Education

Family Doctor Speaks at the Detroit Public Library

In October, I had a great opportunity to speak at the Detroit Public Library about health care. The focus of my talk was our Family Medicine practice in Southwest Detroit called Plum Health DPC. The DPC stands for Direct Primary Care and our mission is to make healthcare more affordable and accessible for everyone.

This talk was well attended by Detroiters and Library Patrons who wanted to learn more about lowering the cost of their health care. Folks in Detroit and across America are facing ever-rising costs for health insurance premiums and prescription drugs, ER visits and lab work.

One such Detroiter showed me the bill from a recent ER visit, which illustrates the inflated cost of medical care, especially the medical care delivered in emergency departments.

 A Detroiter shows me their medical bill, showing the inflated costs of a chest x-ray, breathing treatments, blood work, and an EKG. Shared with permission.

A Detroiter shows me their medical bill, showing the inflated costs of a chest x-ray, breathing treatments, blood work, and an EKG. Shared with permission.

So let’s run through this bill and demonstrate the inflated costs of health care services when you receive them through the emergency department.

This person was charged $120 for a Basic Metabolic Panel, a test that costs $6 in our office.

This person was charged $47 to check their Magnesium level, and it’s $10 in our office.

This person was charged $57 for an EKG in the emergency department, and it’s $2 in our office.

A 2 view x-ray in the Emergency Department cost this person $107, but it can be obtained for $38 in the community.

Worst of all, this Emergency Department visit was billed out at a Level 5, or the highest level of severity for any emergency department visit. This would be on par with a stroke, heart attack, or gun shot wound. Because of this high level coding, this person was charged $1,204.00 for this visit, which was an asthma attack.

At Plum Health, we value price transparency, and we want to make sure that folks understand the costs of their medical care before those services are rendered. This prevents people from being sent to medical bankruptcy, the leading cause of bankruptcy in the United States.

“A study done at Harvard University indicates that this is the biggest cause of bankruptcy, representing 62% of all personal bankruptcies. One of the interesting caveats of this study shows that 78% of filers had some form of health insurance, thus bucking the myth that medical bills affect only the uninsured.” - Investopedia article

This is why I get out into the community and speak at different events - I want to educate folks about how they can live healthier lives and prevent financial calamity in the process.

Thanks for reading, and have a wonderful day,

-Dr. Paul Thomas with Plum Health DPC

Want to take a deeper dive? Read our book, published on Amazon.

 Paul Thomas MD at the Detroit Public Library speaking about Direct Primary Care.

Paul Thomas MD at the Detroit Public Library speaking about Direct Primary Care.

 Paul Thomas MD of Plum Health DPC speaks at the Detroit Public Library about Direct Primary Care and making health care more affordable and accessible.

Paul Thomas MD of Plum Health DPC speaks at the Detroit Public Library about Direct Primary Care and making health care more affordable and accessible.

Paul Thomas MD Speaking at Michigan State University

This week, I was invited to speak at Michigan State University College of Osteopathic Medicine regarding Direct Primary Care. It was a neat experience because the school has three campuses and my lecture was simulcast to the other two campuses. I spoke at the Detroit location (did you know that Michigan State University has a medical school campus in Detroit?) and the talk was broadcast to the East Lansing and Macomb campuses.

The lecture was an hour, and in the first 45 minutes I discuss the current crisis in primary care, I define Direct Primary Care, and then I give real-world examples of how Direct Primary Care is working in our clinic in Southwest Detroit. During the last 20 minutes, I answered as many questions as I possibly can.

I love speaking with students about our healthcare system and about Direct Primary Care because I see the lightbulb go off - I see them ‘get it’ and understand the model and why it works well. I love witnessing that moment - the “aha” moment.

A few students bought my book about Direct Primary Care after the event and the pictures below are of me signing the book. Thanks for reading and have a wonderful day.

-Dr. Paul Thomas with Plum Health DPC

Get your copy of the book, Direct Primary Care: The Cure for Our Broken Healthcare System

  Signing a book  for one of the Michigan State University College of Osteopathic Medicine Students.

Signing a book for one of the Michigan State University College of Osteopathic Medicine Students.

 Dr. Paul Thomas MD of Plum Health DPC signing the book,  Direct Primary Care: The Cure for Our Broken Healthcare System  after a speaking engagement at Michigan State University College of Osteopathic Medicine in Detroit, Michigan.

Dr. Paul Thomas MD of Plum Health DPC signing the book, Direct Primary Care: The Cure for Our Broken Healthcare System after a speaking engagement at Michigan State University College of Osteopathic Medicine in Detroit, Michigan.

Dr. Paul Thomas at the Future of Family Medicine Conference

Last month, I had the opportunity to speak with over 100 students and residents interested in the specialty of Family Medicine. This was at the aptly named “Michigan Future of Family medicine Conference” hosted by the Michigan Academy of Family Physicians. The event was held at Michigan State University and hundreds of students were able to attend on a Saturday morning in October.

 The invitation for the fifth annual Michigan Future of Family Medicine Conference, hosted by Michigan State University and the Michigan Academy of Family Physicians (MAFP).

The invitation for the fifth annual Michigan Future of Family Medicine Conference, hosted by Michigan State University and the Michigan Academy of Family Physicians (MAFP).

For students, it can be hard to get excited about the future of Family Medicine. Family Physicians work long hours, have to deal with tons of insurance bureaucracy and red tape, and earn less than their colleagues in other specialties. It can leave students deflated.

 Dr. Paul Thomas of Plum Health DPC speaks at the Michigan Future of Family Medicine Conference 2018 Panel on Career Options, taken from the Michigan Academy of Family Physicians’ (MAFP) twitter account, here: https://twitter.com/MIFamilyDocs/status/1051106817705725953

Dr. Paul Thomas of Plum Health DPC speaks at the Michigan Future of Family Medicine Conference 2018 Panel on Career Options, taken from the Michigan Academy of Family Physicians’ (MAFP) twitter account, here: https://twitter.com/MIFamilyDocs/status/1051106817705725953

However, I find that when I speak about Direct Primary Care and the opportunities that a DPC model of care can provide, students are energized and excited about the future of family medicine. You see, Family Medicine Doctors have the most tools in their tool set and can have the biggest impact on the community level - we lower admission rates to hospitals and decrease the cost of care for our patients. We also lower the rates of disease and death rates from disease.

But, as mentioned previously, Family Medicine is less desirable from the student’s perspective as it pays less and is a difficult job because of insurance hassles.

I think our profession, Family Medicine, is at a real moment of crisis, but also at a crossroads for opportunity. We can continue to be a part of the healthcare industrial complex, billing and coding, racking up charges on our patients, or we can adopt the Direct Primary Care model and serve our patients and our community with affordable and accessible health care services that are more just and compassionate in their delivery.

That’s my message, I’m glad to have had the opportunity to share it, and I’m very happy to have seen it resonate with so many energetic and eager medical students and residents.

Thanks for reading, and have a wonderful day,

-Dr. Paul Thomas, MD with Plum Health DPC, a Direct Primary Care service in Southwest Detroit

 Dr. Paul Thomas of Plum Health DPC speaks at the Michigan Future of Family Medicine Conference 2018 Panel on Career Options, taken from the Michigan Academy of Family Physicians’ (MAFP) twitter account, here: https://twitter.com/MIFamilyDocs/status/1051097050086035456

Dr. Paul Thomas of Plum Health DPC speaks at the Michigan Future of Family Medicine Conference 2018 Panel on Career Options, taken from the Michigan Academy of Family Physicians’ (MAFP) twitter account, here: https://twitter.com/MIFamilyDocs/status/1051097050086035456

 I had the pleasure of speaking to an audience of over 100 + Medical Students and Medical Residents at the Michigan Future of Family Medicine Conference in October 2018. I shared the stage with Dr. Sheala Jafry, Dr. Fatin Sahhar, and Dr. Amy Keenum. The event was held at Michigan State University and hosted by the Michigan Academy of Family Physicians (MAFP).

I had the pleasure of speaking to an audience of over 100 + Medical Students and Medical Residents at the Michigan Future of Family Medicine Conference in October 2018. I shared the stage with Dr. Sheala Jafry, Dr. Fatin Sahhar, and Dr. Amy Keenum. The event was held at Michigan State University and hosted by the Michigan Academy of Family Physicians (MAFP).

Plum Health serves a Health Professional Shortage Area

Plum Health serves a Health Professional Shortage Area, and we’re proud to do this. Part of our mission is to deliver affordable, accessible health care services in Detroit and beyond. This is important because we are passionate about making health care available to communities that have been traditionally neglected by the existing medical system.

Unfortunately, doctors and hospital systems choose to locate their practices in neighborhoods and communities that have higher income levels and higher rates of private insurance coverage. You see, doctors in the current fee-for-service system only receive what they are paid by third party payers, like Medicare, Medicaid, and private insurance companies.

And some of these payers pay more for services than others. For example, Medicaid reimbursement is much lower than Medicare reimbursement or Private Insurance reimbursement. This really hurts Detroit as a greater proportion of Detroiters rely on Medicaid for health insurance relatives to other counties in our region.

Therefore, the current fee-for-service system incentivizes doctors to locate their practices in higher-income communities, and thus leaves lower-income communities medically underserved. As an example, the ratio of primary care physicians to general population in Detroit is roughly 1 primary care physician for every 6,300 residents. In Oakland county, there’s about 1 primary care physician for every 683 residents.

Below are the medically underserved areas in Detroit as of 2017. We are proud to be practicing in the Southwest Detroit/Corktown neighborhoods and serving our neighbors, community members, and small businesses with high-quality medical services.

2018 Plum Health DPC serves a medically underserved neighborhood in Detroit.png

Thank you for reading and understanding this important issue,

-Dr. Paul Thomas, MD with Plum Health DPC in Detroit, Michigan

More on the above map: Health Resources and Services Administration (HRSA), a Federal Agency, develops shortage designation criteria to determine whether a geographic area, population group or facility is a Health Professional Shortage Area (HPSA) or a Medically Underserved Area/Population (MUA/P). HPSAs may be designated as having a shortage of primary medical care, dental or mental health providers. They may be urban or rural areas, population groups, or medical or other public facilities. MUAs may be a whole county or a group of contiguous counties, a group of counties or civil divisions, or a group of urban census tracts in which residents have a shortage of health services. MUPs may include groups of persons who face economic, cultural or linguistic barriers to health care.

Additional information on Medicaid rates in Wayne county, take from MLive:

Medicaid Rates in Wayne County.png
Michigan Medicaid Map.png

Plum Health DPC on WDET

This week, we ran an advertisement on WDET with the Corktown Business Association. I have been a long-time fan, listener and supporter of WDET and it’s one of the best places to advertise for our business because the people who listen to WDET are those who think and care deeply about Detroit and the issues facing the city.

Also, WDET does an excellent job of informing the public about important issues of the day and it’s a great platform for community-level information and journalism.

At Plum Health, we are addressing the lack of health care and primary care resources in the City of Detroit, and we know that this mission resonates with people who care about the city and its future.

As a part of the Corktown Business Association, we work with other business owners in the neighborhood to make it a better place to live, work, shop, eat, play, and be healthy. I’m proud to be in the Corktown Business Association and I’m glad we had the opportunity to tell the story about a wonderful place to be with vibrant businesses, Corktown Detroit.

Here’s the spot that we sponsored on WDET, with some images added from our archive:

Thanks for reading, and have a wonderful day,

Dr. Paul Thomas, Physician with Plum Health DPC

Paul Thomas, MD Speaks at Oakland University William Beaumont School of Medicine

This week, I was able to speak at the Oakland University William Beaumont School of Medicine to a group of about 50 enthusiastic first and second year medical students on September 24th, 2018. This presentation focuses on the philosophy and practice of Direct Primary Care and the main points of a DPC practice.

I believe in Family Medicine and I believe in Family Medicine doctors and their ability to fix our broken healthcare system, to remake it into a compassionate, intuitive system that delivers comprehensive care.

Because of this belief, I speak as often as I can to medical students, residents, doctors, and allied health professionals about Direct Primary Care and its transformative power in our healthcare ecosystem.

Thanks for reading and watching,

-Dr. Paul Thomas, family medicine physician practicing at Plum Health DPC in Southwest Detroit

I had a blast speaking at the AAFP Direct Primary Care Conference

I cannot tell you how much fun I had speaking at the AAFP DPC Conference, I loved it this much:

 Dr. Paul Thomas speaking about Branding and Marketing your Direct Primary Care practice at the American Academy of Family Physicians Direct Primary Care Conference in Indianapolis, Indiana.

Dr. Paul Thomas speaking about Branding and Marketing your Direct Primary Care practice at the American Academy of Family Physicians Direct Primary Care Conference in Indianapolis, Indiana.

Seriously, I had an amazing opportunity to speak directly with my Direct Primary Care colleagues about Branding and Marketing your Direct Primary Care practice at the American Academy of Family Physicians Direct Primary Care Conference in Indianapolis, Indiana. 

I believe that our family physicians are the backbone of the health care system in America, and I am encouraged and enthused by their willingness to step into their own power and create ideal practices that optimally serve their individual patients and their greater communities.

I'm all in on helping my colleagues create their best practices and to become the doctors they were meant to be. One of the biggest challenges that doctors face is in the realms of branding and marketing as most family physicians have little or no training in these areas. 

What I conveyed in my lecture was how to create a brand, engage in branding your practice, and actively market your practice. I'm posting about this again because I'm that amped up and because the lecture is now live on the AAFP website, here

Thanks for reading and for watching! Below are some bonus screenshots from the talk. If you're an individual looking for this type of care for yourself, your family, or your employees, please call me at 313.444.5630 or send me an email at paul@plumhealthdpc.org. If you're a DPC doctor and you need help branding and marketing your practice, reach out to me because I'm happy to help.

Sincerely,

- Dr. Paul Thomas, MD, physician with Plum Health DPC in Southwest Detroit 

How to Find the Best Prescription Drug Prices in Detroit

As many of us are aware, the price of prescription drugs can be astronomical. People are paying for a retail markup at pharmacies, often paying 10 - 20 times as much as the drug actually costs at wholesale. Even worse, insurance companies often charge more for medications purchased via your insurance plan than the medication would cost if you bought it at the cash price. 

Why is this important to me? I'm a Family Doctor in Southwest Detroit and I took an oath to do no harm, and for me that oath also includes doing no financial harm. So, I am focused on lowering the cost of health care for my patients and the greater community. 

How to find the best prescription drug prices in Detroit

If you're like many people, you probably go to the pharmacy with your Rx card or prescription card from your health insurance company. You then have the pharmacist 'run the card' to find out if you get a discount when you purchase medication. 

What you should do instead is ask the pharmacist, "what is your cash price for this medication?" Also, you can ask for any coupons that the pharmacist might have. If you are dissatisfied with the price, then pull out your insurance card and ask for them to 'run the card'. This will ensure that you have a fair price point to start from. 

In addition, you can shop around for the best prescription drug prices in Detroit or in your local community by comparing prices online. Using tools like GoodRx.com can help you find the exact price for the medication you need. 

Using Direct Primary Care to Lower Drug Prices

There is another option to find even lower prescription drug prices. That option is called Direct Primary Care. In the Direct Primary Care model, doctors aim to provide as much value as possible for patients' health care dollars. In simple terms, we DPC doctors try to lower the cost of health care. 

What does this look like? It looks like 70% - 90% savings on prescription drug prices in Detroit and the Metro Detroit Area. Just check out this chart and see for yourself the actual, wholesale cost of the medication compared to the price you would pay at the pharmacy with the retail pharmacy mark up, or the inflated price. 

 Original image taken from  Consumer Reports .

Original image taken from Consumer Reports.

 

How do we do this? At Plum Health DPC, we buy the medications at a wholesale price and then we sell them to our patients at-cost. This means if we buy a bottle of 1000 blood pressure medications at $10, each pill costs 1 cent. Then your monthly prescription cost for that blood pressure medication is 30 cents.

In the above example, we are able to get Pioglitazone (Actos) for $4.30 per month, Celecoxib (Celebrex) for $6.47 per month, Duloxetine (Cymbalta) for $7.04 per month, Atorvastatin or Lipitor for $2.09 per month, and Clopidogrel or Plavix for $4.28 per month. The total monthly cost would be $24.18 for our patient, and that is a huge cost savings compared to the nearest retail pharmacy.

By lowering the cost of medications, we can improve access to primary care services, better control blood pressure and diabetes, and therefore decrease the risks of heart attacks, strokes, and complications of diabetes in our community. This will lead to lower rates of disability and death, or a healthier society. 

We are proud to make a difference in this way. Thank you for reading and learning about the cost of prescription drugs, and let me know if I can help you or a family member lower the cost of health care.

Sincerely,

- Dr. Paul Thomas, MD with Plum Health DPC

Speaking at the AAFP DPC Summit 2018

Speaking at the AAFP DPC Summit

This weekend, I had the privilege of speaking at the American Academy of Family Physicians' (AAFP) Direct Primary Care Summit 2018. The DPC Summit 2018 took place in Indianapolis, Indiana from July 13th - 15th and we shared best practices about Direct Primary Care.

 Several of the founding members of the Direct Primary Care Alliance, an organization advocating for the needs of the independent DPC doctors, including Dr. Paul Thomas, MD, Dr. Ryan Neuhoffel, Dr. Julie Gunther, Dr. Phil Eskew, Dr. Nicholas Tomsen, Dr. Landon Roussel, Dr. Amy Walsh, Dr. Delicia Haynes, Dr. Jeff Gold, Dr. Luke Van Kirk, Dr. James Gaor, Dr. Staci Benson, et al.

Several of the founding members of the Direct Primary Care Alliance, an organization advocating for the needs of the independent DPC doctors, including Dr. Paul Thomas, MD, Dr. Ryan Neuhoffel, Dr. Julie Gunther, Dr. Phil Eskew, Dr. Nicholas Tomsen, Dr. Landon Roussel, Dr. Amy Walsh, Dr. Delicia Haynes, Dr. Jeff Gold, Dr. Luke Van Kirk, Dr. James Gaor, Dr. Staci Benson, et al.

The name of my talk was "DPC Hustles Harder", an homage to the entrepreneurial spirit and can-do attitude of my home town summed up in the phrase "Detroit Hustles Harder." I also see several parallels between Detroit and the DPC movement - embattled, not fully understood, at a crossroads, with the potential to grow rapidly. 

I named my talk DPC Hustles Harder because as a DPC doctor, your name is not on the back of your patients' insurance card and you will not get referrals from large health care systems or their doctors or administrators. In fact, as a DPC doctor, you have to go out, pound the payment, write for local papers, write blog posts, send emails, and leverage social media platforms to reach your target audience.

All of this can be a ton of work and it can feel overwhelming, especially for physicians who haven't had any formal communications or digital marketing training. So I set out to simplify the tools and processes for doctors to reach more patients. 

I did this because I believe in the Direct Primary Care model and the DPC movement, it's ability to lower the cost of care and deliver a higher quality of service for patients, families, and communities across our nation. I sincerely believe in the abilities of my DPC colleagues, and I want to help and uplift their efforts. 

I don't have the full video version of my presentation, but I will post it as soon as it's available. For now, I have several pictures taken by my colleagues (see below), some great memories from connecting with my colleagues, and a deep sense of gratitude for the ability to teach others about how to overcome challenges when it comes to branding and marketing their Direct Primary Care practices. 

Thanks for reading and have a wonderful day,

- Dr. Paul Thomas with Plum Health DPC

 Speaking at the American Academy of Family Physicians Direct Primary Care Summit 2018, my lecture was called DPC Hustles Harder and it focused on Branding and Marketing your Direct Primary Care Practice. 

Speaking at the American Academy of Family Physicians Direct Primary Care Summit 2018, my lecture was called DPC Hustles Harder and it focused on Branding and Marketing your Direct Primary Care Practice. 

Wayne State University School of Medicine History Presentation

Our video has been posted online! I had the opportunity to present the history of Wayne State University School of Medicine, and it is now available as a YouTube video. Check it out, below.

Thanks for reading and watching!

- Dr. Paul Thomas with Plum Health DPC

 

How is Plum Health Making an Impact?

Family Medicine Doctor Reaching Out in Detroit

 Dr. Paul Thomas speaking to elementary school students at Munger Elementary/Middle School on Detroit's West Side during Career Day.

Dr. Paul Thomas speaking to elementary school students at Munger Elementary/Middle School on Detroit's West Side during Career Day.

This week, I engaged in two outreach events, one at Munger Middle Elementary/Middle School on Detroit's West Side and one at the Northwest Activities Center in NW Detroit. The first event had me speaking to a group of about 30 elementary school students, sitting cross-legged on a gym floor. We talked about what it takes to become a doctor, the dreams that they had for their futures, and the steps that it would take to achieve those dreams. They even made me a nice gift for coming out - a small paper doctor. 

 Dr. Paul Thomas at Munger Elementary/Middle School on the West Side of Detroit.

Dr. Paul Thomas at Munger Elementary/Middle School on the West Side of Detroit.

The event at the Northwest Activities center had me speaking to about 100 senior citizens who had innumerable questions about health and wellness. They asked me about everything from high blood pressure, to diabetes, to nutrition, exercise, arthritis, and declining cognitive function. Also at this event, the community had organized fresh food distribution.

 Dr. Paul Thomas at the Northwest Activities Center in NW Detroit after speaking to a group of senior citizens about health and wellness.

Dr. Paul Thomas at the Northwest Activities Center in NW Detroit after speaking to a group of senior citizens about health and wellness.

Both were inspiring in different ways, and also showed how we can make a big impact by reaching out to the community and educating people from elementary age to senior citizens. I think a lot about impact, and how we're making a positive impact in the community, and I wanted to share an essay I wrote earlier this month:

How a Family Doctor Makes an Impact

The problem that I am solving is access to affordable medical care, not just for individuals, but also for small businesses and communities. On the individual level, I cannot count the number of people who have presented to our clinic to establish care with a family doc for the first time in years, sometimes even decades. They feel comfortable because the price point is understandable, services and charges are transparent, and we've created a welcoming environment for all people.

I’ll give the example of the lifelong Detroit resident who had a uncontrolled blood pressure, who avoided medical care because the cost was simply too high. She signed up for a membership with us, and we are managing her blood pressure with medication that costs under $2/month. She is now at goal, and cried in our office after reaching this critical threshold.

Next, we’re solving a big problem for small businesses. Small business owners want to provide services and benefits that will help them attract and retain employees, and often times traditional health insurance products are financially out of reach. Rather, they choose to provide Plum Health and our health care services for their employees: an affordable product that’s understandable and easy to access for their workers. We are now seeing small businesses that are proud to offer our service as a benefit to their employees as a mean of attracting and retaining talent.

Finally, we’re solving the problem of neighborhood-based primary care services in Detroit, a city that is critically underserved from a primary care perspective. There are fewer than 100 primary care doctors in the City of Detroit, equating to roughly 1 doctor for every 6,300 residents. We are meeting a significant need in our Southwest Detroit location by serving a community that otherwise would not have access.

Thanks for reading, and have a wonderful day,

- Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan

The History of Wayne State University School of Medicine

This week, I was invited to give a presentation on the history of Wayne State University School of Medicine during its Sesquicentennial Celebration. Yes! The WSU SOM is 150 years old, and it has a rich history of diversity, inclusion, and innovation that should be celebrated. Interestingly, the history of the Medical School is the history of the University, as the University grew out of the Medical School. While I can't cover the entire history in a single blog post, I will give some highlights from the early years of the college below. When the full presentation is released later this year, I will post it to the blog as well. 

 Theodore A. McGraw, MD, founder of the Detroit Medical College, which would later become Wayne State University School of Medicine.

Theodore A. McGraw, MD, founder of the Detroit Medical College, which would later become Wayne State University School of Medicine.

The Detroit Medical College was founded in 1868 by five returning Civil War Veterans. One can only imagine the horrors that they saw on the battlefield and you can also imagine the inadequacy that they felt in treating wounded soldiers. In the 1860's, aseptic surgical techniques were only beginning to be used and anesthesia was not fully understood. 

Can you imagine what it might have felt like to be a battlefield clinician, and not having the proper tools or training? Dr. Theodore McGraw, founder of the Detroit Medical College is quoted as saying: "I had discovered in my two years of army activity that I was deficient in that exact knowledge of anatomy that was essential to good surgery.  The advent of antiseptic and aseptic surgery, besides, had opened a new field for operative work, that of the abdomen, which demanded a study of anatomical relations which had never been taught in the schools."

Dr. Theodore McGraw was focused on both teaching and learning, and that desire is summed up in this quote "We entered into the matter with unbounded enthusiasm – enthusiasm for teaching and developing ourselves."

To this end, the charter of the Detroit Medical College elucidated how this would be achieved. In the charter (pictured below), it is written that "Pains will be taken to instruct each Student in PRACTICAL DIAGNOSIS. For this purpose the advanced Students will be called upon in turn to examine patients. After pronouncing a Diagnosis, questions will be asked in relation to differential symptoms... ...Little benefit can result to the Student from seeing cases diagnosticated and treated by the Professor of Practical Surgery and Medicine, unless he is first allowed to exert his own powers, and test his own knowledge, by personal examination of the patients."

 The Detroit College of Medicine charter from 1868, signed by founding physician Thodore A. McGraw, MD. The charter puts forth the founding principles of the institution. 

The Detroit College of Medicine charter from 1868, signed by founding physician Thodore A. McGraw, MD. The charter puts forth the founding principles of the institution. 

This ethos of having students practice medicine, to serve the community, and to learn by doing, echoes throughout the history of the School of Medicine. This is the very foundation of the University and the key to its enduring greatness. It is also the reason that I chose to attend WSU SOM - I wanted to immerse myself in the diversity of the city and the breadth of clinical opportunities available in Detroit, from serving homeless and uninsured patients in community clinics to learning from some of the leading minds and researchers in the country at the University clinics. 

At its inception, the Detroit Medical College set up a relationship with Harper Hospital and St. Mary's Hospital, which allowed students to learn from and serve the people of Detroit. The focus is, and has always been, learning by doing. The early photos below illustrate these tenets. 

 

 

The above photo series include the following images: first is the Detroit Medical College, which housed the medical school after 1868, the second image shows students during anatomy lab sometime around 1900, which is not very different than anatomy lab at the School of Medicine today. The third image is St. Mary's Hospital, one of the two clinical training sites after 1868. The fourth image is the operating theater at St. Mary's Hospital in 1898. The Operator is Dr. Henry O. Walker. At his left, hands behind his back, is Dr. Theodore McGraw, the founder of the Detroit Medical College who emphasized teaching by doing. The final image is Harper Hospital, the primary clinical training site for students at the Detroit Medical College. 

It was an honor to be able to relay the history of Wayne State University School of Medicine to my physician colleagues this weekend, and it is a great reminder of what makes doctors from Wayne State unique and so  skilled - the focus on hands-on clinical training and the diversity of the people we have the privilege of serving. 

Thanks for reading,

- Dr. Paul Thomas, Physician with Plum Health DPC

 

Plum Health at TechTown Detroit

This week, I was invited to speak at TechTown Detroit's Retail Boot Camp, and as a proud alum of the program, of course I said "yes!"

If you're unfamiliar, Retail Boot Camp is about training young entrepreneurs and equipping them with the skills to start or grow a small business in Detroit. Some successful graduates of the program include House of Pure VinParamita SoundTribalfare, Mama Coo’s BoutiqueThird Wave Music and 2015 Hatch Detroit winner Live Cycle Delight.

The students had 45 minutes to ask me anything about my business and about what it takes to be a successful business in Detroit. I participate in events like this because small businesses are the backbone of a successful economy. I'm a life long resident of Southeast Michigan and I want to see Detroit and its surrounding communities thrive. Part of having thriving communities and growing economies is having a robust start-up/entrepreneurial ecosystem. 

Below are some photos from the session! Thanks for reading,

- Dr. Paul Thomas, MD with Plum Health DPC

Plum Health on Bonfires of Social Enterprise

Last month, I had the pleasure of being interviewed by Romy Kochan on her podcast, Bonfires of Social Enterprise. Bonfires of Social Enterprise is focused on highlighting social entrepreneurs and we were happy to be featured on this podcast!

I believe that Plum Health DPC is a social enterprise because we not only focus on growing the business in a traditional sense (revenue, profit & loss, etc...), but we also focus on making a positive impact in the community by providing a medical service that is much needed the SW Detroit community. 

Romy was a great interviewer and made me think differently about my own practice, prompting me to say something I've never said before. She asked if I could dream big, and envision a future for what I'm doing, what could this look like?

I responded by saying, "I think this could look like a nation where we get rid of these old notions of what 'good health care' looks like, and starting to realize that it doesn't look like a piece of plastic in our wallet. It looks like a relationship with someone in our community that is a healer, that can listen, and has time to address your concerns".

2018 Plum Health on Bonfires of Social Enterprise.jpg

The conversation had a broad scope from how we got started, to the impact we're having, to the reaction to our service from the community. Here's how Romy describes it:

We’re back with another episode here on social enterprise. We have a doctor on this show who has been making a big impact in Detroit. It is Dr. Paul Thomas of Plum Health Care DPC. He has a dream of changing the notion of health care from a plastic card in your wallet to true healing from a healing doctor!  What a concept!

This was a wonderful interview and I am so grateful to Romy Kochan for having me on her podcast. Check out the full episode here, and have a healthy week!

- Dr. Paul with Plum Health DPC

PS: you can find this episode on the podcasting platform of your choice:

I Tunes

TuneIn Radio

Stitcher

PRX.org (Public Radio Exchange)

Google Play

I Heart Radio

PPS: Follow us on Instagram!

Plum Health with the Black Health Academy

Last month, we had a great visit from and interview with Lisa A. Smith with the Black Health Academy. We first met during a small business course with the Build Institute in Detroit, and it was great getting back together for this interview! She has a passion for health and wellness and helping people reach their full potential. Here's how she tells her story on her webpage:

Lisa A. Smith, MBA, is the founder of Professionally Fit INC and The Black Health Academy. She began her own weight loss journey in 2012 at 190 lbs. She fell in love with fitness, nutrition and self-development, lost over 60 lbs and gained a bottomless amount of confidence. It wasn't until she gained confidence in her physical health that she was able to gain confidence in her career. With her new found confidence she launched Professionally Fit in July of 2015. Professionally Fit is an executive coaching platform which provides both the customization and accountability necessary for high performing entrepreneurs and executives to achieve their health and wellness goals from anywhere in the world.

Health disparities in detroit

Our conversation focused on health and wellness in the black community. There are almost unbelievable health disparities between white Americans and black Americans, and we discuss some of these differences during our interview. Lisa also highlights these disparities on her website

Here are the facts:

  • 47.8% of African Americans are considered overweight or obese
  • African Americans are 20% less likely to be treated for depression
  • 13.6% of African Americans have fair to poor health
  • 40.9% of black men over the age of 20 have high blood pressure
  • Heart disease, cancer and stroke are the leading causes of death in the black community

Topics covered during our masterclass

During our Masterclass, we discuss these health disparities, what inspired me to become a physician, the community-focused efforts at Wayne State University School of Medicine, why other physicians might not practice in a more community service-oriented way, what Plum Health is, how we manage the volume of patients in our practice, our range of services or scope of practice, the type of feedback that we've been getting from our members, trends in African American health, on not making assumptions about people's health and meeting people where they're at, and on making lifestyle recommendations versus taking medications

I really loved this interview with Lisa A Smith - it was like siting down with an old friend. If you want to learn more about her and what she does, please visit the Black Health Academy or follow her on Facebook

Thanks for reading and watching, and have a wonderful day!

- Dr. Paul Thomas with Plum Health DPC

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A Sample of Lab Test Cost Savings

A friend posted this image on Facebook with the notation: "thank God for health insurance". 

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While it's important to have health insurance, it's also important to understand how it inflates and distorts prices for health care. In the above photo, the insurance price for laboratory testing is shown clearly. What's interesting is if these labs were obtained through our clinic, they would have cost a fraction of the amount reported. Here's a test by test comparison:

 

 

 A comparison of lab costs between typical insurance billing and our prices at Plum Health DPC

A comparison of lab costs between typical insurance billing and our prices at Plum Health DPC

What's crazy here is that the person is being billed at a 765% mark-up from the actual cost of the service. This is why health care in America is so much more expensive - hospitals and health care providers dramatically mark up costs and then 'discount' these costs for insurance companies.

This price 'gamesmanship' is bad for health care consumers. It's bad for folks with insurance and even worse for folks who are uninsured. For example, if this person had 80/20 insurance coverage for these labs, they would end up paying $162.20 - the insurance company would 'pay' $658.80 or 80% and the insured person would pay the remaining 20% of costs or $162.20. 

However, if this person were uninsured, they would bear the full brunt of these charges. The uninsured person would pay the entire $811 for labs that actually cost $106. 

Thanks for reading, and have a great day,

- Dr. Paul Thomas with Plum Health DPC

Plum Health DPC Mentioned in Business Insider

This week, I was delighted to see Plum Health DPC mentioned in two different publications. The first was an excellent, comprehensive piece on Direct Primary Care in Business Insider by Lydia Ramsey.

Ms. Ramsey and I have spoken over the phone about the Direct Primary Care movement, and she asked several insightful questions about our practice in Detroit, Michigan. She has spoken with roughly 16 other DPC doctors and synthesized a great summary of the movement in her article.

I loved the chart she used to compare and contrast traditional Fee-For-Service medicine with Direct Primary Care services:

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Next up, we were mentioned in the South Florida Sun-Sentinel article on Direct Primary Care written by Ron Hurtibise. The article discusses Direct Primary Care and the efforts in the Florida Legislature to make DPC 'legal' in that state. 

Fortunately, in Michigan, Direct Primary Care has been 'legalized' via the efforts of State Senator Patrick Colbeck and his Senate Bill No. 1033. I have placed legal and legalized in quotations above because practicing Direct Primary Care or retainer-based medicine is not illegal, but having laws on the books like Senate Bill No. 1033 in Michigan and the proposed HB 37 in Florida removes any potential legal challenges and allows doctors who want to practice DPC medicine a clear path.

And we need more doctors having a clear path to the type of medical practice that they can enjoy and sustain for the long term. We need more doctors practicing primary care medicine. One of the arguments against DPC is that the panel size is smaller in the typical DPC practice as compared to the traditional Fee-for-Service practice. In the Sun-Sentinel article, a part of my LinkedIn article was quoted:

"As to the charge that Direct Primary Care contributes to the shortage of primary care doctors, Paul Thomas, a doctor with Plum Health DPC, wrote in an essay published on LinkedIn.com last year that the model might actually encourage more medical students to become primary care doctors, rather than pursue higher-paying specialty fields.

"A Direct Primary Care practice with 500 members can provide a primary care provider with more income than some earn with 3,500 patients at a fee-for-service practice, Thomas wrote. And the increased time for personal interaction eliminates “role strain” and allows the provider to address patients as whole people, he said.

I believe that Direct Primary Care practices provide physicians and patients with a better primary care experience, and will allow doctors to practice for longer periods of time without retiring early or leaving the field completely because of burnout. I'm happy to see the DPC movement spreading across the country, and I'm happy to be quoted in these two publications.

Thanks for reading!

- Dr. Paul Thomas with Plum Health DPC

Guy Gordon Discusses Direct Primary Care on WJR

Today, Guy Gordon and Senator Patrick Colbeck discussed Direct Primary Care and the potential impact that it can have on the health and wellness of Michigan residents as well as the sustainability of the Michigan economy. The discussion was held on WJR News Radio (AM 760).

My name is Paul Thomas, M.D. and I am a family medicine doctor practicing in Southwest Detroit. I believe that healthcare should be affordable and accessible for everyone. I also believe that we can achieve this goal through direct primary care medicine.

It is a dream of mine to see and help more family doctors and primary care physicians transition from the fee-for-service model of healthcare to the direct primary care model. This will allow more doctors to deliver compassionate, truly patient-centered care with transparent pricing in our great state of Michigan. 

To this end, I will be speaking at the Michigan Academy of Family Physicians statewide conference in mid July in Kalamazoo, Michigan about this very topic.

Thanks so much for reading and watching, and have a wonderful day!

– Dr. Paul Thomas, M.D.

Heart Health in Detroit Video

Because it's February and it's heart health month, I shot a short video about high blood pressure, changes in blood pressure thresholds, and what you can do to keep your heart healthy!

Heart Health on SEEN Magazine

Today is Valentine's Day and it's a great time to talk about heart health aka cardiovascular health. We were invited to write a blog post for Detroit's SEEN Magazine and it is now live and currently on their front page! Head over to their website to read the full article, here.

Thanks for reading,

- Dr. Paul Thomas with Plum Health DPC

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