Health Care

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).

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 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

PS Follow us on Instagram

Plum Health on Daily Detroit

This week, we were featured on the Daily Detroit Podcast. It was great meeting up with Sven Gustafson and Jeremiah Staes, the journalists behind the publication, and hosting them in our office in Southwest Detroit. 

You can listen to the full episode here:

Here's what Sven Gustafson wrote about our practice, in the context of the interview:

Dealing with health insurance is few people’s idea of a good time — if you can afford it at all, that is.

Now, a doctor operating out of an office in a former Detroit Police Department precinct headquarters? That’s flipping the script on the traditional model of health care.

On this episode of the Daily Detroit Happy Hour podcast, we schedule an appointment with Dr. Paul Thomas of Plum Health in Southwest Detroit. He’s practicing a model known as direct primary care in which patients pay a membership rate, starting at $10 a month for children and climbing to $89 a month for seniors, directly to the doctor. In exchange, patients get more personalized care, better access and lower-cost medications, imaging and laboratory services.

Dr. Thomas, who graduated from the Wayne State University School of Medicine, estimates he can cover 80 to 90 percent of most people’s health care needs. So he acknowledges it’s not a complete solution to our country’s problem-plagued health care system.

We talk to Dr. Thomas about how direct primary care works, how it differs from traditional insurance-directed health care and how it affects both patients and his life as a working physician. He also tells us about the various ways he’s using digital technology to facilitate his job and market his business.

Find us and subscribe on Apple Podcasts or wherever fine podcasts are downloaded. Previous episodes are here.

Daily Detroit's tagline is "what to know and where to go in Detroit" - it's worth knowing more about Detroit, if you're a resident, a Metro Detroiter, or from another part of the world. Sven and Jeremiah cover interesting stories and give great insights, so their podcast is worth a listen/subscription. 

Thanks for reading and listening, and have a wonderful day,

- Dr. Paul Thomas with Plum Health DPC

A Sample of Lab Test Cost Savings

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

2018 Prices for Lab Work.jpg

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:

Direct Primary Care vs Traditional Doctor's Visits.jpg

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.

Plum Health Featured on the Detroit Rising Podcast

This week, Plum Health DPC was featured in Crain's Detroit Business in an article by Senior Reporter Chad Livengood. There is an accompanying audio recording of the interview, here

The Detroit Rising Podcast focuses on business and commerce and the intersection of Public Policy in Detroit. It was a pleasure to be featured on the podcast and on the Crain's Detroit website. Additionally, Chad Livengood brings excellent insights along with his investigative reporting. 

In the audio segment, Mr. Livengood states, "one of the biggest challenges to rebuilding Detroit is getting service-based businesses to set up shop after decades of disinvestment." And, Plum Health DPC is one of those service-based businesses, and it was exciting to discuss how we're making health care more affordable and accessible in Detroit.

During the interview, we talk about the Direct Primary Care business model, the availability of primary care physicians in Detroit, and what the City of Detroit is doing to improve the quality of life in the city. 

Thanks for reading and listening, and have a wonderful day,

- Dr. Paul Thomas with Plum Health DPC

2018 Plum Health Direct Primary Care Crains Detroit Business Chad Livengood.png

A screenshot from the Crain's Detroit webpage featuring our interview.

On February 20th, we were featured on the front page of the Crain's Detroit Business webpage, you just might have to squint to see us!

On February 20th, we were featured on the front page of the Crain's Detroit Business webpage, you just might have to squint to see us!

Detroit Medical Students Run a Free Medical Clinic

For the last 6 years I've been volunteering at a free medical clinic on Detroit's East Side called the Robert R. Frank Student Run Free Clinic or the SRFC. The SRFC services Detroit residents who are uninsured, and as their name implies, it is run by medical students.

Last night we had a stakeholders meeting and I am continually impressed by these medical students and their diligence, commitment, and compassion. 

If you'd like to help these students serve more uninsured Detroit citizens, you can donate here, participate in their upcoming 5K, or participate in their upcoming Golf Outing (date TBD)

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

2018.02.14 Detroit SEEN Heart Healthy.png

Plum Health on Jibs Podcast

This week Plum Health DPC was featured on Jibs Podcast, hosted by Jibran Ahmed. On the podcast he will be interviewing movers and shakers in the Detroit community and discussing topics that can move the city forward. 

From Jibran: "I'm hoping to create a platform that showcases the entrepreneurs, creatives, and hustlers that are moving Detroit forward. In order to make Detroit the city of the future, it's important to share with the world that this city embodies gusto, grit, and innovation."

During our conversation we talked about Plum Health and it's origin story. We also talk about why it's important for business people to build relationships in the community and how those early relationships can translate into a prosperous business.

We dove into the difference between Direct Primary Care and traditional or fee-for-service medical practice and discussed why more doctors aren't practicing in the DPC model of care. We also highlight the many community resources in the Detroit ecosystem that enable businesses in the City and region to thrive. 

Thanks for reading and watching!

- Dr. Paul Thomas with Plum Health DPC

Paul Thomas MD TEDxDetroit Video

THE DAY HAS FINALLY ARRIVED! Our talk at TEDxDetroit has been posted on YouTube! Check it out here: 

In case you missed the original blog post after the TEDxDetroit event, check out my thoughts on speaking during the event, here

Thanks for reading and have a wonderful day!

- Dr. Paul Thomas with Plum Health DPC

Detroit Businesses are Humming in the Motor City, via Inc.com

This week, Inc.com released a video in collaboration with Fiverr. It featured Detroit businesses, including Shinola, Excelerate America, and Plum Health DPC! They had this to say about the video:

Detroit's entrepreneurial scene is exploding with companies who are growing for good. Which is why this rejuvenating city was the perfect stop on our Doers Across America tour. The energy, vibrancy, and warmth was always present when meeting the incredible Detroit entrepreneurial community. There was so much to celebrate and learn from these resilient doers, and by the end of our time there, it was clear why Detroit is the embodiment of the “comeback kid.” 

You can find the full video, here, or in the YouTube link below:

Yes! Detroit's entrepreneurial scene is thriving and I was happy to be a part of this feature! The crew did a marvelous job filming and editing this piece on a tight time schedule - they brought a high degree of professionalism and the video is informative and interesting.

It's an exciting time to be an entrepreneur in Detroit - there is indeed a ton of energy, excitement and attention paid to this community of growing businesses. However, I would like to acknowledge all of those that make up the Detroit small business ecosystem that weren't featured in this video. I know that I would not be successful were it not for the thriving scene that I have immersed myself in. 

I'm hinting at a greater point here, which is best illustrated in an article by Ron Fournier, published in Crain's Detroit Business from October 2017: "Amid Detroit's post-bankruptcy resurgence, the money and attention heaped upon startups in downtown and Midtown threatens to overshadow long-running businesses in Detroit's neighborhoods. That startups are often run by young, white Detroit transplants arriving at the crest of an economic wave and "been-ups" are often owned by minorities who struggled through the worst of times feeds a "two-Detroits" narrative."

So, to all of those 'start-ups' and 'been-ups' in the community, thank you! Let's keep working together to make Detroit beautiful and prosperous!

- Dr. Paul Thomas with Plum Health DPC

One of the screen shots from the Inc.com and Fiverr video featuring Plum Health DPC

One of the screen shots from the Inc.com and Fiverr video featuring Plum Health DPC

Another still shot from the Fiverr and Inc.com collaboration video!

Another still shot from the Fiverr and Inc.com collaboration video!

Last Day For Open Enrollment

Hello all! It's December 15th and the last day to sign up for health insurance. Health insurance is different from Health Care. What I provide at Plum Health DPC is health care - visits with the doctor, wholesale medications, at-cost labs, convenience, etc...

But you also need health insurance - this is a financial tool to protect you from bankruptcy in case of major accidents, illnesses, or injuries. If you have cancer, a heart attack, a stroke or are involved in an auto accident, you need health insurance to cover these costs.

The best way to get health insurance? Go to HealthCare.gov and choose a plan that's right for you. 

Thanks for your time, thanks for reading and watching! And, sincerely, if you need help with this, give me a call!

- Dr. Paul 313.444.5630

These Mobile Businesses are Changing the Game in Detroit

Running a successful business is tough. Running a successful mobile business can be even more difficult! This week, I participated in a panel discussion that took a deep dive into what it takes to run a successful mobile business in Detroit.

The panel was a part of Build Institute's Open City series, and featured four business owners: Lisa Waud of Pot and Box, Alleah Webb of Drifter Coffee, Ebony Rutherford of Trish's Garage, and Paul Thomas, MD (that's me!) of Plum Health DPC. The panel was expertly moderated by Sarah Donnelly of TechTown Detroit

Build Institute's Open City Panel, featuring Ebony Rutherford, Alleah Webb, Paul Thomas MD, and Lisa Waud. The panel was moderated by Sarah Donnelly. The event was hosted by Build Institute's Christianne Malone.

Build Institute's Open City Panel, featuring Ebony Rutherford, Alleah Webb, Paul Thomas MD, and Lisa Waud. The panel was moderated by Sarah Donnelly. The event was hosted by Build Institute's Christianne Malone.

2017 Build Institute Ebony.png

Ebony Rutherford of Trish's Garage talked about the choosing the right events to attend, citing that it's easy to lose money by purchasing table space at a poorly attended event. However, turning lemons into lemonade, she would take that time at a slower event to work on her social media production and marketing.

Alleah Webb of Drifter Coffee has built a successful business around an Instagram-able/Pinterest-able mobile coffee house. Her business is among the most unique in Detroit, creating a mobile coffee experience for her audience.

2017 Build Institute Alleah.png

Alleah often participates in public events, like Noel Night, Open Streets Detroit, and MoPop Detroit, and she has also found success by catering to private events, like weddings. This all makes for an interesting story, and Drifter Coffee has gotten some great traditional media exposure, as in this Hour Detroit article

Lisa Waud of Pot and Box also created a ton of buzz from not only having a mobile flower shop, but also by creating The Flower House Detroit. In the panel, she talked about the pros and cons of operating out of a truck that can have adverse effects on their inventory. For example, when it's 90 degrees outside, the flowers can wilt in less than 3 hours if they are in the truck

2017 Build Institute Lisa Waud.png

As a business person conscious of profit and loss, she is considering the costs and benefits of continuing the flower truck operation. It's expensive to have insurance for a mobile business and it takes a lot of energy and staffing costs to operate successfully. 

Build Institute's Open City Detroit event, held at the  Atwater Brewery , 237 Joseph Campau Ave, Detroit, MI.

Build Institute's Open City Detroit event, held at the Atwater Brewery, 237 Joseph Campau Ave, Detroit, MI.

This was an important point in the conversation! Is a pop-up business/mobile business the end goal or a means to an end? Sometimes, a mobile or pop-up business can lead to a permanent brick-and-mortar establishment. On the other hand, some entrepreneurs prefer the mobile/pop-up business model as it can greatly reduce overhead costs. 

For me, having a mobile offering in the first few months of our operation of Plum Health allowed us to operate with a low overhead while building momentum. The goal was to engage enough customers to justify leasing out an office space. Once we had enough momentum, we were able to lease out our office and build from there. 

At Plum Health, we still offer house calls to our members, but now there is an added cost to these house calls, whereas house calls were standard in the first 2 months of operation. 

All in all, this was a great panel, and I learned a great deal from my fellow panelists and from the moderator, Sarah Donnelly. To the folks at Build Institute, thanks for the invite! And I'm looking forward to the next season of Open City!

- Dr. Paul Thomas with Plum Health DPC

Healthy Aging in Detroit

Let me tell you about one of my favorite things: educating people in the community about how they can be healthier. 

Today I was invited to the Earnest T Ford Recreation Center at 10 Pitkin Street in Highland Park to speak with a group of older men. They had questions and concerns about their health and their health care, and it was a pleasure speaking with them.

This group of senior citizens wanted to know how they could better their lives, and they peppered me with as many questions as they could think of, and I loved it. I love sharing my knowledge as a practicing family medicine doc with the people in my community. 

I especially enjoyed seeing the 'aha!' moments when things started to click with those men in my audience. We talked about high blood pressure, diabetes, erectile function and dysfunction, the aging brain, exercise, osteoporosis and bone health, and the connections between these conditions. Below are some pictures from the event!

Thanks for reading, and have a wonderful day,

- Dr. Paul Thomas with Plum Health in Detroit, MI

Don't Further Entrench an Already Broken System

Dear Congressional Representatives, Leaders in the AAFP, and all of those concerned with improving the health of Americans,

I’ve recently become aware of a part of the Alexander-Murray health reform bill that is concerning for the Direct Primary Care (DPC) movement, my practice and the patients that I care for in Southwest Detroit.

The bill includes a provision that mandates all High Deductible Health Plans cover an allotted primary care benefit. As written currently, the Alexander-Murray bill will cover “3 office visits per year” but many organizations, including the American Academy of Family Physicians (AAFP), are pushing to expand that.

While this may sound like a nice perk for patients, it only further traps patients and their primary care doctors in a broken system that undervalues primary care. It reinforces the notion that government and insurance companies must micromanage our dollars and decisions.

Forcing patients to pre-pay for a “primary care benefit” with no out-of-pocket costs will have a few detrimental effects. First, it will almost certainly increase the up-front costs of already skyrocketing health insurance plans. It will also dissuade patients from taking a proactive approach to managing their own health and health care, instead pushing them to be managed by an insurance plan or government programs. Finally, this pre-paid primary care benefit will discourage people from joining Direct Primary Care Practices, a promising practice model that is already achieving the quadruple aim: improving population health, increasing patient satisfaction, reducing per-capita health care spending, and improving physician and staff satisfaction while practicing medicine.

Furthermore, the Alexander-Murray bill fails to address the Health Savings Account (HSA) issue with regards to Direct Primary Care membership fees, something that my DPC doctor colleagues and I have been advocating for over the last few years.

My recommendation at this time would be to advocate for the Primary Care Enhancement Act (SB 1358), which would address the above HSA issue and not further entrench an already broken primary care delivery model.

In closing, Direct Primary Care is an innovative health care delivery model that has promise for achieving the quadruple aim on a nationwide basis. There are nearly 1,000 primary care doctors already practicing or on the cusp of engaging in this model. This is an opportunity to help us grow this DPC movement, to help us better serve our patients in this innovative way, and to potentially heal a broken primary care system in America. Help us reach our goal.

Thank you for your time and consideration,

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

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Mentoring Students at Wayne State University School of Medicine

Part of my mission, part of the "why" behind what I do, is to educate medical students and inspire them to choose a career in primary care specialties. Primary care doctors have the greatest impact on their communities, have the most tools at their disposal, and are most able to bend the cost curve in the health care ecosystem.

As a part of that mission, I spend a good amount of time interacting with medical students at Wayne State University School of Medicine (WSUSOM). This week, I took part in two different events at WSUSOM. The first was a mentoring session for first year students and the second was a mock interview session for the fourth year students. 

For the first year students, it's an opportunity to get to know each other, learn from each other, and to be a resource. For the fourth year students, it's an opportunity to help them polish their interviewing skills as they prepare for the next step in their careers - residency! 

This next generation of doctors will face significant changes and challenges in the health care system - from greater automation, to precision medicine, to even Artificial Intelligence. I hope that I can be a part of the foundation along with their formal education at WSUSOM that sets them on the right path to success in medicine. 

Thanks for reading, and have a beautiful day,

- Dr. Paul Thomas with Plum Health DPC