dermatologist, they saw an allergist already. All these that was my patient, this morning, in fact, had seen prior multiple specialists, and that patient is not going to get any value from a five minute visit. 

 

Dr. Tea  33:56  

Agree. Well, thank you so much for being here on the podcast and for sharing your journey. I know it's new and fresh, so you're very close to the ground, and I find that to be incredibly valuable, because it wasn't too long ago where that stuff was scary to me, and now that we're finally on the other side, it's like, oh, what took so long? We'll get there. We'll get there.

 

Dr. Stephen Lewellis  34:17  

Yeah. And the challenges just keep getting different, right? You get, you get to that plateau, you see another VISTA and a beautiful view. It was like you haven't got, you're scraped up, and you have your you get your rewards and all of that. And then it's another one, right? But you have a new skill set, so you have new equipment and all these new connections and skills to climb that next one. But it's not also all about just climbing, like look at the view and enjoy it. And I'm sure you're you clearly are. You're very authentic in how you come across and that's because you're doing what you were meant to be doing. And all of you can do that, all of the listeners can. There are many, many, many patients out there waiting, as I said before. And. Your skills are hard earned and extremely valuable, and don't let other people convince you otherwise, because they are generally the people who know exactly how invaluable you are, and they don't want you to realize it. 

 

Dr. Tea  35:14  

Dang. How about that? Guys? Thank you so much for being here and thanks for being on the show. We'll catch you next week.

 

Dr. Stephen Lewellis  35:19  

Take care. Thanks. Tea.

 

Dr. Tea  35:23  

If you enjoyed this episode, please give it a review and share it with a friend so more doctors can learn about direct care. Let's keep the conversation going on LinkedIn so we can help more doctors escape insurance and thrive in private practice. Thanks for listening. I'll talk with you next time take care.