Plum Health Blog
Dr. Paul Thomas Featured on the Soul of Enterprise Podcast
This month, Dr. Paul Thomas was featured on the Soul of Enterprise Podcast and we had a great conversation around the Direct Primary Care Model and how it can benefit individuals, small businesses, communities, and the nation as a whole. It was great being interviewed by Ed and Ron - they brought a high level of professionalism and integrity to the conversation with some excellent questions around the practice and the DPC model. Enjoy!
WHAT HAPPENS WHEN A SMART DOCTOR RECOGNIZES THAT THERE IS A BETTER WAY?
Is it possible for family physician to operate under a subscription-based business model, priced below what you pay for your mobile phone service? What about services not covered by the subscription? Could those be priced with full certainty and transparency?
For episode 269, we had the pleasure of interviewing Dr. Paul Thomas, founder of Plum Health DPC. 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.
Below are show notes and questions we asked our guest. Use these to help guide you along when listening to the podcast (embedded above).
Ed’s Questions
What is Direct Primary Care?
Based on an interview I saw you do, there’s no wait time for patients?
Why did you go this route—Direct Primary Care?
You were burned out in your residency. What was the moment that you said I can’t do what most people are signing up to do?
Most time patients do get with their doctors is spent with the doctor typing and facing a screen.
What are some of things that are covered in your clinic?
What you are capable of doing in your practice is probably 80-90% of what a healthy patient would need in a given year?
It would cost me personally about $840 in your practice. If you’re so cheap, why is healthcare so expensive?
It’s said America pays more than the average OECD country, but there’s no price transparency in the system, which inflates those prices, correct?
What are some of the barriers you see that are still in the way of physicians getting into DPC and patients being able to access DPC?
When you did start, did you consider other pricing models? Yours is based on age, but did you consider, for example, response times, or different services you would include and exclude?
Do you have any jumpers, and by that I mean people who pay for a month and then leave, then come back six months later?
You’re now also offering rates to small businesses in your area?
And the companies pay your membership as part of the employees benefit package?
You believe that patients should also have a catastrophic health insurance plan?
We don’t expect our auto insurance to pay for gasoline but we do expect our health insurance to pay for a blood test. It’s absurd?
I was struck that in your TedX talk you used the phrase “living my truth,” take us through that, what does that phrase mean to you?
Ron’s Questions
In your book, Direct Primary Care: The Cure for Our Broken Healthcare System, you cite a 2016 study performed by Medscape found 51% of physicians experience burnout. Burnout is defined as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. You felt this in your residency. How long did it take you to work up to 500 patients?
How did you market your practice, was it social media, word-of-mouth, press. I know you did a Tedx talk.
I know DPC is in the same family of Concierge Medicine, which has the reputation of being just for the elite, which isn’t true. But the DPC prices are usually less than a mobile phone bill.
On the cover of your book there’s a picture of you trying to catch sand through your hands. Can you explain that analogy?
You talk about technology and how there’s too much borrowing from Henry Ford’s assembly line, treating customers like commodities rather than human interaction. It’s not very efficient to sit and listen to your patient read you poetry. It is, however, highly effective. Would you agree with that?
You also talk how the average of GP doctors have 2,400 patients. Do you think this DPC model will alleviate this GP doctor shortage?
You talk about the growth of urgent care centers in the US is a symptom of a failed primary care system.
Do you feel that people who are not licensed could do some of the work now being done by physicians? What’s your view of occupational licensing and how it folds into this model/
You mentioned to Ed that insurance companies try to get as many dollars passing through the hands. They don’t seem to like the concierge or DPC models, not because they compete with actuarial based insurance but because they compete with pre-paid medical care. Did Michigan pass a law that made it clear that DPC is not an insurance product?
Just seems to be like insurance companies would like to block this model. Is that a fair statement?
There’s obviously some education going on with doctors with respect to DPC, but we also need to re-educate patients to see you even when they are healthy, not just when they are sick. Has that been an educational process to get patients to see you even when they don’t have an issue?
We talk a lot about the market share myth, that growth for the sake of the growth is the ideology of the cancer cell, not a sustainable, profitable business. You phrase it in your book as “Value over volume.” You must be asked a lot that healthcare is different than any other product or service we buy, how do you explain to people that it can be priced like other things we buy
Your model is restoring the sacred relationship between the patient and doctor. You’re bringing this back to the days of Marcus Welby.
I’ve read that most calls (82%) are received during normal business hours, that patients don’t abuse your time off. Has that been your experience unless there’s been an emergency?
Tell us about your new venture, www.startupdpc.com.
If you could wave a magic wand to reform healthcare, what would you do? [Price transparency and quality scores was Dr. Paul’s answer].
HOW TO LISTEN TO THE PODCAST:
Apple Podcast: https://podcasts.apple.com/us/podcast/tsoe-dr-paul-thomas-on-what-is-direct-primary-care/id668653849?i=1000459295760
Try saying, “Alexa, play the Sage Advice Podcast” on your Amazon Echo
Google Play: https://play.google.com/music/m/Dnjmmdjwf4wcptom74ttgymbqam
iHeartRadio: https://www.iheart.com/podcast/263-sage-advice-podcast-27588757/episode/tsoe-dr-paul-thomas-on-53897728/
Spotify: https://open.spotify.com/episode/376LlZkEKLMxe8UH9e8N4J
SoundCloud: https://soundcloud.com/sagena-47293133/tsoe-dr-paul-thomas-on-what-is
PlayerFM: https://player.fm/series/sage-advice-podcast/tsoe-dr-paul-thomas-on-what-is-direct-primary-care
Direct download: http://traffic.libsyn.com/sagena/TLS-TSOE-PaulThomas.mp3
Permalink: http://sageadvicepodcast.com/tsoe-paulthomas
Interview on Small Talk with Mark S. Lee
This week, we were featured on Small Talk with Mark S. Lee! Mark S. Lee is a good friend, and a champion of entrepreneurship in Detroit, so it was a privilege to be on the show. Here’s what we talked about:
Intro (01:45)
Dr. Paul Thomas is introduced by Mark S. Lee. Paul Thomas, MD 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. He is a graduate of Wayne State University School of Medicine and now a Clinical Assistant Professor.
Flashpoint Interview (02:30)
Two weeks ago, we were featured on Flashpoint with Devin Scillian and Dr. Frank McGeorge. We were able to discuss the Direct Primary Care model and what’s included in a membership with Plum Health DPC. At Plum Health, we believe that health care should be affordable and accessible for everyone. We also believe in the power of a personal relationship with your physician. To that end, all of my patients have my cell phone number, and can contact me at any time, and they can have an appointment in our office same-day or next-day guaranteed. People are choosing Direct Primary Care services because they are looking at rising premiums for health insurance and seeing less and less value from these insurance plans. We also discuss how to differentiate health care from health insurance.
The beginnings of Plum Health DPC in Southwest Detroit (04:00)
The beginnings of Plum Health DPC and the growth of the practice - we’ve met and exceeded our growth goals for Plum Health. We currently have 425 to 430 active members in our practice. People choose Plum Health because they want to have a personalized relationship with their doctor.
Why the current health care system is broken (05:30)
People are over-insuring, or insuring everything from Flu Shots to ICU care, and this drives up the prices of everything in between. When you remove the third party payers, you can lower the cost of care.
The Direct Primary Care book (06:00)
Direct Primary Care: The Cure for Our Broken Healthcare System - I wrote the book because our health care ecosystem is so complicated, and I wanted to write a book that could guide folks to understanding the Direct Primary Care movement and our practice. I broke up the book up into three chapters: the current crisis in our primary care system, defining direct primary care, and showing the impact that we’re having in our practice, Plum Health DPC, in Southwest Detroit.
REcent media appearances (07:00)
With the recent media appearances, there are more and more primary care doctors starting Direct Primary Care practices. There’s been a groundswell of physicians taking up this DPC model, because there’s been a groundswell of patients standing up and demanding excellent primary care services from a physician that they can trust.
Clinical Assistant Professor at Wayne State University School of Medicine (08:30)
I love speaking with students because they are really excited to learn about Direct Primary Care. Medical students are looking for a way to become primary care physicians without the insurance headaches like prior authorizations. When I speak with students, the lightbulb goes off, and they understand the model and get excited about practicing primary care. I love this because our country and our communities need excellent primary care physicians - they save communities money, they prevent hospitalizations and ER visits, and reduce unnecessary surgeries. From the American Academy of Family Physicians:
An increase of one primary care doctor per 10,000 people has been shown to result in:
5% decrease in outpatient visits
5.5% decrease in inpatient admissions
10.9% decrease in ER visits
7.2% decrease in surgeries
TedxDetroit Talk (09:30)
We spoke at TEDxDetroit in November of 2017 and, looking back, there have been several key events that helped us grow. The TEDxTalk, the Crain’s Detroit business profile, the Channel 4 WDIV story and the Channel 7 WXYZ story all contributed to our success.
Future Plans for Plum Health (10:30)
As we’re growing, more and more patients are spreading the word about Plum Health DPC via word of mouth. We’ve had some great reviews from our members! Excitingly, we’re growing and planning to add another doctor to our practice this year to be able to care for the next 500 patients who want to join.
Listen to the full interview here:
Thank you so much for reading and listening, and have a great week!
-Dr. Paul Thomas with Plum Health DPC
If you want to meet your goals for 2019, please reach out at paul@plumhealthdpc.com or 313.444.5630