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Delivering Excellent Customer Service in Primary Care

Delivering Excellent Customer Service in Primary Care

Recently, we were featured on Hunter Schultz’s podcast, Winning Healthcare Food Fights and we were able to talk about direct primary care and how we’re actively lowering the cost of healthcare while improving the customer experience in health care. You can listen to the podcast on a variety of platforms, from YouTube, to Apple Podcasts, to Anchor, and others. Here’s what Hunter Schultz had to say about the show:

American healthcare isn't known for great customer service. More like inconvenience. Dr. Paul Thomas thought differently and started Plum Health DPC in Detroit, MI. He learned a secret from other physicians. Changing the business model so his practice could focus on customer service and care. Along the way, he wrote one book and now helps other physicians looking for a better way to provide great patient care.

Dr. Thomas went the never crowded extra mile too. He opened Plum Health DPC in the Corktown area of Detroit, instead of Grosse Pointe. Every day, he and his team provide proof old-fashioned American ingenuity is alive and well. They are putting the Wow back into care by giving great customer service. 

Visit Plum Health DPC, here.

His book, Direct Primary Care: The Cure for Our Broken Healthcare System, is available here.

For more resources and other information, please visit our website.

Paul Thomas, MD at the Plum Health DPC office in Corktown Detroit. The office is located at 1620 Michigan Ave, Suite 125, Detroit, MI 48216.

Paul Thomas, MD at the Plum Health DPC office in Corktown Detroit. The office is located at 1620 Michigan Ave, Suite 125, Detroit, MI 48216.

Many thanks to Hunter for putting together this interview, even more thanks to him for being an Alpha Reader for our first book, Direct Primary Care: The Cure for Our Broken Healthcare System. Here’s some of the topics we covered during the interview:

  • Exciting or positive things in the US Healthcare System, like the growing direct primary care movement and some free market elements in our current system that can help protect patients from overcharges in the current marketplace.

  • The types of tests or new tools for assessing health and wellness - things like 23andMe, Aperiomics, OneOme, Butterfly Ultrasound probe, texting, emails and more consistent communication with patients.

  • Integrating patients’ health goals into their care plan

  • Dr. Paul Thomas’ path to becoming a doctor - volunteering at Cass Clinic and working with compassionate doctors and medical students at Wayne State taking care of uninsured and underinsured patients in Detroit’s Cass Corridor

  • The simplicity of the Direct Primary Care model and aligning the incentives - when patients pay the monthly membership fee for a DPC practice, they are incentivized to use the system and to use the DPC service. Likewise, doctors are incentivized to take care of patients promptly and ensure optimal health and wellness. Doctors in the DPC model are also incentivized to not over-test and over-treat their patients. Rather, we focus on counseling our patients through their healthy behaviors to optimize wellness.

  • Price points at our model, seen here. Our price points are less than a cell phone bill for an individual and less than a cable bill for a family. We are cognizant of the median income in Detroit, our community, and that is $26,000 annually. We intentionally made our service affordable for anyone with an income in our community, and we deliver excellent primary care services to the folks that enroll in our clinic.

  • We discuss our recent Ribbon Cutting ceremony with Mayor Duggan and our recent move to 1620 Michigan Ave, Suite 125, Detroit MI 48216, which is 1.1 miles from our old office. We have a more conveniently location in Corktown, Detroit.

  • We recently hired a medical assistant, Chris, and we recently brought on a new doctor, Dr. Raquel Orlich who is quickly filling her practice with new patients. We typically have 25 to 30 new patients enroll in our practice each month.

  • We discuss having enough time to work with our patients. We typically have 30 minutes to 1 hour to spend with each of our patients. In the typical system, your doctor has 2,400 patients and they only get 10 to 15 minutes to take care of each patient. Having fewer patients allows us to have more time with our patients and to build trusting relationships with our patients.

  • We discuss the importance of having continuity of care, or a long-term relationship, with a primary care doctor. In our practice, we really focus on building the doctor-patient relationship and continuity of care.

  • Demonstrating how valuable it is to have a primary care doctor that knows you well.

  • Delivering an excellent customer experience in primary care at our Plum Health DPC office. This is achieved by meeting people at the door, having enough time for the appointment, addressing their concerns fully, giving the medications from our office and not sending them to a pharmacy, having the ability to draw blood in our office, and the ability to text and email our patients. Because we’re able to do these things well, our patients often have a “wow” experience. This becomes evident over time as more and more folks review our practice and our service (see Google reviews below).

Here’s more information about Winning Healthcare Food Fights in general:

Winning Healthcare Food Fights is a weekly online radio show covering important healthcare issues. Hear from physicians about getting better care, experts explaining how we arrived at our current mess, and how we clean it up!

Healthcare's solutions cannot possibly be described in 2 minute soundbites. It takes some time to sort through the mess to discover the attributes of great care and how we move forward.

The rewards are more confidence about the direction we must head, and what to do about it. Less fear, uncertainty and doubt.

Thanks so much for reading and watching, and have a wonderful day - Dr. Paul Thomas with Plum Health DPC

As of February 2020, Plum Health DPC has 63 five star reviews on Google. Our hours of operation are Monday through Friday, 9 am to 5 pm

As of February 2020, Plum Health DPC has 63 five star reviews on Google. Our hours of operation are Monday through Friday, 9 am to 5 pm

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Emerging Leaders Connect at Michigan Association of CPAs Event

Last week, I was invited as a speaker/panelist at the Michigan Association of CPAs event in Midtown Detroit. The panel focused on entrepreneurship and working with folks who are solo entrepreneurs and self-employed individuals. Many accountants and certified public accountants (CPAs) in Detroit and Metro Detroit are self-employed.

Additionally, many freelancers and self-employed individuals make more than the cutoff point for Medicaid in the State of Michigan (around $17,000) but not enough money to comfortably afford private health insurance. Or, self-employed individuals may not want to spend so much money on health insurance, and rather invest that money back into their businesses.

We take care of many folks in this situation - people are looking for alternative ways to manage their personal health and well-being, and many people are choosing direct primary care services like our Plum Health DPC service as a stand-alone service or as an add-on service to their health insurance plan or catastrophic coverage plan.

This was a great event and brought together many interesting accounting professionals. A big thank you to Matthew Kidd and the Michigan Association of CPAs for the invitation.

Further, it was a pleasure to share the stage with Andrew Dickow, the Managing Director at Greenwich Capital Group. He is an enthusiastic and engaging speaker, and he brought a ton of insights to the table regarding entrepreneurship, investment, and the food and beverage industry in Detroit and beyond.

-Dr. Paul Thomas with Plum Health DPC

We had a great time with the Michigan Association of CPAs Event, called Emerging Leaders Connect. It was a pleasure to speak with Matthew Kidd and Andrew Dickow regarding entrepreneurship in Detroit.

We had a great time with the Michigan Association of CPAs Event, called Emerging Leaders Connect. It was a pleasure to speak with Matthew Kidd and Andrew Dickow regarding entrepreneurship in Detroit.

Photos courtesy of:

Kelly Dzierzawski | Video & Creative Services Senior Manager | Michigan Association of CPAs

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Plum Health in Crain's Detroit Business

This week, we were featured in Crain’s Detroit Business under a special section regarding the Caring for Kids radio program. Here’s the part about Plum Health DPC, our membership model family medicine service in Detroit:

Caring for kids: Advocating for the mental and physical care of children

On his monthly radio program, The Children’s Foundation President and CEO Larry Burns talks to community, government and business leaders about issues related to children’s health and wellness. 

Guests for this discussion were Dr. Stephen Bloom, Medical Director of Rehabilitation, St. Joseph Mercy Hospital Rehabilitation, Ann Arbor; Dr. Paul Thomas, Family Medicine Doctor, Plum Health DPC; and David Coulter, County Executive, Oakland County.

The hourlong show typically airs at 7 p.m. the fourth Tuesday of each month on WJR 760AM. Here’s a summary of the show that aired December 31st; listen to the entire episode, and archived episodes, at yourchildrensfoundation.org/caring-for-kids.

Larry Burns and Dr. Paul Thomas discuss Plum Health DPC

Larry Burns: Plum Health DPC (Direct Primary Care) is the first practice of its kind in Detroit and Wayne Country. Tell us more about your mission.

Dr. Paul Thomas: We believe that health care should be affordable and accessible. We’ve lowered the cost of health care and allowed people to be more proactive in taking care of themselves. With this direct care model, my patients—or members—pay me directly. It’s $10 a month for kids and then it starts at $49 a month for adults. They can come see me any time they need to. They also have my cell phone number so they can call or text me anytime.

Burns: What might a parent get for that $10 kid membership?

Thomas: You have a doctor on call for you. You might send me a photo of a rash and I could walk you through that. Or you might be concerned about an ear infection and I’d want you to come in to be seen for that. Or you have your well visit.

Burns: If somebody has insurance can they still be a member?

Thomas: Yes. We see people who are uninsured, under-insured, and fully insured.

Burns: What are the membership advantages for adults?

Thomas: Again, you have me on speed dial. We also do in-house labs and medications for all of our patients at significantly lower cost. For example, for a cholesterol panel at the hospital, you might be charged $100; at our office it’s $6. Or, if you came in to manage your blood pressure and you’re taking Lisinopril, that tablet might be $10 at the pharmacy for a one-month supply. At our office it’s 1 cent per pill, so your blood pressure medications now cost 30 cents a month.

Burns: How’s the practice going?

Thomas: We initially launched in 2016 as a house call practice. I had a small office in Southwest Detroit with about eight members. We’ve now grown to about 580 members. We hired a second doctor to help with the demand and we moved into a larger office in Corktown.

Burns: What is in the future for Plum Health?

Thomas: We want to continue to grow and bring on a new doctor perhaps every year to meet the demand. There are only 100 primary care physicians practicing in Detroit for 600,000 residents. That’s one doctor for every 6,000 residents. If you go north of Eight Mile into Oakland County there’s one primary care physician for every 600 residents. That’s a 10x disparity in primary care access.

Burns: How can someone become a member?

Thomas: Go to plumhealthdpc.com.

Thanks for reading and have a wonderful day, - Dr. Paul Thomas with Plum Health DPC

This week, we were featured in a special section of Crain’s Detroit Business.

This week, we were featured in a special section of Crain’s Detroit Business.

This week, Paul Thomas, MD of Plum Health DPC was featured in Crain’s Detroit Business with Larry Burns, CEO of the Children’s Foundation.

This week, Paul Thomas, MD of Plum Health DPC was featured in Crain’s Detroit Business with Larry Burns, CEO of the Children’s Foundation.

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Detroit Doctors Cut the Ribbon on a New Corktown Office with Mayor Duggan

Plum Health DPC Cuts the Ribbon on Corktown Office with Mayor Duggan

DETROIT (Dec. 14, 2019) – On Thursday, the Detroit Economic Growth Corporation (DEGC), Mayor Mike Duggan and community members of Corktown joined Motor City Match (MCM) awardee Dr. Paul Thomas at a ribbon-cutting ceremony to celebrate the opening of his Direct Primary Care practice, Plum Health DPC.

The Ribbon is Cut with Mayor Mike Duggan, Paul Thomas, MD, Raquel Orlich, DO, and Chris Lake, medical assistant at Plum Health DPC in Corktown, Detroit.Photo Credit to Nadir Ali at https://www.3andathird.com/

The Ribbon is Cut with Mayor Mike Duggan, Paul Thomas, MD, Raquel Orlich, DO, and Chris Lake, medical assistant at Plum Health DPC in Corktown, Detroit.

Photo Credit to Nadir Ali at https://www.3andathird.com/

Plum Health DPC has expanded its presence in Detroit, moving into a new 1,700 square foot retail space at The Corner - a mixed-use development on the site of the former Tiger Stadium at Michigan Avenue and Trumbull.   

The health care office, previously located in Southwest Detroit, moved to Corktown after a significant increase in demand for Plum Health’s innovative services. The new location in Corktown allows for a much larger, more tailored, and community-oriented space with easy access for patients.

Mayor Mike Duggan speaks about Plum Health DPC and the importance of primary care services in Detroit with Paul Thomas, MD and Raquel Orlich, DO.Photo Credit to Nadir Ali at https://www.3andathird.com/

Mayor Mike Duggan speaks about Plum Health DPC and the importance of primary care services in Detroit with Paul Thomas, MD and Raquel Orlich, DO.

Photo Credit to Nadir Ali at https://www.3andathird.com/

“It is crucial for Detroit residents to have access to healthcare facilities in their communities without having to travel outside of the City,” said Duggan. “We are thankful to Dr. Thomas for his commitment to the wellness of Corktown and nearby residents. I’d like to encourage more health care providers to open throughout the City so that Detroiter’s are able to receive the medical services they so richly deserve.” 

Wayne State University School of Medicine alumnus, Clinical Assistant Professor, and Plum Health DPC owner Dr. Paul Thomas started his business as a house-call only practice in 2016, recognizing the need for affordable and accessible healthcare in Detroit. His physical practice began in a one-room office located inside the Detroit School of Digital Technology, at the former Third Precinct police station in Southwest Detroit. At peak capacity in the old location, Dr. Thomas and his team were serving roughly 500 patients.

“We believe that health care should be affordable and accessible for everyone, and we are very grateful to our many community partners for assisting us in expanding our services, and therefore access to vital primary care resources,” said Dr. Thomas. “First we need to thank our patients for trusting us with their health care. Next, we need to thank Mayor Mike Duggan, the Motor City Match Program, the DEGC, Quicken Loans Demo Day, TechTown’s Retail Boot Camp, and the Build Institute. So many people and organizations have helped us get to where we are today.”

Today, Plum Health DPC has expanded to a team of two physicians, adding Dr. Raquel Orlich, a graduate of Michigan State University College of Osteopathic Medicine, to the practice in July 2019. The two physicians and a newly-hired medical assistant currently serve 600 patients out of the Corktown office.

Dr. Raquel Orlich greets Mayor Mike Duggan at Plum Health DPC in Corktown, Detroit. Paul Thomas, MD and other members of the Detroit business community look on.Photo Credit Shawn Lee at https://www.shawnleestudios.com/

Dr. Raquel Orlich greets Mayor Mike Duggan at Plum Health DPC in Corktown, Detroit. Paul Thomas, MD and other members of the Detroit business community look on.

Photo Credit Shawn Lee at https://www.shawnleestudios.com/

The expansion also enables Plum Health to add a third physician to their team in the future, providing the center with the means to serve more than 1,500 patients in Detroit and beyond. It’s convenient location in the growing and bustling Corktown neighborhood and its low-cost membership model are further addressing Detroit’s primary care shortage.

"From the first moment I met Dr. Thomas I knew his business reflected the genuine values of the Corktown community as well as our efforts to embrace small, local, innovative, Detroit businesses," said Eric Larson, President/CEO of Larson Realty Group. "I am thrilled to welcome Plum Health to The Corner."

Plum Health’s move to Corktown and the build-out for their new space was supported by a $50,000 grant from Motor City Match and a $50,000 award from Quicken Loans Detroit Demo Day. Plum Health has also received technical support from TechTown and Build Institute.

“Quicken Loans Detroit Demo Day exists to bring capital and exposure to businesses in Detroit – especially those with innovative products or services that are creating amenities and jobs in the city. Seeing Plum Health deploy that capital to scale their operations and serve more patients is exactly the kind of outcome we hope for,” said Lauren Hoffman, Director of Entrepreneurship, Quicken Loans Community Fund.

Plum Health DPC uses a membership model for healthcare, charging patients a monthly fee, and billing them directly for specific services. Dr. Thomas said that by eliminating insurance claims for primary care services, he can offer his patients an up to 90 percent reduction in costs. For example, while a hospital might charge $3,000 for an MRI, Dr. Thomas charges only $297 for the same service. A $150 Comprehensive Metabolic Panel costs $6 at Plum Health; a $10 pharmacy charge for blood pressure medication is only $0.36 for patients there.

“Winning an MCM space and cash award allowed Dr. Thomas to build a world-class primary care office in an underserved neighborhood,” said Batton. “With high local demand for the professional health services Plum Health provides, this business is positioned for success and future growth. MCM is pleased to support business owners like Dr. Thomas who are committed to Detroit’s residents and neighborhoods that are providing the type of services that create long-term stability in communities.”

Plum Health’s new location at 1620 Michigan Avenue serves patients of all ages from 9am to 5pm, Monday through Friday. Those interested in the innovative subscription service, a full list of included procedures, and pricing can find more information here.

Dr. Paul Thomas addresses the media at the Plum Health DPC family medicine office in Corktown, Detroit.Photo Credit Shawn Lee at https://www.shawnleestudios.com/

Dr. Paul Thomas addresses the media at the Plum Health DPC family medicine office in Corktown, Detroit.

Photo Credit Shawn Lee at https://www.shawnleestudios.com/

Media Contact:

Paul Thomas, MD | 313.444.5630 | paul@plumhealthdpc.com

Plum Health DPC, 1620 Michigan Ave, Suite 125, Detroit, MI 48216

About Plum Health DPC

Plum Health DPC is a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. The family medicine service has a mission of delivering affordable, accessible health care in Detroit and beyond. This is achieved through on-time appointments, same-day/next-day appointments guaranteed, and 50- to 90-percent savings on procedures, medications, labs and imaging services. Plum Health DPC is located at 1620 Michigan Ave., Suite 125, Detroit, MI 48216. The hours are Monday through Friday, 9:00 a.m. to 5:00 p.m. To learn more, visit www.plumhealthdpc.com or call 313.444.5630.

About Paul Thomas, MD

Dr. Paul Thomas is a board-certified family medicine physician practicing in Corktown Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. His mission is to deliver affordable, accessible health care services in Detroit and beyond. He has been featured on WDIV-TV Channel 4, WXYZ Channel 7, Crain's Detroit Business and CBS Radio. He has been a speaker at TEDxDetroit. He is a graduate of Wayne State University School of Medicine and now a Clinical Assistant Professor. Finally, he is an author of the book Direct Primary Care: The Cure for Our Broken Healthcare System.

About Raquel Orlich, DO

Dr. Raquel Orlich, DO is a board certified family physician. She is excited to join the mission of bringing affordable and accessible health care to Detroit. She is passionate about quality patient-centered care and establishing strong doctor-patient relationships. Her clinical interests include osteopathic manipulative medicine for chronic musculoskeletal issues, women’s health, and preventative health. She is a graduate of Michigan State University College of Osteopathic Medicine and completed her residency training at Ascension Macomb-Oakland Hospital.

About Direct Primary Care

The direct primary care (DPC) model gives family physicians a meaningful alternative to fee-for-service insurance billing, typically by charging patients a monthly, quarterly, or annual fee (i.e., a retainer) that covers all or most primary care services including clinical, laboratory, and consultative services, and care coordination and comprehensive care management. Because some services are not covered by a retainer, DPC practices often suggest that patients acquire a high-deductible wraparound policy to cover emergencies.

Direct primary care benefits patients by providing substantial savings and a greater degree of access to, and time with, physicians. Taken from the American Academy of Family Physicians website: https://www.aafp.org/practice-management/payment/dpc.htm

About Motor City Match

Motor City Match is a unique partnership between the City of Detroit, DEGC, the Economic Development Corporation of the City of Detroit (EDC) and the U.S. Department of Housing and Urban Development (HUD). Through 16 rounds, the program has granted $7.75 million in cash awards and leveraged a total investment of $42 million in Detroit neighborhoods. MCM also awards support in space, business plan, design and building categories. Competitive financial assistance is supported by a broad partnership of Southeast Michigan community development financial institutions and corporations. Detroit Economic Growth Corporation (DEGC) is a non-profit organization that serves as the lead implementing agency for business retention, attraction and economic development initiatives in Detroit.

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Plum Health Featured in Model D Media

This week, the growth and expansion at Plum Health DPC was featured in Model D Media, under their Development News section. Here’s what they said:

Plum Health, the direct primary care practice founded in 2016 by Dr. Paul Thomas, has left its Southwest Detroit beginnings for one of the most high-profile developments in the city: The Corner mixed-use development located at the site of the old Tiger Stadium.

The move to the 1,700-square-foot space results from a significant increase in the amount of patients Thomas serves, from 8 in November 2016 to more than 550 active patients today.

Thomas hired Dr. Raquel Orlich this summer and, with the move, a third physician will be hired, meaning that Plum Health will eventually be able to serve more than 1,500 patients from their new Corktown offices.

"We believe that health care should be affordable and accessible for everyone, and this new office takes us one step closer to that goal," says Thomas.

"Our new family medicine office is warm and inviting, and we look forward to serving the medical needs of our community from this space for many years to come."

In June 2018, Model D wrote that Dr. Thomas "could disrupt the field of primary care" because Plum Health offers direct primary care services based on a subscription model. Rather than charge patients for each visit and service rendered, patients pay a set fee each month, gaining direct access to doctors as needed.

Patients also have access to wholesale medications, at-cost imaging services, and at-cost lab work.

No health insurance is required for Plum Health services.

Plum Health is located in Ste. 125 of 1620 Michigan Ave. in Corktown.

Got a development news story to share? Email MJ Galbraith here or send him a tweet @mikegalbraith.

Plum Health DPC Featurd in Model D Media.png

We’re grateful to Model D Media for the continuing coverage and very excited to continue to serve people in this way. Thanks for reading and have a wonderful day.

Drs. Paul Thomas and Raquel Orlich

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Better Ways to Spend Time and Money on Cyber Monday

There are better ways to spend your time and money during Cyber Monday, I’ll list a few of them here:

  • invest money into a retirement account, like a Roth IRA or a 401K or 403B plan

  • put a little extra money into your mortgage, or if you have an auto loan, pay a little extra on your auto loan

  • invest into a child’s education fund

  • visit an elderly relative or a neighbor, bonus points if you bring them some nutritious food

  • go to the gym and have a good work out, bonus points if you go with a friend or a partner/spouse/significant other

  • take time to make a healthy meal at home

  • schedule an appointment with your doctor

  • schedule an appointment with your dentist

  • check your tires before it snows again

    • your tread can wear down over time, and sometimes the cold weather can cause deflation

  • make a donation to a charity

  • volunteer at a local service organization

  • if you choose to shop, shop at a local small business and get to know the people that work there and the business owner

  • write a thank you note to whoever hosted you for Thanksgiving Dinner or a Thanksgiving-related event

  • meditate

  • be grateful for what you already have

I know that people can overspend during the Holidays, and I’ve read that people can go into about $1,000 in debt due to holiday spending, but there are better ways to spend your time and money on Cyber Monday. You can invest into yourself and into your retirement accounts, invest into your children’s education funds, take time to exercise and eat healthy foods, and visit and spend time with elderly folks in your life and in your community.

Thanks for reading and have a great day,

-Dr. Paul Thomas

2019 Cyber Monday Checklist.jpg
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Daily Detroit Covers the Plum Health Move to Corktown

Daily Detroit, shares what to know and where to go in Southeast Michigan in a 15-20 minute, local podcast. They recently covered our move from Southwest Detroit to our new location in Corktown Detroit. Here’s what we discuss:

  • The move into our new 1,700 Square Foot office in Corktown, at the Corner, which is the historic former site of Tiger Stadium. This is the corner of Michigan and Trumbull, and our address is 1600 Michigan Ave, Suite 125, Detroit MI 48216

  • We’re a Direct Primary Care practice in Detroit, and we provide Family Medicine services through a membership model for health care. Our members pay $10 each month for children, and our adult memberships start at $49 per month. With the membership, our patients can see us anytime they need to without a copay.

  • Dr. Raquel Orlich started with our practice in July 2019. She’s an Osteopathic Physician who studied at Michigan State University and was the Chief Resident in Family Medicine at Ascension Macomb.

  • Why did we move? We moved because we outgrew our original space in Southwest Detroit. We had also won some grant money through the Motor City Match program and the Detroit Demo Day that we needed to use towards our build out of a new office.

  • Why this specific location? We moved to the Corner because it’s very close to our original location. Our new spot in Corktown is only 1.1 miles away from our old spot in Southwest Detroit. Importantly, this allows us to continue serving all of our original members.

  • What have we learned since starting this business? If you’ve ever started a business, you know that it’s not the decisions, it’s the decisiveness. This was something that was difficult to learn as a Physician because Doctors are trained to over-analyze problems and leave no stone unturned. I still use that part of my brain when taking care of patients, but I have to turn that part of my brain off when I think about challenges in our business.

  • How can people get involved? You can enroll on our website, here. Or you can give us a call at 313.444.5630. Finally, you can stop by at our new office - 1620 Michigan Ave Ste 125, Detroit MI 48216.

Listen to the episode on Daily Detroit’s YouTube Channel (below). Our segment starts at the 4:28 mark.

If you like Plum Health, and if you like YouTube, you’ll love our Plum Health YouTube Channel!

Thanks for reading and watching and have a marvelous day - Dr. Paul Thomas and Dr. Raquel Orlich

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How to Quit Drinking Alcohol in Detroit

The holidays are just around the corner. It’s that time of year we catch up with good friends and loved ones. As we are celebrating, it is important that we safely enjoy our alcoholic beverages. It is also imperative to be transparent with your doctor about the amount of your alcohol consumption as we will discuss more below, can greatly impact your physical health causing chronic ailments like heart disease, high blood pressure, and liver disease. Excessive alcohol use can also be associated with mental health concerns such as depression and anxiety.

What does it mean to be above the legal limit for drinking?

According to the CDC, all states in the United States have adopted a blood alcohol content percentage (BAC) 0.08% as the legal limit for operating a motor vehicle for drivers aged 21 years or older. However, drivers younger than 21 are not allowed to operate a motor vehicle with any level of alcohol in their system. 

  • Legal limits are measured using either a blood alcohol test or a breathalyzer.

  • Legal limits are typically defined by state law, and may vary according to individual characteristics, such as age and occupation.

What is one “drink” according to the CDC?

  • 12-ounces of beer (5% alcohol content).

  • 8-ounces of malt liquor (7% alcohol content).

  • 5-ounces of wine (12% alcohol content).

  • 1.5-ounces (1 shot glass) of liquor (e.g., gin, rum, vodka, whiskey).

What are the current recommendations for alcohol use?

With the holidays approaching, it is important to drink alcohol in moderation. This means 1 drink per day for women, and 2 drinks per day for men. These recommendations should adhere to the one “drink” standard described above. This means that wine glasses should not be filled to the brim! It is always important to keep in mind that with certain medications interact with alcohol use, including sleeping pills, muscle relaxers or other sedative medications that may make you drowsy. Always be sure to consult your physician and check your prescription bottle for recommendations in regards to alcohol consumption. 

Guidelines for Excessive Drinking

According to the CDC, binge drinking includes 4 alcoholic beverages for women, or 5 for men, in a two-hour period. Heavy drinking is considered 8+ drinks per week for women, or 15+ drinks per week for men. Any drinking by a pregnant women or individual under the age of 21 is considered excessive. 

What are signs of Alcohol Use Disorder?

Some of the signs and symptoms of alcohol use disorder could include:

  • Inability to limit drinking.

  • Continuing to drink despite personal or professional problems.

  • Needing to drink more to get the same effect.

  • Wanting a drink so badly you can’t think of anything else.

Health Risks of Alcohol Use 

According to the CDC, there are short-term and long-term health risks associated with heavy alcohol use.

Short-Term Health Risks

Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These are most often the result of binge drinking and include the following:

  • Injuries, car crashes, falls, drowning, and burns.

  • Violence, including homicide, suicide, sexual assault, and intimate partner violence.

  • Alcohol poisoning, a medical emergency that results from high blood alcohol levels.

  • Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancy or sexually transmitted diseases, including HIV.

  • Miscarriage and stillbirth or fetal alcohol syndrome disorder among pregnant women.

Long-Term Health Risks

Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including:

  • High blood pressure, heart disease, stroke, liver disease, and digestive problems.

  • Cancer of the breast, mouth, throat, esophagus, liver, and colon.

  • Learning and memory problems, including dementia and poor school performance.

  • Mental health problems, including depression and anxiety.

  • Social problems, including lost productivity, family problems, and unemployment.

  • Alcohol dependence, or alcoholism.

Signs of Alcohol Withdrawal 

After discontinuing alcohol use, within the first 2-4 days days it is possible to have several symptoms including, shakiness, sweating, loss of appetite, nausea, vomiting, headaches and a fast heart rate (also known as tachycardia). More serious symptoms include delirium tremens (DT), seizures and death. Any withdrawal from alcohol should be monitored by your healthcare provider as these symptoms may occur. 

Resources for Alcohol Use 

Substance Abuse and mental health services’  (SAMHSA) National Helpline number, open 24/7 365 days, 1-800-662-HELP (4357)

For more information on how you can safely consume alcohol this winter, please visit the CDC.

How To Quit Drinking Alcohol in Detroit

If you need help with quitting drinking alcohol, we’re happy to help. We can direct you to the best resources available for alcohol cessation, and we can treat alcoholism in our office. The Sinclair Method is a reasonable treatment option in some cases and it involves taking Naltrexone one hour prior to alcohol consumption. There are also local Alcoholics Anonymous meetings and other support groups that you can attend to help you reduce or eliminate your alcohol consumption.

Thanks for reading and have a great day,

-Dr. Paul Thomas and Dr. Raquel Orlich

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Meet our Medical Assistant at Plum Health

Medical Assistant at Plum Health DPC

Everyone this is Chris, Chris this is everyone! He’s our amazing Medical Assistant and he helps us give injections 💉 and draw blood among other things.

Chris Lake is the Medical Assistant at Plum Health DPC

Chris Lake is the Medical Assistant at Plum Health DPC

You might be thinking 🤔 “why is Chris holding a plate of cookies 🍪?” Well, he had a small bet with one of our patients who bruises easily during blood draws. She said that she would definitely bruise, regardless of how good the blood draw was - she just always bruises, she said. Chris made a friendly wager of a plate of cookies 🍪 and our patient delivered after “the best blood draw she’s ever had.” Later that week, a plate of white chocolate macadamia nut cookies found their way to our office!

In all seriousness, it’s great to have Chris as a part of our team. He does excellent work and is a great person to know. We can’t wait to see you for your next appointment,

-Dr. Paul Thomas, Dr. Raquel Orlich, and Chris Lake

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How to get a Pap Test in Detroit?

Affordable Pap Tests Available at Plum Health

Ladies - it’s time that we talk about Women’s Health! An important aspect of routine follow-up with your primary care physician is to discuss screening tests for preventable diseases such as heart disease, high blood pressure, and diabetes. Additionally, it is important to talk to your doctor about cancer screening tests that may be appropriate for you such as for screening for breast, colon, and cervical cancer. 

Many of us know that mammograms are great screening tests to look for breast cancer --Did you know October is Breast Cancer Awareness month? Additionally, a colonoscopy is used (a procedure that uses a camera to look in your colon) for colon cancer screening. However, not as many of us know why our doctors stress the importance of cervical cancer screening and what a pap smear is.

Below we will explain the basics: What is a cervix? What causes cervical cancer? What is HPV? What is a Pap test? When should I get one?

What is a cervix?

The cervix is a muscle at the lowest part of the uterus. It meets with the deepest part of the vaginal canal. There is also a small opening in the center of the cervix called the cervical canal that connects the vagina and the uterus. This opening can open and close at different times --- It opens slightly during your period and fully during childbirth. But it also protects against infections from entering into the uterus. Amazing right? 

Cervical cancer and Human Papillomavirus (HPV)

Unfortunately, this opening of the cervix can become infected by a very common virus called Human Papillomavirus (HPV). In most cases, the infection will clear on its own, however if the infection does not clear on its own, it can pose a risk of developing cervical cancer. According to the Centers for Disease Control and Prevention (CDC),12,845 new cervical cancer cases were diagnosed in 2015 and 4,175 deaths were caused by cervical cancer in 2015. 

More about Human Papillomavirus (HPV) and how is it transmitted?

According to the Centers for Disease Control and Prevention (CDC), HPV infections are so common that nearly all men and women will get at least one type of HPV at some point in their lives. Nearly 80 million Americans are currently infected with some type of HPV. About 14 million Americans, including teens, become infected each year.

HPV is spread through intimate skin-to-skin contact. You can also get HPV by having vaginal, anal, or oral sex with someone who has the virus. There are many types or strains of this virus. Some of the strains can cause warts on the hands and feet and others can infect tissues of the genital region which can cause warts in that region as well BUT can also be associated with some cancers of genital region (i.e. vagina, penis, and anus) and of the head and neck. 

What has been done to help prevent HPV infections?

At this time, the CDC recommends that all boys and girls start vaccination against HPV infection that can be started as early as age 9 through 26 years of age. As of October 2018, the US Food and Drug Administration (FDA) has approved the vaccination for men and women through 45 years of age with Gardasil 9 (common name brand for one of the vaccines). For the HPV vaccine to be most effective, the series should be given prior to exposure to HPV. 

Dr. Paul Thomas and Dr. Raquel Orlich of Plum Health DPC discuss cervical cancer screening at their office in Detroit, Michigan.

Dr. Paul Thomas and Dr. Raquel Orlich of Plum Health DPC discuss cervical cancer screening at their office in Detroit, Michigan.

How can your doctor screen for cancer and precancers of the cervix?

If you are between the ages of 21 and 65 years of age, your doctor will start screening you for cervical cancer. The screening test is called the Papanicolaou test aka the “Pap test or Pap smear”. During a Pap smear, your doctor will need to visualize your cervix with a small utensil called a vaginal speculum. With a small brush, he or she will gently scrape the cervix to collect a sample of the cells in the opening of the cervix. This procedure takes less than 5 minutes and most women report it to be painless or may have minimal discomfort. The sample is then sent to the lab for review.

According to the CDC, decline in cervical cancer cases and deaths in the past 40 years correlated with Pap testing and detection and treatment of cervical precancerous lesions. The majority of cervical cancers (50% to 64%) occur in women who were rarely or never screened.

  • The screening guidelines recommend that women between the ages of 21 and 29 years old should have routine screening every 3 years.

  • The screening guidelines recommend that women between the ages of 30 and 65 year old have two options for routine screening --

    • Have a Pap test every 3 years or 

    • Have a Pap test with an HPV test every 5 years.

*However, if your results are abnormal, you will discuss with your doctor when you should return for a follow-up Pap test or need additional testing. 

 Luckily, cervical cancers usually take years to develop. If you’re getting screened regularly (every 3 or 5 years), you are extremely unlikely to develop cervical cancer. Let’s take control of our feminine health!

You can visit the CDC  for more information on the Pap test and HPV

What does the Pap test NOT test for?

The Pap test does not test for sexually transmitted infections such as chlamydia, gonorrhea, herpes simplex, syphilis, or HIV.

How much does it cost to have a Pap test?

Depending on your insurance plan, Pap testing may be covered as a preventive service. If you are underinsured or uninsured, the test may be costly. 

If you are a member of Plum Health DPC, we are able to provide affordable prices for many screening tests including Pap tests. The price of our Pap test is $30 to $60

How can I sign up for an appointment for a pap smear?

To make an appointment with Dr. Raquel or Dr. Paul, head over to our scheduling link and select her or him as your doctor. After you submit the information, Dr. Raquel will reach out and offer appointment times. 

Thank you for reading and have a great day,

-Dr. Paul Thomas and Dr. Raquel Orlich with Plum Health DPC

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Plum Health Grows into a Larger Office in Corktown

Plum Health expands into mixed-use development at former Tiger Stadium site in Corktown

Memberships and interest in Direct Primary Care prompted the move to a 1,700 square foot retail space at The Corner.

Detroit, Michigan, November 4th, 2019 - Plum Health DPC is pleased to announce that they have expanded their presence in Detroit by moving into a new 1,700 square foot retail space at The Corner, a mixed-use development on the former Tiger Stadium site at Michigan Avenue and Trumbull. 

Doctors Paul Thomas, MD and Raquel Orlich, DO have moved from their previous location in Southwest Detroit to a much larger, tailored, and community-oriented space in Corktown. The move was prompted by the increasing demand for Plum Health’s innovative services and the desire to be more easily accessible to patients.

Additionally, the new space will allow Plum Health to have the capacity to add a third physician, further expanding access to primary care in Detroit. With a third physician, Plum Health will be able to serve over 1,500 patients through their low-cost membership model. Having more doctors will further address Detroit’s primary care shortage.

"From the first moment I met Dr. Thomas I knew his business reflected the genuine values of the Corktown community as well as our efforts to embrace small, local, innovative, Detroit businesses," said Eric Larson, President/CEO of Larson Realty Group. "I am thrilled to welcome Plum Health to The Corner."

Plum Health’s move and build-out into their new space has been supported by a $50,000 grant from the Motor City Match and a $50,000 award from the Quicken Loans Detroit Demo Day.

“Quicken Loans Detroit Demo Day exists to bring capital and exposure to businesses in Detroit – especially those with innovative products or services that are creating amenities and jobs in the city. Seeing Plum Health deploy that capital to scale their operations and serve more patients is exactly the kind of outcome we hope for.” - Lauren Hoffman, Director of Entrepreneurship, Quicken Loans Community Fund.

Doctors Paul Thomas, MD and Raquel Orlich, DO of Plum Health DPC in their new office at the Corner, 1620 Michigan Ave, Suite 125, Detroit MI 48216. We are excited to welcome the community into our space.

Doctors Paul Thomas, MD and Raquel Orlich, DO of Plum Health DPC in their new office at the Corner, 1620 Michigan Ave, Suite 125, Detroit MI 48216. We are excited to welcome the community into our space.

More about Plum Health DPC

At Plum Health, we believe that health care should be affordable and accessible for everyone. Members of the practice can call, text, or email the doctor anytime they need health care services. We guarantee same-day/next-day appointments. Additionally, patients have access to wholesale medications, at-cost imaging services, and at-cost lab work. Plum Health began in November 2016 with 8 patients, and now has 550 active patients, spanning in age from 4 months to 101 years of age. Our vision is to provide the best healthcare experience in Detroit and beyond.

More about Drs. Paul Thomas and Raquel Orlich 

Dr. Paul Thomas is a board-certified family medicine physician practicing in Southwest Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. His mission is to deliver affordable, accessible health care services in Detroit and beyond. He is a Clinical Assistant Professor at Wayne State University School of Medicine. He served as Chief Resident at Oakwood Family Medicine Residency Program. He has been featured on WDIV-TV Channel 4, WXYZ Channel 7, Crain's Detroit Business and CBS Radio. He has been a speaker at TEDxDetroit and is an author of the book Direct Primary Care: The Cure for Our Broken Healthcare System.

Dr. Raquel Orlich is a board-certified family physician. She loves the energy that Detroit has to offer and strives to make healthcare affordable and accessible to Detroit residents and beyond. She is passionate about quality patient-centered care and establishing strong doctor-patient relationships. Her clinical interests include osteopathic manipulative medicine for chronic musculoskeletal issues, women’s health, and preventative health. She is a graduate of Michigan State University College of Osteopathic Medicine and completed her residency training at Ascension Macomb-Oakland Hospital where she served as Chief Resident.  

More about Direct Primary Care 

The direct primary care (DPC) model gives family physicians a meaningful alternative to fee-for-service insurance billing, typically by charging patients a monthly, quarterly, or annual fee (i.e., a retainer) that covers all or most primary care services including clinical, laboratory, and consultative services, and care coordination and comprehensive care management. Because some services are not covered by a retainer, DPC practices often suggest that patients acquire a high-deductible wraparound policy to cover emergencies.

Direct primary care benefits patients by providing substantial savings and a greater degree of access to, and time with, physicians.

Taken from the American Academy of Family Physicians website: https://www.aafp.org/practice-management/payment/dpc.htm

Panoramic view of our new Plum Health office in Corktown. Our office remains in a Health Professional Shortage Area and we are very happy to continue to serve the community out of this new space.

Panoramic view of our new Plum Health office in Corktown. Our office remains in a Health Professional Shortage Area and we are very happy to continue to serve the community out of this new space.

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Taking Care of People with Auto-Immune Conditions in Detroit

Auto-immune conditions can be very difficult and expensive to manage. We recently had a patient present with swollen fingers and painful joints going on for 6 weeks. It was disabling for him and he was having a hard time doing the work he needed to do at home and at work. Worst of all, he was having a hard time playing/being active with his grand kids.

We were able to complete a work up of his condition for about $100 in terms of labs, and about $50 in terms of x-rays. He pays our monthly membership and is able to have as many appointments as he needs in our office without co-pays.

After collecting the labs and x-rays, and after thoughtful deliberation, we came up with a diagnosis of Rheumatoid Arthritis. Rheumatoid Arthritis or RA is an autoimmune disease in which the body's immune system – which normally protects its health by attacking foreign substances like bacteria and viruses – mistakenly attacks the joints. This causes joint swelling and joint pain, as seen in our patient.

Once we had the right diagnosis, we were then able to start him on Methotrexate, a medication to manage his Rheumatoid Arthritis. The medication costs $4.08/week or about $16.32/month, which is affordable for our patient.

Best of all, the medication works really well for our patient and he can now do the work that he needs to do at work and at home, without the considerable joint pain that he initially experienced. Above all, he has a better quality of life, because he can now play with his grand kids and be the grandpa he wants to be.

I love taking care of people - people of all ages and stages, with diverse backgrounds and conditions. Thanks for reading and have a great day.

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

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Press Coverage for Direct Primary Care in Detroit and Michigan

This was a big week for press coverage for Direct Primary Care in Detroit and Michigan. The bottom line is this: people are hearing more and more about this Direct Primary Care movement and we’re getting more and better coverage as the DPC movement grows.

Plum Health DPC Interview on The Craig Fahle Show

First off, we had a fabulous interview with Craig Fahle of Deadline Detroit. Craig Fahle is the former host of the Craig Fahle Show on WDET and he currently hosts the Craig Fahle Show on Deadline Detroit:

A mix of interviews and commentary, The Craig Fahle Show is a daily 30 minute podcast telling the important political, business, and cultural stories that matter to Detroit and Michigan. Hosted by Craig Fahle, an award winning journalist and talk show host who for years hosted his eponymous talk show on WDET, Detroit's Public Radio station.

Craig Fahle’s coverage of our story at Plum Health DPC was insightful and robust. He brought a really well thought out, professional approach to this interview. You can listen to the full episode here:

Dr. Paul Thomas of Plum Health DPC interviewed by Craig Fahle of Deadline Detroit on the Craig Fahle Show. The conversation focused on the Direct Primary Care model and the impact that it is having in the Detroit market.

Dr. Paul Thomas of Plum Health DPC interviewed by Craig Fahle of Deadline Detroit on the Craig Fahle Show. The conversation focused on the Direct Primary Care model and the impact that it is having in the Detroit market.

Paul Thomas, MD of Plum Health Mentioned During WDET’s Detroit Today

Second, during WDET’s Detroit Today radio program with Stephen Henderson, a caller rang in and asked if there was a health care model similar to the Green Bay Packers, where everyone buys in and benefits from the system. Start listening to the interview at the 34:30 mark to hear the question and answer. Additionally, I’ve taken the time to transcribe the conversation here:

Kevin in Grosse Pointe Park: “My idea may be a little simplistic, but I’d love to see something modeled off of the Green Bay Packers. As in, all of us pay our premiums to a hospital on a monthly basis, so the doctors, and the nurses, and the hospitals get our premiums. Let’s eliminate the insurance companies and the in-betweens. The doctors and nurses own the hospitals and we own shares in the hospitals and have an interest in this possibility.”

Stephen Henderson, Host of Detroit Today: “Hmm. Kevin it’s simplistic but it does get to a fundamental issue in the healthcare system. What role do the insurance companies play, and how much money do they add to the cost of things in the system and is there a way to eliminate them all-together. Abdul El-Sayed, we had a physician on the program a few months ago, Paul Thomas here in the City of Detroit, who is treating patients by eliminating insurance. He doesn’t take insurance, he has them pay into kind of a share system like Kevin is talking about. He deals with pharmaceutical companies directly to lower the cost of the meds and it seems like he’s got kind of a solution to some of the problems we see in the system now. The idea of dealing directly with physicians and hospital systems rather than insurance companies. Is that maybe a way forward?

Abdul El-Sayed, MD, MPH: “So, I love Paul’s model and I think it’s a great model for primary care. You pay him, he takes care of you, it’s simple, you eliminate the middle man. In fact though, Kevin’s idea, that’s how insurance companies started.”

Dr. Abdul El-Sayed goes on to talk about the founding of Blue Cross with Baylor’s Hospital System. When I heard this conversation, I was absolutely floored! It’s amazing that Stephen Henderson recalled our conversation and offered our model as a solution to our current health care problems.

Paul Thomas MD of Plum Health DPC was mentioned by Stephen Henderson of WDET and Abdul El-Sayed during a comprehensive conversation of healthcare costs during the Detroit Today radio program.

Paul Thomas MD of Plum Health DPC was mentioned by Stephen Henderson of WDET and Abdul El-Sayed during a comprehensive conversation of healthcare costs during the Detroit Today radio program.

Direct Primary Care Physician on Michigan Radio

Finally, a friend and colleague of mine, Matthew Falkiewicz, MD Of Nova Direct Primary Care in Grand Rapids was interviewed on Michigan Radio with Cynthia Canty.

“Before insurance companies, and co-pays, and filing claims, the relationship between doctors and patients was simple. Those who needed medical care would visit their doctor’s office or request a house call. Once that care was provided, the doctor was paid directly.

“Some physicians are bringing that model into the 21st century by offering direct primary care to their patients on a subscription basis. 

“Dr. Matt Falkiewicz is a physician with Nova Direct Primary Care in Grand Rapids. His practice offers a membership-based model where patients pay a monthly fee”

Michigan Radio Discusses Direct Primary Care.png

All told, three big mentions of Direct Primary Care in Detroit and Michigan over the last 1 week. This tells me that there’s a growing momentum for Direct Primary Care in our state. When I first started in 2016, I was an early adopter, perhaps the second doctor in the state of Michigan with a pure Direct Primary Care practice. Now, there’s over 10 doctors practicing in the DPC model in Michigan.

I believe in this model and these doctors - Direct Primary Care allows us to serve our patients on their own terms, and not at the dictates or mandates of an insurance company. The DPC model allows us to develop caring relationships with our patients and to deliver the best service possible to our patients.

I’m really excited for this growing movement - thanks for reading!

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

Paul Thomas, MD of Plum Health DPC. Direct Primary Care allows doctors and patients to develop deeper, more trusting relationships that can result in better health for both patients and doctors.

Paul Thomas, MD of Plum Health DPC. Direct Primary Care allows doctors and patients to develop deeper, more trusting relationships that can result in better health for both patients and doctors.

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Plum Health at the Detroit Men's Health Event

This week, we were at Ford Field for the Men's Health event. The event was really fun and really well organized. There were stations to have blood pressure checks, EKGs, Vision Screening, Vein Examinations, Skin Examinations to screen for Cancer, and several other tables with information about follow up care and the like.

Raquel Orlich, DO and Paul Thomas, MD of Plum Health DPC at the Ford Field Men’s Health Event.

Raquel Orlich, DO and Paul Thomas, MD of Plum Health DPC at the Ford Field Men’s Health Event.

We were happy to be invited and we met with several Detroit men and women in need of excellent primary care services. There were also some fun moments - they had a giant colon set up to promote colorectal cancer screening tests, like a colonoscopy. Also, we were able to go onto the playing field of the Detroit Lions, throw around a football and kick a few field goals! This was really cool and a nice perk of volunteering at the event.

Finally, if you’re looking for high-quality primary care services for you and your family, we’d be happy to help you with this sort of care. You see, at this type of event, conditions like high blood pressure and diabetes can be diagnosed, but the most important part is the follow up care after the diagnosis to make sure the condition is treated appropriately, well-managed, and ideally reversed with the right diet and lifestyle modifications.

Thanks for reading and have a great day,

-Dr. Paul Thomas and Dr. Raquel Orlich of Plum Health DPC

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Detroit Family Medicine Office Offers Affordable In-Office Procedures

Detroit Family Medicine Office Offers Affordable In-Office Procedures

The beauty of Family Medicine Practice is it can be a one stop shop for you and your medical care. Family doctors can usually take care of 80-90% of your medical needs and that includes medical procedures. Family doctors are trained to perform a wide variety of procedures that can be offered in the office. This can help you save time and money from sending you to a specialist. At Plum Health, we love taking care of procedures for our patients, these can range from Pap tests to biopsies, from toenail removal to earwax removal, from abscess drainage to lipoma removals.

Our patient cut his hand aka had a laceration, and we were able to sew up the cut (suture the wound) about 20 minutes after the incident happened. This can ensure that healing is optimal and scar tissue is minimal.

Our patient cut his hand aka had a laceration, and we were able to sew up the cut (suture the wound) about 20 minutes after the incident happened. This can ensure that healing is optimal and scar tissue is minimal.

List of Common In-Office Procedures Performed by Family Medicine Doctors

Some of the procedures that Family medicine physicians can perform are listed below. 

Procedures that can be performed by your Family Doctor

  • Wound repair (sewing up small to medium sized cuts)

  • Abscess and cyst drainage

  • Skin biopsy of moles

  • Steroid Injection of joints and trigger points 

  • Electrocardiogram (EKG)

  • Pulmonary Function Test

  • Pap smear

  • IUD (intrauterine device) removal

  • Ingrown toenail removal

  • Wart removal

  • Foreign body removal

  • Osteopathic Manipulative Medicine

  • Cerumen Disimpaction (ear wax removal)

With a flick of the wrist we can remove a significant amount of cerumen (ear wax) that may be impairing your hearing. There is no charge for this cerumen disimpaction procedure in our office.

With a flick of the wrist we can remove a significant amount of cerumen (ear wax) that may be impairing your hearing. There is no charge for this cerumen disimpaction procedure in our office.

Unfortunately, some of these procedures can be very costly depending on your insurance plan or lack thereof. A major reason for the expense of procedures vary from your insurance deductible plan and insurance coverage. Usually, the doctor’s offices will charge the insurance companies for the procedure. This inflates the cost.

For example, a typical charge for a sebaceous cyst removal might be $175 - $350. That service is $20 in our office. A skin biopsy can cost anywhere from $150 - $1,000 and an IUD removal can cost $150 - $250. For these procedures, we typically charge about $20 or the cost of the supplies that we use to perform these procedures.

Why are Common In-House Procedures Less Expensive at Plum Health?

At Plum Health DPC, we do not use or bill insurance for your medical care. Our membership plan does include performance of some procedures which helps cut many costs. We may be subject to charge for utensils and medications used during the procedure which is also offered at a discounted price.

Because the patients in our practice pay a monthly membership fee, we can lower the cost of procedures. Instead of charging you or your insurance company $100 or $500 for a procedure, we ask that you pay for the cost of the supplies that we use.

How to Schedule an Appointment to have a Procedure at our Detroit office

To make an appointment with Dr. Raquel Orlich or Dr. Paul Thomas, head over to our scheduling link. After you submit the information, Dr. Raquel or Dr. Paul will reach out and offer appointment times. 

Thank you for reading and have a great day,

-Dr. Paul Thomas and Dr. Raquel Orlich

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How to Get a Flu Shot in Detroit

How to Get a Flu Shot in Detroit

Flu season is just around the corner and according to the Centers for Disease Control (CDC), “During the 2017–2018 influenza season there was an estimated 959,000 hospitalizations and 79,400 deaths due to complications of influenza infection.

So nearly 1 million hospitalizations and close to eighty thousand deaths due to a vaccine preventable illness! This is why we advocate for getting a Flu Shot before the start of the Flu Season - we want to prevent people from going to the hospital and potentially dying from the flu aka influenza.

How Effective is the Flu Shot aka Influenza Vaccine?

The CDC conducts studies each year to determine how well the influenza (flu) vaccine protects against flu illness. While vaccine effectiveness can vary, recent studies show that flu vaccination reduces the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to the flu vaccine. 

So, if you get the flu shot, and the vaccine is well-matched to the circulating virus, you can reduce your risk of getting the Flu by about half - that’s great!

Influenza Vaccine for the 2019 - 2020 season given to one of our patients at Plum Health DPC in Detroit, MI.

Influenza Vaccine for the 2019 - 2020 season given to one of our patients at Plum Health DPC in Detroit, MI.

How Can the Flu Shot Help Me?

There are many reasons to get a flu vaccine each year. Below is a summary of the benefits of flu vaccination:

  • Flu vaccination can keep you from getting sick with flu.

  • Flu vaccination can reduce the risk of flu-associated hospitalization for children, working age adults, and older adults.

  • Flu vaccination helps prevent serious medical events associated with some chronic conditions such as heart disease, diabetes, and chronic lung disease.

  • Vaccination helps protect women during and after pregnancy.

  • Flu vaccine can be life-saving in children.

  • Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.

  • Getting vaccinated yourself may also protect people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions.

So, if you’re a parent with young children, by getting the Flu Shot, you can help protect your kids. If you’re someone with many chronic diseases like diabetes or heart failure, getting the flu shot can reduce your risk of these diseases worsening if you were to be infected with the flu.

What are Flu Symptoms? What Should I Look Out For?

Flu Symptoms have a broad range, but typically people come to the doctor with the following concerns:

  • Fever* or feeling feverish/chills

  • Cough

  • Sore throat

  • Runny or stuffy nose

  • Muscle or body aches

  • Headaches

  • Fatigue (tiredness)

  • Some people may have vomiting and diarrhea, though this is more common in children than adults.

As a doctor treating folks with the flu, there’s something called the pajama sign - if you don’t have the energy to shower and get dressed into regular clothes, and you have some of the above symptoms, it’s more likely that you have the flu. Seriously - I’ve had people compare getting the flu to being hit by a truck - getting an illness as severe as the flu can feel like all of your energy has been taken away.

How Is the Flu Virus Spread?

Most experts believe that flu viruses spread mainly by tiny droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might get the flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose or possibly their eyes.

To rephrase, someone might cough and they might have tiny droplets fly out of their mouth and land on things that you touch, like door handles, shopping cart handles, tables at a restaurant, etc… That’s why it’s so important that you wash your hands before touching your own nose and mouth and before eating. If you are sick, it’s also very important to wash your hands after coughing and sneezing. You can help lessen the spread of the flu virus by washing your hands often during cold and flu season.

For more information, visit the CDC for the most up-to-date information on the flu.

How to Get the Flu Shot in Detroit

Protect yourself and your family (and friends and co-workers) from the flu this year! To make an appointment with Dr. Raquel, head over to our scheduling link and select her as your doctor. After you submit the information, Dr. Raquel will reach out and offer appointment times. 

Thank you for reading and have a great day,

-Dr. Paul Thomas and Dr. Raquel Orlich with Plum Health DPC

Influenza Vaccine instructions for the 2019 - 2020 Vaccine Season including ingredients in the vaccine.

Influenza Vaccine instructions for the 2019 - 2020 Vaccine Season including ingredients in the vaccine.

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Helping Other Detroit Entrepreneurs with their Businesses

Last week, I was invited to participate in a Business Coaching Program with the BUILD Institute and Samuel Adams. It was held at the Jam Handy. BUILD Institute had coordinated for roughly 50 business coaches and 100 small business owners/start up founders to come through for business coaching.

April Boyle runs the BUILD Institute and they focus on helping entrepreneurs start businesses. They give entrepreneurs a set of tools to get started, by focusing on a curriculum with sessions regarding accounting, finance, marketing, branding, customer acquisition, leveraging capital, etc… This where I started my entrepreneurial journey, so I’m excited to be a part of this group!

It was a fun event with a ton of energy in the room - lots of great ideas and exciting new business ventures. It’s great to see a strong entrepreneurial ecosystem in Detroit and it was fun to be a part of this event. Here’s some pics!

Dr. Paul Thomas of Plum Health DPC volunteering at the Build Institute’s Business Mentorship night at the Jam Handy in Detroit, Michigan.

Dr. Paul Thomas of Plum Health DPC volunteering at the Build Institute’s Business Mentorship night at the Jam Handy in Detroit, Michigan.

Group Pics:

A funny story about the above photo session. I was in the back and obstructed, so I took a big jump and seemed to time it pretty well! You can see me leaping in the back.

Have a great day - Dr. Paul

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Plum Health Featured on Small Talk with Mark S. Lee

Today we were featured on Small Talk with Mark S. Lee. This is our third time appearing on this program and it’s always a pleasure to be interviewed by Mark S. Lee.

Our segment starts at 45:13:

46:30 - we introduce Dr. Raquel Orlich, an Osteopathic physician who joined our practice on July 1st, 2019

46:40 - an update: Direct Primary Care is a membership model for health care that has grown tremendously because of the ever-rising costs of health insurance. There are now roughly 1,200 Direct Primary Care practices across the country. Our practice in Detroit, Plum Health DPC, now has over 500 members and we continue to deliver affordable, accessible healthcare in Detroit and beyond. People choose Plum Health because they can have a personal relationship with their doctor. People choose Plum Health because they have affordable costs for their meds, labs, and imaging services.

48:00 - Dr. Raquel Orlich talks about her education at Michigan State University College of Osteopathic Medicine. She also talks about how she found out about Plum Health DPC and how Dr. Paul and Dr. Raquel had a lot of alignment in their goals for medical care and community-based practice.

49:55 - Dr. Raquel Orlich talks about her scope of practice - taking care of people of all ages and stages. Dr. Raquel has special interests in Women’s Health, Preventive Medicine, and Osteopathic Manipulative Therapy.

50:42 - Mark S. Lee talks about our book Direct Primary Care: The Cure for Our Broken Healthcare System and how we thanked him in our Acknowledgments section for his coverage of Plum Health early on, before other journalists began taking notice.

50:55 - On the growth of Plum Health DPC, we have surpassed 500 members! This constitutes a full panel for Dr. Paul Thomas, and therefore we needed to bring on a second doctor, Dr. Raquel Orlich. At this point, any new patients will be patients of Dr. Raquel Orlich. We want to make it clear that there will always be room for new patients at Plum Health DPC and we will work tirelessly to accommodate anyone who needs or wants our care.

51:46 - Plum Health DPC will be moving into The Corner - Detroit development. This is at the Legendary Corner of Michigan and Trumbull in the Corktown neighborhood of Detroit. This is an amazing place because of all the Major League Baseball history at this site - players like Ty Cobb and Babe Ruth graced this diamond and this is the site of the 1984 Detroit Tigers’ World Series Championship. We will be moving into our new space at The Corner in September 2019 if everything goes according to plan and according to the proposed construction schedule.

53:12 - Dr. Raquel Orlich completed her residency at Ascension Macomb Hospital and she is now practicing in Detroit at Plum Health DPC. Mark S. Lee asks for her thoughts on the move. She wanted to have an opportunity to give back, especially with her background in volunteering. She wanted to make sure that she would have enough to spend with her patients and the capacity to provide low-cost services for patients who need it.

55:20 - Our practice, Plum Health DPC, continues to serve folks who have been left out by the traditional fee-for-service system. Dr. Paul Thomas discusses how we often have new patients sign up for the practice who haven’t been to the doctor for 5 - 10 years because they’ve been uninsured or underinsured and concerned about the cost of their potential medical care.

Thanks so much for listening, and have a wonderful day. If you’d like to have this type of health care for you, your family, or your small business, please reach out at 313.444.5630 or enroll online, here.

Again, a big thank you to Mark S. Lee for having us on his program, Small Talk with Mark S. Lee. Until next time!

-Paul Thomas, MD and Raquel Orlich, DO

2019.08.10 Paul Thomas MD Raquel Orlich DO and Mark S Lee on Small Talk Radio Detroit.jpeg
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Osteopathic Family Medicine Doctor Accepting New Patients in Detroit

Osteopathic Family Medicine Doctor Accepting New Patients in Detroit

Dr. Raquel Orlich is an Osteopathic Family Medicine Doctor who is accepting new patients in Detroit, Michigan. She finished a successful first week at Plum Health DPC, our Family Practice office in Southwest Detroit. She has already been able to incorporate Osteopathic Manipulative Medicine techniques with some of our patient’s treatment regimens. Click here to read more about Osteopathic Medicine and Osteopathic Manipulative Medicine for musculoskeletal concerns.

Dr. Raquel Orlich using her hands to apply an Osteopathic Manipulative Medicine Treatment to one of her patients.

Dr. Raquel Orlich using her hands to apply an Osteopathic Manipulative Medicine Treatment to one of her patients.

Dr. Raquel is excited to have started at the practice and she is eager to continue to meet new folks of the community. If you or someone you know needs a primary care doctor, Dr. Raquel is accepting new patients. Click here to learn more about Dr. Raquel and her medical interests.

Which Conditions do Family Medicine Doctors Treat?

Family Medicine physicians are the cornerstone to health maintenance and illness prevention. Family medicine physicians can provide annual wellness exams. Routine annual physical exams are important to address age related cancer screening tests, to evaluate for preventable diseases such as diabetes and heart disease, and discuss other lifestyle choices that may be affecting your overall health such as smoking, alcohol consumption, and inactivity.

Family medicine doctors can address up to 90% of your health concerns. They can manage and evaluate health concerns that arise such as the common cold, heartburn management, back pain, ankle sprains, and many others.  They can also manage chronic medical conditions such as high blood pressure, diabetes, and asthma. 

Family medicine doctors may also offer simple procedures in the office such as laceration repair (sewing up small to medium-sized cuts), knee joint injections, abscess drainage, wart removal, ingrown toenail removal, skin biopsies, and many more.

Why it’s Important to Have a Family Doctor

Detroit is a Health Professional Shortage Area, meaning that there are too few Family Doctors and Primary Care Doctors for the number of Residents in Detroit. There’s roughly 1 primary care physician for every 6,000 Detroit residents. Compare that to 1 primary care physician for every 600 residents in Oakland County, and you find that Detroit has a 10x disparity in access to primary care.

What’s more, An increase of one primary care doctor per 10,000 people has been shown to result in a 5% decrease in outpatient clinic visits, a 5.5% decrease in hospital admissions, a 10.9% decrease in ER visits, and a 7.2% decrease in surgeries.

Why? Because primary care physicians like Family Medicine Doctors are experts at taking care of people in a cost-effective way. Family Doctors are able to treat conditions in their early stages before they become worse or more complicated. For example, if you work with your family doctor to lower your blood pressure, this could prevent a heart attack or a stroke in the future. 

How to Schedule an Appointment with Dr. Raquel

To make an appointment with Dr. Raquel, head over to our scheduling link and select her as your doctor. After you submit the information, Dr. Raquel will reach out and offer appointment times. 

Thank you for reading and have a great day,

-Dr. Paul Thomas and Dr. Raquel Orlich with Plum Health DPC

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What is Osteopathic Medicine?

What is a Doctor of Osteopathic Medicine or “DO”? 

The best way to define an Osteopathic Physician is by what they believe. They follow the four tenets or principles of Osteopathic Medicine. They are as follows:

  1. The body is a unit; the person is a unit of body, mind, and spirit.

  2. The body is capable of self-regulation, self-healing, and health maintenance.

  3. Structure and function are reciprocally interrelated.

  4. Rational treatment is based upon an understanding of the basic principles of body unity, self-regulation, and the interrelationship of structure and function. 

In short, an osteopathic physician is trained to treat the person as a whole as every body system can relate to one another. Because of this holistic approach, not surprisingly many DOs have a strong interest in preventative health and primary care.

Osteopathic physicians complete four years of medical school and at least three years of residency, just like their Allopathic or MD counterparts. However, in addition to their stethoscopes and medical exam equipment, DOs have special training to use their hands as diagnostic and therapeutic tools with a treatment called Osteopathic Manipulative Medicine.

Dr. Raquel Orlich uses her hands to treat a patient at the Plum Health DPC; this is known as Osteopathic Manipulative Medicine.

Dr. Raquel Orlich uses her hands to treat a patient at the Plum Health DPC; this is known as Osteopathic Manipulative Medicine.

What is Osteopathic Manipulative Medicine?

A DO or Doctor of Osteopathic Medicine is trained in Osteopathic Manipulative Medicine also known as “OMM or OMT” during medical school and residency. It is a hands-on technique used to help diagnose, treat, and prevent illness or injury.  

During an osteopathic exam, a head to toe assessment will be performed to evaluate for abnormalities that the Doctor can feel with their hands called somatic dysfunctions. These abnormalities may have an effect on your activities of daily living, like dressing, eating, and bathing. They may also disrupt the way you walk and the way you move because they may be painful, and this can impact your overall quality of life. 

Somatic dysfunctions can be defined as impaired or altered function of the somatic (body framework) system: skeleton, joints, and myofascial structures (muscles, ligaments, tendons) and their relation to the blood vessels, lymphatic system, and nerves. 

A Doctor of Osteopathic Medicine or DO employs treatments that restore and improve range of motion, by focusing on realigning trouble spots. Treatment modalities are patient specific and can include myofascial release (soft tissue work), muscle energy, high velocity low amplitude (traditional chiropractic work), counterstrain, and Still technique. During the visit, time will be set aside to discuss home stretches, exercises, and injury prevention.

What conditions can an Osteopathic Physician Treat with Osteopathic Manipulative Medicine?

Dr. Raquel Orlich uses the Osteopathic Manipulative Medicine technique to diagnose and treat a patient with a musculoskeletal health problem at the Plum Health DPC clinic in Detroit, Michigan.

Dr. Raquel Orlich uses the Osteopathic Manipulative Medicine technique to diagnose and treat a patient with a musculoskeletal health problem at the Plum Health DPC clinic in Detroit, Michigan.

Here is a list of common issues that can be treated and improved with OMM

  • Pain related to improper alignment in the back, hips, shoulders, and neck (chronic and acute)

  • Musculoskeletal pain of the arm and leg

  • Nerve impingement (sciatica, radiculopathy)

  • Range of motion of tissues and joints

  • Headache (tension, migraine, and sinus)

  • Constipation

If you are dealing with some of the issues listed above, you may be a good candidate for OMM as a safe and effective form of therapy. Getting an appointment is easy, just click this link.

-Dr. Raquel

Doctor of Osteopathic Medicine 


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