Plum Health Blog
Direct Primary Care Doctor in Detroit with Concierge Service
Direct Primary Care Doctor in Detroit with Concierge Service
Over the weekend, I made a house call to Ford Field.
Most of our house calls are to help regular Detroiters with the type of affordable and accessible health care services that we are known for at Plum Health.
If you don’t know about our direct primary care service, we offer excellent medical services at a monthly membership. We have an in-house pharmacy and we dispense medications, we offer a wide variety of procedures (biopsies, pap smears, toe nail removal, BOTOX), and we are able to draw labs and have the lab results back for our patients next day.
Most people use our Plum Health service because we can cut out the middle man and deliver a seamless primary care experience for an affordable price.
Every once in a while, we help a visiting executive, athlete, artist, or performer who needs our medical care and attention.
We have taken care of CEOs who require PCR testing with a rapid turnaround, we have taken care of artists who are visiting and who need help before an important gallery opening, and we’ve taken care of performers who need treatment before their big show here in Detroit.
These VIPs use our Plum Health service because we have the time in our schedule to accommodate their needs, we bring our medical care to them, and we give them a seamless experience without hassles. They might call it concierge medicine, but we prefer Direct Primary Care!
Happy Thanksgiving and thank you for considering Plum Health DPC for your health care needs!
-Dr. Paul Thomas with Plum Health DPC
Plum Health DPC is a Best of MichBusiness Award Winner
This month, Plum Health was named the Best Startup in Michigan by CORP! Magazine during their Best of MichBusiness Awards event. Here’s what they said about us:
Start-Up Businesses
One of the biggest issues during the ongoing pandemic has been access to affordable health care, something the folks at Plum Health Detroit know a little something about.
In 2021, Plum Health adapted by focusing on supporting physicians and making sure they had the tools, training, and time they needed to "deliver excellent care and service for our patients."
"Delivering excellent, comprehensive primary care services is challenging in a typical environment, but with the pandemic ongoing, we've increased our support of our doctors to ensure long-term sustainability of our practice," said Dr. Paul Thomas, Plum Health's founder. "At our clinic, we prioritize meeting the needs of our patients, while balancing family and home obligations for happy and healthy physicians. When doctors are happy and satisfied with a flexible work environment and schedule, they'll be able to help their patients to the best of their ability."
That attitude helped lead Plum Health to becoming the overall winner in the Start-Up Business category in the 2021 Best of MichBusiness Awards.
In 2021, Plum Health rolled out curb-side COVID testing and vaccination, helping thousands of Detroiters get vaccinated, either through the clinic or by educating them on nearby resources that they could utilize for vaccination and testing.
To read the full article, head to this link and navigate to pages 52/53 of the January/February issue of CORP! Magazine.
More from Best of MichBusiness Awards:
Thank you for making last week’s Best of MichBusiness Awards a wonderful experience. The community is buzzing around the phenomenal honorees and awards from the week. It was an honor to work with you and celebrate your success.
Here are a few follow up items regarding your honor:
Awards Presentation Link: https://vimeo.com/668363594/c0f05a81f1
Best of MichBusiness Program Book: CLICK HERE
The featured article in Corp! Magazine with the overall winners: January/February issue
Plum Health DPC Specializes In Comprehensive Women's Health
Plum Health DPC Specializes in Comprehensive Women’s Health
We strive to deliver excellent care and services for women in our community. We are fortunate to have two excellent female physicians at Plum Health DPC who go above and beyond for their patients at Plum Health DPC.
Specific Services Offered for Women’s Health at Plum Health
We offer a range of services for women in our community, both at our Detroit and Farmington Hills Office. Dr. Raquel Orlich practices at our Detroit office and Dr. Jamie Qualls practices at our Farmington Hills office. Both physicians are excellent in caring for women’s health concerns, including but not limited to:
Birth Control Services
IUD Insertion and Removal
Pap Smears or Pap Testing
Human Papilloma Virus (HPV) Testing
Sexually Transmitted Infection (STI) testing
Implanon Insertion and Removal
Dietary Counseling
Weight loss management
Aesthetics like Botox at our Detroit office with Dr. Raquel Orlich
Affordable and Accessible Health Care For Women
Health Insurance can often create a barrier for patients getting access to primary care services. If you’re uninsured or underinsured, getting access to a doctor’s visit can be difficult and expensive. With our direct primary care model at Plum Health DPC, we do not bill or use insurance. Therefore, most of our patients pay $49 or $69 monthly to be a part of our health care service (see our prices based on age, here).
In addition, many of the procedures and services that we offer at Plum Health are included in the membership. Included services include:
visits with the doctor
phone calls, emails, and texting with the doctor
many procedures like IUD insertion, IUD removal,
motivational interviewing like dietary counseling
educational services like birth control management
If you need oral contraceptive pills or birth control pills from our office, prices range from $4 to $9 monthly for medications like Sprintec, Aviane, Junel, Junel FE, and Apri.
If you need lab work performed at our office, it’s roughly $75 for Pap Testing with HPV co-testing and it’s roughly $45 for Sexually Transmitted Infection testing like HIV, Syphilis, Chlamydia, and Gonorrhea testing.
How to Sign Up For a Women’s Health Doctor in Detroit and Farmington Hills
If you’d like to sign up for this type of health care service for yourself, your family, or your business, you can enroll online here.
Thanks for reading!
-Dr. Jamie Qualls, DO, MPH and Dr. Raquel Orlich, DO
Family Medicine Doctor Accepting New Patients in Farmington Hills Michigan
Dr. Jamie Qualls is a Family Medicine Doctor practicing in Farmington Hills Michigan with Plum Health DPC. She is accepting new patients.
Dr. Jamie Qualls is a family medicine doctor accepting new patients in Farmington Hills, Michigan. She is a Board Certified Family Medicine doctor who completed her residency here in Southeast Michigan at Ascension Providence Hospital. She is a graduate of Michigan State University College of Osteopathic Medicine.
Dr. Jamie Qualls practices full time at the Plum Health DPC office in Farmington Hills, Michigan - the address is 25882 Orchard Lake Road, Suite 200B, Farmington Hills, MI 48336.
As a family medicine physician, Dr. Jamie Qualls has a broad scope of practice. She helps patients manage chronic conditions like diabetes, high blood pressure, depression, anxiety, mood disorders, asthma, COPD, and many more. Dr. Qualls is also proficient in caring for urgent concerns, like urinary tract infections, laceration repairs, ingrown toenails, strep throat, viral gastroenteritis, and others.
Finally, Dr. Qualls excels at integrating plant based nutrition into her care plans to produce optimal health outcomes for her patients. Dr. Qualls can collect blood work in the office to test for cholesterol levels, thyroid disorders, electrolyte imbalances, and kidney or liver disorders. She can also coordinate imaging studies that may be needed to make an accurate diagnosis.
To become a patient of Dr. Qualls, please sign up here.
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.
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.
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.
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.
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”
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.
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 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
Plum Health at Crain's Detroit Homecoming
Last week we attended Detroit homecoming at the Lexus velodrome sponsored by Crain’s Detroit. It was an event that brought together small business owners in Detroit and members of the Detroit expat community.
First of all, the Lexus velodrome is a really cool and exciting venue! It is a four lane track and there were cyclists racing at certain points of the event which was cool to see. In the middle of the track was a spectator spot with a bar and meeting areas for the small business owners, journalists, and members of the expat community to enjoy. Around the track there was booths for small businesses to set up and that is where we has the opportunity to interact with each other and the expats.
For me it was great to see the Detroit expats getting excited about small business and the growing entrepreneurial community in the city and it was nice to have some of them lend their expertise, knowledge, and insights during the event
The evening programming/after party was held at the Corner where they had a live band and an opportunity to get onto the historic Tiger’s stadium surface and hit some dingers!
In closing this was another fantastic event and a sign of the momentum in the Detroit entrepreneurial ecosystem.
Thanks for reading, and have a wonderful day,
-Dr. Paul Thomas with Plum Health DPC
Dr. Paul Thomas, MD of Plum Health DPC at the Crain’s Detroit Homecoming Event at the Lexus Velodrome in Detroit, Michigan.
Plum Health at the Michigan Central Station
Yesterday was a momentous occasion - Ford Motor Company announced their purchase and their plans for the historic and beautiful Michigan Central Station. The Michigan Central Station has been abandoned since the mid-1980's, and it has been an eyesore on the Detroit skyline for the past 20 years.
The empty station had been an emotional thorn in the side, constantly nagging at Detroit, reminding Detroiters of their past prominence, but also standing as a signal of our post-industrial economic failures.
But all of those bad feelings have been erased after today's event. Now, there's a sense of pride that Detroit has an opportunity to remake this historic site in the best way possible. The event at the Michigan Central Station felt inclusive, as community leaders from several different sectors were invited to be seated on stage.
There's also the impending economic impact of having thousands of Ford Motor Company employees working out of the Michigan Central Station in about 4 years.
As a lover of Detroit, Detroit history, and architecture this was a great day for me. As someone who cares deeply about the health of Detroiters and the prosperity of the region, this was one of the best days for me.
I am hopeful that the benefits of having Ford Motor Company in Detroit will be felt and experienced by all Detroiters - employment and economic prosperity is a key to having great health.
As a physician and a family doctor in Southwest Detroit, with our office just two blocks behind the historic and now revitalizing Michigan Central Station, I'm excited for the future challenges and opportunities.
Thanks for reading and watching,
- Dr. Paul Thomas with Plum Health DPC
Plum Health DPC is a family medicine practice in Southwest Detroit that delivers affordable, accessible healthcare. We remove the profit takers between you and your doctor, lowering the cost of healthcare. Our memberships are $10/month for children and start at $49/month for adults. This allows you to have contact with me, your doctor, any time you need me, as well as the ability to purchase wholesale medications and receive lab work at-cost. To start your journey with Plum Health, head over to our scheduling page: https://www.plumhealthdpc.com/schedule/
Guy Gordon Discusses Direct Primary Care on WJR
Today, Guy Gordon and Senator Patrick Colbeck discussed Direct Primary Care and the potential impact that it can have on the health and wellness of Michigan residents as well as the sustainability of the Michigan economy. The discussion was held on WJR News Radio (AM 760).
My name is Paul Thomas, M.D. and I am a family medicine doctor practicing in Southwest Detroit. I believe that healthcare should be affordable and accessible for everyone. I also believe that we can achieve this goal through direct primary care medicine.
It is a dream of mine to see and help more family doctors and primary care physicians transition from the fee-for-service model of healthcare to the direct primary care model. This will allow more doctors to deliver compassionate, truly patient-centered care with transparent pricing in our great state of Michigan.
To this end, I will be speaking at the Michigan Academy of Family Physicians statewide conference in mid July in Kalamazoo, Michigan about this very topic.
Thanks so much for reading and watching, and have a wonderful day!
– Dr. Paul Thomas, M.D.
The Radically Accessible Doctor in Detroit
This week, we took on a new patient on a Sunday evening. They had developed a pretty serious abscess in their armpit over the Thanksgiving weekend. On their drive home, they realized that they should probably have it looked at. By searching Google, they found our clinic!
Our new patient searched "Doctor Open Today", that's when they found Plum Health DPC!
Because it was a Sunday evening, they knew that it would be difficult to find an available doctor in Detroit. They searched "Doctor Open Today" and fortunately found our Plum Health clinic.
I believe that health care should be affordable and accessible. Because of that belief, I am radically accessible for the patients in my care.
So, that patient called around 2:30 pm on Sunday, and I was able to see them at 4:20 pm. We drained the abscess and started the appropriate antibiotic, dispensed from our in-clinic/on-site pharmacy. They had a follow up appointment during regular business hours on Tuesday, and was feeling much better!
Thanks for reading, and have a great day!
- Dr. Paul Thomas with Plum Health DPC
Starting a Direct Primary Care Practice in Detroit: What Inspired Me
I initially discovered direct primary care while on a road trip in November 2012. I was driving back to Detroit from a residency position interview at the University of Minnesota. I believe it was a libertarian-minded podcast featuring an interview with Dr. Josh Umbehr, discussing his startup in Wichita, Kansas, called Atlas MD.
It was refreshing to hear a Family Medicine doctor speaking so passionately about saving people money, delivering better care, and practicing in a unique way. The message resonated with me, but at that time I was pursuing a faculty position at a residency program because I enjoyed teaching so much. Suffice it to say that I filed this “Direct Primary Care” concept in the back of my mind.
Between my second and third years of residency, I went to the Michigan Academy of Family Physicians (MAFP) annual meeting in Traverse City. It was July 2015. There I met Dr. Clint Flanagan of Nextera Healthcare in Denver, Colorado. He spoke unequivocally about the value of being a primary care doctor and the tremendous value that we provide for our patients. His passion for the profession also came through in a way that I hadn’t experienced before.
These two leaders in the field served as a contrast to the typically burnt out and grumbling physician that I had met thus far in training. Even the best doctors grumbled about paperwork, prior authorizations, late patients, packed schedules, and all of the other difficult parts of being a primary care doctor.
At that point, I knew that I would pursue an alternative practice model. It only made sense – less-than-fulfilled physicians practicing in a less-than-ideal system surrounded me and I knew that life could be better on the other side. Additionally, I always had this inner drive to deliver medicine in a more equitable and just system. Direct primary care seemed to align with my values as an individual and as a doctor, but I needed to dive deeper.
So, as an elective rotation, I drove out to Wichita and Denver, and spent a week learning from both Drs. Umbehr and Flanagan. I kicked the tires, took copious notes, and tried to bring the best of their practices to my community in Detroit, Wayne County, and Southeast Michigan.
Now it's September 2017 - almost 5 years after I had initially heard of "Direct Primary Care". Now, I'm living DPC every day, taking care of people of all ages and stages in my clinic in Southwest Detroit. I'm even caring for people while on vacation - I helped about 10 of my patients while I was traveling abroad over the last week.
I am able to do this - to be the doctor that I was meant to be - because I am a Direct Primary Care doctor. This post is about inspiration, and what inspired me, and what continues to inspire me.
I am inspired by the fact that I can help people with real health care needs either in my office or over the phone, or via video chat or email. I am inspired by the fact that I am able to serve people who haven't seen a doctor in years, because we've lowered the cost barriers and therefore have made our service more accessible. I'm inspired by the fact that we can do so much good in such a small space.
I'm also inspired by the potential for Plum Health to grow, and to serve more people in our immediate community and across the region. I'm inspired by the happy patients that I get to work with everyday.
I've had great mentors along the way, specifically from the pioneers in the Direct Primary Care world, and I'm grateful for their help in getting me to a successful and sustainable DPC practice.
Thanks for reading this reflection, and have a wonderful day,
-Dr. Paul with Plum Health DPC
Dr. Paul Thomas of Plum Health DPC, in the Plum Health office!
How Many Direct Primary Care Practices in Michigan?
The number of Direct Primary Care doctors in Michigan is difficulty to quantify. A reasonable place to start is with a definition of what Direct Primary Care is and is not. Philip Eskew is both a lawyer and a DPC physician over at DPC Frontier, and he sets forth a good criteria:
FOR THE PRACTICE TO QUALIFY AS A DIRECT PRIMARY CARE, IT MUST:
1) CHARGE A PERIODIC FEE
2) NOT BILL ANY THIRD PARTIES ON A FEE-FOR-SERVICE BASIS, AND
3) ANY PER VISIT CHARGE MUST BE LESS THAN THE MONTHLY EQUIVALENT OF THE PERIODIC FEE
I wanted to apply this definition to the State of Michigan, my home state, to see how many "DPC" practices meet this criteria. As far as pure Direct Primary Care offerings open to the public, there are two: Chad Savage, MD with YourChoice in Brighton and Plum Health DPC in Detroit.
There are other Hybrid DPC offerings within clinics that also bill third party insurance companies: Dr. Younes in Dearborn, Dr. Tindle in Grand Blanc, and Dr. Kevin Roy in Saginaw. I take issue with the Hybrid practices, because you lose the accessibility piece that makes DPC such a great delivery model - these doctors are still seeing a significant number of insurance-based patients and offering DPC to a subset of patients. So if a DPC patient needs to be seen, they "jump the line" and are seen ahead of the insurance-based patients. This is less than ideal.
Premier Private Physicians offers what I would define as Concierge Care or Concierge Medicine. The membership is $200/month or $2400 for the year and some labs and vaccines are billed to insurance companies. Visits are included, but they do not have contracts for at-cost meds, labs, or imaging because their patients are typically high income earners/wealthier people who are not as cost sensitive.
The other category of "DPC" in the State is employer-based DPC. Some large employer groups like United Shore have contracted with a "DPC" provider like SALTA or ProactiveMD to have on-site doctors to care for their employees. These practices are not open to the public and people who are not employees at these companies cannot access these services.
Because the access to care is limited, this operates more like a third party structure as the large company finds that it saves money to pay a capitated rate for each employee to an on-site doctor, rather than the patient using their employer-provided insurance to seek out urgent care or emergency services. Unfortunately, employees may start to use the "DPC" doctor more for urgent care type visits and less for primary care, chronic care, or preventive services.
If you wanted to include all of the above practices in the definition of DPC, there are roughly 8 "DPC" providers in the State of Michigan. My argument is that there are only 2 "pure" or authentic DPC practices in the State of Michigan. Sincerely, I would love to see more doctors taking the plunge into authentic DPC medicine, and am here to inspire, encourage, and consult other doctors to do just that.
If you want to add to the conversation or debate, please send me a message or write a comment below!
Thanks for your time,
- Dr. Paul with Plum Health DPC
Plum Health DPC in Grosse Pointe
On Tuesday night we were invited to speak to a group called the Eastside Republicans at the Grosse Pointe War Memorial in Grosse Pointe Farms, Michigan about Plum Health and Direct Primary Care.
Other speakers were Chad Savage, MD of YourChoice Direct Care and Senator Patrick Colbeck, a staunch supporter of Direct Primary Care in Michigan. This is a part of a tour across the State, a series of events across Michigan where Senator Colbeck and Direct Primary Care doctors talk about free market options in healthcare.
This was the largest crowd on this tour, and there were about 100 people in the audience. There were some great questions asked and good information shared about DPC, health shared savings plans, and unique solutions for employers.
The next event will be in St. Clair Shores on April 24th - mark your calendars!
Thanks for reading and have a great day,
- Dr. Paul with Plum Health
What is Family Medicine?
Hello, this is Dr. Paul Thomas with Plum Health DPC and I'm a Family Medicine Doctor in Detroit. I operate Plum Health Direct Primary Care, which delivers affordable, accessible health care services in Detroit.
This week, I'm talking about Family Medicine Week, an official announcement from Governor Rick Snyder that makes February 19th - 25th Family Medicine Week. I'm a month late in bringing this up, but it's still important to recognize Family Medicine and the contribution of Family Medicine Doctors across the State of Michigan.
For starters, Family Medicine Doctors compete four years of undergraduate education, four years of medical school, and three years of residency. That's 11 years after high school and 7 years after college. Furthermore, some Family Medicine Doctors sub-specialize within Family Medicine.
They complete a 1 year fellowship to become Sports Medicine doctors, or Family Medicine doctors that sub-specialize in adolescent medicine, geriatric medicine, addiction medicine, etc...
The point is that Family Medicine doctors are highly trained, and specialize in taking care of the whole patient in the context of the family and the community.
Family Medicine doctors care for people of all ages and stages! We help deliver babies, we help infants meet developmental milestones, we complete school, work, and sports physicals, we take care of injuries like fractures and lacerations, and we take care of chronic conditions like diabetes, high blood pressure, and asthma.
Family Medicine doctors also work across a variety locations. Family Medicine doctors work in emergency departments, in-patient hospital settings, and out-patient clinics. Family Medicine doctors lead health departments for Cities, Counties, and States. Family Medicine doctors teach at medical schools, volunteer at homeless clinics, and travel abroad with organizations like Doctors without Borders.
Personally, I love being a Family Medicine Doctor - I love taking care of people regardless of their age, race, gender, and orientation. I love being able to offer care and compassion to those who need it, along with the standard medical care.
Finally, we need more Family Medicine doctors to create healthy communities, healthy cities, and a healthy nation. Family Medicine doctors address small issues before they become big, complicated problems. Family Medicine doctors and Primary Care Physicians can effectively increase the health of a community and lower the cost of care in that community.
Primary Care and Family Medicine is vital, and I'm glad that we have a week to recognize the work that Family Medicine doctors carry out each day in the State of Michigan.
Thanks for your time, and have a wonderful day,
- Dr. Paul Thomas
Plum Health Featured in Healthcare Michigan
On February 9th, I was invited as a panelist at the Future of Healthcare event at Wayne State University School of Medicine. While at the event, I met Paul Natinsky, a writer for Healthcare Michigan. Friendly, outgoing and genuinely interested in the work that I was doing, Mr. Natinsky and I scheduled to meet up a few weeks later.
When Mr. Natinsky came to our Plum Health office, he brought his tape recorder and camera, and most importantly he brought his insight and some tough questions. We talked for well over an hour on a variety of subjects. This week, he released his notes from that meeting in the form of a publication in Healthcare Michigan.
The work that we're doing with Plum Health is the feature story in the March 2017 issue, and we couldn't be happier about spreading the word about Direct Primary Care in Michigan. You can read the article in full, here.
Thanks for reading, and have a wonderful day!
- Dr. Paul
