Plum Health Blog
Dr. Paul Thomas Interviewed on the Talk2MeDoc Podcast
Dr. Paul Thomas Interviewed on the Talk2MeDoc Podcast
This month, I had a great interview with Andrew Tisser of the Talk2MeDoc podcast. We discussed the direct primary care model and why it’s beneficial for patients and why it’s beneficial for doctors. We talk about primary care, access to care, health disparities, physician burnout, and so much more. Here’s what they had to say:
Join Andrew Tisser with Dr. Paul Thomas as they talk about an exciting new model of primary care. In this episode, you’ll learn:
What is Direct Primary Care?
Benefits of DPC to patients and physicians alike
How to negotiate wholesale prices on labs and imaging
Much more!
Here’s that full episode and below I take a deeper dive into some of these topics.
The Private Medical Practice is Not Dead
During medical school, medical students are told that the only way to have a career in medicine is via an employed model. That simply isn’t true. The private medical practice is not dead. In fact, once you get outside of the health insurance model, the private medical practice is thriving.
When I first started our direct primary care practice back in November of 2016, there were only about 400 practices across the country. Now, there’s over 1,300 direct primary care practices, and the movement continues to grow.
Why? Because patients are looking for kind, caring, and thoughtful physicians who have enough time to fully address all of their concerns. And guess what? The Direct Primary Care model allows doctors to have the time and space to take care of their patients in a comprehensive manner with enough time to fully listen.
Doctor, Heal Thy Self
For too long, primary care physicians have been battling burnout and moral injury by practicing in the fee-for-service model. This has lead to many doctors experiencing burnout and compassion fatigue. As many of 54% of physicians are affected by burnout.
In this podcast episode I make the analogy of half of your lights in your house burning out. If this were to happen, you wouldn’t change each individual lightbulb. Instead, you’d call the big energy company and inquire about the electrical grid in your city, or you’d call up an electrician and have them evaluate the electrical panel in your home.
Yet, when 54% of doctors face burnout, the hospital systems and insurance companies tell them to engage in meditation exercises, retreats, or self-care activities. Sometimes they just tell the doctors to “be more resilient.”
This approach is a slap in the face for hard working and compassionate doctors across our country.
What needs to happen is a comprehensive, systems-based reform of our health insurance and medical care payment systems that uplift the doctor patient relationship rather than forcing doctors into a one-size-fits-all model of high-volume, low-quality patient visits.
About Paul Thomas, MD:
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 two books Direct Primary Care: The Cure for Our Broken Healthcare System and Startup DPC: How to Start and Grow Your Direct Primary Care Practice
You can find Dr. Thomas.
Website: https://www.plumhealthdpc.com/
Facebook: https://www.facebook.com/PlumHealthDPC/
Detroit Doctor Discusses the Importance of Health Communication
Detroit doctor discusses health Communication and Health literacy
This week, we had a great interview with SHANKX Web Development about the importance of Health Communication. We believe that health communication is at the core of better health outcomes. When doctors and patients can communicate seamlessly, questions are asked and answered that leads to a better understanding of symptoms, diagnoses, and treatment options.
For us, health communication is super important, and it starts with developing trusting relationships with our patients. When we have trusting relationships and open lines of communication - text messages, emails, phone calls, video chats - we can truly help our patients understand their symptoms, our diagnoses, and the best way forward in terms of treatment and management.
Further, in communities like Detroit with lower levels of health literacy, excellent communication becomes even more important.
I got to meet Shankar Poncelet and Antrea Ferguson at a recent Direct Primary Care conference and we discussed this topic at that time, and they wanted to follow up with a deeper dive. We decided to engage in an Instagram Live discussion, which went well other than the poor sound quality on my end. I hope you enjoy the conversation!
recognizing national health literacy month
Here’s what they had to say: In light of National Health Literacy Month, we were joined by Dr. Paul Thomas MD of Plum Health, a Direct Primary Care Physician who runs a novel Direct Primary Care clinic in Detroit.
With three doctors and two locations of Plum Health already established, and a fourth doctor joining the Plum Health team in February 2021, Dr. Thomas shares how social media and the DPC model have been "primary" drivers of growth.
Literacy takes two distinct faces in our talk with Dr. Thomas:
Educating the patient community in Detroit about the alternatives available to them when it comes to accessing health care that TRULY serves their needs
Educating doctors and the broader medical community about how to harness the power of social media to not only build your personal brand but actually perform outreach in under-served communities and share the ways in which medical professionals can SERVE their patients
For more on Dr. Thomas's practice, Plum Health DPC, visit our website here.
If you’d like to sign up to be a patient of Plum Health DPC, you can enroll here.
If you're a medical professional looking to start your own successful DPC practice, be sure to check out Dr. Thomas's book, Startup DPC: How To Start And Grow Your Direct Primary Care Practice.
Plum Health DPC Featured in Start Up TV Show on PBS This Fall
Exciting news! We’re going to be on a TV 📺 show called @startuptvshow on @pbs this fall 🍁 🍁 Our episode airs November 8th at 1:30 pm 🙌🏼 🙌🏼
Here’s what they said:
“😱 🤯 What if we told you that there is a direct primary care physician 👨⚕️ in Detroit that does house calls and offers books 📚 about how to start your own practice?
Awesome, right? You will learn more about Plum Health and their desire to provide affordable and accessible health care 💉 💊 🥼 on this season of START UP, premiering October 18th!”
Tune in every Sunday, as the show will be featuring some amazing business in Detroit 💯
Filming this episode was a multi-day process at our office in Corktown Detroit. We got to work with a very talented film crew with an amazing creative vision. The crew put a ton of effort and energy into the filming process and we hope that energy will be reflected in the final product.
This is our first time being featured for an extended interview, so there was a lengthy sit-down interview process and a great deal of B-roll footage, from us performing physical exam maneuvers on our patients in our office, to us counting out meds, and even a scene of Dr. Paul Thomas on a bicycle!
The episode will air on November 8th at 1:30 pm Eastern Time, so mark your calendars!
If you’d like to become a member of Plum Health, you can sign up here:
Thanks for reading and setting your DVRs!
-Dr. Paul Thomas with Plum Health DPC
More about the Start Up TV Show
Crain’s Detroit Business did a nice write up on the show, and described it as follows:
"Start Up," in its eighth season, gives viewers a look inside the world of the American entrepreneur. This season, with the first episode set to air at 1:30 p.m. Oct. 18, will feature 13 entrepreneurs — 12 of them based in Michigan. The season, according to show creator Gary Bredow, will center on how small-business owners and entrepreneurs have adapted to and navigated their way through what has been a turbulent 2020. The show will air on more than 350 PBS stations nationwide.
Start up season 8 teaser trailer
The Start Up crew put together a fantastic teaser trailer for Season 8, and you can see that teaser here:
Dr. Paul Thomas Speaks with Wayne State Medical Students About Lowering the Cost of Health Care
This week, I was invited to speak with Wayne State University School of Medicine students who are interested in the Direct Primary Care model and who are interested in how the model makes health care more affordable and accessible.
During this session, I talked with the students about the current problems in the United States Health Care System, the challenges that doctors face when taking care of patients, and the solutions that the Direct Primary Care model offers.
The students asked some excellent questions during the question and answer session.
Thanks for watching,
- Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan
Virtual Walk with the Doctor in Detroit's Oldest Neighborhood - Corktown
Virtual Walk with the Doctor in Detroit’s Oldest Neighborhood - Corktown!
This week, I'm hosting a virtual walk with the doctor. We're headed out into Detroit's oldest neighborhood, Corktown!
Boundaries of the Corktown Neighborhood
Corktown is a historic district located just west of Downtown Detroit, Michigan. It is the oldest extant neighborhood in the city. The current boundaries of the district include I-75 to the north, the Lodge Freeway to the east, Bagley and Porter streets to the south, and Rosa Parks Boulevard (12th Street) to the west. The neighborhood was listed on the National Register of Historic Places in 1978.
Why is Corktown Called Corktown?
The Great Famine of Ireland of the 1840s resulted in extensive Irish migration to the United States and Canada. By the middle of the 19th century, they were the largest ethnic group settling in Detroit. Many of these newcomers settled on the west side of the city; they were primarily from County Cork, and thus the neighborhood came to be known as Corktown.
Biggest New Investment in the Corktown Neighborhood
One exciting new development in Corktown is the Ford Headquarters that will be within the Michigan Central Station. The Michigan Central Station is on the western end of the Corktown neighborhood and it's been vacant since 1986. There is currently a billion dollar investment into the former train station to modernize the building and make it fit for the Ford Motor Company's headquarters.
This single investment is prompting other individuals and businesses to invest in the community by renovating old commercial and residential properties, as well as build new commercial and residential properties.
The Best Part about Corktown
The best part of Corktown in my opinion are the people who have invested in the community for the long term - the neighbors, the long-term residents, and the small business community. There are several small business that we pass on this walk that have been neighborhood stalwarts. They include but are not limited to:
My goal with this is to provide some education and entertainment during these trying times of Covid 19, quarantine, political uncertainty, and the stress of daily life. Take a few moments to enjoy this video and immerse yourself in a calming environment.
Perhaps you'll watch this video while on your treadmill, or perhaps this video will inspire you to check out your nearest park, nearest walkable community, or to hike a trail close to your home. Importantly, the Department of Health and Human Services recommends the following activity levels for adults:
For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity aerobic physical activity. Preferably, aerobic activity should be spread throughout the week.
Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week.
Adults should also do muscle-strengthening twice weekly and this has added health benefits
I bring this up because I’m a family doctor and because the leading cause of death in the United States is heart disease. From the CDC:
Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States.
One person dies every 36 seconds in the United States from cardiovascular disease. About 655,000 Americans die from heart disease each year—that's 1 in every 4 deaths.
The best way to combat heart disease is with regular exercise, a health diet, and no smoking cigarettes and limited alcohol consumption.
Thanks for reading and watching and I hope this video inspires you to strive for your health goals and to get outside for a walk this week!
-Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan
Dr. Paul Thomas Speaks with The Gold Humanism Honor Society at Wayne State
This week, I had the privilege of speaking with the medical students who make up the Gold Humanism Honor Society at Wayne State University School of Medicine. Here’s what they had to say about it:
Tonight we had the opportunity to hear from Dr. Paul Thomas about direct primary care and providing affordable and accessible care for everyone. We are so grateful that you took the time to talk with us and we were able to learn more about @plumhealthdpc 💜
When I was a medical student at WSU SOM, I was a part of the Gold Humanism Honor Society. Here’s what they’re all about:
The Gold Humanism Honor Society Chapter at Wayne State University School of Medicine was founded in 2005. We strive to embody the following tenets:
Excellence in patient care and advocacy
Compassion for patients and their families
Professionalism and leadership among colleagues, students and staff
Commitment to teaching students
Devotion to promoting humanism in medicine through behavior and attitude
Throughout my training and career in medicine, I’ve worked to cultivate my compassion for others and humanistic approach to medical care. Speaking with students is always a great reminder of the attributes that make up a kind and caring physician, so it was great to be invited to talk with these students.
Thanks for reading and have a great day,
-Dr. Paul Thomas of Plum Health DPC
Dr. Paul Thomas Interviewed on Leading the Rounds Podcast
Recently, I was interviewed on Leading the Rounds Podcast. In this episode, two medical students from Wayne State University School of Medicine, Peter Dimitrion and Caleb Sokolowski, interviewed me to talk about direct primary care and leadership in medicine.
We discuss the difference between fee for service medicine and direct primary care. In the fee-for-service model, patients need to have an insurance plan to access health care. This leaves the roughly 27 million Americans who do not have health insurance vulnerable and without access to health care. I started my direct primary care practice because I believe that healthcare should be affordable and accessible for everyone.
During my residency when I was employed by a large hospital system, I hated to see the front desk staff turn away uninsured patients. I knew that there had to be a better, more compassionate way to deliver health care. When I discovered direct primary care, I knew it was the best option for me to start my own practice and deliver health care services on my own terms, for the good of my patients and for the good of my community.
We discuss the difference between direct primary care and concierge medicine. In short, concierge medicine costs $2,400 annually and requires a health insurance plan to participate. In direct primary care, patients pay about $65 monthly and they do not have to have an additional insurance coverage, although it’s highly recommended. I talk about this topic in depth in this blog post and YouTube video.
We also talk about why patients would want to choose direct primary care and why doctors are choosing to practice in the direct primary care model. Patients choose direct primary care practices like Plum Health in Detroit because they can have a genuine relationship with their physician - our patients know that they can call, text, or email their doctor any time they need to. This accessibility gives our patients peace of mind. Patients choose direct primary care because they know the cost of their care, and there are no surprise bills - patients often save 50 to 90% on their medications, lab work, and imaging services.
Doctors are choosing direct primary care because they can spend more time with their patients and less time with their computers.
“I went into medicine to spend time with my patients, not to spend time with my computer.” - Dr. Paul Thomas of Plum Health DPC on Leading the Rounds Podcast
Doctors can also liberate themselves from insurance company mandates, and practice medicine on their own terms, maximizing the benefits for their patients. Hear about all this and more in the episode, here:
From Wayne State University School of Medicine:
Wayne State University School of Medicine students Peter Dimitrion and Caleb Sokolowski have jumped into the popular world of podcasting as the creators and hosts of “Leading the Rounds: A Medical Leadership Podcast.”
“We began this podcast because we are both passionate about leadership development, which is its own field and needs to be studied like pathology, biology and more,” said Dimitrion, a second-year M.D./Ph.D. student. “There are few resources for medical trainees that are accessible and affordable. Leadership development is overlooked in contemporary medical education, yet medical students and physicians find themselves in leadership roles from the beginning of their training. Other industries, such as the military and business, have formal leadership development courses, but physicians receive no formal leadership training as a part of their medical curriculum. We want to meet this need and improve our comprehension and understanding of leadership principles.”
His co-host is also in his second year of the M.D. program. Dimitrion and Sokolowski published seven episodes so far, with guests including Army Maj. Cal Walters and Paul Thomas, M.D., a Class of 2013 alumnus and founder of the direct primary care clinic Plum Health in Detroit.
The show will focus on three facets they believe are critical to their development as future medical leaders: leadership development, personal development and health systems literacy.
“Leading the Rounds” is available on Apple Podcasts or Spotify.
“We also have a website, www.leadingtherounds.com, which we are constantly updating with links to our episodes and resources for anyone who is interested in following up on the ideas that we talk about in our podcast. People can also connect with us on Instagram @Leadingtherounds,” Dimitrion added.
Virtual Walk with the Doctor on Detroit's Beautiful Belle Isle
Virtual Walk with the Doctor in Detroit
This week, I'm hosting a virtual walk with the doctor. We're headed out into beautiful Belle Isle park in the middle of the Detroit River, walking through one of my favorite trails and seeing wildlife along the way.
Exploring Beautiful Belle Isle with Dr. Paul Thomas
Detroit's Belle Isle was designed in the late 1800s by Frederick Law Olmstead, who also designed Central Park in New York City, Mount Royal Park in Quebec, and the Emerald Necklace in Boston. The wooded areas were a central feature of his design, so it's fitting that we're able to walk through one of those wooded areas.
As you spend time on Belle Isle, you'll see a broad array of wildlife. There are groundhogs (aka chuck hogs or whistle pigs), chipmunks, squirrels, eagles, herons, Canadian geese, woodcocks (aka timberdoodles) ducks, frogs, woodpeckers, blue jays, hawks, and many more. During our walk today, we saw several blue jays, ducks, and frogs.
If you want to explore Belle Isle outside of the wooded areas and wildlife areas, there are several attractions. These include the Belle Isle Aquarium, Coy Fish Pond, the Belle Isle Conservatory, the Belle Isle Beach, and many others - the Casino, Detroit Boat Club, Detroit Yacht Club, Dossin Great Lake Museum, Nancy Brown Peace Carillon Tower, Belle Isle Golf Range, Livingstone Memorial Lighthouse, etc...
One exciting new development on the island is the new and ongoing construction of the Oudolf Garden - Piet Oudolf is best known for his work with the High Line in New York and Lurie Garden in Chicago. It's really exciting to have this type of investment into the island, and this new garden will be situated at the base of the Nancy Brown Peace Carillon Tower.
Why 30 Minutes of Daily Exercise is Important for Long-Term Health
My goal with this is to provide some education and entertainment during these trying times of Covid 19, quarantine, political uncertainty, and the stress of daily life. Take a few moments to enjoy this video and immerse yourself in a calming environment.
Perhaps you'll watch this video while on your treadmill, or perhaps this video will inspire you to check out your nearest park and to hike a trail close to your home. Importantly, the Department of Health and Human Services recommends the following activity levels for adults:
For substantial health benefits, adults should do at least 150 minutes (2 hours and 30 minutes) to 300 minutes (5 hours) a week of moderate-intensity aerobic physical activity. Preferably, aerobic activity should be spread throughout the week.
Additional health benefits are gained by engaging in physical activity beyond the equivalent of 300 minutes (5 hours) of moderate-intensity physical activity a week.
Adults should also do muscle-strengthening twice weekly and this has added health benefits
I bring this up because I’m a family doctor and because the leading cause of death in the United States is heart disease. From the CDC:
Heart disease is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States. One person dies every 36 seconds in the United States from cardiovascular disease. About 655,000 Americans die from heart disease each year—that's 1 in every 4 deaths.
The best way to combat heart disease is with regular exercise, a health diet, and no smoking cigarettes and limited alcohol consumption.
Thanks for reading and watching and I hope this video inspires you to strive for your health goals and to get outside for a walk this week!
-Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan
The Shocking Reason Why Health Insurance Premiums Continue to Rise
This year, I had the opportunity to speak at TEDxDetroit. At first, I struggled with what to say, other than I’m grateful for the platform and the opportunity. But, I realized that it was important to discuss the outrageous increases in health insurance costs for the average American family.
The Way Rising Health Insurance Costs Affect the Take Home Pay of Americans
The average family in the United States paid about $3,500 for employer-sponsored health insurance coverage in 2009 and that amount of money ballooned to about $6,000 in 2019.
What’s even worse is that employers were spending $9,860 per employee in 2009 to administer those health insurance plans, and in 2019 they’re paying $14,561 for those same health insurance plans.
All of this money spent on Health Insurance costs is a huge detriment for our national economy and for the paychecks of individual Americans. Imagine if health insurance costs were the same today as they were in 2009, each American family would have an extra $10,000 in wages from their employer. Instead, that extra $10,000 is spent on health insurance costs.
The Reason Why Health Insurance Costs Continue to Rise in the United States
Let’s start by discussing the 80/20 rule in the Affordable Care Act (ACA). The ACA set forth some well-intentioned provisions. Here’s what HealthCare.gov has to say about this 80/20 rule:
The 80/20 Rule generally requires insurance companies to spend at least 80% of the money they take in from premiums on health care costs and quality improvement activities. The other 20% can go to administrative, overhead, and marketing costs. The 80/20 rule is sometimes known as Medical Loss Ratio, or MLR.
According to the American Economic Association: “Rather than lower premiums, insurers searched for other ways to come into compliance. Initially, there were efforts to relabel some administrative costs as “quality improvements”—like lobbying to count spending on nurses’ hotlines as part of the 80 percent. But the easiest route to meeting the requirement was simply to let medical claims increase. That companies opted to do this, instead of lowering premiums, didn’t come as a surprise”
Within that 20% of administrative, overhead, and marketing costs, insurance companies have their profit margin. Therefore, the more money spent on insurance claims, no matter how bogus, the larger the profit margin becomes for the insurance companies.
Increased Health Care Spending on Inflated Health Insurance Claims
This brings me to the glaring example of inflated health care costs based on questionable medical care and out-of-network billing. In December 2019, I heard about the $25,865 throat swab that Blue Cross Blue Shield of Minnesota paid for. The gist of the story, from NPR’s Bill of the Month series, is that a woman in Manhattan went to a doctor for a sore throat, received a throat swab, and was given an antibiotic.
Because the throat swab was processed by an out-of-network lab, the cost of the throat swab was $25,865.
First of all, a good primary care doctor can develop a trusting relationship with a patient, obtain a history of the illness, and perform a physical exam for 99% of viral or bacterial throat infections or cases of pharyngitis. In other words, a throat swab is NOT NEEDED in 99% of pharyngitis cases.
Second, the fact that the insurance company paid for this $25,865 throat swab is insane. The reasonable cost for a throat swab like this might be $100 to $500, no $25,865. If I ran the insurance company, I would be calling the out-of-network lab’s bluff here and they’d be paid a reasonable $500 at most.
However, as discussed above, the more money insurance companies spend on health care or medical losses, the more profits they’re able to rake in due to the 80/20 rule in the affordable care act.
That’s why we’ve seen our health care spending increase from $2.5 Trillion in 2009 to $4.01 Trillion in 2020.
We must end these insane health insurance practices before it further affects our earnings and our Nation’s economy.
Thanks for reading and thanks for watching my TEDxDetroit talk,
-Dr. Paul Thomas with Plum Health DPC in Detroit
Paul Thomas MD at TEDxDeroit 2020
Paul Thomas MD at TEDxDetroit 2020
It’s a tremendous honor to be back at TEDxDetroit! I spoke in 2017 about our mission to provide affordable and accessible healthcare in Detroit and beyond.
This year, I’m grateful for TEDxDetroit, the community of positive supporters who are working to make Detroit better everyday, and the opportunity to share my perspective on why our health care costs continue to rise.
Join me tonight on the virtual main stage at 8:15 pm - the event is free and all are welcome!
If you're not already registered, GO! What are you waiting for? TEDxDetroit 2020 starts at 10am and it's FREE: http://tedxdetroit.connect.space/
If you're registered, snap a selfie in the virtual photo gallery: https://virtual.fancyflashpb.com/virtual/capture/owZX3
Men's Health in Detroit
Men’s Health in Detroit
There are a number of preventive services that men need to stay healthy as they age. Basic items include annual flu shots and annual blood work to check for cholesterol levels. Checking your blood pressure, height, and weight is also important to screen for hypertension and obesity.
As men age, more complex screening tests are needed. For example, at age 50, men need a Colonoscopy to check for colon cancer. Men who smoke require an ultrasound of the abdominal aorta to rule out an aortic aneurysm at age 65. Men who smoke the equivalent of 1 pack per day for 20 years would benefit from a CT scan of the lungs to rule out lung cancer starting at age 50. From the United States Preventive Services Task Force:
The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults ages 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
If you’d like us to help you coordinate these tests by becoming your primary care doctor, you can sign up on our website, here.
Men’s Health Event in Detroit
On the note of preventive service, this weekend, the MIU Men’s Health Foundation is providing an opportunity to do check some of these screening tests off of your list. This Saturday, September 26th, the foundation is hosting its 10th annual Men’s Health Event at the Michigan State Fairgrounds. The event will run from 9AM-4PM and the entrance is located at 770 W. State Fair, in Highland Park. To avoid waiting in a line, they do recommend scheduling a time for your drive-through by registering at this website.
All Metro Detroit-area men, ages 18 years and older, with or without insurance, can participate in this completely drive-through event. All services are completely free, and include vital screenings, a bloodwork panel, flu vaccinations, FIT kits for colorectal cancer screening, COVID-19 nasal swab testing, and HIV testing. All testing will be administered without participants needing to leave their vehicles. Blood work results will be texted back, unless other arrangements are made at the event, and you do not need to be fasting for the blood draw. More information about the event is available here.
The Debate on Prostate Cancer Screening in Detroit
Prostate Cancer screening is a double-edged sword. Prostate specific antigen is a protein made by the prostate that can become elevated during prostate cancer. It can be easily tested with a blood draw. Just because it can be easily tested, doesn’t mean it should be tested. Usually, PSA testing is done on an annual basis for men with a family history of prostate cancer.
The test is only recommended for men between the ages of 55 and 69. If you don’t have a family history of prostate cancer, and you get the PSA test, and it comes back high, a workup may be recommended. To find out if you have prostate cancer, a trans-rectal biopsy is performed. That means a Urologist or a prostate cancer specialist inserts an instrument into your butthole/rectum, and uses an instrument to take a piece of tissue from your prostate.
Because this biopsy is close to other important nerves and blood vessels that can control urine function and erectile function, this transrectal biopsy and other procedures to test for and treat prostate cancer can result in loss of urinary function and loss of erectile function.
You must know these facts before being tested for prostate cancer with a simple blood test.
From the United States Preventive Services Task Force:
For men aged 55 to 69 years, the decision to undergo periodic prostate-specific antigen (PSA)-based screening for prostate cancer should be an individual one. Before deciding whether to be screened, men should have an opportunity to discuss the potential benefits and harms of screening with their clinician and to incorporate their values and preferences in the decision. Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction. In determining whether this service is appropriate in individual cases, patients and clinicians should consider the balance of benefits and harms on the basis of family history, race/ethnicity, comorbid medical conditions, patient values about the benefits and harms of screening and treatment-specific outcomes, and other health needs. Clinicians should not screen men who do not express a preference for screening.
I’ll repeat that information for emphasis: Screening offers a small potential benefit of reducing the chance of death from prostate cancer in some men. However, many men will experience potential harms of screening, including false-positive results that require additional testing and possible prostate biopsy; overdiagnosis and overtreatment; and treatment complications, such as incontinence and erectile dysfunction.
Thanks for reading, and we hope you take advantage of these screening tests, when appropriate.
-Dr. Paul Thomas with Plum Health DPC
Family Medicine Office in Detroit Accepting New Patients
Plum Health DPC is a Family Medicine Office in Detroit Michigan that is accepting new patients. For new and prospective patients, we’re excited to share our latest 3D rendering of our office - you can now take a virtual tour of our Plum Health DPC office using the navigation system below. We have a waiting room, a conference room, 3 exam rooms, a medication room, and more.
Check out this excellent 3D rendering created by our friends at The Handbuilt City. Here’s what they had to say about our service:
Plum Health DPC (Direct Primary Care) is a family practice doctor’s office in Detroit’s Corktown neighborhood, occupying a storefront space in the new development at the former Tiger Stadium. Dr. Paul Thomas, MD, and Dr. Raquel Orlich, DO, are the two doctors here, while Dr. Jamie Qualls, DO, MPH, operates out of a new office in Farmington Hills. Paul has written two books, one explaining the emergent phenomenon of Direct Primary Care, and one explaining the practice for doctors from a startup and entrepreneurial standpoint.
The Handbuilt City had more good things to say:
Plum Health started a few blocks away in the Detroit School of Digital Technology, a former police precinct, on West Vernor Highway. DPC is a healthcare model that emphasizes individual access. Patients pay a subscription fee per month, the “direct” part of the DPC– almost like “medicine-as-a-service.” Patients can text, call, or e-mail their doctor directly, rather than having to schedule weeks-out appointments through the increasingly byzantine and faceless processes of corporate medicine. In comparison, one might pay five times more per month for a high-deductible health insurance plan, but might have to nonetheless wait weeks to schedule an appointment with a doctor who doesn’t have the time to get to know you as a patient. DPC also provides affordable access to a range of common medications, affordable lab testing, vaccinations, and more.
As GoodRX notes: “[DPC] physicians are able to avoid the time normally spent preparing and filing insurance paperwork. This allows for in-depth visits and consultations with their patients. Direct primary care practices also typically have fewer patients than those accepting insurance.”
The practice has been well-reviewed on Google (5.0 stars out of 72 reviews) and Yelp (5.0 stars out of 5 reviews). See JC Reindl’s write-up in the Free Press, coverage from MJ Galbraith in Model D Media, and this article from TheHUB.
Thanks for reading and have a wonderful day,
-Dr. Paul Thomas with Plum Health DPC
House Call Doctor in Detroit
I make house calls because I believe that healthcare should be affordable and accessible. 🥼
That accessibility piece can be out of reach for some elderly and disabled patients who cannot leave their home. This is especially true in Detroit, where nearly one third of Detroiters lack access to reliable transportation. 🚗
Studies on the effects of house calls on healthcare outcomes show fewer hospitalizations 🏥, fewer emergency room visits, decrease in re-admissions (going back to the hospital shortly after discharge), and these house 🏠 calls save patients money 💵.
That’s why it’s important for me to offer this vital service. This pic was taken last week in the Five Points neighborhood. I’m proud of this work and of how we’re able to lower the cost of care and make excellent health care available to more people.
The vast majority of our visits take place in our offices - we have two locations where we take care of people face to face and by using virtual visits. But, house calls can be used at any time to help our patients who are shut in, who have mobility issues, or who have concerns where they’d prefer not to leave their homes.
From the American Academy of Family Physicians:
House calls, also referred to as home visits, are increasing in the United States. Approximately 40% of patient visits in the 1930s were house calls. By 1996, this decreased to 0.5% because insurance reimbursements for house calls decreased. The pendulum in the United States is swinging again to house calls because of the need to develop care models for the growing aging population.
More information from the American Academy of Family Physicians on the benefits of house calls:
The Independence at Home program demonstrated a 23% reduction in hospitalizations, a 27% decrease in 30-day readmissions, and a cost savings of $111 per beneficiary per month, which is a $70 million savings over three years. Similarly, a large systematic review (N = 46,154; nine studies) evaluating home-based primary care outcomes for homebound older adults reported fewer hospitalizations, hospital bed days of care, emergency department visits, long-term care admissions, and long-term bed days of care.
If you’d like this type of care and service for yourself or your family, you can sign up here.
Dr. Paul Thomas Welcomes 300 New Medical Students to Detroit
Last week, Dr. Paul Thomas welcomed 300 new medical students to Wayne State University School of Medicine. Typically, the incoming students are packed into a large lecture hall at WSU SOM’s Scott Hall. But this year, due to Coronavirus, the event was held outdoors at Chevrolet Plaza, adjacent to the Little Caesars Arena. This open air venue accommodated 100 medical students at a time, and there were three “Welcome to Detroit” sessions throughout the day.
Dr. Paul Thomas gave a “Welcome to Detroit” lecture to the incoming medical students that emphasized the significant history and culture of the City of Detroit. There are so many opportunities for students to immerse themselves in service learning, by volunteering at local free clinics and by giving back to Detroit and the surrounding communities, by working with grade school students and the elderly, by volunteering at food banks and soup kitchens.
Dr. Paul Thomas shared a quote from Jeanette Pierce, “Detroit is big enough to matter in the world, and small enough for you to matter in it.”
Direct Primary Care Removes the Middlemen and Lowers the Cost of Health Care
There are perverse incentives in the healthcare system. As a part of my mission to provide affordable and accessible health care in Detroit and beyond, it needs to be said that the middlemen in healthcare inflate the cost of the care that you receive.
Anthem Revenue $104 Billion (2019)
Cigna Revenue $154 Billion (2019)
United Revenue $242 Billion (2019)
Cigna CEO salary $18.9 million (2018)
United CEO salary $21.5 million (2018)
Blue Cross CEO salary $19.2 million (2018)
The total annual healthcare spending in the US is over $3.6 trillion annually.
Healthcare spending on administration: 34%
Healthcare spending on physician salary: 8.6%
When your doctor can’t get you the tests/imaging/procedures/surgery/medication you NEED, remind yourself that the middle management, the CEOs, the lobbyists for health insurance company did NOT swear an oath to put your health above money.
Your doctor did.
Doctors are missing sleep, skipping vacation, answering calls on weekend and holidays, missing important family events, and otherwise working tirelessly to keep you healthy.
All of that's to say that I firmly believe in the power of the doctor-patient relationship and removing the middlemen from this equation. This is why we do what we do at Plum Health DPC.
https://www.plumhealthdpc.com/
#DirectPrimaryCare #PlumHealth
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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
Plum Health DPC Specializes In Comprehensive Women's Health
Plum Health DPC Specializes in Comprehensive Women’s Health
We strive to deliver excellent care and services for women in our community. We are fortunate to have two excellent female physicians at Plum Health DPC who go above and beyond for their patients at Plum Health DPC.
Specific Services Offered for Women’s Health at Plum Health
We offer a range of services for women in our community, both at our Detroit and Farmington Hills Office. Dr. Raquel Orlich practices at our Detroit office and Dr. Jamie Qualls practices at our Farmington Hills office. Both physicians are excellent in caring for women’s health concerns, including but not limited to:
Birth Control Services
IUD Insertion and Removal
Pap Smears or Pap Testing
Human Papilloma Virus (HPV) Testing
Sexually Transmitted Infection (STI) testing
Implanon Insertion and Removal
Dietary Counseling
Weight loss management
Aesthetics like Botox at our Detroit office with Dr. Raquel Orlich
Affordable and Accessible Health Care For Women
Health Insurance can often create a barrier for patients getting access to primary care services. If you’re uninsured or underinsured, getting access to a doctor’s visit can be difficult and expensive. With our direct primary care model at Plum Health DPC, we do not bill or use insurance. Therefore, most of our patients pay $49 or $69 monthly to be a part of our health care service (see our prices based on age, here).
In addition, many of the procedures and services that we offer at Plum Health are included in the membership. Included services include:
visits with the doctor
phone calls, emails, and texting with the doctor
many procedures like IUD insertion, IUD removal,
motivational interviewing like dietary counseling
educational services like birth control management
If you need oral contraceptive pills or birth control pills from our office, prices range from $4 to $9 monthly for medications like Sprintec, Aviane, Junel, Junel FE, and Apri.
If you need lab work performed at our office, it’s roughly $75 for Pap Testing with HPV co-testing and it’s roughly $45 for Sexually Transmitted Infection testing like HIV, Syphilis, Chlamydia, and Gonorrhea testing.
How to Sign Up For a Women’s Health Doctor in Detroit and Farmington Hills
If you’d like to sign up for this type of health care service for yourself, your family, or your business, you can enroll online here.
Thanks for reading!
-Dr. Jamie Qualls, DO, MPH and Dr. Raquel Orlich, DO
Dr. Jamie Qualls to Start a Plant-Based Blog
Dr. Jamie Qualls is a family doctor in Farmington Hills Michigan and she focuses on a food-as-medicine approach. She will be writing about her approach on a monthly blog and we post her insights and wisdom here. If you want to follow Dr. Jamie Qualls on Instagram, she’s at @jamie_plumhealthdpc.
vegmichigan
We at VegMichigan are so excited to be partnering with Dr. Jamie (@jamie_plumhealthdpc) for this new, monthly feature to our blog!
Dr. Jamie is going to be sharing years and years of knowledge through her blog and we are so lucky to have her share her wisdom!
Subscribe to our newsletter (link in bio) to find out each Health Corner topic of the month 👍
#herbivore #eatplants #plantbased #nomeat #meatfree #plantbasedhealth #vegmichigan #veganmichigan #govegan #plantbased #plantstrong #vegandetroit #plantbaseddoctors #michiganeats #michiganfood #veganeducation #veganfoodshare #veganforbeginners #howtovegan #poweredbyplants #healthylifestyle #michiganmade #michiganvegan #michiganvegans #michiganhealth #detroitfoodie #michiganeats #whatveganseat
Dr. Jamie Qualls is a Family Medicine Doctor Accepting New Patients in Farmington Hills
Dr. Jamie Qualls is a Family Medicine Doctor Accepting New Patients in Farmington Hills, Michigan
Dr. Jamie Qualls has joined the team at Plum Health DPC. She is accepting new patients at our new location in Farmington Hills, Michigan. Dr. Jamie Qualls is trained in Family Medicine and she takes care of patients of all ages and stages, from birth to children, from adolescence to adulthood, from older adults to the elderly. She focuses on using plant-based nutrition to help her patients heal themselves by using food as medicine.
Thanks for reading and have a wonderful day,
-Dr. Paul Thomas MD
Help Protect Other People From Coronavirus, Wear A Mask
How can you help protect yourself and other people from coronavirus? Wear a Mask
This week, Daily Detroit asked me a ton of questions about the Coronavirus and how to protect yourself, your family, and your community from the spreading virus. It boils down to wearing a mask. I answer many other questions during the podcast, listen here:
Why Should I wear a Mask?
You should wear a mask to prevent the spread of coronavirus. Here’s why:
Coronavirus has a long incubation period. People can have the virus without knowing it or having symptoms for about 4 to 5 days on average. This 4 - 5 day period of having the virus without showing symptoms is known as the incubation period. Some people can be in this incubation period for up to 14 days! Therefore, you could be walking around, infected with coronavirus and unknowingly spreading the virus to your friends, family, coworkers, and vulnerable people in your community. This is the main reason why you should wear a mask.
Coronavirus does not always cause symptoms. For COVID-19, data to date suggest that 80% of infections are mild or asymptomatic, 15% are severe infection, requiring oxygen and 5% are critical infections, requiring ventilation. So, in most cases, if you get the Coronavirus, you’ll be asymptomatic. If you’re asymptomatic, you can still spread the virus, so it’s important to wear a mask to prevent spreading the virus to your close contacts.
Wearing a mask prevents you from spreading the virus via respiratory droplets. When you talk, cough, sneeze, sing, yell, or breathe, you give off tiny respiratory droplets. These droplets carry the coronavirus and can land on surfaces or land in the noses or mouths or eyes of your close contacts. Wearing a mask puts a physical barrier between your nose and mouth and those around you, and therefore decreases the spread of droplets and the spread of coronavirus. If you want to explore this further, check out this blog post from Indian Express. Briefly, if you wear a mask it reduces the amount of bacterial and viral particles that you expel from your mouth when talking, as demonstrated in this image.
Why are bars being told to shut down?
Many bars in Michigan are closed or being ordered to close after outbreaks of coronavirus. There are four big reasons why bars are the best places to get coronavirus:
People drink at bars, and it’s difficult to wear a mask while drinking. Without a mask, it’s easier to spread Covid 19.
There tends to be loud music at bars, so people tend to raise their voices and speak more forcefully. This forceful speech tends to spread more respiratory droplets, which leads to an easier spread of coronavirus.
People tend to get closer to one another at bars - the less physical distance between people, the easier it is to spread Covid 19.
Bars are enclosed, intimate spaces, usually with poor ventilation. Many bars are windowless with low ceilings and poor ventilation systems. This can serve as a great space for a virus to circulate.
This is why bars like Harper’s in East Lansing have seen outbreaks of Coronavirus.
Here’s what Daily Detroit had to say:
Welcome to the holiday weekend, everybody. This is certainly a strange one, with coronavirus numbers once again on the upswing in Michigan and across much of the country, adding a complicated wrinkle to what is normally one of the busiest travel weekends of the year.
On today’s show, we make a house call to our friend Dr. Paul Thomas, founder of Plum Health Direct Primary Care in Detroit, for help answering your burning questions about COVID-19. We talk face masks, whether it’s safe to eat at restaurants or fly on airplanes, what to make of coronavirus liability waivers and more. And we’ll remind you that if you’ve got health-related questions about coronavirus, send ’em to us at dailydetroit@gmail.com and we’ll do our best to include them in future episodes with Dr. Paul. You can even send us audio of your question and we’ll try to work that audio into the show.
Also, we talk the latest, dispiriting COVID-19 data from the state and how we’re holding up from a mental health perspective more than three months into this weird, horrible quarantine that unfortunately shows little sign of ending anytime soon.
Thanks for reading, and stay safe out there!
-Dr. Paul Thomas with Plum Health DPC