Throwback to March 2018: Paul Thomas MD on IT in the D

Unfortunately, David Phillips, long-time Detroit podcaster, has passed away. To honor his memory, and to highlight his humor and magnetism, here’s our interview with Bob Waltenspiel, David Phillips, Jer Staes, and Randy Walker. As a warning, there is some adult humor and language in this episode, so if you want to jump to a cleaner portion of the interview, skip to time 31:00:

Why Direct primary care is appealing for Patients

During the episode, the host Gary Bredow interviews a few of our patients. He talks with Will Langford and he talks about being seen by his doctors, and understood by his doctors. Will says that “I believe that Plum Health is the future of medicine.” He goes on to say that, “for people who’ve never experienced direct primary care - it’s worth it. If you’ve ever felt that a doctor didn’t see you, or didn’t hear you, or didn’t believe you, anybody who’s just wanted help, and they haven’t gotten it from people who were supposed to help, try direct primary care.”

Will “The Poet” Langford discusses why he’s a part of Plum Health DPC with Gary Bredow, the host of the Start Up show on PBS.

Why Direct primary care is appealing for Doctors

During the episode at about the 10 minute mark, Gary Bredow sits down with Dr. Raquel Orlich and asks “what do you find attractive or appealing about this model versus the traditional model?” Dr. Orlich discusses the importance of talking with patients and getting to know them, and the ease of communication via in-person appointments, text messages, and emails. She also discusses the importance of having enough time to work through all of the factors that are affecting her patients’ health, and this can lead to patients feeling heard and being able to get to the root of their health care problems.

Raquel Orlich, DO of Plum Health DPC during the filming of Start Up with Gary Bredow on PBS. Plum Health DPC is a direct primary care practice in Detroit and Farmington Hills that delivers affordable and accessible health care services.

Dr. Jamie Qualls is working with Plum Health out of our Farmington Hills, Michigan location and she joined our practice because she can “go out and be the doctor I really wanted to be.” She goes on to say that this direct primary care model is growing rapidly not only across the country, but locally, and patients are loving the experience of being a part of Plum Health and a part of direct primary care practices in general. The direct relationship between doctors and patients is really appealing to patients in our practice.

Dr. Jamie Qualls, DO, MPH of Plum Health DPC talks with the host Gary Bredow about why the direct primary care model works for both patients and doctors.

“Maybe the direct primary care model is the future.”

There were so many memorable moments from this episode, but perhaps the most powerful sentiment was communicated in the closing remarks of the host of the show, Gary Bredow. He said:

“After speaking with several of his patients, his model is working. Throughout our conversation, I couldn’t help but wonder why a common-sense approach to health care seemed so foreign to me. Dealing with insurance companies is all that many of us have ever known. Waiting on hold for hours at a time trying to speak with someone and trying to decode confusing bills has always been synonymous with healthcare for me. I just assumed that it’s a part of the wellness process.

“But this is something entirely different. Individuals pay an affordable monthly rate for the service, the doctor gets to spend more time with patients, which possibly leads to better preventative care and you don’t have to wonder what your next visit is going to cost, or have to deal with co-pays, deductibles, or out of pocket expenses. To me, the health care system is not working for everyone equally with millions of people uninsured or underinsured. Maybe the direct primary care model is the future. Either way, it’s nice to know that there’s options available.”

We agree - direct primary care is the future, or at least a part of it. While direct primary care will never replace catastrophic insurance or some form of insurance coverage that serves as a financial tool to prevent bankruptcy, insurance can never give to patients what direct primary care gives to patients - a straightforward and trusting relationship between doctors and their patients.

How to Sign Up

If you want this type of care for yourself or your loved ones, your business or your family, you can enroll here.

Thanks for reading and watching this segment, and we are happy to help you in your journey to better health!

-Drs. Paul Thomas, MD, Raquel Orlich, DO, Jamie Qualls, DO, MPH, and Leslie Rabaut, DO

Paul Thomas, MD of Plum Health DPC during the filming of Start Up with Gary Bredow on PBS. Plum Health DPC is a direct primary care practice in Detroit and Farmington Hills that delivers affordable and accessible health care services.

How Plum Health DPC Started

Recently, I had a great interview with Dr. Kevin Cuccaro and Dr. Melissa Cady of the Changed Physician. We discussed why I went into medicine and how Plum Health DPC came to exist. Here’s what they said about our practice:

This is Episode 67 of The Changed Physician Podcast with Dr. Paul Thomas discussing his journey into direct primary care with hosts, Dr. Kevin Cuccaro and Dr. Melissa Cady.

Timeline:

• 01:00​ Why he went into medicine

• 03:00​ Community outreach and art

• 06:30​ His realizations during residency

• 09:15​ What led to him discovering a new model of delivering medicine

• 12:30​ Physician shortage area

• 14:30​ What is DPC (Direct Primary Care)

• 15:30​ How he provides affordable meds and labs for patients

• 16:15​ Why Americans are screwed over by the Medical Industry

• 17:00​ How DPC model empowers patients

• 19:20​ How his interaction with his patients is now

• 22:20​ Why he named his business Plum Health

• 24:45​ The cost of his direct primary care model

• 26:50​ How his practice model gives him time for his other pursuits
  

What is Plum Health DPC

Plum Health DPC is a membership model for primary care in Detroit, Michigan and Farmington Hills, Michigan. We believe that healthcare should be affordable and accessible for everyone. Our patients pay a membership to be a part of the practice, starting at $49 each month for adults. With that membership, they can call or text their doctor anytime they need care. We guarantee same-day or next-day appointments and no wait time for scheduled appointments. We also save our patients 50% to 90% on their medications, labs, and imaging costs.

What is Direct Primary Care

Direct Primary Care allows you to have a direct relationship with your doctor. For the equivalent of a monthly cell phone bill, you can receive direct, primary health care services that are tailored to your individual needs.

Plum Health Direct Primary Care Simplifies How Patients Connect with their Doctor

Health Insurance Overcomplicates Health Care

Intentionally or unintentionally, health insurance companies have made the practice of medicine overly complicated. As a patient, have you ever felt like you wanted to ask your doctor a simple question, but didn’t want to have to call the office, to leave a message, to have someone pass that message to the doctor, to have the doctor call you back 3 days later? I mean, what gives? We have text messaging and emails that make communication seamless among regular people, but for some reason, doctors remain out of reach.

I was watching the Super Bowl Halftime Show when I saw The Weeknd trying to find his way through a house of mirrors. It reminded me of how patients feel when trying to navigate the health insurance system - it’s hard to find your way through a distorted system with blinding lights. So, I made this post on my LinkedIn page (connect with me on LinkedIn if you haven’t already!):

Trying to navigate the health insurance system when all you want to do is ask your doctor a simple question...

This is why so many people are reaching out to their Direct Primary Care doctor - we get rid of this house of mirrors and the distorted versions of primary care and create a system where the patient's needs are prioritized.

See what all the buzz is about at Plum Health DPC.

Direct Primary Care Simplifies the Healthcare Experience

The direct primary care model simplifies health care delivery in that our patients are able to text, email, or call us anytime. We guarantee a response within 24 hours, and if you text during business hours, you’ll often hear from us within a few minutes to a few hours. This takes a lot of the anxiety and stress out of the health care experience and our patients can seamlessly access the care that they need, when they need it.

If you’d like to enroll in our service, you can sign up here:

Thanks for reading and have a wonderful day,

-Dr. Paul Thomas with Plum Health DPC

Detroit-based Restaurant Workers and Food Service Workers are Now Eligible for COVID Vaccine

The COVID 19 vaccine is now available for all Detroit-based restaurant workers or food service workers. If you live in Detroit OR work in Detroit, you're eligible. There is no age limitation.

To set up an appointment, call: 313.230.0505

You can schedule an appointment 9 am - 6 pm via the above phone line.

More information on the Detroit website: https://detroitmi.gov/departments/detroit-health-department/programs-and-services/communicable-disease/coronavirus-covid-19/covid-19-vaccine-latest-updates

This will be a drive through operation at the TCF center.

The eligibility is also expanded to security guards and janitors:

- All food or beverage workers living or working in the City of Detroit: Grocery stores, restaurants, meat packing, food and beverage handling facilities.

- Security guards and janitors.

It might be a good idea to bring your ID and a paystub to make sure you meet eligibility.

From the Detroit Free Press:

The newly eligible workers include employees of restaurants, grocery stores, meatpacking companies and food and beverage firms. There is no age requirement for the workers but they must live or work in the city. Duggan estimates the groups total several thousand people.

https://www.detroitnews.com/story/news/local/detroit-city/2021/02/02/duggan-provide-update-expanded-covid-19-vaccinations-detroit/4352603001/

Thanks for reading and have a great day,

- Dr. Paul Thomas with Plum Health DPC

313.444.5630

Coronavirus Update and Vaccine Side Effects with Dr. Jamie Qualls and Dr. Paul Thomas

Coronavirus Update for January 26th, 2021

Today, Dr. Paul Thomas and Dr. Jamie Qualls of Plum Health DPC discuss the Coronavirus pandemic and what’s happening in Detroit and Southeast Michigan with regard to the Coronavirus.

There have been 551,080 cases of Coronavirus in Michigan and there have been 14,326 deaths from coronavirus. In context, losing that many people to COVID 19 is like losing the entire population of Rochester with a population of 13,162, Wixom with a population of 13,902, or Harper Woods with a population of 13,895.

Age Groups Affected by the Coronavirus

The age group with the highest number of cases are those between 20 and 29 years. There have been about 103,956 cases in this age group and 54 deaths. The age group with the highest number of deaths are those 80 years old or older. In those 80 years of age or older, there have been 27,327 cases and 6,675 deaths.

The death rate among the elderly in Michigan is staggering. If you are 80 years of age or older and you are infected by the coronavirus, there’s about a 24% chance of dying from COVID (6,675 deaths among 27,327 cases).

That’s why it’s so important that the elderly (those 75 years of age and older) are prioritized for vaccine access.

Coronavirus Vaccines Administered (So Far)

So far, about 19 million first doses have been given out in the United States and about 3 million people in the US have received both doses of the COVID 19 vaccine. In Michigan, about 730,000 vaccines have been administered. You can dive into the nitty gritty at the Michigan Coronavirus vaccine dashboard.

Coronavirus Vaccine Side Effects

With the COVID-19 vaccine rollout, there is understandably much apprehension about its potential side effects. According to the CDC, some of the most common side effects reported are pain and swelling at the region of injection, as well as fevers, fatigue, chills, and muscle aches. (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html)

The CDC recommends taking an over the counter medication like ibuprofen or Tylenol to reduce the discomfort of these side effects. It’s also recommended to drink plenty of fluids and get adequate rest. Most of these side effects resolve on their own within a few days. These side effects are likely a result of your body responding to the vaccine and mounting an immune response, which is a sign that the vaccine is doing its job (https://www.aarp.org/health/conditions-treatments/info-2020/coronavirus-vaccine-side-effects/).

Side effects from the COVID vaccine may cause recipients to miss a day or two of work, but typically resolve without further intervention.

Cough, shortness of breath, rhinorrhea, sore throat and loss of taste or smell are not typical following vaccination. If you develop these symptoms, the CDC recommends staying home from work pending evaluation for possible causes including COVID-19.

There have been reports of people developing a severe allergic reaction to the vaccine. The CDC recommends seeking immediate medical attention in the event of an allergic reaction. It is important to keep in mind that these reactions, though serious, are relatively rare, seeing as tens of thousands of people have been vaccinated without severe reactions. (https://www.cdc.gov/mmwr/volumes/70/wr/mm7002e1.htm)

Finally, it’s important to recognize that side effects from all vaccines are common. The seasonal flu shot, for example, can cause fever, fatigue, and muscle aches, amongst other vaccines. The important thing is to weigh the temporary discomfort of such side effects to the long term benefits: a potentially high level of protection from a disease that has killed more than 1.6 million people globally.

Final Thoughts

As always, wear a mask, wash your hands, maintain a minimum of 6 feet of physical distance between yourself and others, and limit unnecessary travel, trips, and crowded areas.

Thanks for reading and have a wonderful week,

-Dr. Paul Thomas and Dr. Jamie Qualls of Plum Health DPC

Non-Profit Hospital Systems and Financial Assistance Programs

Many hospitals in the metro Detroit region have a non-profit status. Part of that non-profit status is forgiving medical bills for patients who earn below a certain threshold. So, if you have a low income and you have been hospitalized, and you are unable to pay the bill, you may be eligible for a financial assistance program through your hospital.

Here’s how it works. You can start by Googling your hospital system and their financial assistance policy, let’s take Beaumont Health as an example.

From the Financial Assistance Policy page, you can find the exact dollar amounts you would have to earn to have your medical care forgiven by the non-profit or not-for-profit hospital system. These are based on the Federal Poverty Guidelines. At the hospital in this example, if you earn up to 200% of the Federal Poverty Guideline, you can have 100% of your medical care forgiven. If you earn up to 300% of the Federal Poverty Guideline, you can have 76% of your medical care forgiven. Read this page for the full Financial Policy.

Charity Care Adjustments for 2021 at Beaumont Health, a not-for-profit company.

If you find yourself in this situation, of receiving medical care that you cannot afford while being below 300% of the Federal Poverty Guideline, you can apply for medical bill forgiveness via this form.

This is just one example of how to get this done, as there are distinct hospital systems with distinct Financial Assistance Policies. But, a quick google search and a few forms may help you save a lot of money on a hospital bill.

Thanks for reading, and have a great day,

-Dr. Paul Thomas

Oakland County Vaccine Rollout Update

COVID-19 vaccine update in Oakland County: Save Your Spot Sign-up Available until Vaccine Supply Increases

Pontiac, Michigan – Oakland County Health Division (OCHD) is asking residents to remain patient during this time because of the overwhelming demand for the COVID-19 vaccine. The Health Division has received 7,800 doses, administered about 5,600 vaccines, and scheduled an estimated 17,000-plus first- and second-dose appointments through the end of February. Minimal vaccine supply, however, limits our ability to schedule appointments for the hundreds of thousands of eligible workers and Oakland County residents who are still waiting to be vaccinated. Use the newly launched Save Your Spot link on our website oaklandcountyvaccine.com to help us identify individuals who are eligible and interested in receiving the COVID-19 vaccine. For anyone unable to complete the form, call our upgraded health hotline at 800-848-5533. 

"We are asking the community to help us plan for administering future doses of vaccine we receive by completing this new form," said County Executive David Coulter. "This will help us reach residents and workers who are eligible for vaccination when more doses become available.  As we receive more vaccine, we will continue to administer them quickly and efficiently until everyone has the opportunity to receive the vaccine."

The Health Division is currently vaccinating individuals in phases 1A and 1B of the Michigan Department of Health and Human Services (MDHHS) COVID-19 vaccination plan who work or live in Oakland County.

The Health Division is following MDHHS and Centers for Disease Control and Prevention (CDC) recommendations for prioritizing distribution of COVID-19 vaccines to individuals. According to MDHHS, those now eligible to receive the vaccine include:

• Healthcare workers

• Residents 65 years and older

• Frontline essential workers including police officers, first responders, frontline state and federal workers, jail, and prison staff; and preK-12 teachers and childcare providers (Phase 1B)

In addition to frontline essential workers, there are over 217,000 residents age 65 and older eligible to receive the vaccine in Oakland County. To receive updates on COVID-19 vaccine availability, register your email address at oaklandcountyvaccine.com or text OAKGOV COVID to 468311. The Health Division phone lines are very busy and sometimes Nurse on Call receives over 20,000 calls per day. Oakland County appreciates the public's patience. Nurse on Call is available at 800-848-5533 to answer health-related questions, make COVID-19 testing appointments, and assist those unable to complete the 'Save Your Spot' link.

Currently the COVID-19 vaccine is available through local health departments and local health systems. Residents are encouraged to check their health providers online medical chart or portal as all local health systems are going to start making appointments for their patients once they vaccinate their medical personnel.

• Beaumont Health

• St. Joseph Mercy Oakland

• Ascension Providence

• McLaren Oakland

Vaccine information can be found at:

• Oakland County: https://oaklandcountyvaccine.com/

• MDHHS: Michigan.gov/COVIDVaccine

• CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html

More information about COVID-19 can be found on the Health Division's website at www.oakgov.com/covid. For up-to-date public health information, follow @publichealthOC on Facebook and Twitter. 

I Love Direct Primary Care

I love Direct Primary Care.

What is Direct Primary Care?

It’s not concierge.

It’s not insurance-based care.

It’s not a referral source for the hospital systems.

It doesn’t inflate the cost of care.

It doesn’t let people slip through the cracks of the health care system.

It’s affordable and accessible.

It’s comprehensive and compassionate.

It’s personable and reliable.

You can visit in person with your own doctor, for an hour if you need the time.

You can call, text , FaceTime, or email with your doctor.

You can communicate via Messenger or Instagram.

It’s medical care and a real relationship with an independent physician who truly cares about you and your family.

I love Direct Primary Care because it’s how primary care is supposed to be delivered.

City of Detroit Vaccine Rollout Update

The vaccine rollout here in Michigan has been relatively slow compared to other states. The Washington Post has a great article tracking vaccinations. Here’s where Michigan stands in the COVID vaccine effort:

At least 222,379 first doses have been administered (total population is 9.987 million)

covering 5.2% of the prioritized population...

and 2.2% of the state’s population.

Michigan has been allocated 696,600 doses,

enough to vaccinate 16.0% of the prioritized population...

and 7.0% of the state’s population.

On Monday, we received a press release from the City of Detroit about the Coronavirus Vaccine out of the TCF Center. Here it is, in full:

Statement from Detroit COO Hakim Berry on TCF COVID Vaccine Scheduling process

Since 9am this morning our COVID vaccine scheduling call center staffed by Rock Connections has experienced extremely high volumes, receiving more than 100,000 calls. Those who predicted that Detroiters would not be interested in receiving the vaccine were clearly incorrect.

Rock Connections has already increased its call center staff from 42 to 56 representatives booking the appointments.  Call Center hours have now been increased by two hours a day and will operate 9 AM and 8 PM. 

Our system is set up so that calls will not be kept on hold if there is more than a half-hour wait to speak to a representative.  If your call is dropped, please call later today or anytime this week.  At any point the wait time is under 30 minutes, your call will go through.

A major cause of call volumes is a large number calls from individuals who are not eligible.  We do not have the capacity to answer questions from people under 75 or non-Detroiters about vaccinations in general.  If you are not eligible to book the vaccine, please do not tie up the call lines. 

As a reminder, people should call 313-230-0505 to schedule an appointment only if they meet the following qualifications: 

• A Detroit resident 75 and older

• Any “good neighbor" 65 and older who drives a 75 year old (or older) Detroit resident to TCF

• The following Group B essential workers: K-12 teachers and support staff and child care workers

We are booking 20,000 appointments through February 5th.  The call center has the ability to book up to 4,000 appointments per day, so we expect to be booking appointments at least through the end of the day Friday.  We will add to those appointments as fast as the federal government provides vaccines.

We thank Detroiters for their patience in this process and, most of all, for their commitment to being vaccinated so life can get back to normal as soon as possible. 

---

This is somewhat frustrating, because the listed qualifications above are narrower than what was previously released. The previous statements from the State of Michigan include more people in the Phase IB, but the City of Detroit must be focusing on Group A only at this time, which includes only seniors over the age of 75:

Group A:

• Persons 75 years of age or older not covered in Phase 1A.

  • This includes those in a congregate setting that were not reached in Phase 1A.

Henry Ford Health System Vaccine RollOut

Henry Ford Health System is also rolling out the vaccine here in Detroit, so if you have a MyChart account with Henry Ford, you could potentially receive an email from Henry Ford Health System (HFHS) about this vaccine option. See below for full details - this information was sent out to HFHS staff on January 8th.

What’s interesting to note is that Henry Ford is following the State of Michigan guidelines for eligibility, including “anyone 65 years and older and a broader category of essential workers.”

---

We have made considerable progress vaccinating our team members, having administered first doses to nearly 17,000 employees, with second doses underway for those vaccinated during our first days of the campaign. We are now expanding eligibility to volunteers, Henry Ford retirees 65 years and older, and approximately 3,000 students from our clinical education community. Additionally, we are partnering with multiple leaders across our region in a collaborative effort to vaccinate private practice physicians and other healthcare workers.

As you likely know, the state of Michigan has also expanded guidelines for eligibility to include anyone 65 years and older and a broader category of essential workers. Based on that guidance, we are finalizing our plans to begin vaccinating patients and members that meet those guidelines beginning next week.

• Sites: We plan to launch two types of sites over time – those that will operate from our existing primary care clinics and others designed to serve as “mass vaccination sites” to accommodate larger numbers of patients safely, provide greater access and parking, and operate without disruption to our normal clinical activities. Here’s a breakdown by market:

  • South - The K-building at Henry Ford Hospital will open Monday, Jan. 11, with Henry Ford Medical Center – Ford Road expected to open by the end of next week

  • North - Three sites are expected to open by the end of next week: Henry Ford Medical Centers Lakeside and Columbus and the HAP Troy administrative building

• Central - Two sites are expected to open next week: One Jackson Square as early as Monday, Jan. 11, followed by Henry Ford Allegiance Specialty Hospital, the current site for drive-through testing

• Staffing: We know staffing continues to be a challenge but we have identified a number of viable options including our own primary care team members to staff the medical center locations. Additionally, HR plans to activate our central staffing model early next week to help identify needs, as well as team members who may be able to redeploy.

• Scheduling & Patient Engagement: Initially, we will need to prioritize existing Henry Ford patients 65 years and older and plan to contact them proactively via email, providing resources to help them make an informed decision and encouraging them to sign up for MyChart if they haven’t already, for online scheduling when appointments become available.

We know that much of this is new territory and we will need to be agile as things change. A complex, community-wide vaccination campaign of this size and uniqueness requires unprecedented partnership, innovation and determination. We can’t imagine pulling this off with any other team and we are so proud of your efforts in service to our communities and each other.

---

Thanks for reading, and best of luck navigating these vaccine resources.

-Dr. Paul Thomas with Plum Health DPC

Frustrations Around Vaccine Rollout are Palpable

As we learn more about Coronavirus Vaccine availability, we'll keep you updated.

Vaccine Options for Oakland County Residents

For residents of Oakland County, there are some options, but they are not robust at this time.

One option would be the Oakland County Health Department. It looks like they are not yet vaccinating https://oaklandcountyvaccine.com/eligibility/

You could periodically check this website to see when they are opening up mass vaccinations.

The other option would be Beaumont Health. However, their website crashed on Friday from people trying to make appointments.

You could try to create an account via the MyBeaumont Chart, here: https://www.beaumont.org/my-beaumont-chart and hope that they send an email to you.

Some of our patients have received an email invitation via the Beaumont MyChart system to get the vaccine. They are trying to give it to people over 75 and then over 65 years of age.

Henry Ford Hospital is doing something similar. Here’s some information from the Detroit Free Press:

Don't call us. We'll call you.

That's what the state's COVID-19 vaccine website and many local health departments are telling seniors, teachers, child care workers and law enforcement officers who will be eligible starting Monday for coronavirus vaccines through an expansion of the statewide immunization program.

In part, that's because local health officials had almost no heads up before Gov. Gretchen Whitmer announced anyone 65 or older would soon be eligible to be vaccinated.

Whitmer announced Wednesday that starting next week, people in Priority 1B group will be able to get COVID-19 vaccines along with health care workers, people living and working in long-term care facilities and emergency medical responders who are part of the 1A Priority group.

In short, a lot of people are feeling frustrated and confused about the vaccine roll out - you're not alone in this.

As we know more information, we will share it with you.

As an addendum, in yesterday’s blog we talked about the Vaccine Rollout at the TCF Center in Detroit. Some of our patients have been calling the number since 9 am and it has been continually busy. If you get through, please send me an email or drop a comment on the bottom of this post.

- Dr. Paul Thomas with Plum Health DPC