Primary Care Doctor

Plum Health teaming up with Veterans Care Network

Plum Health teaming up with Veterans Care Network

Plum Health DPC is teaming up with Veterans Care Network to provide affordable, accessible healthcare services to those who have served in the military. Veterans Care Network has set aside some funding to sponsor a few Veterans and help them receive primary care services. They chose to use Direct Primary Care because they know how valuable the services in the DPC model can be.

Plum Health DPC Serves Veterans in Detroit

At Plum Health, we’re passionate about serving veterans and providing excellent healthcare services to all people, but especially those who have served our country. One of the biggest concerns that my patients who are Veterans have is the level of customer service at the Veterans Administration hospital. We rectify that issue by focusing our care on the patient and making sure that they not only have excellent healthcare, but also an excellent experience.

We’re excited to partner with Veterans Care Network, and if you’d like to apply for this opportunity, follow this link.

Thanks for reading and have a wonderful day,

-Dr. Paul Thomas with Plum Health DPC

Veterans Care Network and Plum Health DPC team up to provide Direct Primary Care services for Veterans in Detroit, Michigan.

Veterans Care Network and Plum Health DPC team up to provide Direct Primary Care services for Veterans in Detroit, Michigan.

What is a Plum Health Membership?

What does it mean to be a member of Plum Health dpc?

What’s involved in being a member of Plum Health DPC? We hear this question often. So, it’s worth taking some time to address it head on. Plum Health is a family medicine service run by Dr. Paul Thomas. Our mission is to deliver affordable, accessible healthcare. We are unlike other offices in several ways. We highly value the doctor-patient relationship and we routinely spend thirty minutes to one hour with each of our patients per visit.

This time together is essential because it allows us to build a trusting relationship. When you’re a member of our practice, when you’re a member of Plum Health DPC, you have the opportunity to build this trusting and healing relationship with Dr. Paul Thomas over time.

In contrast, at a typical family medicine office in the fee-for-service or insurance-based system, doctors prioritize seeing as many patients as possible to increase their payments from insurance companies. This is why you may only have five to twelve minutes with a primary care doctor in the insurance-based system.

Committed to a long-term relationship between doctor and patient

Being a member of Plum Health means that you’re committed to being a part of the membership model. If you’re looking for a one-off visit or one-time services, Plum Health probably is not the right fit for you. However, if you’re looking for a dependable physician who is responsive to your calls, texts, and emails at anytime of day, who cares about you as an individual and not as another number, then Plum Health DPC will be a great fit for you.

Furthermore, we love taking care of people who believe what we believe - that health care should be individualized, that the doctor-patient relationship should be strong and seamless, that health care should be affordable and accessible. If you value these tenets like we do, then we’d love to have you as a part of the Plum Health DPC membership.

How much does a plum Health DPC membership cost?

A membership with Plum Health DPC costs $10/month for children, and starts at $49/month for adults. We have our full pricing structure here. With that membership, you can visit the office anytime without a copay. You also can call, text, or email the doctor anytime. Additionally, members of Plum Health DPC are able to get wholesale medications, at-cost labs, and at-cost imaging services at a fraction of the typical cost.

How do I sign up for a Plum Health DPC membership?

The signup process for Plum Health DPC is an easy one. Our online form takes about 5 minutes to complete. The form will ask for a credit card to complete the registration. Your card will not be billed until your account is confirmed by our staff and an appointment is made. We want to make sure you’re a good fit for our practice before we start billing you for the service.

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

Dr. Paul Thomas with Plum Health DPC

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 DPC on Channel 7 Action News Detroit

Plum Health DPC on Channel 7 Action News Detroit

This week, our clinic Plum Health DPC was interviewed by the journalists at Channel 7 Action News in Detroit. The piece will be airing on Monday September 24th at 11 pm, after the season 2 premiere of “The Good Doctor”. This will air on Channel 7 in the Greater Detroit television market.

I was very impressed by the depth of questioning and level of examination our Direct Primary Care practice received during the course of the filming and interviewing. The journalists at Channel 7 WXYZ Detroit did a phenomenal job of learning about our practice and what makes us unique.

They went into great detail about the membership pricing, the wholesale medications, at-cost labs, and at-cost imaging services. I came away with a greater understanding and appreciation for how much work goes into each and every segment that we watch on the local news and I am so excited to see the final piece, tonight at 11!

Thanks for reading and watching, teaser trailer after the break,

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

To make an appointment, call 313.444.5630. To enroll online, go to this link. To learn more, check out our main webpage.

Full Video from WXYZ Channel 7 News Featuring Dr. Paul Thomas of Plum Health DPC.

Video trailer of the WXYZ Detroit Channel 7 News Clip featuring Dr. Paul Thomas of 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

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

Motivation to Quit Smoking

We are all on a journey, and at Plum Health we like to guide people to better lifestyle choices. For example, if you're trying to quit smoking, we can help you by reminding you of your commitment. 

How do we do this? It's really simple, actually. We just send you a text message! Here's a real life example, sent to one of our members last week: 

Smoking Cessation in Detroit Text Message.png

These are real text messages, and this is a real patient. Their name has been removed for patient privacy sake, but you get the idea. When you're a part of Plum Health, you are someone who I think about and that I care about and that I want to help. Sincerely, whenever I think about this person, I send them a text and ask - "how's it going?"

And, there is a great deal of evidence to support these types of interventions. There is a systemic review/meta analysis on Text Messaging-Based Interventions for Smoking Cessation in the Journal of Medical Internet Research that came to this conclusion: "The current meta-analytic review provides unequivocal support for the efficacy of text messaging interventions for smoking abstinence."

That's why I send messages like this:

Quit Smoking in Detroit with Text Messages.png

Further, texting patients about their health can have different applications. For example, a text message to a patient regarding their exercise patterns or medication adherence can help them to achieve their goals.

So, what's your goal? How do you want to become healthier? Can I help you get there?

Thanks for reading, and have a great day!

- Dr. Paul with Plum Health 

Plum Health featured in Good Life Detroit

This week, Plum Health DPC was featured on the blog Good Life Detroit. Jennifer is the creative spirit behind Good Life Detroit, and she did a fantastic job writing about our clinic and Direct Primary Care in general.

I really appreciated her perspective as a mother - she notes in the article that she has 5 children! - and that she paid $125 for a 20 minute doctor's visit for one of her children. Contrast that with our clinic, her child could have been seen for a full year for $120, with as many visits as needed included in that price. 

This is how we make our primary care services valuable for the community that we serve. If you were not aware, Detroit is a large, low-income population. We recognize this as a fact, and have adjusted our pricing to be accommodating for the community that we serve. 

Another great point that she brought up in the article is the frustration that people can experience when trying to reach their doctor! Sometimes reaching the doctor can be like pulling teeth. She puts it more eloquently, here: 

"Another great benefit of Plum Health Direct Primary Care is patients have the opportunity to speak directly to Dr. Paul without the hassle of long wait times and call screenings. Instead of having to go through a series of steps just to talk to their doctor, patients can call, text, or email Dr. Paul directly. In some cases, some doctors require you to leave a message with the office staff for a callback.

"Most of the time the office staff member screen’s the doctor’s calls and you have to tell the staff member exactly what it is you need or what your question is. Then you wait for the doctor to call you back, which can be anywhere from the same day or one to two days later, all depending on the doctor’s schedule.

"Members of Plum Health have Dr. Paul’s cell phone number and email address. They can reach him anytime they need to ask a question in regards to their health."

There are several other great points that she makes throughout the article. I was really impressed at her depth and thoroughness. I also appreciate her helping to get the word out about affordable, accessible health care in #Detroit. We're trying to serve as many folks who need this type of care, and articles like these help us to reach communities outside of our circle of influence. 

Thanks for reading and have a wonderful day,

Dr. Paul Thomas with Plum Health Direct Primary Care 

Plum Health Direct Primary Care is in Detroit, Michigan. We practice old-fashioned family medicine, but we use technology to make ourselves more accessible to our patients when they need us! I love this graphic that Jennifer at Good Life Detroit created for us! 

Plum Health Direct Primary Care is in Detroit, Michigan. We practice old-fashioned family medicine, but we use technology to make ourselves more accessible to our patients when they need us! I love this graphic that Jennifer at Good Life Detroit created for us! 

I also really liked this graphic that Good Life Detroit made about our pricing tiers at Plum Health DPC - really easy to read and understand! 

I also really liked this graphic that Good Life Detroit made about our pricing tiers at Plum Health DPC - really easy to read and understand! 

Primary Care Clinic in Detroit

When I was a first year medical student, I worked with a group of my fellow medical students to build an outdoor medical clinic. We wanted to raise awareness about the lack of primary care services in Detroit, and we accomplished this by constructing an outdoor medical clinic.

Currently, there are roughly 50 - 100 primary care doctors in the City of Detroit. This equates to about 1 primary care doctor for every 6,000 - 12,000 residents, which is horribly underserved. In the future, I would like to see 1 primary care doctor in every single Detroit Neighborhood, from East English Village to Ford/Wyoming, from Old Redford to Lafayette Park. 

Having community primary care doctors creates a tremendous amount of value for the surrounding neighborhood - that doctor becomes a go-to person for folks who need health care and even emotional support. 

However, the current reality in Detroit is that folks either don't have access to a primary care doctor or are driving to the suburbs for their care. To illustrate that lack of primary care services, our group of medical students built an outdoor clinic as a part of the Heidelberg Project on Detroit's East Side or what you may call the McDougall Hunt Neighborhood. Of course, we had the approval of Tyree Guyton, who checked in on our work that day, and we also received some press from the Detroit Free Press and the Wooster Collective out of NYC. 

It was a simple clinic, with a reception desk, a door frame, a door, an exam table, and some chairs. On the door, we wrote all of the barriers to accessing health care services in Detroit and in the Nation. This was in 2009, when the debate over the Affordable Care Act was raging. 

I visit the location periodically, to see how it has changed over the years. The last time I visited the site was in September 2016 during the Tour de Troit, an annual bicycling event that takes riders around the city. Someone had added a skeleton and some body parts, and it looks like Tyree made his signature drawings of faces on our plexiglass wall. 

Plum Health may be in its infancy, but I know that we are already filling a need in the community in terms of primary care services. We recently surpassed 100 members and continue to grow, adding new members each week. We've taken care of newborns, toddlers, teens, and adults, and have addressed conditions ranging from sore throats to cancer.

As I continue to serve in the community, I hope to live up to the ideals that I put forth in this work of public art, to be the kind of community doctor that addresses the lack of access to health care in Detroit. I will also work to inspire the next generation of Family Physicians to take the leap into private practice in a community-based setting.

Thanks for reading, and have a wonderful day,

Dr. Paul Thomas with Plum Health DPC 

Common Criticisms of Direct Primary Care

In this blog post, I'm going to list some common criticisms to Direct Primary Care and my responses to these criticisms. 

In a traditional family medicine practice, each doctor typically sees a panel of 2,500 patients. If each patient comes in twice each year, that means roughly 100 visits each week, assuming that the doctor works 50 weeks each year, or roughly 20 visits each day. In Direct Primary Care, doctors reduce their clinic panel to 500 patients. Now, if each patient visits twice each year, the doctor will see 20 patients each week, or 4 patients each day. If each patient visits three times each ear, the doctor will see 30 patients each week, or 6 patients each day. This allows the doctor to spend up to an hour with each patient and use the remaining time in their schedule to answer phone calls, texts, and emails as well as handle the administrative duties that go along with running a Direct Primary Care practice.

The biggest criticism of doctors who switch from a traditional or fee-for-service practice to Direct Primary Care is this notion of patient abandonment. This means that if the doctor cuts down their practice from 2,500 patients to 500 patients, there will be 2,000 patients that are "abandoned" or without primary care services.

My response to this is simple: I will no longer perpetuate a bad system. In the current fee-for-service system, patients do not have enough time with their doctor for a thorough evaluation, for all of their questions to be answered, and to feel truly cared for. In the current fee-for-service system, doctors are rushing from room to room to room and are unable to provide the kind of high-quality care that their patients deserve,

In the current system, primary care doctors are marginalized and devalued, predisposed to burn out and leaning towards early retirement. Younger medical students see their burnt-out, grumbling, and overstretched attending doctors in Family Medicine and choose not to become primary care doctors in the first place. Why earn less than other specialties in a field that is less-than fulfilling? 

Direct Primary Care doctors are fighting to make primary care relevant again, to restore the doctor-patient relationship, and to create value for patients in a way that the current fee-for-service system cannot.

There's an old adage: "take care of yourself so you can care for others", and it's something that primary care doctors have forgotten about. The expectation of the system is that we should work hard, keep our heads down, and not question the health care administrators who send an overwhelming volume of patients into our clinics each day. 

But when we begin to sacrifice the quality of our work simply because we don't have enough time, it's time to take a stand and re-think our practices. 

This brings me to the next criticism: how many conditions can a primary care doctor really treat? aka how much coverage can a family medicine doctor really provide? 

When a well-trained family medicine doctor is able to practice at the top of their training, they are able to manage between 80 and 90% of all patient concerns. From sore throats, to blood pressure management, Pap tests, skin biopsies, abscess drainage, diabetic management, and beyond, family medicine doctors are able to care for a broad and diverse range of conditions. 

The secret sauce in Direct Primary Care is the amount of time we are able to spend with our patients. If I have an hour, I can use it to drain an abscess, to talk about the efficacy of your antidepressants, to draw your blood for the lab work you need, to remove that ingrown toenail, to fully evaluate your vertigo, to evaluate your child's Vanderbilt scores for ADHD, to dispense the necessary medications and more. 

In the current fee-for-service system, the expectation is that primary care doctors perform a cursory evaluation and then make a referral to a specialist. In the Direct Primary Care model, primary care doctors have more time to address concerns to the fullest of their training. And if that specialty referral is necessary, Direct Primary Care doctors have enough time to personally manage the transition of care, to make the follow up phone call and to get a full picture of what happened during that referral. 

To summarize, Direct Primary Care doctors who leave the traditional fee-for-service system are not abandoning their patients. Rather, they are now free to practice medicine to the best of their ability by having enough time to give high-quality, thoughtful, and comprehensive primary care services to their patients. This will allow burnt out doctors to stay in practice for a longer period of time and it may inspire the next generation of medical students to choose primary care. 

Thanks for reading, and have a wonderful day,

- Dr. Paul Thomas with Plum Health Direct Primary Care

 

Plum Health at Build Institute

This week, I was invited to sit on a panel at the Build Institute to celebrate their 5th year of investing in and uplifting small businesses in the City of Detroit. Fortunately, I was able to take and graduate from a Build Institute course over the summer of 2016.

This Build Institute Course allowed me to develop and solidify my business plan, make connections with fellow entrepreneurs, and tap into Build's ever-expanding network of small business owners and service providers. Through Build, I was able to be a part of big events like Detroit Homecoming sponsored by Crain's Detroit. I was also able to meet future customers and future service providers like my lawyer. 

On Wednesday, I was invited to sit on a panel of small business owners who have benefitted from the Build Institute's unique programming. It featured Lana Rodriguez of Mama Coo's Boutique, April Anderson of Good Cakes and Bakes, April Boyle of Build Institute, and Christianne Malone of Build Institute. 

After the panel, Steve Garagiola of Local 4 News (WDIV) asked if I'd be interested in an interview. I invited him to my office at 1759 West 21st Street, Detroit MI, and he came over with his cameraman. During the interview, we discussed the basics of what we provide at Plum Health DPC. 

I was surprised at how fast the turn around time was for the interview, as it aired during the 6 pm news on Detroit's Local 4 News. In case you missed it, here's the interview!

In addition, Kurt Nagl, a writer from Crain's Detroit wrote an article about the event and it appeared on their website on Tuesday. 

Thanks so much for reading and watching!

- Dr. Paul with Plum Health DPC

Match 2017 at Wayne State University School of Medicine

This week, I was happy to hear about the highly successful match at my alma mater, Wayne State University School of Medicine. On Friday, March 17th, WSU SOM matched 97.3% of its graduating seniors into residency programs! This rate is much higher than the national average of 93%. In addition, 40% of those new doctors will be training in primary care specialities. 

This is one of the points that I continue to emphasize: we need more primary care doctors in this country, in this state and in this region. And training primary care doctors begins with inspiring medical students to chose primary care specialties like Family Medicine, General Internal Medicine, Pediatrics and Obstetrics/Gynecology. 

In other news, this Saturday I volunteered at Cass Clinic. I try to get out to Cass every month, and this month I helped the medical students take care of about 15 or more homeless, uninsured, and otherwise medically underserved people in the community. This mostly consists of managing blood pressure and diabetes as well as performing physical exams for work or school opportunities, just like all other people.

Finally, I'm talking about the EpiPen - $600 if you buy it via Mylan Pharmaceuticals. What you're paying for is a patented delivery device as the actual epinephrine medication costs $2 at wholesale. When I make this for my patients, I use an AutoInject 2, which costs $35 and insert the epinephrine into a syringe and place the syringe in the Auto Injector.

My Beta name for this product is the Epinephrine Delivery Device (EDD). I probably need to come up with a better name, but it is epinephrine within the AutoInject 2 and it is roughly equivalent to an EpiPen. Here's the video from Saturday:

Stay tuned for more updates!

- Dr. Paul with Plum Health DPC

Opinion Published in the Detroit News

This week I wrote an opinion piece and it was published by the Detroit News! I'm very excited about getting the word out about the benefits of Primary Care and the work that needs to be done to address the health disparities in our city and in our region. Here's the link. A sincere thank you to Ingrid Jacques for giving me the opportunity to write this.

There are always constraints, with time and with resources, and the article was edited to fit the allotted space in the Sunday paper. So, here is the essay that I wrote in its entirety prior to editing by the News:  

If you live in the City of Detroit, you may find yourself driving to the suburbs for your primary care services.

According to top officials in the Detroit Health Department, there are roughly 50 – 100 primary care doctors in Detroit. For a city of 683,000 people, that’s about 1 doctor for every 6,000 – 12,000 residents, which is horribly underserved.

Interestingly, Wayne County as a whole has 1 primary care doctor for every 1,515 residents. But, the supply of doctors is not equitably distributed across communities within Wayne County. Areas like Grosse Pointe and Dearborn have a relative saturation, while cities like Inkster and Detroit remain underserved.

By contrast, Washtenaw County has 1 primary care doctor for every 598 residents and Oakland County has 1 primary care doc for every 655 residents. These are more equitable and desirable ratios.

We need more primary care doctors in our communities. Research has shown that as the number of primary care doctors increases, health outcomes improve and costs decrease.

Data released by the American Academy of Family Physicians reveals that an increase in one primary care doctor per 10,000 people reduces hospital admissions by 5.5%, ER visits by 10.9% and surgeries by 7.2%.

In an era of greater awareness of healthcare expenditures, that’s a lot of bang for your buck.

Unfortunately, the medical system does not incentivize primary care medicine. Specialists like Orthopedists, Cardiologists and Dermatologists are reimbursed at much higher rates than primary care specialists like Family Medicine doctors, General Internal Medicine doctors and Pediatricians.

And the graduating medical student is acutely aware of these discrepancies in pay.  The median level of med school debt for the class of 2015 was $183,000 and the total cost may surpass $400,000 if paid over the long term with interest.

As the average student considers an average salary of $443,000 as an Orthopedist or $204,000 as a Pediatrician, choosing primary care medicine becomes economically strenuous.

And for those doctors who choose primary care specialties, primary care offices are often set up in more affluent neighborhoods where the reimbursement levels are higher. These location selection decisions are often out of the hands of individual doctors and dictated by corporate, profit-driven health systems.

This suburbanization of primary care medical services has had a terrible effect for Detroit’s residents. WalletHub recently ranked the City of Detroit as the least healthy major city in the United States, ranking 150 out of 150.

After the WalletHub list was published, the former Health Department Director was quoted in a Detroit News article: “Detroit health chief Dr. Abdul El-Sayed wasn’t surprised with the results, which he blamed partly on the lack of doctor’s offices in neighborhoods, healthy food stores, transportation and safe places to exercise.”

But, there is hope. The longstanding work of free and low cost clinics like CHASS, the Student Run Free Clinic, HUDA, and Joy-Southfield Clinics should be acknowledged. It is also encouraging that the Michigan State University of Osteopathic Medicine Popoff Clinic on Mack Avenue on the East Side is complimenting these stalwarts. Additionally, a Direct Primary Care service, Plum Health DPC, in Southwest Detroit/Corktown is providing another option for Detroit residents.

Finally, as Downtown, Midtown and New Center become more sustainable, primary care services should begin to take hold with potential spill over benefits for adjacent neighborhoods.

Paul Thomas, MD

Family Medicine Doctor with Plum Health DPC

Thank you for reading, and have a wonderful day,

- Paul Thomas, MD

A newspaper clipping from this Sunday's Detroit News about health care and health disparities in the city of Detroit and the potential solutions to address them. 

A newspaper clipping from this Sunday's Detroit News about health care and health disparities in the city of Detroit and the potential solutions to address them. 

Plum Health at DNewTech Q&A

We were invited to pitch at DNewTech on Wednesday night, and after our pitch, we had 5 minutes to answer questions about Plum Health DPC. Here's the video of the event! 

You can see the original Pitch Video here, and you can see our original blog post here

One of the biggest barriers for people learning about our model is the difference between health care and health insurance. You need health insurance to protect you against the unknown or unforeseen: cancer, stroke, heart attacks and car accidents. Your health insurance should not cover your primary care services, because it introduces a middle man (or several middle men) between you and your doctor, driving up the price of those services. 

Health care is what we deliver at Plum Health. As your primary care doctor, I'm not that expensive and you're really paying me for my time. This allows me to answer your phone calls, texts, and emails in a timely fashion. It also allows me to get you in for an appointment when you need it, rather than having you wait for weeks just to be seen. 

Health care delivers the basics, like office visits, meds, labs, stitches when you cut yourself, and advice/counseling on lifestyle changes when you need it. Health insurance covers the unforeseen circumstances that are beyond our control. 

An analogy is auto insurance. We all have auto insurance, but we almost never use it, unless we're in an accident or our car is stolen. However, we don't expect our auto insurance to pay for the routine maintenance of our vehicles, like oil changes, tire rotations, and gas at the pump. If we did require our auto insurers to pay for these things, it would drive up the prices and make these basic services a hassle. Could you imagine long lines at the pump, prior authorizations to drive to Chicago, and auto insurance that only covers the basic oil, not the Valvoline. 

This would be an absurd way to take care of our cars. And I know that cars and people are different, but the way we've structured our health insurance coverage has caused very similar stress points to the imagined scenario above: long wait times to see your doctor, prior authorizations to get imaging studies like CT scans, and health insurance coverage that only covers some medications, but not others. 

In Direct Primary Care, we get rid of all of these middle men to deliver excellent, affordable services without the hassle. 

Thanks for reading and watching,

- Paul Thomas, MD

Vaccine Finder

Recently, I wrote a blog post about getting your flu shot! #GetYourFluShot And when I was reading articles on the CDC website, I came across Vaccine Finder. Vaccine Finder is a nifty online resource that allows you to enter your zip code to find the nearest clinic or pharmacy that dispenses vaccines.

It lists the basics like the address, phone, hours of operation and website. In addition, as the clinic or pharmacy owner, you can enter in the price of the vaccines that you dispense. As a Direct Primary Care clinic with transparent pricing, we did just that! You can see that our Influenza Vaccine costs $10.53, our Hepatitis A vaccine costs $68.42, and our TDaP vaccine costs $47.47. 

Another cool feature is that you can use the website to hail an Uber to get you to the vaccine dispensing location! 

FYI, we're in Corktown/Southwest Detroit, and if you enter in our zip code (48216), we will be the #1 result! 

Thanks for reading, and have a wonderful day, and #GetYourFluShot,

- Paul Thomas, MD

Flu Cases Increasing

You need a flu shot. I will say it again, you need a flu shot. Flu cases are on the rise currently, see this article from the CDC. Yes, the flu most commonly affects the very young and the very old, but each year young adults are hospitalized and die because of the influenza virus. I'm writing today to dispel some myths and tell you that you can be a part of the solution.

As a part of routine care at Plum Health, I offer a flu shot to all of my members. It costs $10.53 because I buy it at wholesale and I don't mark up the cost. Inevitably, objections are raised by my patients. The most common being "I've never had the flu, so I don't see the point in getting the vaccine" or "I seem to get the flu after I get the flu shot". 

First of all, the vaccine strain produced this year is a particularly good one. The composition of U.S. flu vaccines is reviewed annually and updated to match circulating flu viruses. Flu vaccines protect against the three or four viruses that research suggests will be most common. For 2016-2017, three-component vaccines are recommended to contain:

  • A/California/7/2009 (H1N1)pdm09-like virus,
  • A/Hong Kong/4801/2014 (H3N2)-like virus and a
  • B/Brisbane/60/2008-like virus (B/Victoria lineage).

Second, you can't get the flu from getting the influenza vaccine. When you get a flu shot (influenza vaccine), I inject inactivated viral particles, not the virus itself. By giving you inactive viral particles or proteins from the virus, your body's immune system is able to recognize these as foreign and mount an immune response. During that immune response, you may have a slight temperature and you may feel tired and your body shifts it's energy to meet your immune system's needs, but you will not get "the flu" because you don't have the whole virus. 

Because you get the flu shot, your body will recognize the actual virus should you get it. When your body sees the proteins that make up the virus, it will mount an even stronger immune response, killing the virus more quickly and keeping you out of the hospital.

Common places to pick up the flu virus include door knobs, the treadmill at the gym, the grocery store key pad, the gas pump, etc... You can't possibly disinfect all of these surfaces, so just do yourself a favor, be proactive and get the flu shot.

Importantly, influenza activity most commonly peaks in the United States between December and March. Additionally, the flu season can last until May. 

I say that you can be a part of the solution because you can prevent the spread of the flu. One, get the flu shot. If you happen to get the virus, it will be easier for your immune system to fight it and you will be less likely to pass it on to your loved ones. Even if you're "fine" without it, your grand parents, parents, children, nieces, and nephews may not. So, by protecting yourself, you can protect them.

Finally, wash your hands well! This is probably one of the best things that you can do to prevent the spread of germs, viruses, and bacteria. 

Thanks for reading and have a great day,

- Paul Thomas, MD

 

Our Influenza Vaccine stock at Plum Health DPC, a Family Medicine Practice at 1759 West 21st Street, Detroit, MI 48216. 

Our Influenza Vaccine stock at Plum Health DPC, a Family Medicine Practice at 1759 West 21st Street, Detroit, MI 48216. 

Volunteering at Cass Clinic

Volunteering in the community is an important part of what I do as a doctor. I enjoy helping medical students learn the basics of primary care and serving the community in this way.

This week, I'm at Cass Clinic for their Saturday Morning clinic. It's in Detroit's Midtown Neighborhood and they serve people without insurance, who are homeless, living in drug rehab centers or otherwise vulnerable.

I am grateful that the Wayne State University Medical Students continue to care for the community in this way as they run this clinic without much outside help. If you want to donate medication, bathroom supplies, or hats, gloves, and socks, there's a donation link on their webpage - www.cassclinic.com.

Additionally, I volunteer at the Student Run Free Clinic on the East Side of Detroit at 5555 Connor Ave, just south of I-94. I volunteer at the SRFC once a month and at Cass Clinic about once a month as well. 

I have been volunteering at the Cass Clinic since about age 17. I grew up attending a Methodist church and I was looking for unique volunteer opportunities. I came across the Cass Clinic as it is a part of the Cass Community Social Services, which is a Methodist organization. When I started volunteering, I worked with Medical Students at WSU SOM as they took care of patients in this setting. Watching these young medical students was an inspiration, and from that point on knew which medical I wanted to attend - Wayne State! 

In Detroit, just like in many communities, the needs are great. I know that a few half days a month will not save the world, but these small actions do make a big difference in the lives of the patients that we serve. 

Thanks so much for reading and watching!

- Paul Thomas, MD

February Update

Hey everybody! It's February 2nd and time for an update about our services and a little bit of an overview about what we do. January was our first full month of operation in a brick-and-mortar space and we were able to have 20 new members join the practice! We are currently located at 1759 West 21st Street, Detroit, MI.

What makes them want to join? First it's our dedication to great service. When you make an appointment, you typically get 1 hour of uninterrupted time with me, Dr. Paul Thomas. We talk about your medical history, review any records that you bring, perform a physical exam, draw any blood samples if necessary and give any medications if necessary.

The great thing about our Direct Primary Care model is that we get these labs at-cost and the medications at whole-sale prices. Our lipid panel is about $7 and our Comprehensive Metabolic Panel is about $4. Our current price for Azithromycin or a "Z-pak" is $1.15. We sell Lisinopril for about $0.40/month. Yes, you read that correctly! Forty cents for a one month supply of Lisinopril. 

I give Flu shots for $10.53, Hepatitis A vaccine for $68.42, Tetanus Diphtheria and Acellular Pertussis (TDaP) vaccine for $47.47. Our price for Metformin is $0.40/month if you take 1 pill each day and $0.80/month if you take 2 pills each day. I recently dispensed Augmentin for a skin infection for $4.82. 

If you're interested in this type of care: more time with your doctor, clear and consistent pricing, the ability to have easier communication with your doctor via text and email, you should sign up for our services.

You can either call 313.444.5630 to set up an appointment or enroll on our website, here.

Thank you for watching and reading, and have a great day!

- Paul Thomas, MD

An Interview with Dr. James Blessman

Today, I attended the monthly Wayne County Medical Society meeting. There were several topics discussed and my mentor Dr. James Blessman brought up an upcoming lecture. Dr. Joel Fuhrman will be at the Detroit School of Arts on February 2nd, 2017 at 6 pm (doors at 5 pm). There's more information at this link. Full video of the interview is below!

During the meeting at the Wayne County Medical Society of Southeast Michigan, several topics were discussed. Currently, the Detroit Public School system stresses abstinence first in their curriculum. This does not mean that the DPS teaches abstinence only, so a group of Medical Students from Wayne State University School of Medicine came to the meeting to clarify the curriculum and obtain the Medical Society's support. 

Additionally, the Medical Society discussed burnout and health habits among physicians, the recent increase in Hepatitis A cases in Wayne County, and the recent publication of a Human Trafficking Awareness video. As for the Hepatitis A, you can receive a shot for $10 via the Wayne County Health Department in Wayne, Michigan. At Plum Health, we wholesale the Hepatitis Vaccine for about $70 and in the insurance world, coverage varies depending on which private insurance company you use.

Dr. Blessman also brought up Joel Fuhrman, MD and his upcoming lecture at the Detroit School of Arts on 123 Selden Street in Midtown. The event will be held on February 2nd at 6 pm. Dr. Fuhrman is a leading thinker in the area of medical nutrition, with several best-selling books on the subject. He has been noted to say that the foods that you should eat include the "GBOMBS", or Greens, Beans, Onions, Mushrooms, Berries, and Seeds. The main point is that you want to have more micronutrients in the foods that you consume. 

Thanks for reading, and watch the video below!

- Paul Thomas, MD