Wellness

How many calories should I eat each day?

How many calories should I eat each day? This is a question that my patients commonly ask of me and there is not a one-size-fits all answer. There are several steps to finding the appropriate calorie intake on a daily basis. One of those steps is calculating your basal metabolic rate

Once you know your basal metabolic rate, you can add in the amount of calories that you burn each day from exercising. If you jog for 30 minutes each day, you may burn about 200 calories. If you do yoga for 30 minutes each day, you can burn around 150 calories. 

Take the number of calories burned in the day and add that to your basal metabolic rate. If you have a reasonably stable weight, you can estimate that you are taking in about that calorie total in your diet. 

Then you have to consider your weight goals. Are you trying to lose weight or gain weight? If you seek weight loss, then removing 100 - 200 calories from your diet each day may be a safe number for you to achieve your goals. Remember, in general, it is unsafe to lose more than 1 - 2 pounds each month.

Using an app like MyFitnessPal can be really helpful, especially if you are meticulous about documenting the foods that you consume and workouts that you perform each day. If you're a patient with Plum Health, I will review your data in the App and then we can make better decisions about dietary changes and exercise regimens. 

In general, my opinion is more about eating healthier foods, not necessarily less food. I recommend eating foods discussed in "The End of Dieting", found on Amazon here: http://amzn.to/2snb78z

In it, Dr. Fuhrman recommends eating GBOMS, Greens, Beans, Onions, Mushrooms Seeds and Nuts. The point is to get more nutrients/calorie and he sums it up this way: Health = Nutrients/Calorie. The more nutrients per calorie, the better your health.

Kale, Bok Choy, Quinoa, Blueberries, Almonds, Walnuts, Wild Caught Salmon are a handful of examples of highly nutrient dense foods! This would be in contrast to Iceberg Lettuce, bananas, peanuts, and ground beef - these foods are less nutrient dense then the aforementioned foods. 

Making healthier food choices, especially those foods that are nutrient dense, can help you to be healthier. Further, if you make organic selections, you will have less toxins in your body. Physician and author Dr. Mike Dow discusses the importance of eating organic foods in his book The Brain Fog Fix

I hope that this is a helpful and comprehensive answer for you! Thanks for reading, and have a wonderful day,

- Dr. Paul Thomas with Plum Health Direct Primary Care in Detroit, Michigan

The Importance of Primary Care

Primary care is essential to having a healthy family, healthy community, and a healthy society. You may know a primary care doctor, like your Family Medicine doctor, General Internist, Pediatrician, or Gynecologist. These are the doctors that partner with you to create better health outcomes. 

There's been a great deal of research conducted about the benefits of having community doctors or primary care doctors. In an article from the American Academy of Family Physicians, it is noted that "an increase of one primary care doctor per 10,000 people has been shown to result in:

  • 5% decrease in outpatient visits
  • 5.5% decrease in inpatient admissions
  • 10.9% decrease in ER visits
  • 7.2% decrease in surgeries"

Further, counties with more primary care doctors have lower healthcare costs and better mortality rates. MLive.com wrote a nice piece about the importance of primary care doctors and they even have a tool so that you can evaluate how many primary care docs are in your community. In Washtenaw County, there's a primary care doctor for every 598 residents. In Cass County, there's a primary care doctor for every 7,463 residents. 

Washtenaw County is likely saturated with primary care doctors because it encompasses Ann Arbor and the U of M Health System. From the MLive.com article, "The U.S. Department of Health and Human Services' Health Resources and Services Administration has calculated that Michigan's supply of primary care physicians meet 63.3 percent of the population need." That means about 63% of the state is serviced with enough primary care providers. 

Unfortunately, Detroit itself is underserved. There are roughly 50 - 100 primary care doctors in Detroit for roughly 680,000 residents. That's roughly 1 doctor for every 6,000 - 12,000 residents in the City of Detroit. 

If you were to look at the data for Wayne County, which includes Detroit, Dearborn, Inkster, the Grosse Pointes, etc..., you would see that there's 1 doctor for every 1,515 people, which is a relatively equitable ratio. However, when you look closer at the distribution of physicians in Wayne County, you will see that several are concentrated in wealthier suburbs like Grosse Pointe and Dearborn. This leaves places like Detroit and Inkster underserved. 

The black dots on this map indicate the locations of licensed physicians. While there are a good number of doctor's offices in Wayne County, the distribution of these offices is skewed with a higher concentration of offices in Dearborn and Grosse Pointe than in the City of Detroit itself. This image was a part of a larger presentation given by former Detroit Health Department Director and now Candidate for Governor of Michigan, Abdul El-Sayed. In case you were wondering, the yellow stars indicate pop-up clinics planned by the City of Detroit Health Department to distribute contraceptives. 

The black dots on this map indicate the locations of licensed physicians. While there are a good number of doctor's offices in Wayne County, the distribution of these offices is skewed with a higher concentration of offices in Dearborn and Grosse Pointe than in the City of Detroit itself. This image was a part of a larger presentation given by former Detroit Health Department Director and now Candidate for Governor of Michigan, Abdul El-Sayed. In case you were wondering, the yellow stars indicate pop-up clinics planned by the City of Detroit Health Department to distribute contraceptives. 

One of the several reasons why I've started Plum Health in Detroit is to address the health disparities and access to care issues that are currently facing the City. Because we provide our services, medications, labs, and imaging at such an affordable price, we are able to care for people of all socio-economic strata. This allows us to aspire to a more just and equitable health care system, and it starts with excellent primary care. 

Finally, I want to inspire high school students, college students, medical students at Wayne State University, and current Family Medicine residents to practice Family Medicine in a Direct Primary Care practice or traditional fee-for-service model in the City. We need excellent primary care doctors for our community to be healthier and to address the health disparities in our city. 

Yours in Good Health,

- Paul Thomas, MD

Primary care is essential to having a healthy community and a healthy society. In this episode, we explore the importance of having a primary care doctor who can help you stay healthy! You can find out more about Plum Health at http://www.plumhealthdpc.com/

Ice Skating at Clark Park

This week I was able to ice skate at Clark Park in Southwest Detroit. First, ice skating is a fun, enjoyable activity for the winter months in Detroit and Michigan. Many families are able to stamp down enough snow and construct a wooden border, flood the area and allow it to freeze. These back yard rinks are the stuff of memory and family lore, but it's nice to have a community rink that is open to all. 

Second, 60 minutes of activity each day can increase our physical and emotional wellness. Children especially need to be active and create habits of activity and exercise that will help them maintain a healthy weight and avoid chronic diseases as they age. Here's some key stats:

  • Children now spend more than seven and a half hours a day in front of a screen (e.g., TV, videogames, computer).
  • Only about one in five homes have parks within a half-mile, and about the same number have a fitness or recreation center within that distance.
  • Nearly one-third of high school students play video or computer games for 3 or more hours on an average school day.

If you want to learn more facts and stats about healthy activity patterns, hit this site: https://www.fitness.gov/resource-center/facts-and-statistics/ 

Third, I was able to mentor some neighborhood kids and help them with their skating, passing, and shooting. It's always great to help kids build confidence in their abilities, and this was a nice opportunity to work with a group of kids in the neighborhood.

The ice rink at Clark Park is run by the Clark Park Coalition. If you want to learn more about what they do, or donate to their ongoing programming, hit their link! http://www.clarkparkdetroit.com/ 

Thanks for reading!

- Paul Thomas, MD

So, Why Plum?

When people talk with us, they often ask: "So, why Plum?"

For us, a Plum is healthy. It fits in your hand. It's purple. It's simple. It's two overlapping circles.

A Plum is a healthy food, and at Plum Health DPC we know that taking better care of yourself begins with what we eat and how we move. The choice of a Plum is inspired by bike rides to Eastern Market, and finding those healthy foods. At Plum Health, we can direct you to healthy resources throughout Detroit and Metro Detroit.  

A Plum is simple, it fits in your hand, and you can take it with you. At Plum Health DPC, we have set out to simplify health care for our members. We aim to eliminate the frustrations in the fee-for-service system like waiting too long to see your doctor, confusing billing, and co-pays.

You can also take our services with you. Say you're traveling and something comes up, we can help to guide you through whatever problems you face. Maybe it's talking you through a head cold, reviewing a management plan, or sending a medication that you forgot at home to the pharmacy nearest you. 

A Plum is purple. At Plum Health DPC, we proudly serve and welcome people of all backgrounds. All ages, stages, races, ethnicities, and orientations are welcome. Additionally, our price points for individuals are less than a typical cell phone bill. Our price points for families are less than a typical cable bill. This allows us to serve people of all income levels. 

Finally, a Plum can be drawn with two overlapping circles. To us, this symbolizes the doctor - patient relationship. At Plum Health, there is more overlap in the relationship between doctor and patient. We believe that having a closer relationship with your doctor can allow you to live a healthier and happier life.  

- Paul Thomas, MD