Plum Health Blog
Dr. Paul Thomas on the Soul of Enterprise
Dr. Paul Thomas on the Soul of Enterprise
In February 2022, Dr. Paul Thomas was featured in an episode of The Soul of Enterprise with Ron Baker and Ed Kless. In the episode we discuss all things Direct Primary Care! and they plug my book, Startup DPC:
Dr. Paul WROTE THE BOOK on Direct Primary Care. It’s called Startup DPC. Ron recommends this book because you can learn a lot from Dr. Paul’s experience. Here’s the Amazon link.
Dr. Paul Thomas is a family medicine physician who started Plum Health DPC in 2016, right out of residency. He is a board-certified Family Medicine Physician.
Direct Primary Care (DPC) is a model of primary care that is growing in popularity as an alternative to the traditional fee-for-service model. In a DPC practice, patients pay a monthly or annual membership fee for access to comprehensive primary care services. This fee typically covers all office visits and DPC practices offer at-cost medications, lab work, and imaging services to lower the cost of care for patients.
One of the benefits of DPC is that it allows for more time for the physician to spend with each patient. This is because DPC practices typically have fewer patients than traditional practices, which allows for more personalized care. Additionally, DPC patients often have direct access to their physician through phone or email, which can lead to quicker resolution of health concerns.
Another benefit of DPC is that it can help to lower healthcare costs for patients. By eliminating the need for insurance and reducing the number of unnecessary tests and procedures, DPC can save patients money in the long run.
Dr. Paul Thomas has been offering DPC services for the last 6 years and has seen positive results in the health of his patients. He believes that the DPC model allows for better continuity of care and a stronger physician-patient relationship, which leads to better health outcomes.
A big thanks to Ed Kless and Ron Baker for highlighting the work of Dr. Thomas and Plum Health DPC on The Soul of Enterprise!
-Paul Thomas MD with Startup DPC
Plum Health DPC Lowers the Cost of Prescription Drugs via Channel 7 Action News
Plum Health DPC Lowers the Cost of Prescriptions Drugs in Detroit and Beyond
This evening we were featured on Channel 7 Action news for lowering the cost of medications in Detroit. We started Plum Health DPC in 2016 with a mission: to make health care more affordable and accessible in Detroit and beyond. One part of that broader mission is to lower the cost of medications for our patients.
Paul Thomas MD of Plum Health on Channel 7 Action News
Paul Thomas MD of Plum Health DPC is on Channel 7 Action News with Jennifer Ann Wilson, discussing how we lower the cost of medications in Detroit and beyond.
We buy the most common medications at wholesale and sell them to our patients directly - without a mark up. That’s why our service is called Plum Health DPC, the DPC stands for Direct Primary Care - we deliver primary care services directly to our patients.
By delivering care directly to our patients, we remove the profit takers, pharmacy benefit managers, and retail pharmacies between you and your medications, effectively lowering the cost of those prescriptions by 50% to 90%. Here’s the cost of our seven most commonly used medications:
Metformin 500 mg 1.2 cents/pill or $0.36 for a 1 month supply
Ibuprofen 600 mg 7 cents/pill or $2.10 for a 1 month supply
Lisinopril 10 mg 2.3 cents/pill or $0.66 for a 1 month supply
Amlodipine 5 mg 1.1 cents/pill or $0.33 for a 1 month supply
Sertraline/Zoloft 50 mg 4.8 cents/pill or $1.44 for a 1 month supply
Cetirizine/Zyrtec 10 mg 5.2 cents/pill or $1.52 for a 1 month supply
Loratadine/Claritin 10 mg 3.4 cents/pill or $1.02 for a 1 month supply
We do this work because we know that the cost of medications continues to climb and that people in our community need a fair shake when it comes to getting the medications that they need to stay healthy.
Here’s what Detroit’s Channel 7 Action News (WXYZ Detroit) had to say:
Dr. Paul Thomas started Plum Health Direct Primary Care four years ago in Detroit with a mission.
"We believe that medication should be affordable and accessible," Dr. Thomas said.
His membership-based business model eliminates the pharmacy and prescription benefit managers by getting medications directly from the wholesalers then selling it to his patients at cost.
Here’s the full interview from Channel 7 Action News:
Thanks for reading and watching, and have a wonderful day,
-Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan
Paul Thomas MD of Plum Health DPC on Channel 7 Action News
Dr. Paul Thomas on Channel 7 Action News discusses how Plum Health DPC lowers the cost of medications for patients in Detroit and beyond.
Coronavirus Update for August 2020 in Detroit
This is Dr. Paul Thomas with Plum Health DPC https://www.plumhealthdpc.com/ and I'm giving a Coronavirus Update for August 2020.
What's up with the spikes of cases in Oakland and Macomb County recently? It's likely that people are gathering for big events (I'm looking at you Jobbie Nooner, 43rd Port Huron Float Down, and the unofficial Woodward Dream Cruise) and not wearing masks or maintaining social distancing.
Stay safe. Wash your hands. Wear a mask. Protect yourself, your loved ones, and your neighbors, near and far.
#PlumHealth #CoronavirusUpdate #DirectPrimaryCare
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
Coronavirus Update for Detroit Michigan March 2020
Coronavirus Update for Detroit, Michigan for March 2020
I’m a Family Doctor in Detroit, and today I’ve gotten a ton of questions about the Coronavirus - ask me anything!
For starters, here’s what I sent out to all of my Plum Health DPC (https://www.plumhealthdpc.com/) patients earlier today and I thought everyone should know these things as well. Beyond what’s written below, ask me anything:
Plum Pack!
The Coronavirus is causing concern at this time - the President spoke last night about closing access to the USA from Europe, the NBA, NHL, and NCAA have cancelled/postponed all of their games, and other major events have been cancelled - but do not panic.
People Will Become Sick This Spring
Many people will get sick and have upper respiratory symptoms over the next few days and weeks. Most of these will be from the common cold, many of these symptoms will be from seasonal allergies, some will be the flu, and some may be due to the Coronavirus.
What I can do for you is to help you triage - I can help you determine if you're sick with the flu, a cold, or having an allergy flare up. I can help you determine if you have symptoms that are concerning for the Coronavirus.
If you contact me and I'm concerned, I may send you to the emergency department for further testing. As of now, Coronavirus testing is not available at our clinic.
Here are some algorithms about how I approach caring for our patients, caring for all of you.
Additionally, heres information from the State of Michigan regarding Coronavirus, released earlier today:
Finally, below is what we know and what you can do to protect yourself:
What You Can Do to Prepare for the Coronavirus
You can prepare for the Coronavirus by taking several actions and non-actions:
wash your hands thoroughly before eating
wash your hands thoroughly after using the bathroom
wash your hands thoroughly before touching your T-zone (eyes, nose, or mouth)
Cough or Sneeze into the crook of your arm/the bend in your elbow; again, wash your hands after coughing or sneezing
purchase food and supplies in case you need to be self-quarantined
if you become sick with a respiratory infection, but you’re not sick enough to require hospitalization, you may need to self-quarantine or stay at home to avoid infecting your neighbors and co-workers
if you become ill, call your doctor and discuss your symptoms. It may be better to call or text your physician, as going to the doctor’s office may
cancel any non-essential travel to areas where the virus is spreading like China, Iran, South Korea, and Italy
avoid large gatherings - parades, sporting events, campaign rallies - to avoid catching the virus or spreading the virus
What We Know About the Coronavirus or Covid-19
Here’s what we know thus far:
Every single one of us has had a coronavirus infection in the past — it’s one of the viruses (along with rhinovirus, adenovirus, etc.) that causes the common cold. This novel Coronavirus (COVID-19) is just a variation (or mutation).
This new coronavirus can cause anything from nothing to a mild cold to a potentially lethal viral pneumonia.
Those who seem to be most affected by COVID-19 thus far are those who are more at risk to begin with: those who are older, those with multiple chronic health conditions, etc.
The evidence out of the initial outbreak in Wuhan, China revealed:
Median age = 59 years of age
Estimated basic reproduction number (the number of people an infected person infects) is approximately 2.2
The average length of time from the onset of symptoms to hospitalization was 9.5 to 12.1 days
There have been new coronaviruses in the past — most notably the SARS (2002, 2003) and MERS (2012 – Present) epidemics; however, the mortality rate of COVID-19 (2.0% to 4.0% or below) is notably lower than SARS (9-10%) and MERS (36%).
From the WHO, they estimate that the mortality rate is somewhere around 3 - 4%. We are more concerned about this Coronavirus than the typical flu virus because of this higher mortality rate. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200306-sitrep-46-covid-19.pdf?sfvrsn=96b04adf_2
This virus spreads from person to person, though we aren’t exactly sure how. Our best hypothesis is that it is spread via bodily fluids and droplets from speaking, breathing, coughing, sneezing, etc (and potentially through the GI tract).
Children absolutely can get the Coronavirus that causes COVID-19. Two interesting points about pediatric patients: 1) there is early evidence that they carry a high “viral load” and — combined with the fact that they aren’t great at washing hands, not touching their face, etc. — because of this may be more likely to spread the illness and 2) children who do get COVID-19 seem to have a lower mortality rate than those who are older who contract the disease.
Here’s what we don’t know:
We don’t know if this virus will peter out as the warmer months kick in; we also don’t know if this is a one-season thing or if it will come back strong again next cold & flu season.
We don’t know when or if we’ll have a successful vaccine to prevent against this new virus. In a late February 2020 press conference, Dr. Anthony Fauci did a great job describing how a vaccine is created (starts at about 11:00 into the clip) and how far we are away from a successful vaccine.
How to Protect Yourself and Others from the Coronavirus
How to protect yourself & others:
Just like any other respiratory virus: stay home if you’re sick!
Just like preventing any other respiratory virus: take good care of yourself! Exercise regularly, eat nutritious, balanced meals, practice stress mitigation techniques, and get a solid 7-9 hours of sleep a night, etc.
Just like preventing any other respiratory virus: wash your hands! A lot!
Just like preventing any other respiratory virus: don’t touch your eyes, mouth, nose, etc., and get into the habit of washing your hands before eating.
If you can, avoid contact with those who are sick or are caring for the sick.
If you are not actively sick (or caring for someone who is), ear-loop/surgical masks are not likely helpful. Healthcare workers will wear masks (and often higher-rated ones than the ear-loop masks), as they have a much higher likelihood of caring for someone with the disease and are prioritizing mitigating the spread to others.
Those who are exposed to someone with COVID-19 or those who are being tested for COVID-19 will likely be asked to self-quarantine (currently not mandatory). If your job permits, start asking your employer about work-from-home opportunities; if your job doesn’t permit work-from-home, ask your employer what their plan is to keep you safe!
Because of the real possibility of a quarantine, stock a couple week’s worth of non-perishable foods items in a pantry. Also make sure you have the basics — like medications, OTCs like ibuprofen, acetaminophen, diphenhydramine, and pseudoephedrine, and (a rational amount of) toilet paper, facial tissues, etc.
How to Quit Drinking Alcohol in Detroit
The holidays are just around the corner. It’s that time of year we catch up with good friends and loved ones. As we are celebrating, it is important that we safely enjoy our alcoholic beverages. It is also imperative to be transparent with your doctor about the amount of your alcohol consumption as we will discuss more below, can greatly impact your physical health causing chronic ailments like heart disease, high blood pressure, and liver disease. Excessive alcohol use can also be associated with mental health concerns such as depression and anxiety.
What does it mean to be above the legal limit for drinking?
According to the CDC, all states in the United States have adopted a blood alcohol content percentage (BAC) 0.08% as the legal limit for operating a motor vehicle for drivers aged 21 years or older. However, drivers younger than 21 are not allowed to operate a motor vehicle with any level of alcohol in their system.
Legal limits are measured using either a blood alcohol test or a breathalyzer.
Legal limits are typically defined by state law, and may vary according to individual characteristics, such as age and occupation.
What is one “drink” according to the CDC?
12-ounces of beer (5% alcohol content).
8-ounces of malt liquor (7% alcohol content).
5-ounces of wine (12% alcohol content).
1.5-ounces (1 shot glass) of liquor (e.g., gin, rum, vodka, whiskey).
What are the current recommendations for alcohol use?
With the holidays approaching, it is important to drink alcohol in moderation. This means 1 drink per day for women, and 2 drinks per day for men. These recommendations should adhere to the one “drink” standard described above. This means that wine glasses should not be filled to the brim! It is always important to keep in mind that with certain medications interact with alcohol use, including sleeping pills, muscle relaxers or other sedative medications that may make you drowsy. Always be sure to consult your physician and check your prescription bottle for recommendations in regards to alcohol consumption.
Guidelines for Excessive Drinking
According to the CDC, binge drinking includes 4 alcoholic beverages for women, or 5 for men, in a two-hour period. Heavy drinking is considered 8+ drinks per week for women, or 15+ drinks per week for men. Any drinking by a pregnant women or individual under the age of 21 is considered excessive.
What are signs of Alcohol Use Disorder?
Some of the signs and symptoms of alcohol use disorder could include:
Inability to limit drinking.
Continuing to drink despite personal or professional problems.
Needing to drink more to get the same effect.
Wanting a drink so badly you can’t think of anything else.
Health Risks of Alcohol Use
According to the CDC, there are short-term and long-term health risks associated with heavy alcohol use.
Short-Term Health Risks
Excessive alcohol use has immediate effects that increase the risk of many harmful health conditions. These are most often the result of binge drinking and include the following:
Injuries, car crashes, falls, drowning, and burns.
Violence, including homicide, suicide, sexual assault, and intimate partner violence.
Alcohol poisoning, a medical emergency that results from high blood alcohol levels.
Risky sexual behaviors, including unprotected sex or sex with multiple partners. These behaviors can result in unintended pregnancy or sexually transmitted diseases, including HIV.
Miscarriage and stillbirth or fetal alcohol syndrome disorder among pregnant women.
Long-Term Health Risks
Over time, excessive alcohol use can lead to the development of chronic diseases and other serious problems including:
High blood pressure, heart disease, stroke, liver disease, and digestive problems.
Cancer of the breast, mouth, throat, esophagus, liver, and colon.
Learning and memory problems, including dementia and poor school performance.
Mental health problems, including depression and anxiety.
Social problems, including lost productivity, family problems, and unemployment.
Alcohol dependence, or alcoholism.
Signs of Alcohol Withdrawal
After discontinuing alcohol use, within the first 2-4 days days it is possible to have several symptoms including, shakiness, sweating, loss of appetite, nausea, vomiting, headaches and a fast heart rate (also known as tachycardia). More serious symptoms include delirium tremens (DT), seizures and death. Any withdrawal from alcohol should be monitored by your healthcare provider as these symptoms may occur.
Resources for Alcohol Use
Substance Abuse and mental health services’ (SAMHSA) National Helpline number, open 24/7 365 days, 1-800-662-HELP (4357)
For more information on how you can safely consume alcohol this winter, please visit the CDC.
How To Quit Drinking Alcohol in Detroit
If you need help with quitting drinking alcohol, we’re happy to help. We can direct you to the best resources available for alcohol cessation, and we can treat alcoholism in our office. The Sinclair Method is a reasonable treatment option in some cases and it involves taking Naltrexone one hour prior to alcohol consumption. There are also local Alcoholics Anonymous meetings and other support groups that you can attend to help you reduce or eliminate your alcohol consumption.
Thanks for reading and have a great day,
-Dr. Paul Thomas and Dr. Raquel Orlich
What is a Plum Health Membership?
What does it mean to be a member of Plum Health dpc?
What’s involved in being a member of Plum Health DPC? We hear this question often. So, it’s worth taking some time to address it head on. Plum Health is a family medicine service run by Dr. Paul Thomas. Our mission is to deliver affordable, accessible healthcare. We are unlike other offices in several ways. We highly value the doctor-patient relationship and we routinely spend thirty minutes to one hour with each of our patients per visit.
This time together is essential because it allows us to build a trusting relationship. When you’re a member of our practice, when you’re a member of Plum Health DPC, you have the opportunity to build this trusting and healing relationship with Dr. Paul Thomas over time.
In contrast, at a typical family medicine office in the fee-for-service or insurance-based system, doctors prioritize seeing as many patients as possible to increase their payments from insurance companies. This is why you may only have five to twelve minutes with a primary care doctor in the insurance-based system.
Committed to a long-term relationship between doctor and patient
Being a member of Plum Health means that you’re committed to being a part of the membership model. If you’re looking for a one-off visit or one-time services, Plum Health probably is not the right fit for you. However, if you’re looking for a dependable physician who is responsive to your calls, texts, and emails at anytime of day, who cares about you as an individual and not as another number, then Plum Health DPC will be a great fit for you.
Furthermore, we love taking care of people who believe what we believe - that health care should be individualized, that the doctor-patient relationship should be strong and seamless, that health care should be affordable and accessible. If you value these tenets like we do, then we’d love to have you as a part of the Plum Health DPC membership.
How much does a plum Health DPC membership cost?
A membership with Plum Health DPC costs $10/month for children, and starts at $49/month for adults. We have our full pricing structure here. With that membership, you can visit the office anytime without a copay. You also can call, text, or email the doctor anytime. Additionally, members of Plum Health DPC are able to get wholesale medications, at-cost labs, and at-cost imaging services at a fraction of the typical cost.
How do I sign up for a Plum Health DPC membership?
The signup process for Plum Health DPC is an easy one. Our online form takes about 5 minutes to complete. The form will ask for a credit card to complete the registration. Your card will not be billed until your account is confirmed by our staff and an appointment is made. We want to make sure you’re a good fit for our practice before we start billing you for the service.
Thanks for reading and for watching, and have a wonderful day.
Dr. Paul Thomas with Plum Health DPC