By Nisha Chellam, M.D.
A few years ago, when I quit insurance, I found myself drowning in debt. I went from 1000 patients to “0” patients.
Letting go of my staff wasn’t an option I was willing to consider.
At the time, my coach introduced me to a CPA—a brilliant one. His job was to assess my financial situation, determine if I was a good fit for his services, and see if he could help.
The moment he reviewed my numbers, his advice was blunt: “Cut your losses. Let go of your staff. Strip everything down to the bare minimum.”
That conversation ended quickly. I never called him back.
Was he wrong? No, he was absolutely right.
But the way he approached it didn’t work for me. I was in a vulnerable place, trying to process a major financial shift. I needed time, a plan, and some level of support—ironically, my staff was a crucial part of that support system.
That experience taught me something invaluable.
In the past, when I saw a patient who lives on processed food, scrolls through their phone all night, and never exercises, I used to tell them to overhaul their lifestyle. I highlighted how each of these habits was destroying their health.
They got overwhelmed, and never followed through.
I never understood it till the experience I had with the CPA.
It’s not that people don’t know what is wrong with their habits and health. They don’t know how to get out of the rut.
They come for professional guidance they need to first develop the confidence that change is feasible.
Today I have a different approach, thanks to my CPA encounter:
I take it one step at a time.
I follow a process:
1️⃣ Gather data – I assess their health objectively.
2️⃣ Explain the lab results – I provide all possible explanations for their abnormalities.
3️⃣ Let them reflect – I ask what they think might be contributing to their health issues. Without fail, they recognize the patterns: “I do eat a lot of junk,” or “I really need to cut back on wine,” or “I never sleep before midnight.”
4️⃣ Ask what support they need – More often than not, they already know what needs to change.
This process helps patients take ownership of their health.
It’s like starting at a kindergarten level and gradually progressing toward a PhD in lifestyle change.
Small, sustainable steps lead to long-term transformation.
If, on day one, I told them to cut out alcohol, ditch processed foods, and eat only whole foods, most wouldn’t come back—just like I didn’t go back to that CPA.
I’m still refining this approach, but I’ve found that when people understand the problem and take part in creating the solution, change becomes possible.
What’s a time you’ve learned that how advice is given matters just as much as the advice itself?
