Michigan

Plum Health at Crain's Detroit Homecoming 

Last week we attended Detroit homecoming at the Lexus velodrome sponsored by Crain’s Detroit. It was an event that brought together small business owners in Detroit and members of the Detroit expat community.

First of all, the Lexus velodrome is a really cool and exciting venue! It is a four lane track and there were cyclists racing at certain points of the event which was cool to see. In the middle of the track was a spectator spot with a bar and meeting areas for the small business owners, journalists, and members of the expat community to enjoy. Around the track there was booths for small businesses to set up and that is where we has the opportunity to interact with each other and the expats.

For me it was great to see the Detroit expats getting excited about small business and the growing entrepreneurial community in the city and it was nice to have some of them lend their expertise, knowledge, and insights during the event

The evening programming/after party was held at the Corner where they had a live band and an opportunity to get onto the historic Tiger’s stadium surface and hit some dingers!

In closing this was another fantastic event and a sign of the momentum in the Detroit entrepreneurial ecosystem.

Thanks for reading, and have a wonderful day,

-Dr. Paul Thomas with Plum Health DPC

 Dr. Paul Thomas, MD of Plum Health DPC at the Crain’s Detroit Homecoming Event at the Lexus Velodrome in Detroit, Michigan.

Dr. Paul Thomas, MD of Plum Health DPC at the Crain’s Detroit Homecoming Event at the Lexus Velodrome in Detroit, Michigan.

Plum Health at the Michigan Central Station

Yesterday was a momentous occasion - Ford Motor Company announced their purchase and their plans for the historic and beautiful Michigan Central Station. The Michigan Central Station has been abandoned since the mid-1980's, and it has been an eyesore on the Detroit skyline for the past 20 years. 

The empty station had been an emotional thorn in the side, constantly nagging at Detroit, reminding Detroiters of their past prominence, but also standing as a signal of our post-industrial economic failures.

But all of those bad feelings have been erased after today's event. Now, there's a sense of pride that Detroit has an opportunity to remake this historic site in the best way possible. The event at the Michigan Central Station felt inclusive, as community leaders from several different sectors were invited to be seated on stage. 

There's also the impending economic impact of having thousands of Ford Motor Company employees working out of the Michigan Central Station in about 4 years. 

As a lover of Detroit, Detroit history, and architecture this was a great day for me. As someone who cares deeply about the health of Detroiters and the prosperity of the region, this was one of the best days for me. 

I am hopeful that the benefits of having Ford Motor Company in Detroit will be felt and experienced by all Detroiters - employment and economic prosperity is a key to having great health. 

As a physician and a family doctor in Southwest Detroit, with our office just two blocks behind the historic and now revitalizing Michigan Central Station, I'm excited for the future challenges and opportunities. 

Thanks for reading and watching,

- Dr. Paul Thomas with Plum Health DPC

Plum Health DPC is a family medicine practice in Southwest Detroit that delivers affordable, accessible healthcare. We remove the profit takers between you and your doctor, lowering the cost of healthcare. Our memberships are $10/month for children and start at $49/month for adults. This allows you to have contact with me, your doctor, any time you need me, as well as the ability to purchase wholesale medications and receive lab work at-cost. To start your journey with Plum Health, head over to our scheduling page: https://www.plumhealthdpc.com/schedule/

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.

The Radically Accessible Doctor in Detroit

This week, we took on a new patient on a Sunday evening. They had developed a pretty serious abscess in their armpit over the Thanksgiving weekend. On their drive home, they realized that they should probably have it looked at. By searching Google, they found our clinic!

 Our new patient searched "Doctor Open Today", that's when they found Plum Health DPC!

Our new patient searched "Doctor Open Today", that's when they found Plum Health DPC!

Because it was a Sunday evening, they knew that it would be difficult to find an available doctor in Detroit. They searched "Doctor Open Today" and fortunately found our Plum Health clinic. 

I believe that health care should be affordable and accessible. Because of that belief, I am radically accessible for the patients in my care. 

So, that patient called around 2:30 pm on Sunday, and I was able to see them at 4:20 pm. We drained the abscess and started the appropriate antibiotic, dispensed from our in-clinic/on-site pharmacy. They had a follow up appointment during regular business hours on Tuesday, and was feeling much better!

Thanks for reading, and have a great day!

- Dr. Paul Thomas with Plum Health DPC

Starting a Direct Primary Care Practice in Detroit: What Inspired Me

I initially discovered direct primary care while on a road trip in November 2012. I was driving back to Detroit from a residency position interview at the University of Minnesota. I believe it was a libertarian-minded podcast featuring an interview with Dr. Josh Umbehr, discussing his startup in Wichita, Kansas, called Atlas MD. 

It was refreshing to hear a Family Medicine doctor speaking so passionately about saving people money, delivering better care, and practicing in a unique way. The message resonated with me, but at that time I was pursuing a faculty position at a residency program because I enjoyed teaching so much. Suffice it to say that I filed this “Direct Primary Care” concept in the back of my mind.

Between my second and third years of residency, I went to the Michigan Academy of Family Physicians (MAFP) annual meeting in Traverse City. It was July 2015. There I met Dr. Clint Flanagan of Nextera Healthcare in Denver, Colorado. He spoke unequivocally about the value of being a primary care doctor and the tremendous value that we provide for our patients. His passion for the profession also came through in a way that I hadn’t experienced before.

These two leaders in the field served as a contrast to the typically burnt out and grumbling physician that I had met thus far in training. Even the best doctors grumbled about paperwork, prior authorizations, late patients, packed schedules, and all of the other difficult parts of being a primary care doctor.

At that point, I knew that I would pursue an alternative practice model. It only made sense – less-than-fulfilled physicians practicing in a less-than-ideal system surrounded me and I knew that life could be better on the other side. Additionally, I always had this inner drive to deliver medicine in a more equitable and just system. Direct primary care seemed to align with my values as an individual and as a doctor, but I needed to dive deeper.

So, as an elective rotation, I drove out to Wichita and Denver, and spent a week learning from both Drs. Umbehr and Flanagan. I kicked the tires, took copious notes, and tried to bring the best of their practices to my community in Detroit, Wayne County, and Southeast Michigan.

Now it's September 2017 - almost 5 years after I had initially heard of "Direct Primary Care". Now, I'm living DPC every day, taking care of people of all ages and stages in my clinic in Southwest Detroit. I'm even caring for people while on vacation - I helped about 10 of my patients while I was traveling abroad over the last week. 

I am able to do this - to be the doctor that I was meant to be - because I am a Direct Primary Care doctor. This post is about inspiration, and what inspired me, and what continues to inspire me.

I am inspired by the fact that I can help people with real health care needs either in my office or over the phone, or via video chat or email. I am inspired by the fact that I am able to serve people who haven't seen a doctor in years, because we've lowered the cost barriers and therefore have made our service more accessible. I'm inspired by the fact that we can do so much good in such a small space.

I'm also inspired by the potential for Plum Health to grow, and to serve more people in our immediate community and across the region. I'm inspired by the happy patients that I get to work with everyday.

I've had great mentors along the way, specifically from the pioneers in the Direct Primary Care world, and I'm grateful for their help in getting me to a successful and sustainable DPC practice. 

Thanks for reading this reflection, and have a wonderful day,

-Dr. Paul with Plum Health DPC

 Dr. Paul Thomas of Plum Health DPC, in the Plum Health office!

Dr. Paul Thomas of Plum Health DPC, in the Plum Health office!

How Many Direct Primary Care Practices in Michigan?

The number of Direct Primary Care doctors in Michigan is difficulty to quantify. A reasonable place to start is with a definition of what Direct Primary Care is and is not. Philip Eskew is both a lawyer and a DPC physician over at DPC Frontier, and he sets forth a good criteria: 

FOR THE PRACTICE TO QUALIFY AS A DIRECT PRIMARY CARE, IT MUST:

1) CHARGE A PERIODIC FEE 

2) NOT BILL ANY THIRD PARTIES ON A FEE-FOR-SERVICE BASIS, AND

3) ANY PER VISIT CHARGE MUST BE LESS THAN THE MONTHLY EQUIVALENT OF THE PERIODIC FEE

I wanted to apply this definition to the State of Michigan, my home state, to see how many "DPC" practices meet this criteria. As far as pure Direct Primary Care offerings open to the public, there are two: Chad Savage, MD with YourChoice in Brighton and Plum Health DPC in Detroit. 

There are other Hybrid DPC offerings within clinics that also bill third party insurance companies: Dr. Younes in Dearborn, Dr. Tindle in Grand Blanc, and Dr. Kevin Roy in Saginaw. I take issue with the Hybrid practices, because you lose the accessibility piece that makes DPC such a great delivery model - these doctors are still seeing a significant number of insurance-based patients and offering DPC to a subset of patients. So if a DPC patient needs to be seen, they "jump the line" and are seen ahead of the insurance-based patients. This is less than ideal.

Premier Private Physicians offers what I would define as Concierge Care or Concierge Medicine. The membership is $200/month or $2400 for the year and some labs and vaccines are billed to insurance companies. Visits are included, but they do not have contracts for at-cost meds, labs, or imaging because their patients are typically high income earners/wealthier people who are not as cost sensitive. 

The other category of "DPC" in the State is employer-based DPC. Some large employer groups like United Shore have contracted with a "DPC" provider like SALTA or ProactiveMD to have on-site doctors to care for their employees. These practices are not open to the public and people who are not employees at these companies cannot access these services.

Because the access to care is limited, this operates more like a third party structure as the large company finds that it saves money to pay a capitated rate for each employee to an on-site doctor, rather than the patient using their employer-provided insurance to seek out urgent care or emergency services. Unfortunately, employees may start to use the "DPC" doctor more for urgent care type visits and less for primary care, chronic care, or preventive services. 

If you wanted to include all of the above practices in the definition of DPC, there are roughly 8 "DPC" providers in the State of Michigan. My argument is that there are only 2 "pure" or authentic DPC practices in the State of Michigan. Sincerely, I would love to see more doctors taking the plunge into authentic DPC medicine, and am here to inspire, encourage, and consult other doctors to do just that. 

If you want to add to the conversation or debate, please send me a message or write a comment below!

Thanks for your time,

- Dr. Paul with Plum Health DPC 

Plum Health DPC in Grosse Pointe

On Tuesday night we were invited to speak to a group called the Eastside Republicans at the Grosse Pointe War Memorial in Grosse Pointe Farms, Michigan about Plum Health and Direct Primary Care. 

Other speakers were Chad Savage, MD of YourChoice Direct Care and Senator Patrick Colbeck, a staunch supporter of Direct Primary Care in Michigan. This is a part of a tour across the State, a series of events across Michigan where Senator Colbeck and Direct Primary Care doctors talk about free market options in healthcare. 

This was the largest crowd on this tour, and there were about 100 people in the audience. There were some great questions asked and good information shared about DPC, health shared savings plans, and unique solutions for employers. 

The next event will be in St. Clair Shores on April 24th - mark your calendars!

Thanks for reading and have a great day,

- Dr. Paul with Plum Health

What is Family Medicine?

Hello, this is Dr. Paul Thomas with Plum Health DPC and I'm a Family Medicine Doctor in Detroit. I operate Plum Health Direct Primary Care, which delivers affordable, accessible health care services in Detroit. 

This week, I'm talking about Family Medicine Week, an official announcement from Governor Rick Snyder that makes February 19th - 25th Family Medicine Week. I'm a month late in bringing this up, but it's still important to recognize Family Medicine and the contribution of Family Medicine Doctors across the State of Michigan.

For starters, Family Medicine Doctors compete four years of undergraduate education, four years of medical school, and three years of residency. That's 11 years after high school and 7 years after college. Furthermore, some Family Medicine Doctors sub-specialize within Family Medicine. 

They complete a 1 year fellowship to become Sports Medicine doctors, or Family Medicine doctors that sub-specialize in adolescent medicine, geriatric medicine, addiction medicine, etc...

The point is that Family Medicine doctors are highly trained, and specialize in taking care of the whole patient in the context of the family and the community. 

Family Medicine doctors care for people of all ages and stages! We help deliver babies, we help infants meet developmental milestones, we complete school, work, and sports physicals, we take care of injuries like fractures and lacerations, and we take care of chronic conditions like diabetes, high blood pressure, and asthma. 

Family Medicine doctors also work across a variety locations. Family Medicine doctors work in emergency departments, in-patient hospital settings, and out-patient clinics. Family Medicine doctors lead health departments for Cities, Counties, and States. Family Medicine doctors teach at medical schools, volunteer at homeless clinics, and travel abroad with organizations like Doctors without Borders. 

Personally, I love being a Family Medicine Doctor - I love taking care of people regardless of their age, race, gender, and orientation. I love being able to offer care and compassion to those who need it, along with the standard medical care. 

Finally, we need more Family Medicine doctors to create healthy communities, healthy cities, and a healthy nation. Family Medicine doctors address small issues before they become big, complicated problems. Family Medicine doctors and Primary Care Physicians can effectively increase the health of a community and lower the cost of care in that community.

Primary Care and Family Medicine is vital, and I'm glad that we have a week to recognize the work that Family Medicine doctors carry out each day in the State of Michigan.

Thanks for your time, and have a wonderful day,

- Dr. Paul Thomas

Plum Health Featured in Healthcare Michigan

On February 9th, I was invited as a panelist at the Future of Healthcare event at Wayne State University School of Medicine. While at the event, I met Paul Natinsky, a writer for Healthcare Michigan. Friendly, outgoing and genuinely interested in the work that I was doing, Mr. Natinsky and I scheduled to meet up a few weeks later. 

When Mr. Natinsky came to our Plum Health office, he brought his tape recorder and camera, and most importantly he brought his insight and some tough questions. We talked for well over an hour on a variety of subjects. This week, he released his notes from that meeting in the form of a publication in Healthcare Michigan.

The work that we're doing with Plum Health is the feature story in the March 2017 issue, and we couldn't be happier about spreading the word about Direct Primary Care in Michigan. You can read the article in full, here.

Thanks for reading, and have a wonderful day!

- Dr. Paul