Paul Thomas MD interviewed on the Soul of Enterprise Podcast

This week, I had a one-hour conversation with Ed Kless and Ron Baker. Here’s the full audio recording:

Ed and Ron both asked some amazing questions, here’s what we discussed on the show, via their website:

Join Ed and Ron for our second interview with Dr. Paul Thomas, Founder of Plum Health DPC (Direct Primary Care), to discuss COVID-19, and his experience dealing with this from the front lines. Also, his new revolutionary business model in medicine. Is this the cure for our broken healthcare system, and how’s it going so far?

A Quick Bit About Dr. Paul Thomas

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.

Here are Ed’s questions from the interview:

  • How are you?

  • What about the people in your local community, how’s it going there?

  • About 40% of hospital beds in Michigan are filled with COVID patients, does that sound right?

  • Is there a difference between intubation and being on a ventilator, or are they the same thing?

  • And that’s different from being on oxygen?

  • There are potentially long-term risks with being intubated, even after you come off it, such as challenges with your lung capacity coming back?

  • What has been the effect, if any, on your business model? Has there been any significant challenges with Direct Primary Care (DPC) model?

  • Are they waiving any regulations to be able to provide telemedicine, for example?

  • Do you think COVID-19 might lead to a significant increase in DPC?

  • Will doctors get acclimated to provide telemedicine?

  • The numbers we’re all seeing at John Hopkins or Worldometer, the numbers are pretty scary, but they are also are staggeringly incomplete. I don’t think we can really believe the number of cases in China being limited to 81,000, for instance.

  • You talked a little bit about the tests with Ron, what are your thoughts about the at-home tests? Will we all be able to test ourselves at home and get some better numbers about what’s happening?

  • The FDA and CDC sort of messed up the process with the test when all this began. What are your thoughts on that?

  • This is less political than governmental. The nature of bureaucracy that may have been the downfall, regardless of the administration.

  • On your website blog, you did a great job debunking the Vitamin C myth that’s out there. What about hydroxychloroquine as a possible treatment?

  • What about the potential vaccine for this? If one was quickly developed would we be able to get it out quick enough, or would that run into bureaucratic hurdles?

  • Does that 15-18 months include the testing and verification, or just the development of a vaccine?

  • What about links you’ve seen to diabetes or pre-diabetic condition, or does it mostly just affect those who are older?

  • Age and diabetes are correlated aren’t they?

…and here are Ron’s questions:

  • In times like this, do you think this business model has deepened your relationship with patients?

  • Do you think the subscription model helps you weather a storm like this rather than a more transactional business model?

  • Can you explain the protocol for a COVID-19 test? Don’t they test for the flu first, and only as a last resort test you for COVID-19?

  • We don’t have a clear idea of the “denominator,” we don’t how many people are walking around with asymptomatic symptoms, right?

  • Settle a big dispute: Should we be wearing masks when we go out? [Yes!]

  • Does it have to be an N95 mask? [No]

  • You probably remember that in 2009-10 we had the Swine Flu, and between April 12, 2009 and to April 10, 2010, 12,469 people died in the USA alone, with 87% being under age 65. What makes COVID-19 deadlier than the swine flu?

  • Can this can back in different strains? Can you get again once you’ve had it and recovered?

  • Have you seen any granular demographic, age, comorbidities information on the reported deaths and/or cases?

  • With older patients, there’s a difference between dying from and dying with corona virus. How do they make that distinction when they gather the death statistics?

  • The University of Pittsburgh has developed a vaccine, they say they’ve seen development antibodies in mice. And I just finished a book by the oncologist Dr. Azra Raza, who wrote The First Cell. She says, at least for cancer, having anything to do with mice doesn’t really work when translating to humans. But is that not true with vaccines? The fact it works with mice, is that promising for humans?

  • We say it takes 12-18 months to develop a vaccine. Is there a way for the FDA to expedite this process. What is the risk of a vaccine developed quickly?

  • On your website blog video from March 26, 2020 you answer the question, “How can I become immune?” You listed two ways:

    • Get Infected then Recover (your body produces IGM/IGG) and you now have the antibody

    • Vaccination

  • You said to create herd immunity you need 50-60% of people, can that immunity happen plasma transfusions from people who had the virus and recovered?

  • What about this virus running it course and achieving of herd immunity? How long does that process take without a vaccine?

  • Unless it comes back in a different strain?

  • I’m looking at Worldometer, and Michigan has now surpassed California in cases. We were taking flights from China during December and January, at the rate of at least 7,000 per day. There’s only 246 deaths in CA—each a tragedy—can you account for that? Why wasn’t CA hit has hard as New York, New Jersey, or even Michigan?

  • Could it be herd immunity, why CA wasn’t hit as hard?

  • Where do you see this ending? How and when?

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