Plum Health Blog
How Plum Health DPC Started
Recently, I had a great interview with Dr. Kevin Cuccaro and Dr. Melissa Cady of the Changed Physician. We discussed why I went into medicine and how Plum Health DPC came to exist. Here’s what they said about our practice:
This is Episode 67 of The Changed Physician Podcast with Dr. Paul Thomas discussing his journey into direct primary care with hosts, Dr. Kevin Cuccaro and Dr. Melissa Cady.
Timeline:
01:00 Why he went into medicine
03:00 Community outreach and art
06:30 His realizations during residency
09:15 What led to him discovering a new model of delivering medicine
12:30 Physician shortage area
14:30 What is DPC (Direct Primary Care)
15:30 How he provides affordable meds and labs for patients
16:15 Why Americans are screwed over by the Medical Industry
17:00 How DPC model empowers patients
19:20 How his interaction with his patients is now
22:20 Why he named his business Plum Health
24:45 The cost of his direct primary care model
26:50 How his practice model gives him time for his other pursuits
What is Plum Health DPC
Plum Health DPC is a membership model for primary care in Detroit, Michigan and Farmington Hills, Michigan. We believe that healthcare should be affordable and accessible for everyone. Our patients pay a membership to be a part of the practice, starting at $49 each month for adults. With that membership, they can call or text their doctor anytime they need care. We guarantee same-day or next-day appointments and no wait time for scheduled appointments. We also save our patients 50% to 90% on their medications, labs, and imaging costs.
What is Direct Primary Care
Direct Primary Care allows you to have a direct relationship with your doctor. For the equivalent of a monthly cell phone bill, you can receive direct, primary health care services that are tailored to your individual needs.
Plum Health Direct Primary Care Simplifies How Patients Connect with their Doctor
Health Insurance Overcomplicates Health Care
Intentionally or unintentionally, health insurance companies have made the practice of medicine overly complicated. As a patient, have you ever felt like you wanted to ask your doctor a simple question, but didn’t want to have to call the office, to leave a message, to have someone pass that message to the doctor, to have the doctor call you back 3 days later? I mean, what gives? We have text messaging and emails that make communication seamless among regular people, but for some reason, doctors remain out of reach.
I was watching the Super Bowl Halftime Show when I saw The Weeknd trying to find his way through a house of mirrors. It reminded me of how patients feel when trying to navigate the health insurance system - it’s hard to find your way through a distorted system with blinding lights. So, I made this post on my LinkedIn page (connect with me on LinkedIn if you haven’t already!):
Trying to navigate the health insurance system when all you want to do is ask your doctor a simple question...
This is why so many people are reaching out to their Direct Primary Care doctor - we get rid of this house of mirrors and the distorted versions of primary care and create a system where the patient's needs are prioritized.
See what all the buzz is about at Plum Health DPC.
Direct Primary Care Simplifies the Healthcare Experience
The direct primary care model simplifies health care delivery in that our patients are able to text, email, or call us anytime. We guarantee a response within 24 hours, and if you text during business hours, you’ll often hear from us within a few minutes to a few hours. This takes a lot of the anxiety and stress out of the health care experience and our patients can seamlessly access the care that they need, when they need it.
If you’d like to enroll in our service, you can sign up here:
Thanks for reading and have a wonderful day,
-Dr. Paul Thomas with Plum Health DPC
Coronavirus Update and Vaccine Side Effects with Dr. Jamie Qualls and Dr. Paul Thomas
Coronavirus Update for January 26th, 2021
Today, Dr. Paul Thomas and Dr. Jamie Qualls of Plum Health DPC discuss the Coronavirus pandemic and what’s happening in Detroit and Southeast Michigan with regard to the Coronavirus.
There have been 551,080 cases of Coronavirus in Michigan and there have been 14,326 deaths from coronavirus. In context, losing that many people to COVID 19 is like losing the entire population of Rochester with a population of 13,162, Wixom with a population of 13,902, or Harper Woods with a population of 13,895.
Age Groups Affected by the Coronavirus
The age group with the highest number of cases are those between 20 and 29 years. There have been about 103,956 cases in this age group and 54 deaths. The age group with the highest number of deaths are those 80 years old or older. In those 80 years of age or older, there have been 27,327 cases and 6,675 deaths.
The death rate among the elderly in Michigan is staggering. If you are 80 years of age or older and you are infected by the coronavirus, there’s about a 24% chance of dying from COVID (6,675 deaths among 27,327 cases).
That’s why it’s so important that the elderly (those 75 years of age and older) are prioritized for vaccine access.
Coronavirus Vaccines Administered (So Far)
So far, about 19 million first doses have been given out in the United States and about 3 million people in the US have received both doses of the COVID 19 vaccine. In Michigan, about 730,000 vaccines have been administered. You can dive into the nitty gritty at the Michigan Coronavirus vaccine dashboard.
Coronavirus Vaccine Side Effects
With the COVID-19 vaccine rollout, there is understandably much apprehension about its potential side effects. According to the CDC, some of the most common side effects reported are pain and swelling at the region of injection, as well as fevers, fatigue, chills, and muscle aches. (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html)
The CDC recommends taking an over the counter medication like ibuprofen or Tylenol to reduce the discomfort of these side effects. It’s also recommended to drink plenty of fluids and get adequate rest. Most of these side effects resolve on their own within a few days. These side effects are likely a result of your body responding to the vaccine and mounting an immune response, which is a sign that the vaccine is doing its job (https://www.aarp.org/health/conditions-treatments/info-2020/coronavirus-vaccine-side-effects/).
Side effects from the COVID vaccine may cause recipients to miss a day or two of work, but typically resolve without further intervention.
Cough, shortness of breath, rhinorrhea, sore throat and loss of taste or smell are not typical following vaccination. If you develop these symptoms, the CDC recommends staying home from work pending evaluation for possible causes including COVID-19.
There have been reports of people developing a severe allergic reaction to the vaccine. The CDC recommends seeking immediate medical attention in the event of an allergic reaction. It is important to keep in mind that these reactions, though serious, are relatively rare, seeing as tens of thousands of people have been vaccinated without severe reactions. (https://www.cdc.gov/mmwr/volumes/70/wr/mm7002e1.htm)
Finally, it’s important to recognize that side effects from all vaccines are common. The seasonal flu shot, for example, can cause fever, fatigue, and muscle aches, amongst other vaccines. The important thing is to weigh the temporary discomfort of such side effects to the long term benefits: a potentially high level of protection from a disease that has killed more than 1.6 million people globally.
Final Thoughts
As always, wear a mask, wash your hands, maintain a minimum of 6 feet of physical distance between yourself and others, and limit unnecessary travel, trips, and crowded areas.
Thanks for reading and have a wonderful week,
-Dr. Paul Thomas and Dr. Jamie Qualls of Plum Health DPC
Oakland County Vaccine Rollout Update
COVID-19 vaccine update in Oakland County: Save Your Spot Sign-up Available until Vaccine Supply Increases
Pontiac, Michigan – Oakland County Health Division (OCHD) is asking residents to remain patient during this time because of the overwhelming demand for the COVID-19 vaccine. The Health Division has received 7,800 doses, administered about 5,600 vaccines, and scheduled an estimated 17,000-plus first- and second-dose appointments through the end of February. Minimal vaccine supply, however, limits our ability to schedule appointments for the hundreds of thousands of eligible workers and Oakland County residents who are still waiting to be vaccinated. Use the newly launched Save Your Spot link on our website oaklandcountyvaccine.com to help us identify individuals who are eligible and interested in receiving the COVID-19 vaccine. For anyone unable to complete the form, call our upgraded health hotline at 800-848-5533.
"We are asking the community to help us plan for administering future doses of vaccine we receive by completing this new form," said County Executive David Coulter. "This will help us reach residents and workers who are eligible for vaccination when more doses become available. As we receive more vaccine, we will continue to administer them quickly and efficiently until everyone has the opportunity to receive the vaccine."
The Health Division is currently vaccinating individuals in phases 1A and 1B of the Michigan Department of Health and Human Services (MDHHS) COVID-19 vaccination plan who work or live in Oakland County.
The Health Division is following MDHHS and Centers for Disease Control and Prevention (CDC) recommendations for prioritizing distribution of COVID-19 vaccines to individuals. According to MDHHS, those now eligible to receive the vaccine include:
Healthcare workers
Residents 65 years and older
Frontline essential workers including police officers, first responders, frontline state and federal workers, jail, and prison staff; and preK-12 teachers and childcare providers (Phase 1B)
In addition to frontline essential workers, there are over 217,000 residents age 65 and older eligible to receive the vaccine in Oakland County. To receive updates on COVID-19 vaccine availability, register your email address at oaklandcountyvaccine.com or text OAKGOV COVID to 468311. The Health Division phone lines are very busy and sometimes Nurse on Call receives over 20,000 calls per day. Oakland County appreciates the public's patience. Nurse on Call is available at 800-848-5533 to answer health-related questions, make COVID-19 testing appointments, and assist those unable to complete the 'Save Your Spot' link.
Currently the COVID-19 vaccine is available through local health departments and local health systems. Residents are encouraged to check their health providers online medical chart or portal as all local health systems are going to start making appointments for their patients once they vaccinate their medical personnel.
Vaccine information can be found at:
Oakland County: https://oaklandcountyvaccine.com/
MDHHS: Michigan.gov/COVIDVaccine
CDC: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html
More information about COVID-19 can be found on the Health Division's website at www.oakgov.com/covid. For up-to-date public health information, follow @publichealthOC on Facebook and Twitter.
I Love Direct Primary Care
I love Direct Primary Care.
What is Direct Primary Care?
It’s not concierge.
It’s not insurance-based care.
It’s not a referral source for the hospital systems.
It doesn’t inflate the cost of care.
It doesn’t let people slip through the cracks of the health care system.
It’s affordable and accessible.
It’s comprehensive and compassionate.
It’s personable and reliable.
You can visit in person with your own doctor, for an hour if you need the time.
You can call, text , FaceTime, or email with your doctor.
You can communicate via Messenger or Instagram.
It’s medical care and a real relationship with an independent physician who truly cares about you and your family.
I love Direct Primary Care because it’s how primary care is supposed to be delivered.
City of Detroit Vaccine Rollout Update
The vaccine rollout here in Michigan has been relatively slow compared to other states. The Washington Post has a great article tracking vaccinations. Here’s where Michigan stands in the COVID vaccine effort:
At least 222,379 first doses have been administered (total population is 9.987 million)
covering 5.2% of the prioritized population...
and 2.2% of the state’s population.
Michigan has been allocated 696,600 doses,
enough to vaccinate 16.0% of the prioritized population...
and 7.0% of the state’s population.
On Monday, we received a press release from the City of Detroit about the Coronavirus Vaccine out of the TCF Center. Here it is, in full:
Statement from Detroit COO Hakim Berry on TCF COVID Vaccine Scheduling process
Since 9am this morning our COVID vaccine scheduling call center staffed by Rock Connections has experienced extremely high volumes, receiving more than 100,000 calls. Those who predicted that Detroiters would not be interested in receiving the vaccine were clearly incorrect.
Rock Connections has already increased its call center staff from 42 to 56 representatives booking the appointments. Call Center hours have now been increased by two hours a day and will operate 9 AM and 8 PM.
Our system is set up so that calls will not be kept on hold if there is more than a half-hour wait to speak to a representative. If your call is dropped, please call later today or anytime this week. At any point the wait time is under 30 minutes, your call will go through.
A major cause of call volumes is a large number calls from individuals who are not eligible. We do not have the capacity to answer questions from people under 75 or non-Detroiters about vaccinations in general. If you are not eligible to book the vaccine, please do not tie up the call lines.
As a reminder, people should call 313-230-0505 to schedule an appointment only if they meet the following qualifications:
A Detroit resident 75 and older
Any “good neighbor" 65 and older who drives a 75 year old (or older) Detroit resident to TCF
The following Group B essential workers: K-12 teachers and support staff and child care workers
We are booking 20,000 appointments through February 5th. The call center has the ability to book up to 4,000 appointments per day, so we expect to be booking appointments at least through the end of the day Friday. We will add to those appointments as fast as the federal government provides vaccines.
We thank Detroiters for their patience in this process and, most of all, for their commitment to being vaccinated so life can get back to normal as soon as possible.
This is somewhat frustrating, because the listed qualifications above are narrower than what was previously released. The previous statements from the State of Michigan include more people in the Phase IB, but the City of Detroit must be focusing on Group A only at this time, which includes only seniors over the age of 75:
Group A:
Persons 75 years of age or older not covered in Phase 1A.
This includes those in a congregate setting that were not reached in Phase 1A.
Henry Ford Health System Vaccine RollOut
Henry Ford Health System is also rolling out the vaccine here in Detroit, so if you have a MyChart account with Henry Ford, you could potentially receive an email from Henry Ford Health System (HFHS) about this vaccine option. See below for full details - this information was sent out to HFHS staff on January 8th.
What’s interesting to note is that Henry Ford is following the State of Michigan guidelines for eligibility, including “anyone 65 years and older and a broader category of essential workers.”
We have made considerable progress vaccinating our team members, having administered first doses to nearly 17,000 employees, with second doses underway for those vaccinated during our first days of the campaign. We are now expanding eligibility to volunteers, Henry Ford retirees 65 years and older, and approximately 3,000 students from our clinical education community. Additionally, we are partnering with multiple leaders across our region in a collaborative effort to vaccinate private practice physicians and other healthcare workers.
As you likely know, the state of Michigan has also expanded guidelines for eligibility to include anyone 65 years and older and a broader category of essential workers. Based on that guidance, we are finalizing our plans to begin vaccinating patients and members that meet those guidelines beginning next week.
Sites: We plan to launch two types of sites over time – those that will operate from our existing primary care clinics and others designed to serve as “mass vaccination sites” to accommodate larger numbers of patients safely, provide greater access and parking, and operate without disruption to our normal clinical activities. Here’s a breakdown by market:
South - The K-building at Henry Ford Hospital will open Monday, Jan. 11, with Henry Ford Medical Center – Ford Road expected to open by the end of next week
North - Three sites are expected to open by the end of next week: Henry Ford Medical Centers Lakeside and Columbus and the HAP Troy administrative building
Central - Two sites are expected to open next week: One Jackson Square as early as Monday, Jan. 11, followed by Henry Ford Allegiance Specialty Hospital, the current site for drive-through testing
Staffing: We know staffing continues to be a challenge but we have identified a number of viable options including our own primary care team members to staff the medical center locations. Additionally, HR plans to activate our central staffing model early next week to help identify needs, as well as team members who may be able to redeploy.
Scheduling & Patient Engagement: Initially, we will need to prioritize existing Henry Ford patients 65 years and older and plan to contact them proactively via email, providing resources to help them make an informed decision and encouraging them to sign up for MyChart if they haven’t already, for online scheduling when appointments become available.
We know that much of this is new territory and we will need to be agile as things change. A complex, community-wide vaccination campaign of this size and uniqueness requires unprecedented partnership, innovation and determination. We can’t imagine pulling this off with any other team and we are so proud of your efforts in service to our communities and each other.
Thanks for reading, and best of luck navigating these vaccine resources.
-Dr. Paul Thomas with Plum Health DPC
Frustrations Around Vaccine Rollout are Palpable
As we learn more about Coronavirus Vaccine availability, we'll keep you updated.
Vaccine Options for Oakland County Residents
For residents of Oakland County, there are some options, but they are not robust at this time.
One option would be the Oakland County Health Department. It looks like they are not yet vaccinating https://oaklandcountyvaccine.com/eligibility/
You could periodically check this website to see when they are opening up mass vaccinations.
The other option would be Beaumont Health. However, their website crashed on Friday from people trying to make appointments.
You could try to create an account via the MyBeaumont Chart, here: https://www.beaumont.org/my-beaumont-chart and hope that they send an email to you.
Some of our patients have received an email invitation via the Beaumont MyChart system to get the vaccine. They are trying to give it to people over 75 and then over 65 years of age.
Henry Ford Hospital is doing something similar. Here’s some information from the Detroit Free Press:
Don't call us. We'll call you.
That's what the state's COVID-19 vaccine website and many local health departments are telling seniors, teachers, child care workers and law enforcement officers who will be eligible starting Monday for coronavirus vaccines through an expansion of the statewide immunization program.
In part, that's because local health officials had almost no heads up before Gov. Gretchen Whitmer announced anyone 65 or older would soon be eligible to be vaccinated.
Whitmer announced Wednesday that starting next week, people in Priority 1B group will be able to get COVID-19 vaccines along with health care workers, people living and working in long-term care facilities and emergency medical responders who are part of the 1A Priority group.
In short, a lot of people are feeling frustrated and confused about the vaccine roll out - you're not alone in this.
As we know more information, we will share it with you.
As an addendum, in yesterday’s blog we talked about the Vaccine Rollout at the TCF Center in Detroit. Some of our patients have been calling the number since 9 am and it has been continually busy. If you get through, please send me an email or drop a comment on the bottom of this post.
- Dr. Paul Thomas with Plum Health DPC
Getting the Coronavirus Vaccine in Detroit and Southeast Michigan
Getting the coronavirus vaccine in Detroit and Southeast Michigan will be challenging as this is a new experience for our country in recent history - we haven’t seen mass vaccination efforts like this since perhaps the Polio vaccinations of the 1950’s.
I am writing this blog post to get as much information out to our communities as quickly as possible, and to help educate folks around vaccine options.
The state of Michigan just published a Vaccine Prioritization Guidance and you can find that PDF by clicking here. I will summarize the key points from the document here.
The state of Michigan just published a Vaccine Prioritization Guidance and you can find that PDF by clicking here. Everyone in Phase 1A should have gotten their first dose of vaccine already, these include Health Care Workers and Residents of Long-term Care Facilities and Staff, like nursing homes and assisted living facilities.
Now the State of Michigan is entering Phase 1B and rolling out the vaccine to a broader audience - those 75 years of age and older, Frontline Workers, School and Child Care Staff, and Corrections Facility Staff.
Everyone in Phase 1A should have gotten their first dose of vaccine already, these include Health Care Workers and Residents of Long-term Care Facilities and Staff, like nursing homes and assisted living facilities. If you are in Phase 1A and you haven’t gotten the vaccine, there are a few options that I explored in a previous blog post.
Who is in Phase 1B for Vaccination in Michigan?
Now the State of Michigan is entering Phase 1B and rolling out the vaccine to a broader audience - those 75 years of age and older, Frontline Workers, School and Child Care Staff, and Corrections Facility Staff. If you read the Vaccine rollout document closely, you’ll see the following info about who is in Phase 1B.
PHASE 1B:
Persons 75 years of age or older and frontline essential workers in critical infrastructure.
Group A:
Persons 75 years of age or older not covered in Phase 1A.
This includes those in a congregate setting that were not reached in Phase 1A.
Group B:
Prioritized frontline workers whose work role has frequent or intense exposure, and, due to the nature of the work, are not able to maintain social distance.
For example, a first responder may have to physically touch other people in their response, and a child care provider cannot maintain social distance from children when caring for their physical needs.
The specific prioritized categories are:
Pre-Kindergarten through high school teachers, support staff and child care workers who usually have direct contact with children
First responders not covered in Phase 1A (e.g., firefighters, police, conservation officers, inspectors)
Corrections workers (e,g,, staff in prisons, jails, juvenile justice facilities)
Workers in homeless shelters, congregate child care institutions, and adult and child protective services
Group C: Other frontline essential workers in sectors essential to the functioning of society and at substantially higher risk of exposure to SARS-CoV-2 because their work related duties must be performed on site and involve being in close proximity (i.e., within 6 feet) to the public or to coworkers.
Frontline essential workers in critical infrastructures include by ACIP are:
Food and agriculture workers
Critical manufacturing workers
Public transit workers
Grocery store workers
U.S. Postal Service workers
Workers with unique skill sets not covered above, such as non-hospital laboratories and mortuary services
If further sub-prioritization is needed of frontline essential workers due to limited vaccine supply, local health departments may consider prioritizing workers in locations of their jurisdiction where high rates of transmission and/or outbreaks have occurred and/or workers who are at increased risk for severe illness based on age or underlying medical conditions.
The Logistics of How to Get Vaccinated in the City of Detroit if You’re in PHase 1b
The City of Detroit Health Department will be administering the vaccines. The vaccines will be administered drive through style at the TCF center. On Thursday the city began giving on-site vaccines at Senior Care Home, critical care workers and homeless shelters. Friday they started vaccinating city essential (police, fire, EMS, and DDOT). Staring Monday the remainder of those eligible in Phase 1B are able to register on a first come, first serve basis to get vaccinated. This includes essential frontline workers. The call center is open Monday through Friday from 9am-6pm. Call 313.230.0505 be prepared to schedule two vaccine dates (two shots are required two weeks apart).
How to Schedule an Appointment
Starting Monday, Detroit residents age 75 and older and their “good neighbor” drivers 65 and over, will be able to call 313-230-0505 starting Monday to schedule an appointment at the TCF center. The first appointments will take place on Wednesday.
Detailed information on the TCF testing site is available at detroitmi.gov/covidvaccine. As additional independent vaccination sites at pharmacies and elsewhere come online in the city, a map of locations will be added to the website.
Driving directions to the TCF Center to get the vaccine.
It looks like you will enter the TCF Center’s surrounding area via West Jefferson, turning onto Steve Yzerman Drive near the old Joe Louis Arena site.
Thanks for reading and please share with a neighbor who may not have internet access or a car to get to the vaccine site. You could be that good neighbor that helps prevent the spread of Coronavirus by helping a neighbor get vaccinated.
-Dr. Paul Thomas with Plum Health DPC in Detroit MI
Coronavirus Update with Daily Detroit and Dr. Paul Thomas
This week, we had a great conversation with Jeremiah Staes of Daily Detroit about where we stand in terms of the Coronavirus, the number of infections, the number of deaths, and the status of the vaccine.
Will There Be Another Spike in Cases After the Holiday Season?
There were 8 million travelers who flew during the holiday season. It’s possible that we may see a large spike in new cases after the holiday break as more people visit friends and family out of state, contract the virus, and bring it back to Michigan. We may see a lag in this spike as people tend to be busier around the holiday season and this can cause people not to want to visit the doctor’s office to get tested during this time. So, we shall see what happens.
Can I Work Out at the Gym During the Coronavirus Pandemic?
Just because a place is open, it doesn’t mean that it’s a great place to hang out at. This definitely applies to gyms, as gyms are a great place to pick up the coronavirus. In the gym, people are touching multiple surfaces, breathing heavily, and coming into close contact. Just think of all of the surfaces inside a gym locker, or a treadmill, or an elliptical machine, or a rack of weights. It’s virtually impossible to wipe down every single surface after every use, so it’s best to exercise outside or at home.
We Discuss Equitable Vaccine Distribution
More vaccine doses have gone to
Fighting for Equitable Vaccine Access in Detroit
Vaccine Distribution Challenges in Detroit
This week, we’ve been frustrated by the way the Coronavirus vaccine has been distributed. Large hospital system primary care doctors, who mostly operate in suburban communities, have been able to get vaccinated. Meanwhile, independent primary care physicians, including our staff and other neighboring Detroit-based primary care doctors, have struggled to gain access to the vaccine at this time.
The issue is that, in our region especially, there is a corporate-based vaccine distribution. The majority of the vaccine has gone to large corporate health systems, and those doctors, nurses, and support staff who are employed by those larger health systems are more likely to get vaccinated.
This is a big frustration because this inequity in vaccine distribution will likely trickle down and affect our region negatively; suburban folks who live closer to larger health systems may have easier access tot he vaccine than those residents in urban underserved communities.
We recently talked to the news media about this issue, and we’re grateful to Ross Jones and Channel 7 Action News for picking up the story.
A National Perspective
On a National level, doctors have expressed frustration to National Public Radio (NPR) about inequality of vaccine distribution within the hospital. The article states that:
“At hospitals in Massachusetts, New York, Arizona, California and elsewhere, medical professionals say that those with the most exposure to COVID-19 patients are not always the first to get vaccinated. And others who have little or no contact with COVID-19 patients have received vaccinations.”
Possible Solutions
What could solve this issue? Perhaps we could have a national database for people to sign up, to ensure that no one is missed in vaccination and that no one receives too many doses or too few doses. Because vaccine recipients are given a plain card with the vaccine date and a follow up date, I could see the vaccine distribution becoming a problem for those with low health literacy, mental illness, or memory problems like Alzheimer’s disease.
Additionally, we could ensure that there is more equitable vaccine distribution among local health departments and hospital systems. For profit hospital systems will always act in a self-interested manner, vaccinating their employees and patients first. Health departments are more likely to reach out to the highest risk populations in the community and deliver the vaccine to nursing homes, assisted living facilities, vulnerable populations, and community-based primary care offices.
For example, my colleagues in other states and other counties have received phone calls and invitations for vaccines at their local health department. Other regions have hospital systems that act in a more equitable manner, inviting physicians and support staff and high risk populations from the community to get vaccinated at that hospital system.
Why Vaccine Distribution Matters
While I understand that this coronavirus pandemic is a once-in-one-hundred-years type of event, I will never stop advocating for health equity, especially at the community level. Vaccine distribution shouldn’t be based on which individual or corporation has the most money, but it should be based on risk factors and need. Equitable vaccine distribution matters, and we’ll keep pushing for that ideal.
Thanks for reading and watching,
-Dr. Paul Thomas at Plum Health DPC
Plum Health DPC Ribbon Cutting - One Year Later
On December 12th, 2019, we had a fabulous event at our Plum Health DPC office in Corktown - we officially cut the ribbon and opened our space on Michigan Avenue to the surrounding community.
Our patients, friends, families, neighboring businesses, community leaders, members of the news media, and Mayor Mike Duggan were on hand to make it a very special occasion.
This space serves us so well - it holds all of the medications that we need for our patients, it holds all of the equipment like EKGs that we need for patient care, it houses all of the laboratory equipment and blood draw supplies that we need to lower the cost of lab work for our patients.
One year later, our only regret is that we didn’t build a larger office! The only thing we’re missing is a little more space to accommodate more doctors and therefore serve more patients.
That aside, we look back on December 2019 with a big smile for the fond memories, as it marked the beginning of something great, and that is to serve our patients and the broader community with affordable and accessible healthcare services.
Thanks for reading and have a wonderful day,
-Dr. Paul Thomas, Dr. Raquel Orlich, Dr. Jamie Qualls, and Medical Assistant Chris Lake with Plum Health DPC in Detroit Michigan
Dr. Raquel Orlich and Dr. Paul Thomas of Plum Health DPC gather with members of the community to celebrate the ribbon cutting of Plum Health DPC in Detroit, Michigan. The office is at 1620 Michigan Ave, Suite 125, Detroit, Michigan 48216.
Bis Das Si Cito Das
Bis das si cito das is one of my favorite phrases that I learned while studying Latin in high school. It literally translates to “twice you give if quickly you give” and it more or less means “you give twice if you give quickly.”
This idea has stuck with me more than a decade later and it is part of the ethos of our work at Plum Health and as a direct primary care doctor.
When a patient has a problem, the best time to address it is now. If one of our patients calls our office, we do our best to answer the phone right away. When one of our patients texts us or emails us, we do our best to respond with in a few minutes or a few hours. We guarantee a response within 24 hours for these sort of digital communications.
When we give information and guidance to our patients quickly, it’s worth more to them than having to wait hours and hours or maybe even days and days for the appropriate care and guidance. That’s one of the big reasons why our patients stay with us long term - we offer unrivaled speediness when it comes to responding to their health concerns.
Therefore, bis das si cito das.
Thanks for reading, and have a wonderful day,
-Dr. Paul Thomas with Plum Health DPC
Bis das si cito das or you give twice if you give quickly is a guiding principal of our practice at Plum Health DPC.
Dr. Jamie Qualls is a Family Medicine Doctor in Farmington Hills, Michigan
Shout out to Dr. Jamie Qualls, family physician and frontline healthcare worker. 👩🏼⚕️
Dr. Jamie has been helping us serve patients at our Plum Health DPC office in Farmington Hills, Michigan.
She is diligent, caring, and an excellent physician - we're lucky to have her serving and healing patients in our broader community. 🏥
Thank you Dr. Qualls for all that you do, and in helping us deliver affordable and accessible care in Detroit and beyond. 💉 💊 🌱
Jamie Qualls, DO is a trusted family medicine doctor in Farmington Hills, Michigan. She operates Plum Health DPC - Farmington and is accepting new patients.
Jamie Qualls, DO, MPH is both a family medicine physician and a master of public health. She is able to take care of patients individually and the greater community with her additional training. She is passionate about forming strong relationships with her patients. Her clinical interests include community and public health, chronic disease prevention and reversal using a food as medicine approach, LGBTQ-friendly medicine, and osteopathic manipulative medicine for chronic musculoskeletal issues. She is a graduate of Michigan State University College of Osteopathic Medicine and completed her residency training at Ascension Providence Hospital.
Thanks for reading,
-Dr. Paul Thomas with Plum Health DPC
Open Enrollment in Detroit Michigan
We wrote an Opinion on open enrollment, and how it upholds the bottom line for insurance companies, rather than protecting the health of every day Americans.
You see, if you miss the open enrollment period, you can be excluded from health insurance coverage for 12 months, which will reduce your ability to have access to healthcare resources.
Plus health insurance plan prices are often exorbitant, forcing folks to pay hefty deductibles before any "coverage" from the health insurance company kicks in.
Finally, it's a mistake to tie health insurance coverage to employment - as we've seen with this pandemic, millions of job losses lead to millions more uninsured, and this is horrible considering that the job losses are due to a pandemic that leaves folks vulnerable to high cost hospitalizations.
I have to give a big thank you to my co-author Geoffrey Ginter a 3rd year medical student at Wayne State University School of Medicine. Also a big thank you to the editorial staff at The Detroit News for featuring our opinion.
Conversations about Direct Primary Care with a Senior Undergraduate Student at Michigan State
Conversations about Direct Primary Care with a Senior Undergraduate Student at Michigan State
Pre-medical students have a ton of questions about their future and their careers in medicine. As an undergraduate, this can often be a black box - you can see doctors on the other side, but it's hard to look closely at the medical school and residency training processes.
Often times, I'll chat with pre-medical students, medical students, and residents who have insightful questions about medicine and the future of health care in our country. Karan, a Senior Undergraduate student or a pre-medical student at Michigan State University, allowed me to record our conversation and to share it with other pre-medical students like him.
We had a wide ranging conversation as we discuss Direct Primary Care, Plum Health DPC, what inspired me to be a doctor, how to prepare for medical school interviews, and more. Here’s a list of what we touched on during this conversation:
How to scale a direct primary care practice
What does a direct primary care doctor do with their time each day
How a diverse group of doctors can best serve the needs of our communities
Building a team that reflects the needs of our population
Physician burnout and what may be causing physician burnout among doctors
Patient panel sizes in primary care and how they are different between direct primary care and fee-for-service medicine
Price points for direct primary care practices
How direct primary care bridges the gap between Medicaid and private insurance plans
How direct primary care practices can help people across the income spectrum
How direct primary care practices can lower the cost of medical care by preventing emergency room care and urgent care visits
How the Affordable Care Act codified perverse incentives in the health care ecosystem
How the limited free market in the health care space drives up prices in health care
The downsides of having health insurance provided via employment and employment contracts
How we can push towards transparent pricing at a grassroots movement
How has the Coronavirus Pandemic affected Direct Primary Care practices
How can pre-medical students improve their chances of getting into medical school and what kind of activities can help them considering the limited opportunities of shadowing during the Coronavirus pandemic
What inspired Dr. Paul Thomas to go into primary care medicine
How will the health care system change over time, especially in the context of the ongoing Coronavirus Pandemic
The three factors that make a career in medicine fulfilling
The real reason why you should pursue a career in medicine
This conversation was a little bit different than the typical videos that populate my YouTube channel and associated blog, but I think you'll find this information valuable and enjoyable. My goal with this is to uplift the doctor and patient relationship, and help to doctors and patients to find greater understanding of each other, and I think this video helps with this process.
After our conversation, the undergraduate student sent me this note:
"As someone who is extremely excited about going into medicine, the constant messaging to us about how the healthcare system is broken, how as doctors we aren't set up to serve our community, but rather to line the pockets of insurance companies, was very discouraging. It was a breath of fresh air to meet with you to see that there are still doctors who love what they do and are working to help fix a broken system and provide the best care to individuals. " - Karan, Undergraduate Student at Michigan State University
Thanks for reading and watching, and a big thanks to Karan for engaging in this sort of discourse,
- Dr. Paul Thomas, MD of Plum Health DPC
How To Prepare for the Holidays During the Coronavirus Pandemic
As winter approaches with COVID cases surging, taking steps to keep yourself and your loved ones both physically and mentally healthy is of paramount importance.
Get a Flu Shot
First and foremost, those who are able should receive the annual influenza vaccine as soon as possible. The CDC defines flu season as the period from December to January, meaning the peak for influenza cases this year is rapidly approaching.
While the flu shot will not specifically protect you from COVID, the vaccination confers a host of benefits, including reduced likelihood of hospitalization or exacerbation of chronic diseases such as COPD, diabetes, or heart disease. Reducing hospitalizations can relieve some of the burden on our already-strained hospital system as we contend with the rising number of patients with COVID.
For context, influenza caused 38,000,000 symptomatic illnesses, 18,000,000 medical visits, 400,000 hospitalizations, and 22,000 deaths in the United States during the 2019 to 2020 flu season. If everyone got a flu shot prior to this season, we could see a dramatic reduction in these numbers.
Winter Holiday Planning
Another consideration is planning for the winter holidays and the gatherings that tend to accompany them. As the cold weather drives more people inside and impairs the ability to gather outdoors, we expect to see the number of COVID cases increase markedly.
This is obviously a touchy subject; this has been a stressful year, and most of us want nothing more than to spend time with our friends and families. A strong social support network lowers stress, promotes good mental health, and can even lower your blood pressure.
While these benefits from social support systems are certainly desirable, steps should be taken to ensure everyone can enjoy the festivities without increasing the risk of getting sick. The current statewide restrictions limit indoor gatherings to a maximum of 10 people and no more than two households, so it is important to plan accordingly.
To maximize safety, anyone you invite should be practicing safe habits, including wearing a face covering like a mask, maintaining physical distancing at 6 to 10 feet at all times, and washing their hands regularly, prior to coming to the event to reduce the likelihood of catching COVID from community spread.
If there is any doubt as to whether someone may have acquired coronavirus before coming to your house, there are many sites where free testing is available, including the City of Detroit testing site at the Joseph Walker Williams Community Center on Rosa Parks Boulevard and most commercial drug stores like Walgreens and CVS.
If you test positive or test negative and have symptoms highly suspicious for COVID, including fever, dry cough, and loss of taste or smell, the safest course of action is to stay home and self-quarantine for 10 days. The worst case scenario would be to spread coronavirus from yourself to an older, sicker, or more vulnerable member of your family who could die from COVID or suffer significant physical impairments from the virus.
At the gathering, try to maintain physical distance as much as possible, wash your hands frequently, avoid sharing utensils, and consider shortening the duration of the event, as longer time spent indoors is associated with a greater risk of spreading the virus.
How a Healthy Lifestyle Can Help
Finally, try to maintain your regular healthy lifestyle habits, even during the winter months. If you typically exercise outside, dress in layers and ensure you are well-hydrated. Do your best to get eight hours of sleep each night, and practice healthy eating as much as possible.
There is always the temptation to overeat during the holidays, so conscientious eating and portion control can help reduce excess calorie intake and still allow you to enjoy your favorite holiday dishes.
The changes in weather and lack of sunlight can also trigger or worsen depression in some individuals, so it is important to communicate with your primary care physician about any depressive symptoms you may be experiencing. In general, it is good practice to keep in touch with your primary care physician, as they are best equipped to manage your healthcare concerns.
For those without a Primary Care Physician, my practice, Plum Health DPC, is currently accepting new patients. We offer subscription-based care and affordable testing and medications, including flu shots and COVID antibody testing. Anyone interested in signing up or seeking additional information can visit our website, here.
Thanks for reading and watching,
-Dr. Paul Thomas with Plum Health DPC, written with Geoffrey Ginter, Third Year Medical Student at Wayne State University School of Medicine
Dr. Paul Thomas Talks Health and Wellness with Strategic Community Partners
The Coronavirus Pandemic has been a trying time for our personal health and wellness. It has disrupted our typical routines, strained our relationships, and limited our ability to volunteer. The Coronavirus pandemic has also been a burden for our personal finances, as we’ve put off taking care of important projects at our homes and for our families.
This week, I was able to sit on a wonderful panel with three other people in the health and wellness space to discuss these challenges and see how we can address them going forward.
Thanks for reading and watching, and have a wonderful day,
-Dr. Paul Thomas with Plum Health DPC
Healthy Food, Nutrients, Cognition, and Emotions in Detroit
Healthy Foods and Nutrients that can help with Cognition and Emotion
Today I’m talking about health food and nutrients and how they can impact your emotions and cognition. I love gardening and pulling tomatoes, peas, peppers, eggplants, cucumbers, and squash fresh from the vine. We have a relatively small garden, three raised beds, but they churn out a good amount of food each year. Tomatoes usually do the best, but we had a surprisingly robust batch of peppers this year.
We use the tomatoes in dishes like salads and ratatouille and the peppers can season many different dishes. Here’s some photos:
Without further ado, let’s get into some healthy foods that can help with your brain health and emotional health.
Omega 3 Fatty Acids
Omega 3 fatty acids help to delay cognitive decline in the elderly and can help with mood disorders. Found in wild caught salmon, flax seeds, krill, kiwi, butternut, walnut
Vitamin D
Vitamin D can help preserve cognition in the elderly. Vitamin D can be found in fish liver, fatty fish, mushrooms, milk, soy milk, and some fortified foods like cereal grains. AND you can get more vitamin D by hanging out in the sunshine.
B Vitamins
B Vitamins like B6 and B12 has positive effects on memory performance in women of various ages. Vitamin B6 is found in a wide variety of foods, including: pork poultry, such as chicken or turkey, some fish, peanuts, soy beans, wheatgerm, oats, and bananas.
Vitamin C and E
Combinatoin of Vitamin C and E can help to delay cognitive decline in the elderly. Sources of Vitamin C include Citrus fruits, tomatoes and tomato juice, potatoes, red and green peppers, kiwifruit, broccoli, strawberries, Brussels sprouts, and cantaloupe.
Want to learn more and read some relevant research? Check out this article:
START UP TV Show Featuring Plum Health DPC Airing Sunday at 1:30 pm on PBS
START UP TV Show Featuring Plum Health DPC Airing Sunday at 1:30 pm on PBS
Sunday November 15th at 1:30 pm in the Detroit market and Sunday November 22nd nationally, Plum Health DPC will be featured on the START UP TV Show on PBS. They’re focusing on how we’re lowering the cost of healthcare in Detroit and beyond. If you didn’t know, the number one reason for bankruptcy in the US is medical debt. 🏥 💰This is wrong and it needs to be fixed. 🛠
As doctors 🥼 , we took an oath to “first do no harm”, and that oath needs to include financial harm. Join us as we work towards a more just and equitable health care delivery system. 💊 💉
Here’s what they had to say about us:
Dr. Paul Thomas knew what he wanted to do with his life since the age of 17. After completing medical school, residency and a short stint at an urgent care facility, he founded Plum Health. Plum Health offers direct primary care services based on a subscription model. Rather than charge patients for each visit, patients pay a set fee each month, gaining direct access to doctors as needed, including access to wholesale medications, imaging services and lab work. This is a story about disruption, and being the change that you wish to see.
Here’s the description of START UP TV Show from their website:
What does it really take to follow your dreams? Learn from the people who've done it.
Join host Gary Bredow as he travels across America interviewing small business owners to hear their personal stories and find out what it really takes to start a successful business from the ground up. Energetic, inspirational, and educational, START UP is a fast paced series that captures the heart and imagination of anyone who has ever dreamed of starting their own business.
The filming process for this episode took a lot of time, effort, and energy, so we’re grateful to the START UP TV Show team.
Thanks for reading and have a wonderful day,
-Dr. Paul Thomas with Plum Health DPC
Dr. Jamie Qualls uses an osteopathic manual medicine technique for one of our patients. Dr. Jamie Qualls is a board certified family medicine physician who practices out of our Plum Health DPC location in Farmington Hills. You can learn more about Dr. Jamie Qualls, here.
Dr. Raquel Orlich counts out medications, getting ready to dispense them from our in-house pharmacy at our Plum Health DPC location in Corktown, Detroit. Dr. Raquel Orlich is a board certified family physician taking care of patients in our Corktown Location. You can learn more about Dr. Raquel Orlich, here.
Exercise Your Right to Vote in Detroit and Michigan
I truly believe that exercising your right to vote is a very healthy activity.
If you haven't already voted absentee or by mail, please take the time today to vote.
Michigan has an excellent Voter Information Center, here: https://mvic.sos.state.mi.us/
Here are the big issues they tackle on the website:
Where are my clerk’s offices? https://mvic.sos.state.mi.us/Voter/Index/#yourclerk
Where are my ballot drop boxes? https://mvic.sos.state.mi.us/Voter/Index/#yourclerk
Where is my polling place? https://mvic.sos.state.mi.us/Voter/Index
How to Register to vote? https://youtu.be/x4nZKG7H35s?t=137
You can still register to vote on election day if you haven't yet.
If you lack access to transportation, our friends at The Detroit Bus Company are giving people free rides to the polls. If you need a ride to the polls, or if you want to volunteer to give a ride to the polls, head to this link: https://thedetroitbus.com/dbc-vote-rides/
If you are in Detroit and experience any intimidation, please call the NAACP Voter Intimidation Hotline: 313-644-2424
Thank you and have a wonderful day!
- Dr. Paul Thomas