Plum Health Blog
Doctors Embracing Startup DPC Book on Social Media
Startup DPC Book Gets Great Feedback on Social Media
This week, we’ve been getting a lot of love for the Startup DPC Book on Social Media.
Let me preface this post by stating a few things. First, I’m a physician on a mission to delivery affordable and accessible healthcare here in Detroit and beyond. Second, I’m an educator. Not only am I a clinical assistant professor at Wayne State University School of Medicine, but I also teach in other ways. One of those ways is by teaching other doctors how to successfully start and grow their own direct primary care practices.
I truly believe that direct primary care is a better way of serving our patients - we have more time to listen to our patients, we have more tools to deliver compassionate care, and we can actively lower the cost of medical care for our patients. Therefore, I want to reach as many doctors as possible with this information.
My physician colleagues have responded and they’ve sent me some tremendous feedback via social media. Below are a few of those posts!
Direct Primary Care Doctor Inspired by Startup DPC Book
Recently, Rebecca Berens, MD of Vida Family Medicine in Houston Texas sent out very kind post on Instagram. She recently read the Startup DPC book, Startup DPC: How to Start and Grow Your Direct Primary Care Practice and she posted a quote on her Instagram that I used in the book from John C Maxwell, “Growth is the great separator between those who succeed and those who do not. When I see a person beginning to separate themselves from the pack, it's almost always due to personal growth.”
This is the quote that I used at the beginning of Chapter 6 on How to Prepare for Direct Primary Care While in Residency. I used the quote here because I believe that new doctors and residents have the greatest opportunity to learn a new system of care, and they have a unique opportunity to adopt the DPC model and the DPC mindset before getting enmeshed in the dysfunctional fee-for-service system as an employed physician.
Here’s what Dr. Berens had to say:
I love this quote that Dr. Paul Thomas from @plumhealthdpc added to his new book, #startupdpc Direct Primary Care is a new concept to many patients (and even doctors), but it was truly personal growth that led me to take this path. I was so tired of churning patients through the system in 10 minute increments, never having enough time to really help them in the way I knew I could. Meanwhile, I was arriving home to my family emotionally drained and physically exhausted. Becoming a mother made me realise that I needed to do better, for my patients and my family. Starting your own business is a huge risk (even without a pandemic throwing a wrench in the mix!) but in the end all of the stress and uncertainty it will be worth it.
.
.
Does spending more time at home during pandemic have you reflecting too? How have you grown over the last few months?
TESTIMONIAL FOR STARTUP DPC BOOK AND COURSES
Post from Dr. Prisiliano Salas about the Startup DPC Book and Startup DPC Courses:
Just finished a course by Paul Thomas, M.D. from Plum Health DPC and #startupdpc. Let me just say that Paul knows his stuff. I met him in 2018 at the Family Medicine DPC Summit. He gave a lecture about his experience starting a #DirectPrimaryCare practice and using social media marketing strategies. I've been following him on/off during this time but had not fully made the jump onto social platforms the way he describes it. Now two years later his practice growth is testament to this method. He's full and added a new doc! On top of that he remains faithful to his mission, to empower the #DPC community with his knowledge and reproducible success. I'm now ready to embrace social media to share my knowledge and experience with my patients (though still working up to youtube to get more camera ready 😎 ). Take one of his courses or read one of his 2 books, he won't disappoint. Keep the momentum going!
Thank you so much for the shout out Dr. Salas! and best of luck with your direct primary care practice. I know that you’ll have every advantage on attracting new patients after taking our Sales Funnel course.
Regina Allen Hardin, MD of Modern Medicine made this post on LinkedIn:
Medical Student gives a shout out to the Startup DPC book
This week, Startup DPC got a nice shout out from Pretty Girl Practice on Instagram. If you’re a direct primary care doctor, social media applications like Facebook and Instagram can be great platforms to reach new audiences and also to improve your branding. If you don’t have a Facebook Page or an Instagram page for your direct primary care practice, consider making one to improve how people in your community perceive your brand and your business. I teach doctors how to do this, step-by-step, in the Sales Funnel course on our website, here.
Here’s what Pretty Girl Practice on Instagram had to say about direct primary care:
You pay a monthly membership fee (like Netflix) to your Doctor
You can schedule as many visits as you like with your DOCTOR and text your doctor medical questions when needed (no more Dr. Google 🤓)
Hour long visits and you receive higher quality care (currently insurance companies often have quick 20 minute visits to see more patients and therefore make more money)
great for fields like Family Medicine, Pediatrics, even some Dermatologists use this model
allows Doctors to be entrepreneurs again! and brings back the treasured physician-patient relationship. Also, decreases burnout for physicians. Plus patients are more satisfied, win-win!
I really think DPC will be the practice of the future. It’s the practice a lot of us dreamt of when we first became doctors.
The following image is a screenshot from her story about Direct Primary Care:
Startup DPC gets a nice shout out from PrettyGirlPractice on Instagram.
Sincerely thank you to all of the doctors who’ve picked up a copy of the book and who’ve used their social media platforms to share about the book. I appreciate all of you!
-Dr. Paul Thomas with Plum Health DPC
Startup DPC Book Reaches Number 1 on Amazon in the Physicians Category
This is Dr. Paul Thomas with Plum Health DPC here in Detroit Michigan. We believe that healthcare should be affordable and accessible for everyone, and we are doing our part to make that happen here in Corktown, and Detroit, and beyond.
However, several doctors have reached out to me and asked how we made Plum Health such a successful direct primary care practice. How are we attracting new patients? How are we lowering the cost of healthcare? How are we lowering the cost of medications, labs, and imaging services? How are we cutting all of the bureaucratic red tape?
I answered all those questions individually for my physician colleagues, but I also saved those answers in a word document, which eventually became this book.
This book is intended to help family physicians and internal medicine physicians start and grow their direct primary care practices. We want to see more doctors adopt this model that lowers healthcare costs and puts patients first.
The response to the book has been tremendous, and we’ve received many great reviews and a ton of great feedback about the content of the book. Thank you so much to everyone who has purchased the book, thank you for everyone who has left a review on Amazon, and thank you for making us number one on Amazon in the physicians category. We sincerely appreciate all of you!
- Dr. Paul Thomas with Plum Health DPC
PS if you're a doctor looking to start a direct primary care practice, check out Startup DPC
Startup DPC: How to Start and Grow Your Direct Primary Care Practice is the number 1 new release on Amazon in the Physicians category!
Startup DPC Paperback is Now Available
Direct Primary Care Book Available in Paperback Format
The Startup DPC book is published and it feels amazing to have it in my hands. It took me 3 years to write this book, as I documented many of my experiences in starting and growing a direct primary care practice. I took all of my experience, knowledge, and wisdom and poured it into this text.
My goal is to help other doctors start and grow successful and thriving direct primary care practices. There are so many challenges and obstacles that they will face along the way, and I know that this book will help them overcome those challenges and obstacles.
Today was a big day for me, as I published the book on May 5th, and received my first few copies in the mail today. I'm really excited to see this direct primary care movement grow and I'm wishing all of the DPC doctors out there continued success. I know that we are improving health care for our patients, our communities, and our nation.
Thanks for reading and watching,
- Dr. Paul Thomas with Plum Health DPC
Paul Thomas MD Publishes Startup DPC: How to Start and Grow Your Direct Primary Care Practice
Dr. Paul Thomas of Plum Health DPC Publishes a New Book
I am proud and excited to announce that my new book, Startup DPC: How to Start and Grow Your Direct Primary Care Practice has officially been published! And it is currently the #1 new release in Amazon’s Family Practice Medicine category!
Why This Book on Direct Primary Care Was Written?
I wrote this book for so many reasons - to begin with, starting and growing a Direct Primary Care practice has changed my life. I’ve been able to serve people in my community with a high-value family medicine service, I’ve been able to advocate for causes that I feel passionate about, and I’ve been able to be creative in my approach to solving people’s healthcare challenges. In short, I’ve been able to become the doctor I’m meant to be.
I’ve also learned a ton from my colleagues in the direct primary care movement, and I wanted to give back in a tangible way. So, I took all of my learnings, all of my knowledge and wisdom that I’ve gained over the past four years and put those lessons into this book. I’ve had a lot of victories, but I’ve also made a ton of mistakes and I’ve had my share of failures - I wanted to share about the spectrum of success and failure and give my primary care colleagues as many advantages as possible when they set out to do this kind of work.
What The Direct Primary Care Doctors Have Said About Startup DPC
"I have followed Dr. Paul Thomas' career since he started Plum Health DPC in 2016. His ability to integrate podcasts, blogs, and media appearances within his brand is incredible. Dr. Paul presents direct primary care to physicians in a digestible, seamless format that has solidified his position as a DPC influencer across the country. His branding and marketing techniques are top notch, and I can't wait to see what creative ideas he formulates in the future. Dr. Paul is truly a rising star in the DPC movement."
- Dr. James Pinckney II, CEO & Founder Diamond Physicians
"Starting your own direct primary care practice can be a stressful and confusing endeavor. Dr. Paul Thomas does an excellent job alleviating much of that stress and confusion in this detailed, engaging account of starting a successful, thriving practice. If you have ever wondered whether direct primary care might be for you, do yourself a favor and read this book before making that decision - I bet you'll find it less intimidating than you expect."
- Tiffany Leonard, MD, FAAFP, Owner and Physician of Deer View Family Medicine
"Dr. Paul Thomas does it again! An easy to understand and implement guide to making your DPC practice as successful as it can be!"
- Eleanor Host, MD, Whole Family Direct Care
"Dr. Paul's content is simultaneously engaging and thorough, filling a void in the literature up until this point. His latest book is pioneering in its ability to walk someone through the process of starting a direct primary care practice from a to z, hitting on all of the most salient points and leaving nothing to the imagination."
- Phil Hellman, MD, Paradox Health
"Dr. Thomas' experience with personal branding is extremely helpful to budding direct primary care physicians. In this book, he walks you through the important steps, from creating a logo to engaging with local media and then using social media to market your practice. You really can't find this hands-on, real-life advice anywhere else. I wish his book had been in print when I opened my direct care practice in 2018!"
- Aleea Gupta, MD, Family First Direct Primary Care
"Dr. Thomas has been a huge inspiration to me as a new DPC doctor!His first book was an excellent introduction to the model, but this book really dives deep into the nuts and bolts of how to start and market your practice.As doctors we are not educated on how to run a business, but this guide answered all my questions and makes this scary process feel manageable!"
- Rebecca Berens, MD, Vida Family Medicine PLLC
"Dr. Paul is an influential thought leader of the direct primary care movement. His efforts to advocate for the doctor-patient relationship and assist his colleagues in navigating to the direct primary care model are exemplary."
- Dan Schaefer, M.D. Family physician, Owner and founder of Whole Health Family Medicine Clinic.
Startup DPC Book Description
We all know that our current healthcare system is broken, especially for primary care doctors and their patients. Primary care physicians have to see more and more patients in less and less time in order to keep up with declining reimbursement from insurance companies. This leads to rushed office visits, missed opportunities for genuine connections between doctors and their patients, frustrated patients, and burned out doctors. But it doesn't have to be this way.
Direct primary care offers a real opportunity at a fulfilling practice of medicine. It’s a golden opportunity to restructure your time, build the practice of your dreams, and spend your best hours taking care of patients and prioritizing your family life, rather than wasting time as a data entry clerk for an insurance company. In short, direct primary care gives you the opportunity to become the doctor that you're meant to be.
But how do you get this done? How do you go from a less-than-fulfilled doctor in the dysfunctional fee-for-service system to an empowered, entrepreneurial direct primary care physician capable of starting their own successful DPC practice?
The answers you're seeking are in this book!
My name is Dr. Paul Thomas, and I'm a Board Certified Family Medicine Doctor - I launched my own direct primary care practice straight out of residency in Southwest Detroit with over $100,000 in student loan debt. In my first month of practice, I had 7 patients. A few years later, we have over 700 patients, and I've hired a medical assistant and a second family doctor to help me manage the growing demand for our services.
I was named the entrepreneur of the year in 2018 by the Detroit Vanguard Awards, I gave a TEDxDetroit talk on direct primary care, and I've been featured in the Detroit Free Press, Reason Magazine, CBS Radio, Detroit's ABC affiliate WXYZ, Detroit's NBC affiliate WDIV, and Crain's Detroit Business. I've also been a speaker multiple times at the American Academy of Family Physicians (AAFP) DPC Summit, the Direct Primary Care Nuts and Bolts Conference, and the Hint Health DPC Summit.
In this book, I'm going to teach you everything I know about direct primary care and about starting a successful direct primary care practice. Here's a smattering of the topics that we'll cover:
- How to have the right mindset to be successful in your direct primary care journey
- How to become the doctor you're meant to be
- What a typical day looks like for a direct primary care doctor
- How to finance your direct primary care startup
- How to raise money for your DPC practice
- How to overcome a lack of business training in medical school and residency
- How to construct the perfect timeline for starting your DPC practice
- How to write a business plan for your direct primary care clinic
- How to start a direct primary care practice straight out of residency
- How to convert an existing fee-for-service clinic to a direct primary care practice while remaining profitable
- What's the difference between direct primary care and concierge medicine
- How to hire a second doctor for your DPC practice
- How to find a profitable location for your DPC practice
- How to negotiate a lease deal for your medical practice
- How to build out the medical office of your dreams
- How to attract patients to your direct primary care practice
- How to brand your practice so you stand out in your marketplace
- How to build your personal brand to grow your direct primary care practice
And so much more!
By picking up this book, you may be taking your first step in starting your direct primary care practice, or you may be taking the next big leap in growing your direct primary care practice. I know that whoever you are, and whichever stage you're at in your DPC journey, this book will inspire you and demonstrate in concrete methods how you can be even more successful.
Here's to your success in the growing DPC movement!
- Dr. Paul Thomas with Plum Health DPC
Direct Primary Care Book Reaches 50 Reviews
Today is an amazing day and I’m very excited that my book Direct Primary Care: The Cure for Our Broken Healthcare System has reached 50 reviews on Amazon! A sincere thank you to everyone who helped me write, edit, and publish the book, and a heartfelt thank you to everyone who has read the book and reviewed it on Amazon.
I wrote this book because I wanted to communicate the ethos of the direct primary care movement - why do we do what we do as direct primary care doctors and how it impacts our patients, our communities, and the greater healthcare system. A year and a half after its publication, I believe the book is continually achieving those aims.
Here’s the latest review:
This was a fantastic, passionate, and very simple approach to addressing a huge problem in the American healthcare system. I learned a lot from reading Dr. Thomas’s book. I highly recommend any physician read it if anyone is considering going into direct primary care.
There’s a lot of crazy stuff happening in our world right now, but there’s a lot that I’m grateful for as well, so thank you again.
-Dr. Paul Thomas with Plum Health DPC
Today, May 5th, 2020, I just received my 50th review for my book, Direct Primary Care: The Cure for Our Broken Healthcare System, and I couldn’t be happier!
Direct Primary Care Book by Paul Thomas MD
Direct Primary Care: The Cure for Our Broken Healthcare System
This week, I had the privilege of publishing and releasing my first book, Direct Primary Care: The Cure for Our Broken Healthcare System. Here’s the blurb I wrote for the book on Amazon:
They said it couldn't be done. It wouldn't be possible to fix our broken healthcare system. It wouldn't be possible to fix a healthcare system that undervalues primary care and human relationships. But here we are, a courageous group of primary care doctors, tirelessly working to create value for our patients in communities across the country. This is the story of the Direct Primary Care movement, and how it could revolutionize not only primary care, but the entire healthcare system. The book begins by describing the current crisis in primary care and goes on to define the scope of Direct Primary Care. It closes with concrete examples of how the Direct Primary Care model is working at Plum Health DPC in Southwest Detroit.
It’s been a long journey from “idea” to “published”, and there’s still a lot of work to do promoting the book and getting it out into the world. I wrote the book because I believe that healthcare should be affordable and accessible for everyone, and I also believe that the Direct Primary Care model gets us closer to that goal. So, in the book, I set out to explain and describe the ethos of the Direct Primary Care movement and the work that I do in SW Detroit with Plum Health DPC.
Screenshot from Amazon.com with the Kindle version of the book. Direct Primary Care: The Cure for Our Broken Healthcare System.
Screenshot from Amazon.com with the Paperback version of the book. Direct Primary Care: The Cure for Our Broken Healthcare System.
Within 72 hours, these titles will be merged into one page on Amazon!
Author Page for Paul Thomas MD on Amazon.com
One of the things that I had to do to publish the book on Amazon, was to set up an Author Page for myself, Paul Thomas MD, on Amazon.com. My bio reads something like this:
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 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 a graduate of and Clinical Assistant Professor at Wayne State University School of Medicine. You can find out more at PlumHealthDPC.com.
It’s pretty neat and motivating to get working on the next book! I have a lot of ideas that I want to write about, mostly involving Direct Primary Care, and this was such a cool process.
The Process of Writing the Direct Primary Care Book
I wrote the book in about one week in January 2018. I thought I’d have it published in March. Boy was I wrong! After writing it, I sent the draft to some brave alpha readers, who read it and gave me feedback. That brought me to February. I then edited the draft with those suggestions and came up with a second draft, which I sent to some beta readers.
From there, Amanda and I edited the entire book and had the final draft. This was March. I still needed a cover design, formatting, promotional quotes from people I knew, and so many other things that I was naive to prior to starting this process.
In the spirit of Thanksgiving, I have a million people to thank, from those alpha readers to those who helped me design the cover through those who wrote blurbs for the book and my publisher. It definitely took a village to get this over the finish line. A very special thank you to Zain Ismail for writing the foreword.
Reception So Far
So far, the reception to the Direct Primary Care book has been good. We have been number one in the “Physician & Patient” and “Administration & Policy” categories on Amazon.com, which is exciting, and we broke the top ten for “Medical eBooks!”
Direct Primary Care: The Cure for Our Broken Healthcare System trending in Medical eBooks “Administration and Policy”.
Direct Primary Care: The Cure for Our Broken Healthcare System is trending in Medical eBooks “Physicians & Patient” Category on Amazon.com
Thanks so much for reading, I appreciate all of you, and enjoy the book!
- Dr. Paul Thomas, MD, Physician with Plum Health DPC and now author of Direct Primary Care: The Cure for our Broken Healthcare System
We’ve been getting a ton of support on Social Media, like our Facebook post. Follow us on Facebook, here: https://www.facebook.com/PlumHealthDPC/
We’ve been getting a lot of support on Social Media, like on our Instagram Page, follow us here: https://www.instagram.com/plumhealthdpc/
Heart Health on SEEN Magazine
Today is Valentine's Day and it's a great time to talk about heart health aka cardiovascular health. We were invited to write a blog post for Detroit's SEEN Magazine and it is now live and currently on their front page! Head over to their website to read the full article, here.
Thanks for reading,
- Dr. Paul Thomas with Plum Health DPC
Digital Marketing for my Direct Primary Care Doctor Colleagues
Starting a Direct Primary Care practice is a tall task, by any measure. Doctors emerge from residency with little to no business training. Starting a DPC practice is starting a business, and for many doctors, this is their first attempt at something like this. The journey from 'idea' to 'successful practice' is fraught with pitfalls and difficulties.
Knowing how hard it is to start a business and how hard it is to start a DPC practice, I wrote a blog post for my colleagues. It is my sincere hope that they are able to grow while minimizing mistakes, errors, and difficulties. One area where I see that doctors could make significant improvements is their digital marketing.
Specifically, DPC docs need to know how to build a sales funnel for their services. You see, when a doctor is employed by a large health system, her name is on the back of the insurance card for thousands of patients. That same doctor, when she breaks free from the insurance-based system, has to find her own patients. Where will these patients come from?
Direct Primary Care (DPC) doctors must leverage social media, email marketing, networking events, etc... in order to grow their practices successfully. This piece that I wrote on the Hint Health blog will facilitate this growth, and it focuses on building a sales funnel for your practice.
Thanks for reading, and have a wonderful day,
- Dr. Paul with Plum Health
Limitless or My Thoughts on Optimizing Productivity
This week I watched the movie "Limitless" starring Bradley Cooper. The film follows a struggling writer who can't seem to get anything done. Even though he has a book deal, he hasn't written a page, not even a word. He finds himself lingering at the bar, talking about what he might do rather than just doing it.
Then, Bradley Cooper's character meets an old acquaintance who introduces him to a medication - NZT - that improves his brain's capacity to access information, concentrate and focus. Within 4 days, he finishes his book and within a month, he is the lead consultant on the largest corporate merger in American history.
I found it interesting that the very first thing Bradley Cooper's character does when taking this mental capacity-enhancing medication is to clean his entire apartment. He literally throws away all of the things he doesn't need, washes his dishes, organizes his book shelf, tweaks the layout of his apartment, and sets up a desk that is most conducive to being productive.
Hollywood hyperbole aside, I think this movie touches on some really important take-aways. First, how do you organize your life? What does your physical space look like? Are you able to be productive in that space? What about your schedule? Are you creating space in your schedule so that you can capitalize on your peak brain capacity, your peak productivity?
For me, I am most effective when I exercise first thing in the morning and then schedule myself 2 - 3 hours of un-interrupted work. I can really zero-in on the one or two most difficult tasks for the day. This is the time that I'm "in the zone" or experiencing a "flow state" - I am engrossed in my work and able to interact with complex thoughts and decisions.
The time of day and how you mentally prepare for your peak productivity may be different for you. For example, you may be more productive in the night-time hours, after everyone else in your family has gone to bed. The point is this: it is incredibly important to think critically about how you structure your day and your life for optimal productivity, and even happiness.
I believe that this has important applications for medical conditions, namely depression, anxiety and ADHD. Let's tackle ADHD, for example. With ADHD, the two mainstays of treatment are medications and cognitive behavioral therapy (CBT). And, in CBT, the focus is on time management, organization, and making short- and long-term plans.
Here's why CBT is relevant for patients with ADHD, taken from CHADD, the national resource on ADHD: "CBT is relevant for adults with ADHD in two ways. First, in recent years, CBT programs have been developed specifically for adults with ADHD. Some of these programs aim to help adults overcome their difficulties in everyday executive functions that are needed to effectively manage time, organize and plan in the short term and the long term. Other programs focus on emotional self-regulation, impulse control and stress management".
As for Depression, if you are dealing with depression, and you are not structuring your day to include exercise, you may be missing out on a powerful form of treatment. Exercise can be a powerful antidepressant. However, the evidence is limited at this time. According to an article in the American College of Sports Medicine's Health and Fitness Journal, "Only two studies, both from researchers at Duke University, compared the effectiveness of exercise with pharmacotherapy. No differences between exercise and antidepressant medication were noted".
Final takeaways, you have the power to improve your mood and your productivity by organizing your life. Think critically about how you structure your schedule, physical space, and mental space, and create your schedule around your peak productivity.
Thanks for reading, and have a great day!
- Dr. Paul with Plum Health in Detroit, MI
A Golden Apple in My Office
This week, I was taking care of a family of 6 in my office! There was a lot of joyful movement and one of the toddlers grabbed an item from its resting place- it's an Apple, a Golden Apple, that I keep on my shelf and it's a reminder of my mission, vision, and values.
When I was in medical school at Wayne State University, I was awarded with the Golden Apple Student Award for having an understanding of the Art of Medicine as displayed by the care and understanding of patients. It was a tremendous honor, and it's something that I carry with me, as well as something that I want to give to my patients and reflect in my practice.
Often, my patients will ask me about the best course of action going forward, and sometimes the answer isn't always clear. You see, there's the science of medicine, the reproducible, empiric evidence with its best practices and treatment recommendations. These guidelines are important to know and important to follow in most cases. But, on the other side, is the Art of Medicine, and because every one is unique, an individual, with unique medical concerns, treatment choices aren't always clearly defined.
When difficult choices need to be made, I often ask my patients which course of action they'd like to pursue. This may be a unique aspect to my practice, but I know that it's important to engage in shared decision-making with the people that I care for. When decisions are made together, we can be on the same page about treatment, compliance to the plan is higher, and people feel like they have more control over the condition and situation.
Thanks so much for reading and have a wonderful day,
- Dr. Paul with Plum Health
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!
My Thoughts on The Dip
Today, I finished reading "The Dip" by Seth Godin. In the book he talks about when to stick with a project and when to quit. I picked up this book for a few different reasons. First, it was recommended to me by a colleague in my small business community. Second, I felt instinctively that I was facing a decision point in my business, and I needed an external voice to validate what I've been feeling over the past few weeks.
"The Dip" is a relatively short book, and a key takeaway can be found in the section subtitled "Never Quit". Mr. Godin urges his readers to quit, which may be surprising at first. But his main point is this: "Never quit something with great long-term potential just because you can't deal with the stress of the moment".
Starting a Direct Primary Care practice in Detroit has been one of the most difficult challenges that I've faced in my young career. With undergraduate study, MCAT preparation, medical school, and residency training, there is a great deal of certainty. The equation for success in these regimented environments is simple: study hard, get good grades, perform well on exams and you will succeed. There is a comfort in these structured environments, because I knew that if I studied for "x" amount of hours, I would earn "y" result.
But with business and running a Direct Primary Care clinic, there is a great deal of uncertainty and a less direct relationship between effort and reward. For example, if I put too much effort into one marketing channel (Facebook or YouTube) and not enough into another marketing channel (email or in-person events), then I may not attract as many new clients. There is no specific formula for success.
Even though there isn't as much of a direct relationship between effort and reward, I know that Direct Primary Care has excellent long-term potential. I truly believe that it delvers better health care at a lower cost, and that demand for this healthcare delivery model will grow, perhaps even exponentially as economic forces in the broader economy change.
That doesn't change the fact that there is a lot of stress in the current moment! The uncertainty about growth, next steps for the company, and broader adoption in the marketplace cause me a good deal of stress, and I was looking for something that spoke to these aspects of my business. Reading "The Dip" was like having an excellent pep-talk from a personal business coach.
Intuitively, I can sense that I am in a dip, as described in the book by Seth Godin, and reading his book validated my feelings on my business at this point in time. It also gave some pragmatic wisdom with which I can rededicate myself to my business. After 6 months of operation, I can start to analyze what's working and what's not working. As Godin writes, "The opposite of quitting is an invigorated new strategy designed to break the problem apart".
He goes on to describe a challenge I'm currently facing: acquiring more customers in the marketplace. He urges his readers to focus on the broader market rather than the individuals. I.e. don't call one lead 10 times, which he sums up nicely here in this passage, "If you try to influence one person, persistence has its limits". It's difficult to change the mind of an individual, and you want to avoid pestering people.
But, the market is different than individual people. One line that struck me regarding this subject was his assertion that "most of the people in the market have never even heard of you". And this may be a good thing! He relates the story of Sergei Brin of Google and how it was better if customers found out about Google later on rather than right now. This gave Google more time to iterate and improve the product, which would then create better customer experience.
For now, I will continue to focus on improving my services and clinic flow, because I know that as each day passes, the experience of my customers improves. I will also be rededicating myself to email marketing, as I've let this slide over the past few weeks, so check your inbox!
Thanks for reading about the struggles of starting a Direct Primary Care practice. I'm looking to include some of these writings in a future project, so if some of the blog posts here seem random, know that they're adding up to something bigger in the future!
- Dr. Paul Thomas with Plum Health DPC
