104 - Why Most Physicians Are Failing at Managed Care & What You Actually Need To Know After Residency Training

Are you building a medical career… or just working in one? STOP leaving money, autonomy, and fulfillment on the table.

In this episode of The Independent Physician’s Blueprint, we explore how one physician broke away from the traditional medical grind and transformed a podiatry career into a thriving business—without ever being taught how in medical school. Through an engaging story of two physicians with the same name and a twist of fate, you'll uncover how business savvy, financial clarity, and managed care knowledge can reshape your medical future.

 You’ll learn:

• How strategic cash flow planning can help physicians regain control and reduce stress.
• Why mastering the business side of medicine—IPAs, managed care, and niche specialization—can multiply your income.
• What it really takes to build a sustainable, burnout-resistant medical practice from the ground up.

It’s time to stop operating like an employee and start thinking like a physician-entrepreneur. Hit play now and learn how to reclaim your practice, your profits, and your purpose.

Discover how medical graduates, junior doctors, and young physicians can navigate residency training programs, surgical residency, and locum tenens to increase income, enjoy independent practice, decrease stress, achieve financial freedom, and retire early, while maintaining patient satisfaction and exploring physician side gigs to tackle medical school loans.

Transcript

Coach JPMD (00:00)
By the end of this replay episode, you'll understand how two physicians with the same name ended up transforming how they practice medicine and how you can do the same. Welcome to the Independent Physicians Blueprint with your host, Coach JPMD, that's me, where we help younger physicians decrease stress and increase income by transitioning from corporate to independent practices, even without any business experience. In this episode, you'll discover at least three things.

Number one, how strategic cash flow planning can help physicians decrease stress. Number two, why mastering the business side of medicine with IPAs, managed care and niche specialization can multiply your income. And number three, what it's like to build a sustainable burn resistant medical practice from the ground up. So we're here with Jude Pierre. It's just funny saying that and it's a

It's such a pleasure to have you on the podcast, the Practice Impossible podcast, Jude Farley-Pierre. It's a pleasure. Today, we're going to talk about specialists, your specialist in medicine and your podiatrist in the Spring Hill area. Before we even get into the practicing, we have to just clear the air out with the origin story, our origin story and how we met. I don't know if you want me to start or you want to start?

Jude-Farley Pierre, DPM (01:20)
for it. I'll just interject.

Coach JPMD (01:22)
So I met Jude 2002. I had just moved to Spring Hill. I probably went four or five months into Spring Hill. I got a phone call from my team member and she was like, Dr. Pierre, there's a Jude Pierre on the phone and he says he wants to speak to you. I'm like, what is this? Come on. What do mean Jude? He says, this is Dr. Jude Pierre wants to speak to you. So I said, okay, whatever. I get on the phone and you tell me, well, I just tried to apply for privileges at the hospital and they said, I have privileges.

So tell me how that started. Like what were you, you hadn't had privileges and you called or you went to the hospital, how'd that work?

Jude-Farley Pierre, DPM (01:56)
So

I moved in, I think, May 2002. I started working with a podiatrist in Spring Hill. Of course, I was living in Palm Harbor. So in the process of getting credentialed and getting on staff at some of the area hospitals, I don't know what happened, but somehow I don't remember applying for privileges at Oak Hill, but somehow they sent me a welcome package. I'm like, why? Okay. At the same time,

there was an ad in the paper that said, welcome Dr. Jude Pierre to Spring Hill. I'm like, wow, this is really a small town coming from New York, of course. I'm thinking, wow, I must be really in the blues because man, you can't sneeze without someone saying, gesundheit. So I was like, okay, well, it must be a small town thing. Whatever, I'll I'll roll with it. So when I did go to the hospital, I'm like, you know, you have a mistake here. I'm not an MD, I'm a DPM. They're like,

But that's not what your application says. I'm like, what application? So needless to say, I found out there is another Jude Pierre in the area. So I'm like, that's impossible. I mean, I'm from New York, from Brooklyn, where pretty much every Haitian person lives. And I come to like the most backwards corner of Florida to find another Jude Pierre. That doesn't make any

Coach JPMD (03:20)
In the same hospital system too.

Jude-Farley Pierre, DPM (03:22)
make

no sense whatsoever. So I'm like, no, there's no way. So I think I can't remember who the person was, but they gave me the number and said, you need to call and figure this out. So I all right. So I called the number and I was actually anxious because I'm thinking maybe it's a small mistake. Maybe it's just one accent away, just something different. And of course, the person who answered the phone said, you know, Dr. Drew Beers, I'm like, huh? It's so weird to call.

and hearing your name being sent back to you. So I'm like, all right, well, I'd like to speak to Dr. because I'm thinking this has got to be a joke. So hey, I want to hear this from the horse's mouth, so to speak. And then that's where you picked up.

Coach JPMD (04:07)
And then I think I told you, you need to come to the office. I I remember saying, I said, you need to come to the office.

Jude-Farley Pierre, DPM (04:12)
I

remember that conversation because just like, we have to see who you are because we just started talking. Like, okay, where are you from? New York. I'm like, where? Okay. And found out you're from Queens, Laurelton area.

Coach JPMD (04:22)
Yeah, I was born in Brooklyn. you were living in Brooklyn. And your parents moved to New York, I think around the same time that my parents moved to New

Jude-Farley Pierre, DPM (04:26)
And...

Probably. From Haiti. Yep. I think they're from different parts of Haiti, is, because my dad's from up north. Ironically, he looks a lot more like your dad. They look like they could be brothers. Small stature, fair skin, balding. So, that was kind of a shock. I remember at the end of the conversation though, you said, all right, one more question. Is your wife named Christine? I was like, no. I'm not married. So, I was like, okay, good.

Coach JPMD (04:58)
Hahaha

Jude-Farley Pierre, DPM (05:02)
Because even you were like, yeah, this must be a twilight zone.

Coach JPMD (05:05)
Yeah. And I actually think I asked you for your license. said, let me see your license. Yeah. Yeah. And then you said your dad's first name is my middle name. So you could have easily been a Jude Antoine. So in my infinite wisdom, you know, I said, you know what? You need to join us at Access because I was like, I have to say it was selfish of my part. I was like, we can do the marketing blitz on this and Jude Pierre and

Jude-Farley Pierre, DPM (05:09)
Yeah, you're right.

is absolutely correct.

Absolutely.

Coach JPMD (05:34)
Jude Pied, podiatrist and internist on the same block. So you ended up moving your office or joining us on the same street, actually right next door or two doors down from where my office was.

Jude-Farley Pierre, DPM (05:47)
actually pretty much next door. think you were 5362 and I was 5374.

Coach JPMD (05:51)
Yeah, yeah, yeah. It was great marketing. mean, it was just it caused a mass confusion and and the cross promotion. Yeah.

Jude-Farley Pierre, DPM (06:00)
see.

Coach JPMD (06:10)
I don't know if we should admit that right now.

Jude-Farley Pierre, DPM (06:13)
Probably not. But it worked out though. It worked out.

Coach JPMD (06:16)
Well,

so actually recently it's still happening. So recently I was, I was being juda and, and, and, Karel judas like nosy. And I listened to everything my staff is saying on the phones and try to interject if I need to the way they speak to patients. But last week we had like a plethora of phone calls and they kept saying, no, this is not the podiatrist office. This is the internist office. I'm like, why they keep saying that? Why? And I do a Google search on your name and my phone number pops up on your Google, on your Google page.

So I had to actually contact and it's interesting because I tell in our course and the llama course, I have a course on marketing that actually tells providers that they need to go on Google, make sure their stuff is updated because who knows what they're doing online. So it can cause mass confusion. So, so now you're in Spring Hill. It's been a couple of years and if we can, I want to talk about some personal stuff before we get delved into the medical. Cause I think you went through some traumas initially.

just after I met you a couple of years after I met you with your first son who was a preemie.

Jude-Farley Pierre, DPM (07:18)
Yeah, yeah. was born three months early. We were expecting him in November. while we were vacationing in New York, he decided to make an appearance. we ended up having to actually we ended up having to stay there for a few months. And while I was working in Spring Hill, so I was flying back and forth while he was in the hospital. I mean, they kept him there for three months. That was crazy.

Coach JPMD (07:46)
I remember those times. How did you cope with that?

Jude-Farley Pierre, DPM (07:51)
Oh man, I'm gonna tell you, it was hard because it was like first time becoming a parent and you know, there are no books, no instruction manuals and this stuff. So, and no one I know ever, ever went through that. So it was mind boggling. I think I even went through some depression because it was just like, I didn't know. And that's just what was happening in terms of him being born early, but

also what the long-term consequences would be for someone born in that type of predicament. mean, with those type of disabilities from the beginning. But I do remember having a conversation with a very good friend of mine who actually said something that I kept for forever till this day. He said, nothing crazy, nothing, hey, I'm sorry, nothing, the typical things that people would come and tell you.

you know, that, I feel bad for you, oh, blah, blah, blah. But in the meantime, you know that don't wish that on themselves at all. So a friend of mine just said, one thing you should keep in mind is that God never gives you more than you can handle. It was a quote from Job's and I was like, really? Wow. So I kept that for forever. And honestly, that's how I was able to deal with it. I just kept thinking to myself, okay, you're right. You know, God.

can't even is not giving me more than I can handle. So that means I should be able to handle this. So we just plugged away one day at a time. Went through countless sessions of physical therapy, occupational therapy, speech therapy, countless appointments with the ophthalmologist. I mean, it was just crazy. Then see the light at the end of the tunnel. But I just kept marching through because in the back of my head, I'm like, you know what? God is definitely not giving me more than I can handle. So that means I definitely can't handle this.

I don't know for those of you guys who may be wondering who this friend was, his name is Jude Antoine Pierre.

Coach JPMD (09:50)
Yeah,

Jude-Farley Pierre, DPM (09:52)
So I never forgot that. That stayed with me forever. And every time I go through any type of adversity, I just kind of recall that conversation. And it definitely does get me through a lot of things.

Coach JPMD (10:04)
And

seeing Nemo, I mean, if I can say his name, I'm gonna call him out now. Yeah, absolutely. He's 200 pounds, solid muscle, thriving in college.

Jude-Farley Pierre, DPM (10:15)
Absolutely. He's far exceeded anything that the doctors and all the specialists even thought about him because the scary part was when he was born, tell us, you know what, every day was a small victory. But they said, don't get excited because he may not be able to see.

Coach JPMD (10:17)
I'm so happy to see that.

Jude-Farley Pierre, DPM (10:40)
he may not be able to walk or he may not be able to hear. may not be able to talk. I mean, every day was, OK, he passed the hearing test. Yay. You celebrate for like just a few minutes and then you're on to the next one. And is he going to be able to see? Is he going to be able to walk? So seeing him now is just like amazing. mean, these kids are almost six feet tall, 200 pounds, plays football, soccer, solid muscle, as smart as a whip, lazy, but smart.

Coach JPMD (11:08)
Don't so don't you can't call about like that? I'm sticking up for you nemo

Jude-Farley Pierre, DPM (11:13)
He's not that lazy, buddy. Hey, listen, you know what? You're right. He's not lazy. He plays instruments. He plays the cellos, classical cellists. He speaks three languages. He's always been a good kid and he still is till this day having his best life at Florida State. We'll see what happens.

Honestly, again, I'm gonna have to go back to this friend of mine who talked me into having more kids, which is ridiculous. At the time, you know, we both had one kid and they thought it was great, you know, and then all of a he decided to have another kid. like, well, hey, listen, you need to have one too. I'm like, really? Is this how we're gonna do this? We're gonna match pair for pair. So, I ended up having a beautiful daughter named Jiel Pierre who happens to be my good friend's goddaughter.

Obviously it was only fitting because he played such an instrumental part in my life and getting me through a lot of difficult times.

Coach JPMD (12:15)
did

the work, man. You did the work.

Jude-Farley Pierre, DPM (12:17)
But sometimes it's good to have someone point out the world. You know what mean? Hey, you know, it's good.

Coach JPMD (12:23)
So you're a podiatrist. And I know there's, you had to explain to me that there's a difference between podiatry and podiatric surgeon. So you're going to have to explain to our audience for those who don't really know. is the schooling different or what's the difference between a podiatrist, podiatric surgeon and or an orthopedic surgeon that does a foot surgery.

Jude-Farley Pierre, DPM (12:42)
Okay, so I'll start with the orthopedic surgeons. So orthopedic surgeons are basically someone who went through a traditional allopathic school of medicine or an osteopathic school of medicine and they specialize in orthopedic surgery and they're able to work on different parts of the body, mostly involving bones. Some orthopedic surgeons specialize in backs, some specialize in hips, knees, some actually specialize in foot and ankle as well.

A podiatrist, now again, I'm gonna be, you know, like dating myself and I'm not that old, but still. When I went to podiatry school, way back when, there was a difference. So you can go through podiatry school, which is a four-year program after you've had your bachelor's degree as a science, and then you go on to do a residency program. So back then, the residency program was somewhat varied. So there are some podiatrists who only did

what's called a primary podiatric medicine residency where they do mostly routine functions, diabetic nail care and so forth. And there are those who did a podiatric orthopedic residency and those involved mostly bracing, orthotics and even sports therapy and a lot of them end up working with sports teams, recommending shoes, orthotics and so forth. And then

there was the podiatric surgical residency. So now everyone could choose which one of those they would go into and that would obviously determine where you end up and what your practice basically consists of. So I did the latter, which was the podiatric surgical residency. Therefore I became a podiatric surgeon as opposed to sisters who chose to do a podiatric primary medicine residency and therefore did not do much surgery. I mean, you can still do surgery.

not board certified. That's what happens.

Coach JPMD (14:41)
So what did you see yourself doing after the pediatric surgical residency? Were you going to stay in New York? Were you going to travel? Were you actually looking to come down to Florida or?

Jude-Farley Pierre, DPM (14:49)
Well, no, actually that's another funny story. So, I don't even know if I should admit this, but I was quite disillusioned with the field of podiatry because you have to understand when I finished, I was in New York, there weren't that many positions open to people that looked like me. So, a lot of them were open to people who already had a parent who was in the field and therefore those positions were passed down to them.

So you had to fight in order to at least be recognized or shine a little bit. So if you weren't at the top of your class, you probably weren't gonna get noticed. And I've had people just say, hey, you're not gonna make it, at least not in New York anyway. So that disillusioned me just a lot. And then, so I thought about just quitting and then a friend of mine,

who actually graduated with me. She's a podiatric surgeon over in Pennsylvania. She said, no, I'm not gonna let you give up. We went through too much, studied too hard. No, we're not doing this. So we did one final year residency with one of our mentors, Dr. Emilio Gómez. And I learned different things. We did a lot of trauma rotations. So I found that I actually liked limb salvaging. liked...

cutting people, so to speak, legally, of course. I like the idea of putting things back together or taking things off that didn't belong there or no longer viable, basically. So I thought about surgery. I thought it was a good field to go into because you can make a drastic difference in the outcome of someone's life. So I wanted to start practicing in New York, but 9-11 happened. So where I did my surgical residency,

was downtown Manhattan. The hospital is actually called NYU Downtown. It was one of those sought after surgical residency programs because of its location, number one. So it's literally right there at ground zero. We could see planes actually crashing into the buildings. Our hospital as well as another hospital down there, Gouverneur, we saw the majority of the traumas that occurred from that tragedy.

So we volunteered, we were treating dogs and firemen, police officers. I mean, it was just chaos, trauma everywhere, amputations, limb loss, all sorts of things. so, yeah, it was a tough, tough time to, and again, I was a resident and I was literally graduating, I was done. So the only thing I had to do was start applying Medicare number, license, you know, instead of...

Coach JPMD (17:20)
I didn't realize that.

Jude-Farley Pierre, DPM (17:34)
going from the resident license to a regular license. So all that stuff got frozen and nothing. New York shut down, government shut down, every application, everything a piece of mail was being sprayed down for anthrax. It was nothing. Couldn't do anything. So I was stuck after graduation, after finishing up my residency and not knowing how I'm going to work and where I'm going to work. So I started Googling and started looking around and found

that Florida was one of the few states that had reciprocity, meaning whatever you accomplished in New York, they would recognize and all you had to do was just pay. You didn't have to take another exam. You didn't have to jump through hoops. It was just pay your money, here's your license, and that's it.

Coach JPMD (18:21)
Okay. So, I mean, you struck me as a almost miracle worker on some of my patients. So, I know that it's probably some of the experiences that you had in New York, but we had a patient, Dr. Singh and I, and we were just darting out and growing the practice and we had a patient that had a wound, I think for about a year. I won't say his name, but I think you remember him. He a charcoal joint, heavy guy. So, it was very hard to get its weight off foot. And you came along and I think within three months, the wound was healed.

And I'm like, what is this? Who are you? And so from that point on, you know, because you were right next door to me, marketing ploy, I would just send patients to Jude and he'd take care of the wounds or he'd come over to the office. So that really, really helped us in the managed care world because, know, our idea is to manage the whole patient and make sure that they don't go to the hospital, that they don't get expensive drugs and medications and expensive surgeries, that may not work.

So what had been your managed care experience prior to joining us and how has it been since then?

Jude-Farley Pierre, DPM (19:24)
Okay, so that's easy. My prior managed care experience was zero, nothing. Never even heard of the word. I had no idea what that was at all. I knew Medicare, Medicaid, and some things in between, and that's it. So I was completely taken aback by this whole managed care system, and it took a while for me to actually understand it. So Dr. Singh threw some exhaustive

late night sessions, tried to drill it into my head how the system is supposed to work. And then of course, you hear a lot of stories from other doctors and colleagues of mine as well. And everyone hated managed care because, you don't get paid, they expect you to work like a dog and they pay you pennies on the dollar. And so I was starting to become a little jaded and like, God, this is probably not the best thing for me. So

being part of a group like Access Healthcare started to open up my eyes and give me a new perspective on how patients should be treated. So, I know I've heard this before and this is from school, from podiatry school where they tell you, you you need to understand that patients feet don't walk in by themselves, they're attached to a body. you have to be mindful of the fact that that person has

systemic issues that may contribute to their foot problems. And so you have to be a doctor. You're not a pedicurist. You're not a nail technician. You're physician and you need to treat the patients accordingly. So my approach then became like that. I basically started asking more questions. I started looking at the patient as a whole and therefore I was able to

coordinate the care with my colleagues such as yourself in order to, you know, attain reasonable and desirable goals and as far as wound care. So I fell in love with wound care early on and I loved it. I have to thank Dr. Traynor who had a huge impact on my life. She was a PhD, an R.M. with a PhD in wound care. I remember everyone hated going to wound care clinic because it smelled so bad and it was so much work.

having to put on those OODA boots every week. horrible. But man, I thrived on that and I loved it. So I made up my mind. I was board eligible for surgery. I decided to take my boards in limb salvaging and diabeck foot ulcers management instead. So now I'm a wound care board certified podiatric physician who also does surgery. So in that capacity, I'm able to do a lot of things that

your traditional wound care specialist can't, which is not just manage the wound, but I can also manage the underlying osseous issues that causing the wounds. Like, you know, if someone has a maritalisal that's just too pronounced or prominent, I can alleviate that problem by doing certain surgical procedures that can take care of that and as well as take care of the wound forever rather than just put them in a pair of shoes.

Coach JPMD (22:43)
Yeah. So you've niched out, you've niched out even the podiatry practice in terms of what you do. What are your other colleagues doing? they, because I know that, I mean, not everyone is doing this. How are the colleagues managing their practices? I know some are going to nursing homes, assisted livings. How do they land these jobs in these positions? How do they practice?

Jude-Farley Pierre, DPM (23:06)
So, I noticed a lot of the podiatrists in this one, our area specifically, so the majority of them, they did a lot of nursing homes, which I also did in the beginning as well because again, it's one of those like, oh, hey, this is what you're supposed to do, so I did it. Until I was like, no, there has to be a better way. So, that's when I decided to niche out. Again, with Dr. Singh's help, it was kind of easy to say, hey, know, pick out what you think you're good at and then just do that.

Other guys, I noticed they do a lot of primary care stuff like they'll hire podiatric assistants, which is someone that they train to do a lot of the basic functions like nail care, callous care and things of that nature. So you have five or six of those girls like or guys working on the patient and you're able to, I guess it's kind of like networking. You have five or six people doing the work and then you just go in and you provide a certain amount of care. But

they're working under you, that's how they're able to do some of things that they do. Otherwise, it's impossible to make a good living because it's a numbers name.

Coach JPMD (24:14)
Yeah. It's mostly a fee for service, right? Yes, mostly fee for service. I also heard you speak about contracts and some HMOs or some managed care organizations will give podiatry groups contracts. Are they capitated contracts or are they fee for service contracts as well?

Jude-Farley Pierre, DPM (24:28)
There are certain podiatry groups who have been here in existence for quite some time in the Tampa Bay area and they're able to form what you call an IPA and therefore compete for some of the capitated contracts that some of the managed care plans had to offer. Now, again, business savvy, that's fine because it serves your group. You go in, you lowball basically. You offer the best

price you think the insurance company is going to allow and then they give you the contract and you, it's a numbers game. Again, you're like, okay, I'm going to be the only group to see all of these members. Therefore it's going to be fine. Now, when the care plans grow and therefore you don't have a presence in this county and the managed care plan is there, then you subcontract with another podiatrist like myself, for instance, you give them a fee for service contract.

there you're able to so that they can see the patient but basically underneath your capital contract. So you send in a claim and they'll pay you based on the contract that you signed with them. And that contracts usually for a set amount based on a certain amount of code that they allow, which is actually a really good system because it definitely cuts out a lot of the menial

nonsense that you have to deal with for a traditional Medicare plan, which is modifiers and different codes. know what mean? When you have a managed care plan, it's so much easier because you have X amount of codes, they sell much you get paid. Boom, it's very easy. You submit your claim, you get paid. That's it.

Coach JPMD (26:16)
So

what Judith's talking about is really something that I've been trying to hone in on the Money Tree series that I started up a couple of weeks ago. And he's describing IPA contracting. So if you take a look at the Money Tree series, there's a couple of series already out there. I invite you, the listeners, to actually re-listen to those episodes, especially the one about the IPA and the MSOs, because that will kind of help you understand what we're talking about here in that Money Tree series. So that was a plug to another series.

Jude-Farley Pierre, DPM (26:44)
And it all ties in.

Coach JPMD (26:45)
It all ties in and that's what we're trying to do here to help physicians understand this stuff because we're definitely not taught this stuff in medical school or residency.

Jude-Farley Pierre, DPM (26:54)
Never even heard of it.

Coach JPMD (26:56)
You know, as you grew, you got busier and you invited your sister to be part of your practice. How was that?

Jude-Farley Pierre, DPM (27:04)
Yeah, that was interesting. as we grew and it got to a point where, again, being part of a group such as Access allowed me to get very busy very quickly because I had a tremendous amount of support from my colleagues as far as referrals are concerned. It didn't hurt things that I was the only podiatrist in the group. So, it was kind of easy. Oh, wow, you have a foot problem, boom. Instead of taking care of it myself now,

we have someone who can do it for you. So it was easy. So I stayed very busy. We tried hiring different podiatrists over time and things just never actually worked out because again, it's sad to say, but when you go to med school, podiatrists school, dental school, chiropractor school, you're just not taught the business of it. So a lot of them came in with unrealistic expectations.

They thought things were the exact same as when they were in residency. Not a clue as to how it is to manage a practice, let alone a managed care practice. It's just not that black and white. There are so many different variables that you have to take into account. It's not hard once you actually commit yourself to learning it. Once you learn the system, it's fairly easy. It literally runs by itself, but you have to understand it in order to do it.

needless to say, we went through a few, at least a couple, they work out. And at the time, I think my sisters were in New York and they were getting a little tired of the politics and the hustle and bustle of New York City. Therefore, they were looking to relocate. So I told them, hey, listen, you know, we have a growing practice here. Why don't you

bring your expertise down to Florida if you want to and we can see if it works. know, five years in, she's still there. It's a work in progress. Working with family is never easy, but you have to kind of find a way to do it. It's definitely a lot more challenging than I'd expect before, but it's still there, you know.

There's pros and cons. mean, the pros are good in fact that you can actually pull her aside and say, hey, listen, this is not working or you need to do something different because you can't do that with someone who's not related to you because that person will take offense quickly as far as like, well, you're trying to tell me how to practice. No, but if it's coming from a sibling, it's a little bit easier to swallow.

Coach JPMD (29:44)
Well, you've got a big heart.

Jude-Farley Pierre, DPM (29:46)
I guess so. Yeah, I suppose we can say that.

Coach JPMD (29:52)
So what would you tell the younger version of you, now that you've done this for 20, 20 plus years, about practicing podiatry or even practicing medicine, what would you tell them that you would have done differently?

Jude-Farley Pierre, DPM (30:04)
Wow,

there's so many things I would tell my younger self. Let me see. First thing I would tell my younger self is probably don't do it. Don't go to med school. Become a DJ. You can make more money and less time. But if you absolutely have to do it, I'd say

Coach JPMD (30:12)
Don't say that.

Because you want to do it because that's what I said because you have the

Jude-Farley Pierre, DPM (30:25)
to do it. I

would say you need to learn everything, not just the stuff that teach you in school, but you also need to learn the business of it. You need to actually know how to run a business because at the end of the day, yes, we're taking care of patients, but it's still a business. You don't have that type of mentality. You're not going to make it for very long. You're going to burn out quickly because you have to learn how to work smart.

not just hard. Working hard is absolute because that's going to happen regardless, but you also have to learn how to work smart.

Coach JPMD (31:03)
That's great advice and that's what we're trying to teach in the practice impossible podcast. So how do we reach you if someone wanted to talk more about you just or if there's podiatrist that is looking to join the community?

Jude-Farley Pierre, DPM (31:16)
So email me. I'm extremely accessible and very easy going. I love to teach, especially after learning so much over the past 20 years from a number of people. mean, some of the stuff that I've learned, I know for sure that no one's teaching that. As a matter of fact, we have a nightly residence at Oak Hill now. And when I ran with them, it's tough to kind of see that things have changed.

to some degree because I remember when we were talking about previously about the different types of podiatry residencies that they had and therefore that would honestly give you a podiatrist versus a podiatric surgeon. Now, podiatry and its, you know, the wisdom decided that makes no sense. It's about time. So now they decided to make it a three-year residency for podiatry period and it includes surgery. So everyone who comes out

is literally a podiatric surgeon. So there's no different sets of podiatrists because it became too difficult in hospitals because you have podiatrists on call and something comes into the ER and you call that podiatrist, he's like, I don't do that. It doesn't make any sense. So now everyone's trained the exact same way, which is thank you God that someone did that. So by talking to the residents, you can still see where there's a huge lack of teaching. They're not learning.

they're not being taught rather the things that they really do need to learn. So I find myself teaching them those things like little things like how to like carefully dissect you know a chart and how to see the patient in a different way, how to manage a patient. You don't just go and start ordering pre-albumin levels on every patient because that's an expensive test that's unnecessary. know what mean? You need to learn

not to order an MRI on every single person who has a wound. It's completely unnecessary. So, things like that. Sad to say, but you have to kind of unteach them what they learned. So, it's a challenge, but I'm up for it. I love it.

Coach JPMD (33:25)
Yeah,

we're all up for it. That's why we're here. That's why we're what we're doing.

Jude-Farley Pierre, DPM (33:32)
with someone like us back then, you know?

Coach JPMD (33:35)
There

were, it's just, you know, they're in pockets. They're in pockets. We got to make it so that it's everywhere. that's what we need to, we need to do it. We're going to do it. We're going to do it. So thank you so much for the conversation and it's been great. And now we've got it memorialized. I think that's a term. This is going to be around for our kids to listen to, for Nemo to listen to.

Jude-Farley Pierre, DPM (33:45)
I so. I hope so. Alright.

I love it. It's gonna be good. It's gonna be good

Coach JPMD (34:03)
So what you learned today are the strategic ways to decreasing your stress. You also learned that it's important to learn the business of medicine post residency and how small of a world we live in when two Jude Piers can practice in the same practice. Thank you so much for listening to the podcast. If you'd like to hear more, subscribe, follow, and your favorite podcast app so you'll never miss an episode.