Plum Health Blog
Is Direct Primary Care the Cure for Our Broken Healthcare System?
Is Direct Primary Care (DPC) the Cure for our Broken Healthcare System? That's the question that Caitlin Morse, PMP posed to me after reading my book with the same title (link to the book).
Direct Primary Care (DPC) is a growing model of health care across the Nation, but does it live up to the hype? This is the question from Caitlin Morse PMP in her article on LinkedIn, among other questions, below.
During this conversation between myself, Paul Thomas MD, and Caitlin Morse PMP, we discuss the following:
What happens when your DPC doctor is sick or goes on vacation?
What does Plum Health use for EMR/EHR if not a system designed to optimize billing?
Would this model break if all of the patients currently on Medicaid were switched to this model?
The difference between Direct Primary Care and Concierge Medicine.
What about childhood vaccinations? Public health facilities won’t vaccinate people with any insurance, even if self-pay. I was quoted thousands of dollars for out-of-network vaccines. These are included with every insurance plan at the PCP - are they included with DPC?
How does this model handle malpractice insurance/liability? Does more of a focus on preventative care expose primary care doctors to greater liability?
Could DPC provide follow-up for cancer patients in remission, stroke patients post-rehab, post-acute care, etc?
The claim is made that 80-90% of what the average patient needs could be addressed by a family physician at a DPC facility, but it would be helpful to understand what that number really represents and how it compares to the current use of PCPs. Is that 80-90% of a patient’s lifetime health needs or 80-90% of what the average patient goes to the doctor for in a single year? Or everything that 80-90% of the population need from a doctor? What percentage of healthcare costs does this represent?
Who are the people who use Direct Primary Care Services? What are their income levels? Why should a family sign up for Direct Primary Care?
These are questions that folks have about Direct Primary Care and how they can use these DPC services and benefit from them, so I’m happy to take the time and answer them. Thanks for reading and watching, and have a wonderful day.
-Dr. Paul Thomas with Plum Health DPC
Plum Health featured in Excelerate America's Tenacity Tales
This week we were featured in Excelerate America’s Tenacity Tales! Here’s what they said about us:
Imagine being able to access your doctor anytime by phone, text or email. And knowing that you can get in to see him or her that very day, or within 24 hours at the longest.
Well Dr. Paul Thomas and Plum Health DPC is making this revolutionary possibility a reality for hundreds of Metro Detroit, Michigan-based patients.
The concept is specifically called Direct Primary Care. It's a completely new healthcare movement, one that's so different than the system most people are used to that Dr. Paul was compelled to write a book about it.
He's also constantly invited to speak about it at large conferences and galas, and was even invited to the White House earlier this month as a guest of Health and Human Services Secretary Alex Azar.
Read more about Dr. Paul's incredible entrepreneurial journey in an all-new healthcare space.
What’s the obstacle that you’ve overcome that you’re most proud of?
This has been a big year!
Publishing the book, "Direct Primary Care: The Cure for Our Broken Healthcare System", has been a big accomplishment for me.
It was not difficult to write the book, but having the intentionality to move the book from a completed word document on my desktop computer to a physical product that you can buy on Amazon has been challenging, with several small obstacles to overcome week by week and month by month.
I guess it's a good metaphor for being in business—It's not hard to have a great idea, but it is difficult to have the consistency, grit, and intentionality to advance that idea every day and every week towards your stated goals.
Additionally, I'm proud of signing a lease to grow into a larger space. Our practice has grown from zero patients two years ago to over 425 patients today, so we will need a larger office to accommodate the diverse needs of our patients.
The process of signing a lease, designing an office space, and working with several different professionals to get the job done has been challenging.
What do you know now that you wish you’d known then?
Experience is the greatest teacher, and I've made several mistakes along the way.
My biggest mistake by far has been undervaluing my time and talents. I recently finished reading "Entrepreneurial You" by Dorie Clark and it talks about having the courage to charge for your services, including during speaking engagements.
I'm glad to have asked for payments for past speaking gigs, and I need to be better at valuing my time and talents with future consulting gigs and speaking engagements.
What’s your best advice to other small business owners?
If you're waiting for the perfect time to start, that moment when you feel ready, you'll never start.
One quote to reinforce this is from Hugh Laurie, the actor who played “House MD”. His nugget of wisdom is as follows: “It’s a terrible thing, I think, in life to wait until you’re ready. I have this feeling now that actually no one is ever ready to do anything. There is almost no such thing as ready. There is only now. And you may as well do it now. Generally speaking, now is as good a time as any."
Fortunately I had a really compelling reason to start my business, otherwise I may still be dragging my feet about the perfect time to launch. Anyways, a community member signed up online, before I was ready to start. He called me on a Tuesday saying "I just took my last antidepressant, so I need you to be my doctor now." That day, I ordered $100-worth of medications, including the antidepressant that he needed. The next day, I received the medications and made the house call to his rental.
All I had was my doctor's bag, my stethoscope, a blood pressure cuff, oximeter, my laptop, and the medications he needed, but I was able to meet a previously unmet need at an affordable price for this person.
So, my advice is to stop waiting and do the thing. Done is better than perfect.
What’s a typical day like for you?
I typically wake up and go for a run to get my mind and my body ready for the day. Then I make coffee and have breakfast.
Most days, I work in the office 9am - 5pm, sometimes 8am to 6pm or later depending on what needs to be done for which patients. A lot of my patients are working class folks, so they will need appointments outside of their typical eight hour shift and I do my best to accommodate them and deliver an excellent level of service.
I typically see 5-10 patients each day, and use my downtime to write blog posts, work on big projects, follow up on lab results or imaging results, order more medications, and leverage my social media channels to reach more customers.
For a solo entrepreneur, I catch myself spending too much time working on the minutia of the business rather than setting big goals for the business, i.e. working in the business rather than working on the business. Anyways, I'm looking forward to scaling up and adding another doctor so that I can focus more time on the big goals.
What’s next for Plum Health DPC?
Great segue (can we use bad jokes?).
I've mentioned before, but I just signed a lease for a 1,700 square foot space because we're reaching capacity in our small, one room office and I'm looking to grow both in space and in personnel.
My mission is to serve more of the Detroit community and Southeast Michigan with affordable and accessible health care services, so I am leveraging the tools I have available to meet these needs.
Look out for big things in 2019 from Plum Health DPC!
Direct Primary Care Book by Paul Thomas MD
Direct Primary Care: The Cure for Our Broken Healthcare System
This week, I had the privilege of publishing and releasing my first book, Direct Primary Care: The Cure for Our Broken Healthcare System. Here’s the blurb I wrote for the book on Amazon:
They said it couldn't be done. It wouldn't be possible to fix our broken healthcare system. It wouldn't be possible to fix a healthcare system that undervalues primary care and human relationships. But here we are, a courageous group of primary care doctors, tirelessly working to create value for our patients in communities across the country. This is the story of the Direct Primary Care movement, and how it could revolutionize not only primary care, but the entire healthcare system. The book begins by describing the current crisis in primary care and goes on to define the scope of Direct Primary Care. It closes with concrete examples of how the Direct Primary Care model is working at Plum Health DPC in Southwest Detroit.
It’s been a long journey from “idea” to “published”, and there’s still a lot of work to do promoting the book and getting it out into the world. I wrote the book because I believe that healthcare should be affordable and accessible for everyone, and I also believe that the Direct Primary Care model gets us closer to that goal. So, in the book, I set out to explain and describe the ethos of the Direct Primary Care movement and the work that I do in SW Detroit with Plum Health DPC.
Screenshot from Amazon.com with the Kindle version of the book. Direct Primary Care: The Cure for Our Broken Healthcare System.
Screenshot from Amazon.com with the Paperback version of the book. Direct Primary Care: The Cure for Our Broken Healthcare System.
Within 72 hours, these titles will be merged into one page on Amazon!
Author Page for Paul Thomas MD on Amazon.com
One of the things that I had to do to publish the book on Amazon, was to set up an Author Page for myself, Paul Thomas MD, on Amazon.com. My bio reads something like this:
Dr. Paul Thomas is a board-certified family medicine physician practicing in Southwest Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. His mission is to deliver affordable, accessible health care services in Detroit and beyond. He has been featured on WDIV-TV Channel 4, WXYZ Channel 7, Crain's Detroit Business and CBS Radio. He has been a speaker at TEDxDetroit and is a graduate of and Clinical Assistant Professor at Wayne State University School of Medicine. You can find out more at PlumHealthDPC.com.
It’s pretty neat and motivating to get working on the next book! I have a lot of ideas that I want to write about, mostly involving Direct Primary Care, and this was such a cool process.
The Process of Writing the Direct Primary Care Book
I wrote the book in about one week in January 2018. I thought I’d have it published in March. Boy was I wrong! After writing it, I sent the draft to some brave alpha readers, who read it and gave me feedback. That brought me to February. I then edited the draft with those suggestions and came up with a second draft, which I sent to some beta readers.
From there, Amanda and I edited the entire book and had the final draft. This was March. I still needed a cover design, formatting, promotional quotes from people I knew, and so many other things that I was naive to prior to starting this process.
In the spirit of Thanksgiving, I have a million people to thank, from those alpha readers to those who helped me design the cover through those who wrote blurbs for the book and my publisher. It definitely took a village to get this over the finish line. A very special thank you to Zain Ismail for writing the foreword.
Reception So Far
So far, the reception to the Direct Primary Care book has been good. We have been number one in the “Physician & Patient” and “Administration & Policy” categories on Amazon.com, which is exciting, and we broke the top ten for “Medical eBooks!”
Direct Primary Care: The Cure for Our Broken Healthcare System trending in Medical eBooks “Administration and Policy”.
Direct Primary Care: The Cure for Our Broken Healthcare System is trending in Medical eBooks “Physicians & Patient” Category on Amazon.com
Thanks so much for reading, I appreciate all of you, and enjoy the book!
- Dr. Paul Thomas, MD, Physician with Plum Health DPC and now author of Direct Primary Care: The Cure for our Broken Healthcare System
We’ve been getting a ton of support on Social Media, like our Facebook post. Follow us on Facebook, here: https://www.facebook.com/PlumHealthDPC/
We’ve been getting a lot of support on Social Media, like on our Instagram Page, follow us here: https://www.instagram.com/plumhealthdpc/