Plum Health Blog
Dr. Paul Thomas Gives the Welcome to Detroit Lecture for Incoming Class of 2027 at WSU SOM
Dr. Paul Thomas Gives the Welcome to Detroit Lecture for Incoming Class of 2027 at WSU SOM
This year, Dr. Paul Thomas was invited to give a “Welcome to Detroit” lecture for the Wayne State University School of Medicine Class of 2027. These medical students will be immersed in the Detroit community over the next 4 years, and upon graduation, many of them will continue to serve the Detroit and Metro Detroit community.
WSU SOM’s incoming class of 2026 had 300 Students, with 192 in-state and 108 out-of-state students. That class had 22 birth countries and 94 different colleges represented. The 2027 class is likely similar but their demographic data isn’t readily available online.
That being said, the vast majority of these students are experiencing Detroit for the first time. The lecture given by Dr. Paul Thomas highlights important moments in Detroit history, from its founding through the Arsenal of Democracy, through 1967, municipal bankruptcy, and today. It also discusses cultural events, the best coffee shops to study, the best parks to relax and unwind, and the best restaurants for a student budget and for when parents or loved ones come to town for a special occasion.
A short guide for new visitors to Detroit and also for new professional students in Detroit, like medical students or law students at institutions like Wayne State University or the University of Detroit.
So here are the best coffee shops in Detroit for 2023:
Lucky Detroit in Corktown
Momento Gelato in Corktown (great coffee and paninis and gelato)
James Oliver in Corktown (amazing bagel sandwiches and great coffee selection)
Dessert Oasis in Capitol Park
Rosa in Grandmont Rosedale
Oloman Café in Hamtramck
Cafe 1923 in Hamtramck
MadCap in Downtown
The Congregation in New Center/Virginia Park
Milwaukee Caffe in New Center
Anthology Coffee in Eastern Market
Dr. Paul Thomas is a Proud Graduate of Wayne State University School of Medicine Class of 2013
This month, Dr. Paul Thomas attended the Class of 2013 Alumni Reunion Weekend. Dr. Thomas graduated from Wayne State University School of Medicine in 2013 - thereafter, he completed his residence at Oakwood/Beaumont Family Medicine Residency Program, and then started Plum Health DPC in November 2016.
Time flies when you’re practicing medicine - the days are long but the years are short. As physicians, we put our all into taking care of other people and making sure people in our community stay healthy. The School of Medicine’s Mission is as follows:
We will educate a diverse student body in an urban setting and within a culture of inclusion, through high-quality education, clinical excellence, pioneering research, local investment in our community and innovative technology, to prepare physician and biomedical scientific leaders to achieve health and wellness for our society.
It’s refreshing to connect with a group of doctors who share these values - all striving to improve the health and wellness of our community. I’m forever grateful to have been immersed in the culture of WSU SOM and my experiences there informed how I practice today and in the future at my practice, Plum Health DPC.
A Brief History of Plum Health DPC
A Brief History of Plum Health DPC in Detroit
Plum Health DPC is a Family Medicine practice based in Detroit, Michigan that is dedicated to providing high-quality, affordable primary care to its patients. But where did it all begin? Here is a brief history of Plum Health DPC:
Plum Health DPC was founded in 2016 by Dr. Paul Thomas, a board-certified family medicine physician with a passion for improving healthcare for his patients. Dr. Thomas saw firsthand the challenges that patients faced when trying to navigate the traditional fee-for-service healthcare system, and he knew there had to be a better way.
That's when he discovered the direct primary care (DPC) model. In a DPC model, patients pay a monthly or annual fee for access to primary care services. This allows patients to have a close relationship with their primary care doctor and receive a wide range of medical services, including preventative care, chronic disease management, and acute care.
Dr. Thomas was convinced that the DPC model was the future of healthcare, and he set out to create Plum Health DPC to bring this model to his patients in Detroit. Since its founding, Plum Health DPC has grown to serve thousands of patients in the Detroit area and has become a leader in the DPC movement.
Today, Plum Health DPC is committed to providing high-quality, affordable primary care to its patients and improving the healthcare system in Detroit and beyond. We are proud of our history and look forward to continuing to serve our community for years to come.
Bring Your Pup to Plum Health DPC in Corktown!
Bring Your Pup to Plum Health DPC in Corktown!
If you're a dog owner living in the Corktown neighborhood of Detroit, you'll be happy to hear that your furry friend is welcome at Plum Health DPC! We love when people bring their dogs by for a visit, and we even keep treats on the front desk for them.
We understand that pets are an important part of many people's lives, and we want to make our practice as welcoming and inclusive as possible. That's why we're happy to accommodate dogs (and other pets) at our office.
In addition to the joy and companionship that pets bring, there is also evidence to suggest that interacting with animals can have numerous health benefits. For example, pets can reduce stress and anxiety, lower blood pressure, and improve overall mental well-being.
So next time you're coming to see us at Plum Health DPC in Corktown, feel free to bring your furry friend along! We'll be sure to have some treats ready for them, and we'll do our best to make them feel at home.
How to get a Flu Shot in Detroit
Protect Yourself and Your Community with a Flu Shot at Plum Health DPC in Detroit
As the winter season approaches, it's important to take steps to protect yourself and your loved ones from the flu. The flu, or influenza, is a highly contagious respiratory illness that can cause severe symptoms and complications, including pneumonia, bronchitis, and sinus infections.
One of the most effective ways to prevent the flu is by getting a flu shot. At our Plum Health DPC office in Detroit, we carry two types of flu vaccines: Afluria and Fluzone. Both vaccines have been shown to be safe and effective in preventing influenza.
It's important to get a flu shot each year, as the flu virus can change from year to year and the vaccine is reformulated to protect against the most common strains. The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older get a flu shot.
In addition to protecting yourself, getting a flu shot can also help protect your community by reducing the spread of the flu. This is especially important for people who are at high risk of developing serious complications from the flu, such as young children, older adults, and people with certain medical conditions.
Don't wait until it's too late – make an appointment to get your flu shot at Plum Health DPC in Detroit today! Protect yourself and your loved ones from the flu this season.
Plum Health DPC at Men's Health Event at Ford Field in Detroit, Michigan
Plum Health DPC at Men's Health Event at Ford Field in Detroit, Michigan
On Saturday October 8th, we were out at Ford Field for the Men’s Health event - we had a booth and we talked with men of all ages and backgrounds about the affordable and accessible health care services that we offer at Plum Health DPC.
We know that men face many health challenges - mental health concerns, high blood pressure, diabetes, colon health, prostate health, obesity, and so much more
We also know that having an excellent primary care doctor to help you navigate these issues can be transformative. That’s where we come in - to help, serve, and guide our patients through their health challenges so that they can live their best life.
Further, we had a lot of fun at the event! It’s great meeting up with other health care professionals, and it was even cooler meeting up with health care professionals at Ford Field! We were mostly on the concourse, be we were able to go down to the Detroit Lion’s field of play and kick a few field goals. Here’s one:
Corktown Detroit Walking Tour with Dr. Paul Thomas of Plum Health DPC
Corktown Detroit Walking Tour with Dr. Paul Thomas of Plum Health DPC
Today, we decided to do a walking tour of Corktown.
There's a few big developments on Michigan Avenue - the Godfrey Hotel/boutique hotel and the Perennial Apartments/luxury apartment building with a rooftop pool. https://detroit.eater.com/2021/9/29/22700588/corktown-detroit-opening-the-godfrey-hotel-rooftop-lounge-restaurant
Michigan Avenue is set to be replaced with an road surface that will charge electric vehicles as they drive. https://www.freep.com/story/money/cars/mark-phelan/2020/08/13/michigan-avenue-most-advanced-road/3364328001/
As we walk, we pass Momento Gelato, Ottava Via, Brooklyn Street Local, and Detroit Institute of Bagels on the way to Mudgie's Deli. http://www.mudgiesdeli.com/wp/
Importantly, Mudgie's Deli owner Greg Mudge recently passed away and there is an ongoing effort to rename the street in the honor of Greg Mudge. It's heading to Detroit's City Council this week: https://detroitmi.gov/government/city-council
From a medical perspective, you should aim for 30 minutes of vigorous activity each day - cardiovascular exercise like walking, running, biking, swimming, or other aerobic activities. The goal is to get 30 minutes each day for 5 days each week, or 150 minutes in total of vigorous, aerobic exercise.
The new COVID booster is a bivalent booster, meaning that it has the original vaccine PLUS the omicron-specific vaccine. Bivalent just means that the vaccine protects you from TWO strains of virus.
In comparison, the Fluarix Flu shot is a Quadrivalent vaccine, which protects against four strains of flu viruses. This year the Fluarix quadrivalent flu shot protects against the Victoria 2019, Darwin 2021, Austria 2021, and Phuket 2013 flu strains. We have the Fluarix flu shots at our Plum Health DPC office for $24.
We also carry the Fluzone Quadrivalent Flu Vaccine, which again protects against four strains of flu viruses. This year the Fluzone quadrivalent flu shot protects against the Victoria 2019, Darwin 2021, Phuket 2013, and Michigan 2021 flu strains. This Fluzone vaccine is $23 at our Plum Health DPC office.
The Bivalent Covid vaccine is free at most pharmacies and health departments. We will have free doses at Plum Health starting next week on Wednesday (09/28/2022).
Covid Bivalent Booster Vaccine side effects are similar to previous vaccines - arm soreness, it could cause malaise (not feeling well) for 1 to 2 days, it could cause a low-grade temperature increase to 99 to 100 degrees Fahrenheit.
Thanks for reading and have a wonderful day,
-Dr. Paul Thomas with Plum Health DPC
Paul Thomas MD in the USA Today
Back in 2013, Dr. Paul Thomas helped start an organization called Street Medicine Detroit.
Street Medicine Detroit is a student-run organization that delivers primary care medical services to homeless and uninsured people on the streets of Detroit, in parks and in church basements, warming centers and homeless shelters. Street Medicine Detroit is a lifeline for folks who are living on the streets.
Medical Students from Wayne State University School of Medicine run the Street Medicine Detroit program and deliver medical care and compassion to people who are homeless, unsheltered, or without permanent housing.
When I was a fourth year medical student at Wayne State University School of Medicine in 2013, I helped a second year medical student named Johnny Wong start the organization. We went on "street runs" to deliver medical care to homeless people.
During one of those runs, a journalist named John Wisely followed our work and wrote about it in the USA Today.
I've been reflecting about the meaning of our work at Plum Health DPC and it has deep roots in the advocacy and volunteering that I engaged in before, during, and after medical school.
I turned the newspaper article from the USA Today into a plaque that I hang in my office as a reminder to keep meeting people where they are at, to keep delivering compassionate care, and to keep striving to make health care affordable and accessible for everyone.
Thanks for reading and have a wonderful day.
- Paul Thomas, MD with Plum Health DPC
Ganglion Cyst Drainage in Detroit
Ganglion Cyst Drainage at Plum Health DPC in Detroit
At Plum Health DPC in Detroit, we take care of a variety of health concerns. We are Family Medicine Specialists and we help our patients with a variety of health problems.
At Plum Health, we perform many procedures. One of those is a Ganglion Cyst Removal. This procedure takes a few minutes but it can be a tremendous relief.
A ganglion cyst is a pocket of fluid that builds up adjacent to a tendon. The Fluid inside the cyst is viscous and clear. The ganglion cysts are usually not painful, but they can be irritating if you wear a watch. They can also cause people to be self conscious or to wear long sleeves to cover them up.
At our clinic, we clean off the skin overlying the ganglion cyst and we use an 18 gauge needle to draw out the cystic fluid. This helps to relieve the symptoms for the patient.
After this procedure, there is a 50% chance that the ganglion cyst will resolve. For the other 50% of patients, the ganglion cyst will refill. Usually the ganglion cyst will refill slowly over time.
Plum Health DPC Started in 2016
Plum Health DPC Started in 2016
We started Plum Health DPC in November, 2016. We started by making house calls for our patients. We recognized a need for excellent primary care services in Detroit, and we strive every day to meet that demand. We have had great growth over the last 5 and a half years, and we’ve needed to grow and add more doctors.
Plum Health Grew into a Larger Office on Michigan Avenue in 2019
We decided to build out a new space in Corktown, Detroit’s oldest neighborhood, on Michigan Avenue near Trumbull. We’re at “The Corner” or the property where the old Tiger Stadium used to sit. When Tiger Stadium was torn down, the ball field/baseball diamond was perserved as a field for Detroit youth sports via Detroit PAL or Police Athletic Field. The properties around the perimeter of the park became the building where our office is, which has 3 floors of apartments above 1 floor of retail. There are also condos on the perimeter of the old Tiger Stadium site going up on Trumbull avenue.
Anyways, here’s some old pictures from about October 2018 when we leased out our new space and it started construction to eventually become our office.
The construction finished in October 2019! Boy did we have to be patient, but once it was complete, we were ready to serve the community with an amazing primary care and health care experience.
We love practicing in this space, and now we’re coming up on 6 years in practice as Plum Health DPC and 3 years in practice at the Michigan and Trumbull or “The Corner” location.
This is such an amazing place to work and to serve patients and we get to fulfill our mission of delivering affordable and accessible health care services in Detroit and beyond!
Plum Health Continues to Thrive into 2022
Now, we have three amazing doctors - Dr. Raquel Orlich, Dr. Leslie Rabaut, and Dr. Paul Thomas - serving patients in Corktown, Detroit, and beyond. We take care of about 1,150 patients at this point. Our patients are of all ages and stages - pediatric patients, young adults, older adults, and geriatric patients. We take care of a variety of health care conditions - high blood pressure, diabetes, gout, asthma, physical exams for work, and so much more, too many conditions to list.
To celebrate and to say thank you, we are having a thank you party at the Congregation Detroit tonight at 5:30 pm. Join us!
-Paul Thomas, MD with Plum Health DPC
Reproductive Health Care in Detroit Part Two
Reproductive Health Care in Detroit
In an ongoing conversation about reproductive health care, I will be giving some facts and figures about abortion in this blog post. Abortion is a flashpoint in our society; as always, I will be taking a measured, evidenced-based approach to this issue as I am a family medicine physician, and I rely on evidence to make clinical decisions.
The conversation here is adult/mature; the content here may be triggering for some readers. The descriptions of abortion here are not typically discussed in polite society. If you have concerns, read no further.
This week, I discussed much of the following information in the Daily Detroit podcast with Jer Staes. If you’d rather listen to this information, you can do so here:
You can listen to the podcast episode, here.
Abortion Rate in the United States
In 2020, the Census Bureau estimated that women made up about 50.7 percent of the population — some 167 million people. In the United States in 2020, the population of women ages 15-44 was 64,543,832.
In 2019, 629,898 legal induced abortions were reported to CDC from 49 reporting areas.
The majority of abortions in 2019 took place early in gestation:
92.7% of abortions were performed at ≤13 weeks’ gestation;
6.2% of abortions were performed at 14–20 weeks’ gestation
fewer than 1.0% of abortions were performed at ≥21 weeks’ gestation.
Early medical abortion is defined as the administration of medications(s) to induce an abortion at ≤9 completed weeks’ gestation, consistent with the current Food and Drug Administration labeling for mifepristone (implemented in 2016).
In 2019, 42.3% of all abortions were early medical abortions.
I think that knowing how many abortions take place per year is important. In short, there are 629,898 abortions for 64,543,832 women of childbearing age (15 to 44 years of age). That means that less than 1% of American women have an abortion each year (629,898 abortions / 64,543,832 women = 0.975% of women have an abortion every year.
And it’s important to know when these abortions take place during pregnancy. 92.7% of abortions take place at 13 weeks or less, or when the baby is the size of a lemon.
When is a Fetus Viable Outside of the Womb?
Doctors now consider 22 weeks the earliest gestational age when a baby is "viable," or able to survive outside the womb. But this is still extremely premature, and a baby born at this age will need a great deal of medical attention. Even if s/he survives, the risk of permanent disability is very high.
What are Common Scenarios When Abortion May Be Needed to Preserve the Health of the Mother or the Developing Fetus?
Ectopic pregnancy
Many people have heard of an ectopic pregnancy. An ectopic pregnancy is a pregnancy in which the fetus develops outside the uterus, typically in a fallopian tube. An ectopic pregnancy always ends in pregnancy loss. About 1 to 2% of all pregnancies in the United States are ectopic pregnancies.
The image on the left shows an embryo that is implanted correctly within the uterus. The right hand image demonstrates the various locations of an ectopic pregnancy. An ectopic pregnancy in the fallopian tube is called a tubal pregnancy, and can result in severe pain and damage to the fallopian tube.
Attribution: By BruceBlaus - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=44897672
An early ectopic pregnancy without unstable bleeding is most often treated with a medication called methotrexate, which stops cell growth and dissolves existing cells. The medication is given by injection.
Salpingostomy and salpingectomy are two laparoscopic surgeries used to treat some ectopic pregnancies. In these procedure, a small incision is made in the abdomen, near or in the navel. Next, your doctor uses a thin tube equipped with a camera lens and light (laparoscope) to view the tubal area.
In a salpingostomy, the ectopic pregnancy is removed and the tube left to heal on its own. In a salpingectomy, the ectopic pregnancy and the tube are both removed.
Which procedure you have depends on the amount of bleeding and damage and whether the tube has ruptured. Also a factor is whether your other fallopian tube is normal or shows signs of prior damage.
In the context of an abortion ban, doctors may hesitate to intervene on behalf of a woman with an ectopic pregnancy. The doctor may have to contact the legal department at the hospital to ensure that they are not running afoul of the new rules and regulations. This hesitation and the time it takes to clear the legal department will likely result in more ruptured ectopic pregnancies, which will lead to damage to women’s reproductive organs, a decreased chance of healthy pregnancy in the future for these affected women, and potentially death for the mother in cases of sepsis or infected internal organs.
This is a real world consequence of this abortion ban, and this has already happened. Here’s a story from a nurse/health care worker on Instagram who relates how an ectopic pregnancy was not treated in a timely manner, and resulted in a rupture and then 600 mL of blood in the abdomen of the expectant mother, which came close to causing death for the mother.
A story posted on Instagram about a ruptured ectopic pregnancy and the real consequences for an expectant mother.
Here’s a similar story from Kaiser Health News about the importance of prompt care for ectopic pregnancy.
Incomplete Miscarriage
Miscarriage occurs in 8–15% of clinically recognized pregnancies and in ~30% of all pregnancies. Increasing maternal age is associated with an increasing risk of miscarriage. Many women may have a miscarriage and not even know it - they may experience a miscarriage as a heavy period a few weeks after their normal period. Other women may have a pregnancy, have a positive pregnancy test, and then miscarry a few weeks later.
These early miscarriages are often sad and painful, but don’t often require medical intervention as the mother’s lining of the uterus can slough off and expel the embryo/fetus/early pregnancy without retaining any tissue.
However, some pregnancies will experience a spontaneous abortion at 16 weeks or 18 weeks or 20 weeks, and the fetus/baby will be much larger. For whatever reason (usually a severe genetic problem) the baby will die in utero. This is not uncommon. The problem here is that some parts of conception (or body parts of the baby/fetus) can be retained, or some body parts can stay inside the uterus. If these products of conception are not removed, the uterus can be come infected and the mother could become septic and potentially die.
An incomplete abortion is the partial loss of the products of conception within the first 20 weeks. Incomplete abortion usually presents with moderate to severe vaginal bleeding, which may be associated with lower abdominal and/or pelvic pain. It is important to diagnose this early to make sure the patient expels all products of conception.
The overall incidence of spontaneous abortion is 10% to 15%. It is divided into early, <12 weeks, and late, >13 weeks.The causes of abortion are usually unknown but most commonly are attributed to fetal chromosomal abnormalities and the rest due to modifiable etiologies and risk factors. Treatment of incomplete abortion includes expectant, medical, and/or surgical treatment.Complications are rare but can be serious such as sepsis from the retained product, hemorrhagic shock, and uterine rupture. The prognosis for these patients is generally good with a proper workup, close obstetric follow-up, and patient education. [Source]
In patients with conception fragments at the cervical os, a clinician can remove the fragments with forceps to help initiate the process of hemostasis, facilitate uterine contractions, and decrease vagal stimulation. This will prevent cervical shock. In plain English, sometimes body parts of the fetus/baby get stuck in the mom’s uterus/cervix and they need to be removed by the OB/GYN with forceps. This is a heart-wrenching scenario, but again, doctors need to act fast to remove these retained products of conception, otherwise the mom can get a severe infection and die.
Patients with an incomplete abortion and retained products of conception commonly have one or more of the following signs: uterine bleeding, pelvic pain, fever and uterine tenderness. Patients with hemorrhagic shock have obvious blood loss and those with septic abortion have signs of sepsis.
Here’s a story that was circulating on social media over the weekend. A patient had a 16 week gestation fetus/baby in her uterus. Her water broke early, and the baby started to come out of the woman’s uterus, then cervix, then vagina, resulting with the fetus/baby’s foot resting outside of the vagina. In a case like this, the baby will die - it cannot be replaced into the uterus. However, this doctor is practicing in a state that has banned abortion. Because the baby’s heart is still beating, they have to wait until the baby dies before the retained products of conception/fetus/baby can be removed. This is harrowing.
In some cases, an early pregnancy at 8 or 10 or 12 weeks of gestation can die in the womb, but remain in the womb without clearing in a timely manner. This can lead to physical and emotional pain for the mom, and has a risk for infection/sepsis and death in the mother as well. In these cases, doctors can go in and remove the embryo/fetus with a vacuum suction or a dilation and curettage procedure, where the baby is scraped out of the uterus by the doctor.
To make this real, here’s a heartfelt story from NFL player Nick Sundberg about their family’s experience with needing an abortion (dilation and curettage) after his wife miscarried on two separate occasions.
In Vitro Fertilization (IVF)
Depending on the language and interpretation, a state law could curtail access to fertility treatments, and in some cases, make the practice of freezing or discarding unused embryos in In Vitro Fertilization illegal.
The language could affect fertility procedures in two ways.
The first impact could be on selective reduction, or multifetal reduction, the practice of reducing the number of fetuses in one pregnancy.
This procedure is not as common today but may occur if a woman undergoes hormone therapy, which could increase the number of eggs and result in triplets or quadruplets. In these cases, there is a chance the woman or embryos could be at greater risk of an unsuccessful pregnancy, which is why a fertility clinic may decide to reduce one or more of these fetuses. This could meet the definition of abortion in some states.
The more common practice, IVF, which results in half a million deliveries annually, is when eggs are extracted, fertilized and the embryos are formed in a petri dish outside of the body. The embryos are then genetically tested, and only the healthy ones are implanted, reducing the chances of selective reduction because they don’t have to implant as many at once. The unused embryos are either frozen and stored for later use, discarded during or after the process or donated for scientific research.
In some strict interpretations of the abortion ban, freezing or discarding embryos or donating embryos for scientific research could be criminalized.
Babies Without Developed Organs
Anencephaly is a severe congenital condition in which a large part of the skull is absent along with the cerebral hemispheres of the brain. Some women become pregnant and the baby develops without a brain.
Anencephaly is a rare type of neural tube defect that affects about 1 in 4,600 babies. There is no way to treat anencephaly. Babies born with this condition will die before or shortly after birth.
Spina bifida is a congenital defect of the spine in which part of the spinal cord and its meninges are exposed through a gap in the backbone. It often causes paralysis of the lower limbs, and sometimes mental handicap.
Cancer
Chemotherapeutic agents and radiation for cancer treatment can cause birth defects. Studies show there is a risk of birth defects when a woman becomes pregnant while getting or after receiving some types of chemotherapy, radiation therapy, and hormone therapy. In some cases, the risk can last for a long time, making getting pregnant a concern even years after treatment ends.
Rape or incest
Just 1% of women obtain an abortion because they became pregnant through rape, and less than 0.5% do so because of incest.
Does Banning Abortion reduce Abortion Rates?
According to data from the World Health Organization (WHO), the legality of abortion across the world actually has little to no effect on abortion rates throughout the world.
Legal or not, abortions can, will, and do take place.
The legality of abortion, however, does affect how safe those abortions are. Women who do not have access to a legal abortion frequently turn to illegal or "homemade" abortion options, which are typically much riskier, more dangerous, and less effective than legal options conducted by professional doctors in a clinical setting would be. (source)
Is abortion legal in Michigan right now?
Yes. Abortion is still legal in Michigan as long as the injunction is in place.
This is the latest email that I received from LARA or the Licensing and Regulatory Affairs of the State of Michigan:
On Friday, the U.S. Supreme Court overturned a woman’s constitutional right to abortion services. Under this decision, laws and court rulings in each state guide how health professionals provide abortions and abortion-related services. In Michigan, there is an injunction in place, based on a court order prior to Friday’s U.S. Supreme Court decision, that protects women seeking abortion services and the health care professionals assisting them. That order states, “Defendant [the Attorney General] and anyone acting under defendant’s control and supervision, see MCL 14.30, are hereby enjoined during the pendency of this action from enforcing MCL 750.14.” The order also provided that the Attorney General give immediate notice of the preliminary injunction to all state and local officials acting under her supervision. It is LARA’s position that abortion remains legal in Michigan because of the current injunction that prohibits enforcement of the 1931 law.
We understand that you may have some concerns about how continuing to provide medical and surgical services to women seeking abortion may impact your professional license. The Department of Licensing and Regulatory Affairs will not take any action against any health professionals for providing legal abortion services while the current injunction remains in place.
Thank you for your commitment to providing services to women in need and to all Michigan citizens. We will continue to update you as new information becomes available.
Bureau of Professional Licensing, Michigan Department of Licensing and Regulatory Affairs
Where can I Receive an abortion in Michigan right now?
To be clear, we do not perform abortions at our clinic. We do provide counseling, contraceptive care, pap smears, mammograms, women’s health care, and referrals for abortion when needed.
You can likely seek care from your OB/GYN at most major hospital systems or you can seek care from Planned Parenthood. If you are struggling to find options, please reach out to our office so that we can guide you through this difficult process.
How can we reduce abortion rates in michigan?
Abortion should be a last resort for women and for families. It is a difficult decision that can have long-lasting familial, physiological, and emotional effects. There are ways to reduce abortion rates if we want to and that looks like:
Access to free contraceptives
comprehensive sex education
universal health care
paid family leave
welfare funding
secure housing for all
closing the wage gap
funding education
According to the Colorado Department of Public Health and Environment:
The Colorado Family Planning Initiative drove a 50 percent reduction in teen births and abortions, avoided nearly $70 million in public assistance costs and empowered thousands of young women to make their own choices on when or whether to start a family.
A private donor’s investment in the state health department’s family planning program allowed us to train health care providers, support family planning clinics and remove the financial barriers to women choosing the safest, most effective form of contraception.
This initiative empowered thousands of Colorado women to choose when and whether to start a family.
Thanks in large part to the Colorado Family Planning Initiative:
Teen birth rate was nearly cut in half.
Teen abortion rate was nearly cut in half.
Births to women without a high school education fell 38 percent.
Second and higher order births to teens were cut by 57 percent.
Birth rate among young women ages 20-24 was cut by 20 percent.
Average age of first birth increased by 1.2 years among all women.
Rapid repeat births declined by 12 percent among all women.
Costs avoided: $66.1-$69.6 million.
In short, the above example from Colorado is an effective public health policy for reducing abortion. Banning abortion at a Federal level with little thought or care given to the nuances of pregnancy, ectopic pregnancy, miscarriages, etc… is an ineffective way to reduce abortion that will result in harm to the women of our country, their families, and our communities.
Thanks for reading,
-Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan
Reproductive Health Care in Detroit
Reproductive Health Care in Detroit
Abortion is a component of comprehensive medical care.
Healthcare decisions, including whether to have an abortion, are deeply personal and should be made between a patient and their physician.
The implications of today's Supreme Court decision are profound and will disrupt, and in some states, eliminate equitable and safe access to medical care for women and families in the United States.
This Supreme Court decision further threatens to exacerbate already unacceptably high maternal morbidity and mortality rates in the United States. (In 2018, there were 17 maternal deaths for every 100,000 live births in the U.S. — a ratio more than double that of most other high-income countries. In contrast, the maternal mortality ratio was 3 per 100,000 or fewer in the Netherlands, Norway, and New Zealand.)
In Michigan, abortion rights are in question due to a 1913 law that prohibits abortion unless the procedure is "necessary to preserve the life of such woman.” Michigan Attorney General Dana Nessel has made clear that she does not plan to charge anyone under the 1913 law, but County Prosecutors could potentially charge doctors and/or patients under the existing Michigan Law.
This is truly an unprecedented change that has created a lot of chaos and confusion for both patients and their doctors.
At Plum Health, we are committed to upholding the sanctity of the patient-physician relationship and to protecting women's reproductive rights by delivering evidence-based healthcare services.
Pragmatically, we will continue to offer oral contraceptive pills, birth control implants, IUDs, STD testing, Pap testing, HPV testing, beta HCG or pregnancy testing, Levonorgestrel (Plan B One Step or the morning after pill), referrals to doctors who prescribe mifepristone and misoprostol, and referrals to local abortion providers like Planned Parenthood and other board-certified obstetricians and gynecologists.
Additionally, we will continue to provide the high-quality psychiatric health care resources, referrals for behavioral health, a listening ear, and the emotional support that is needed as our patients and members of our community navigate these difficult decisions.
When women have the right to choose, they build healthier families and healthier communities.
The real-world impact of making abortion illegal
According to data from the World Health Organization (WHO), the legality of abortion across the world actually has little to no effect on abortion rates throughout the world.
Legal or not, abortions can, will, and do take place. The legality of abortion, however, does affect how safe those abortions are.
Women who do not have access to a legal abortion frequently turn to illegal or "homemade" abortion options, which are typically much riskier, more dangerous, and less effective than legal options conducted by professional doctors in a clinical setting would be.
Daily Detroit Podcast hits 1,000 Episodes
Daily Detroit Podcast hits 1,000 Episodes
This week, the Daily Detroit Podcast hits 1,000 episodes! That’s a lot of content! The team of Jer Staes, Randy Walker, and Shianne Nocerini are diligent and talented, and they put together insightful, informative, and entertaining shows each week day.
Over the years, I’ve been a guest a handful of times to discuss medical care issues, mostly relating to coronavirus and the COVID 19 pandemic.
Episode from April 5th 2021 on the big coronavirus spike in the spring
Episode from April 15th 2018 about our Plum Health DPC practice
I’m happy to contribute and very proud of what this podcast has accomplished!
Plum Health DPC Featured in Upcoming Alive in Detroit Documentary
Plum Health DPC Featured in Upcoming Alive in Detroit Documentary
Alive in Detroit is a documentary put together by my friend Shiraz Ahmed. He has been acutely interested in health access in Detroit and beyond and our mission of making health care affordable and accessible in Detroit resonated with Shiraz. Shiraz included our work in a forthcoming documentary about health care in Detroit called Alive in Detroit. He’s raising money for the film right now on his Kickstarter campaign, so please contribute if you have the time and the means as this will be a timely and insightful documentary.
Shiraz was recently interviewed on WDET here in Detroit to explain more about the project. Here’s what WDET said:
“Alive in Detroit,” directed by filmmaker Shiraz Ahmed, is an upcoming feature-length documentary about the fight against chronic diseases such as cancer, heart disease and diabetes in the city. This story is a celebration of Detroiters and the work they do to heal their communities of illnesses while also providing them with protection and rights.
The film features a patient, a pastor and a physician whose stories inspire hope but also mask deeper inequities in the health care safety net. It’s a product of the city’s creative ecosystem, benefitting from programming by the Detroit Design Festival, the Freep Film Festival and Documenting Detroit.
“The pandemic’s really exposed all these cracks we have in our system,” he says. “I started this film before the pandemic, and then the pandemic just crystalized the themes I was looking at. It really gave me motivation – especially at a really depressing time when there was not a lot else to do to keep moving forward – because if we don’t address these inequities, another pandemic will happen and more people will keep dying.”
Dr. Paul Thomas Releases His New Book Dressing Well in Medicine
Dr. Paul Thomas Releases His New Book Dressing Well in Medicine
This month, Dr. Paul Thomas released his new book, Dressing Well in Medicine. It’s a short guide to help doctors look and feel their best, so that they can best serve their patients and the broader community.
The book cover for Dressing Well in Medicine, which is available on Amazon.
I wrote this book to help doctors and medical students to look and feel their best, so that they can uplift the doctor-patient relationship. For medical students, they are typically transitioning from college or undergraduate studies, to the professional environment of medical school and rotations through outpatient clinics and hospital settings. But, these medical students are not often given guidance on what to wear and what not to wear. There’s little to no discussion on what doctors wear and why it matters in the medical school curriculum!
My goal with this book is to help medical students look and feel mature and confident as they step into their new clinical roles and as they navigate professionalism and wearing professional attire as a physician. Ultimately, this will enhance students’ abilities to build trusting, healing relationships with their patients.
For practicing doctors, Dressing Well in Medicine serves as a reminder or a refresher on how to look and feel your best when taking care of patients, all while taking into account the latest evidence on this subject from peer-reviewed journals. Again, the goal is to foster trusting and healing relationships with doctors and their patients.
Recently, Dr. Thomas was interviewed by Drs. Melissa Cady and Kevin Cuccaro on their show The Changed Physician. The discussion was wide ranging and at some points, intense! Let’s face it - doctors don’t often discuss what doctors wear and why it matters, and there are so many challenging parts of physician attire and appearance that make for great discussion points, and sometimes, flash points. You can catch the full interview, here:
Finally, here’s a robust description of the Dressing Well in Medicine book:
Dressing Well in Medicine is a short guide for dressing well in medical school and beyond. You will need to look like a professional from the beginning of your medical school interview trail, to the whirlwind of clerkships and rotations, through your residency interviews and residency training, and eventually through your day-to-day clinical practice.
Dressing professionally is important because the trust and confidence of your patients depends in large part on your appearance, and professional attire greatly improves your appearance. A smartly-dressed, polished, and tasteful physician inspires confidence - the rumpled, disheveled, or schlubby doctor does not inspire that same confidence.
Therefore, I have written this book to give general guidelines for what to wear in the clinical setting and I believe that you will find it useful no matter where you are in your career.
As a medical student, there was no clear guidance on how to dress for a successful career in medicine. There’s no course in the medical school curriculum dedicated to appearance and demeanor. There’s no opportunity to discuss how our physical presentation as physicians can help us have better interactions with our patients or how our wardrobe choices can improve our chances of landing the residency program of our choice. There’s often not even a lecture on this topic.
I firmly believe that when we physicians dress intentionally, we can uplift the doctor-patient relationship and create the practice environments that enhance this sacred relationship at the level of the clinic, the hospital, and across the healthcare system.
I wanted to start a dialogue with aspiring doctors and practicing physicians about what we wear and why it matters. I truly believe that by dressing well in medicine, we can be our best selves as physicians, community leaders, and as leaders in the healthcare space.
Let this book serve as that missing piece of the curriculum, that crucial conversation on clothing choices and their impact on our patients, colleagues, and broader community.
Thank you for reading and watching!
-Dr. Paul Thomas with Plum Health DPC
Paul Thomas, MD - Recent Alumni Award Recipient from Wayne State University School of Medicine
Paul Thomas, MD - Recent Alumni Award Recipient from Wayne State University School of Medicine
In 2019, Dr. Paul Thomas received the Recent Alumni Award from Wayne State University School of Medicine. This is a prestigious award that is not given out every year. Here’s how it’s described by WSU SOM:
The Recent Alumni Award, established in 2003, is presented to an individual who received an M.D. degree from the WSU School of Medicine within the last 15 years and has demonstrated outstanding professional achievement, community contributions or service to Wayne State University School of Medicine.
Here’s a list of the previous Recent Alumni Award Winners at Wayne State University School of Medicine:
Plum Health DPC is a Family Medicine Practice in Detroit that is Accepting New Patients
Plum Health DPC is a family medicine practice in Detroit that is accepting new patients.
We have a family medicine clinic with three family medicine doctors and we are all accepting new patients into our practice. We see patients of all ages and stages and help our patients with a variety of medical concerns, like asthma, allergies, sleep apnea, depression, anxiety, diabetes, high blood pressure, hypertension, anemia, acid reflux, obesity, and so much more.
Detroit Medical Office Hiring a Medical Assistant
Plum Health DPC is Hiring a Medical Assistant
Our medical clinic in Detroit, Plum Health DPC, is hiring a medical assistant who can join our practice full time. At Plum Health, we believe that health care should be affordable and accessible for everyone. We are looking to hire someone who is positive and enthusiastic about delivering a delightful health care experience for our members.
Our starting salary is in the range of $15 per hour or more depending on experience. The position is full time, Monday through Friday, 9 am to 5 pm to cover our clinic hours. Two weeks paid vacation, 401K eligibility after 6 months. Please email Paul@PlumHealthDPC.com if interested in this position.
Here is a full list of specific job duties and responsibilities that we are hiring for:
Welcoming patients to the office
Scheduling patient appointments when requested
Emailing/Texting/Calling patients to confirm appointments when requested
Obtaining vital signs on each patient and documenting that information into the medical record
Collecting blood work and other lab samples
Contacting lab vendors for pickups
Assisting physicians with necessary tasks
Assisting with Pap testing
Assisting with skin biopsy and other procedures
Obtaining EKGs and other diagnostic testing when needed
Giving immunizations
Documenting immunization in MCIR
Pulling MCIR data when needed, uploading into medical record when needed
Obtaining COVID Swabs
Curbside COVID testing and in-office COVID testing as needed
Ensuring that all COVID test materials are properly labeled
Ensuring that all COVID samples are picked up each evening when tests are collected
Running MAPS data on patients when needed
Putting MAPS data into medical record
Inventorying medications
Monitoring medication levels, lab supplies, and other supplies and requesting refills when needed
Cleaning rooms once physicians/patients are finished
Cleaning office – desks, floors, bathrooms, etc… - as needed
Answering phones
Properly documenting requests and conversations in the medical record
OR documenting the requests with an email to the appropriate staff member
Processing medical records
Faxing documents
Completing patient paperwork
Scanning and uploading documents
Assisting with release of records documentation
Assisting with revenue collection and patient billing issues
Obtaining mail and packages from the mail room
Attend staff meetings
Assisting physicians with workflow tasks
Assisting physicians and other staff with miscellaneous requests
Plum Health DPC is a family medicine clinic in Detroit Michigan. We’re hiring a medical assistant at this time.
Plum Health Physicians Strongly Recommend COVID 19 Vaccination for Children 5 to 11 Years of Age
Plum Health Physicians Strongly Recommend COVID 19 Vaccination for Children 5 to 11 Years of Age
Today, I got a great question from someone on LinkedIn about the coronavirus vaccination for children. Here’s what they asked:
Hey Paul, wondering if you can point me in the direction of a good resource to cut through all the noise about COVID vaccines for kids 5-11. Weighing the decision to get the shot for my 7 year old daughter now or to hold off for a bit until even more data exists on outcomes post clinical trials. I looked to see if you had anything posted but didn’t come across anything. Thanks in advance!
This is a great question.
The CDC recommends everyone 5 years and older get the COVID-19 vaccine. I attached a link which states that the Pfizer vaccine is good for children 5-11 years. This is a 2 dose series 21 days apart. Vaccination helps children from getting severely sick. Vaccination also helps kids participate in activities - like after school enrichment programs and team sports. Vaccination for children also protects family members, especially older family members or family members with conditions that compromise their immune system.
Before getting approval this vaccine moved through different clinical trials and is now FDA approved. In each phase, the vaccine was tested in a large group of people to test for safety and efficacy. The Phase 2 and 3 trial revealed that the Pfizer vaccine had a good safety profile and protection in children 5 to 11. The Phase 1, 2, and 3 trial had 4,500 children 6 months to 11 years. Among these children, reactions were mostly mild to moderate. The side effects of the vaccine could be pain, redness, and fatigue. There were no cases of myocarditis in these trials, and these cases of myocarditis have been extremely rare in the real world setting.
The composition of the COVID-19 vaccine is safe. The Pfizer vaccine contains messenger RNA which tells the cells to create an immune response to COVID-19. Children 5 through 11 do not get the Pfizer vaccine given to teens and adults. They receive an age-appropriate dose that is one-third the adult dose.
Here is a great link from the CDC which explains the vaccine. There is also a video that describes mRNA vaccine:
This is a good publication that briefly describes the work that was done to develop the vaccine:
https://publications.aap.org/aapnews/news/17751?autologincheck=redirected
Where can you get coronavirus testing and vaccines in Detroit?
At Plum Health DPC, we have been vaccinating adults and children as soon as the appropriate vaccine doses became available for us. We’ve also been testing our patients for COVID to help them travel and stay healthy if they’ve experienced a recent exposure or symptoms concerning for COVID. Our office is in Corktown, Detroit at Michigan and Trumbull. You can get services or more information by calling 313.444.5630.
Thanks for reading,
-Dr. Paul Thomas with Plum Health DPC
Raquel Orlich DO is a Detroit Doctor who is Board Certified in Obesity Medicine
Raquel Orlich DO is a Detroit Doctor who is Board Certified in Obesity Medicine
Dr. Raquel Orlich is Board Certified in Family Medicine and she is Board Certified in Obesity Medicine. Dr. Orlich helps people in our practice lose weight and keep it off with an evidence-based approach. This is just another way that we're making comprehensive health care affordable and accessible at Plum Health DPC.
Dr. Raquel Orlich is Board Certified in Obesity Medicine and Family Medicine. She helps patients lose weight via an evidence-based approach to care.
Rates of Obesity in Detroit
The rate of Obesity in Detroit is 38%, that means that more than 1 in 3 Detroiters are Obese. The rate of Obesity in the State of Michigan is high as well, and it leads to early heart attacks and strokes, as well as an increase in the risk of diabetes. Here’s some striking findings from a recent report from the Michigan Department of Community Health:
Michigan had the 8th highest prevalence rate of obesity in the United States in 2008.
In 2008, 65.3% of Michigan adults were either overweight or obese; 35.2% were overweight and an additional 30.1% were obese.
Blacks had a significantly higher obesity rate (39.8%) than whites (28.8%).
Obese adults had a higher prevalence of arthritis, high blood pressure, high cholesterol, asthma, coronary heart disease, stroke, heart attack, diabetes and inadequate sleep compared with non-obese adults.
Obese adults also reported the highest prevalence of poor life satisfaction, poor general health, poor physical health, poor mental health and activity limitations compared with non-obese adults.
This is why it’s so important to take an evidence-based approach to weight loss via healthy eating and healthy exercising. If we continue to grow heavier as a society and as a community, the weight-related comorbidities will cause big problems for our overall health - physical, psychological, and emotional.
If you’d like to schedule a consultation with Dr. Raquel Orlich, you can do so here.