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Detroit, Education, Family Medicine, Podcast Paul Thomas Detroit, Education, Family Medicine, Podcast Paul Thomas

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.

Here’s the full interview.

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

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Paul Thomas MD interviewed on the Soul of Enterprise Podcast

This week, I had a one-hour conversation with Ed Kless and Ron Baker. Here’s the full audio recording:

Ed and Ron both asked some amazing questions, here’s what we discussed on the show, via their website:

Join Ed and Ron for our second interview with Dr. Paul Thomas, Founder of Plum Health DPC (Direct Primary Care), to discuss COVID-19, and his experience dealing with this from the front lines. Also, his new revolutionary business model in medicine. Is this the cure for our broken healthcare system, and how’s it going so far?

A Quick Bit About Dr. Paul Thomas

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.

Here are Ed’s questions from the interview:

  • How are you?

  • What about the people in your local community, how’s it going there?

  • About 40% of hospital beds in Michigan are filled with COVID patients, does that sound right?

  • Is there a difference between intubation and being on a ventilator, or are they the same thing?

  • And that’s different from being on oxygen?

  • There are potentially long-term risks with being intubated, even after you come off it, such as challenges with your lung capacity coming back?

  • What has been the effect, if any, on your business model? Has there been any significant challenges with Direct Primary Care (DPC) model?

  • Are they waiving any regulations to be able to provide telemedicine, for example?

  • Do you think COVID-19 might lead to a significant increase in DPC?

  • Will doctors get acclimated to provide telemedicine?

  • The numbers we’re all seeing at John Hopkins or Worldometer, the numbers are pretty scary, but they are also are staggeringly incomplete. I don’t think we can really believe the number of cases in China being limited to 81,000, for instance.

  • You talked a little bit about the tests with Ron, what are your thoughts about the at-home tests? Will we all be able to test ourselves at home and get some better numbers about what’s happening?

  • The FDA and CDC sort of messed up the process with the test when all this began. What are your thoughts on that?

  • This is less political than governmental. The nature of bureaucracy that may have been the downfall, regardless of the administration.

  • On your website blog, you did a great job debunking the Vitamin C myth that’s out there. What about hydroxychloroquine as a possible treatment?

  • What about the potential vaccine for this? If one was quickly developed would we be able to get it out quick enough, or would that run into bureaucratic hurdles?

  • Does that 15-18 months include the testing and verification, or just the development of a vaccine?

  • What about links you’ve seen to diabetes or pre-diabetic condition, or does it mostly just affect those who are older?

  • Age and diabetes are correlated aren’t they?

…and here are Ron’s questions:

  • In times like this, do you think this business model has deepened your relationship with patients?

  • Do you think the subscription model helps you weather a storm like this rather than a more transactional business model?

  • Can you explain the protocol for a COVID-19 test? Don’t they test for the flu first, and only as a last resort test you for COVID-19?

  • We don’t have a clear idea of the “denominator,” we don’t how many people are walking around with asymptomatic symptoms, right?

  • Settle a big dispute: Should we be wearing masks when we go out? [Yes!]

  • Does it have to be an N95 mask? [No]

  • You probably remember that in 2009-10 we had the Swine Flu, and between April 12, 2009 and to April 10, 2010, 12,469 people died in the USA alone, with 87% being under age 65. What makes COVID-19 deadlier than the swine flu?

  • Can this can back in different strains? Can you get again once you’ve had it and recovered?

  • Have you seen any granular demographic, age, comorbidities information on the reported deaths and/or cases?

  • With older patients, there’s a difference between dying from and dying with corona virus. How do they make that distinction when they gather the death statistics?

  • The University of Pittsburgh has developed a vaccine, they say they’ve seen development antibodies in mice. And I just finished a book by the oncologist Dr. Azra Raza, who wrote The First Cell. She says, at least for cancer, having anything to do with mice doesn’t really work when translating to humans. But is that not true with vaccines? The fact it works with mice, is that promising for humans?

  • We say it takes 12-18 months to develop a vaccine. Is there a way for the FDA to expedite this process. What is the risk of a vaccine developed quickly?

  • On your website blog video from March 26, 2020 you answer the question, “How can I become immune?” You listed two ways:

    • Get Infected then Recover (your body produces IGM/IGG) and you now have the antibody

    • Vaccination

  • You said to create herd immunity you need 50-60% of people, can that immunity happen plasma transfusions from people who had the virus and recovered?

  • What about this virus running it course and achieving of herd immunity? How long does that process take without a vaccine?

  • Unless it comes back in a different strain?

  • I’m looking at Worldometer, and Michigan has now surpassed California in cases. We were taking flights from China during December and January, at the rate of at least 7,000 per day. There’s only 246 deaths in CA—each a tragedy—can you account for that? Why wasn’t CA hit has hard as New York, New Jersey, or even Michigan?

  • Could it be herd immunity, why CA wasn’t hit as hard?

  • Where do you see this ending? How and when?

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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:

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