Plum Health Blog

Detroit, Education, Family Medicine, Advocacy Paul Thomas Detroit, Education, Family Medicine, Advocacy Paul Thomas

How You Can Save Money on Your Next Prescription Refill in Detroit

Why Do Generic Medications Cost So Much Money?

There's a wide variability in the cost of generic medications from pharmacy to pharmacy. Researchers at Saint Louis University surveyed 175 pharmacies and asked for their prices for the meds Lisinopril, Carvedilol, and Digoxin. These are common heart failure medications.

The researchers found that the prices for three generic medications ranged from less than $20 to more than $150, with the highest price for all three medications being $397 for a 1 month supply!

This is way too much money. If you spent $150/month on medications alone, it would cost $1800 for the year. In contrast, if you spent less than $20/month on these same medications, it would cost less than $240 for the year.

This is a difference of $1,560.

Unfortunately, these costs have the greatest adverse effect on low income communities because they may not have the transportation resources to drive to these less expensive pharmacies. In Detroit, 33% of residents do not have access to reliable transportation, leaving these folks to the potentially higher costs pharmacies in lower income neighborhoods.

Middle Men and How They Inflate the Cost of Your Care

First of all, understand that when you buy medications from a retail pharmacy, you will likely incur a retail markup on your medications. This markup can be 10%, 50%, 100%, 300% or more, as illustrated in the Saint Louis University study cited above. So, shop around and find the best price before setting foot into your neighborhood pharmacy.

The next thing that inflates the cost of your prescription medications are middle men, namely pharmacy benefits managers. These PBMs are supposed to negotiate the formulary (or the medications covered by your insurance company) and their related costs at the local pharmacy. However, the system is full of self-serving PBMs who make more money based on inflating the costs of your medications.

To illustrate, you should be familiar with the term “clawback.”

A “clawback” happens when the patient's copay is more than the pharmacy's cost for the drug. For example, if a customer's prescription copay is $20 but the pharmacy's cost is $5, the PBM claims -- or “claws back” -- the extra $15, which it keeps as profit.

That’s right - if your son or daughter has strep throat, and you want to buy Amoxicillin, and the cash price is about $5, as it should be, but the PBM “negotiated” the price to be $20, and you buy that Amoxicillin with your insurance, you’d pay $20 for the $5 medication and the PBM keeps the difference.

Infuriating, I know! I’m just as mad about this issue as you are.

How You Can Save Money on Your Next Prescription Refill

So, how can you save money on your medications? First, ask around for the best price at different pharmacies. If your insurance-based price is too high, ask your pharmacist for the cash price. Only until recently, pharmacists had a gag order, where they couldn’t tell you the price of the medication if it was cheaper than the “negotiated” insurance-based price.

Another possible solution is Direct Primary Care. DPC doctors like myself buy medications at wholesale prices and give them to our patients at cost, or with a 10% mark up to cover the cost of shipping and handling. For example, at our clinic Plum Health DPC, we can wholesale these same three medications for about $18/month.

I created this video to more fully explain what I mean, see below.

- Paul Thomas, MD

If you’d like to be a part of our direct primary care service at Plum Health in Detroit or Farmington Hills, Michigan, you can sign up, here:

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Plum Health DPC Featured on PBS Nationally

Plum Health featured on PBS’ Start Up Show

Plum Health DPC was featured on the PBS show Start Up - we filmed this in July 2020 and it was a great opportunity to share about our mission to deliver affordable and accessible healthcare services in Detroit and beyond. The host Gary Bredow and his team interviewed our staff and our patients, including our doctors Raquel Orlich, DO and Jamie Qualls, DO.

Plum Health Start Up show Episode Overview

Here’s what PBS had to say about the episode:

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.

Why Direct primary care is appealing for Patients

During the episode, the host Gary Bredow interviews a few of our patients. He talks with Will Langford and he talks about being seen by his doctors, and understood by his doctors. Will says that “I believe that Plum Health is the future of medicine.” He goes on to say that, “for people who’ve never experienced direct primary care - it’s worth it. If you’ve ever felt that a doctor didn’t see you, or didn’t hear you, or didn’t believe you, anybody who’s just wanted help, and they haven’t gotten it from people who were supposed to help, try direct primary care.”

Will “The Poet” Langford discusses why he’s a part of Plum Health DPC with Gary Bredow, the host of the Start Up show on PBS.

Will “The Poet” Langford discusses why he’s a part of Plum Health DPC with Gary Bredow, the host of the Start Up show on PBS.

Why Direct primary care is appealing for Doctors

During the episode at about the 10 minute mark, Gary Bredow sits down with Dr. Raquel Orlich and asks “what do you find attractive or appealing about this model versus the traditional model?” Dr. Orlich discusses the importance of talking with patients and getting to know them, and the ease of communication via in-person appointments, text messages, and emails. She also discusses the importance of having enough time to work through all of the factors that are affecting her patients’ health, and this can lead to patients feeling heard and being able to get to the root of their health care problems.

Raquel Orlich, DO of Plum Health DPC during the filming of Start Up with Gary Bredow on PBS. Plum Health DPC is a direct primary care practice in Detroit and Farmington Hills that delivers affordable and accessible health care services.

Raquel Orlich, DO of Plum Health DPC during the filming of Start Up with Gary Bredow on PBS. Plum Health DPC is a direct primary care practice in Detroit and Farmington Hills that delivers affordable and accessible health care services.

Dr. Jamie Qualls is working with Plum Health out of our Farmington Hills, Michigan location and she joined our practice because she can “go out and be the doctor I really wanted to be.” She goes on to say that this direct primary care model is growing rapidly not only across the country, but locally, and patients are loving the experience of being a part of Plum Health and a part of direct primary care practices in general. The direct relationship between doctors and patients is really appealing to patients in our practice.

Dr. Jamie Qualls, DO, MPH of Plum Health DPC talks with the host Gary Bredow about why the direct primary care model works for both patients and doctors.

Dr. Jamie Qualls, DO, MPH of Plum Health DPC talks with the host Gary Bredow about why the direct primary care model works for both patients and doctors.

“Maybe the direct primary care model is the future.”

There were so many memorable moments from this episode, but perhaps the most powerful sentiment was communicated in the closing remarks of the host of the show, Gary Bredow. He said:

“After speaking with several of his patients, his model is working. Throughout our conversation, I couldn’t help but wonder why a common-sense approach to health care seemed so foreign to me. Dealing with insurance companies is all that many of us have ever known. Waiting on hold for hours at a time trying to speak with someone and trying to decode confusing bills has always been synonymous with healthcare for me. I just assumed that it’s a part of the wellness process.

“But this is something entirely different. Individuals pay an affordable monthly rate for the service, the doctor gets to spend more time with patients, which possibly leads to better preventative care and you don’t have to wonder what your next visit is going to cost, or have to deal with co-pays, deductibles, or out of pocket expenses. To me, the health care system is not working for everyone equally with millions of people uninsured or underinsured. Maybe the direct primary care model is the future. Either way, it’s nice to know that there’s options available.”

We agree - direct primary care is the future, or at least a part of it. While direct primary care will never replace catastrophic insurance or some form of insurance coverage that serves as a financial tool to prevent bankruptcy, insurance can never give to patients what direct primary care gives to patients - a straightforward and trusting relationship between doctors and their patients.

How to Sign Up

If you want this type of care for yourself or your loved ones, your business or your family, you can enroll here.

Thanks for reading and watching this segment, and we are happy to help you in your journey to better health!

-Drs. Paul Thomas, MD, Raquel Orlich, DO, Jamie Qualls, DO, MPH, and Leslie Rabaut, DO

Paul Thomas, MD of Plum Health DPC during the filming of Start Up with Gary Bredow on PBS. Plum Health DPC is a direct primary care practice in Detroit and Farmington Hills that delivers affordable and accessible health care services.

Paul Thomas, MD of Plum Health DPC during the filming of Start Up with Gary Bredow on PBS. Plum Health DPC is a direct primary care practice in Detroit and Farmington Hills that delivers affordable and accessible health care services.

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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

 

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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.

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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.

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.

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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.

Bis das si cito das or you give twice if you give quickly is a guiding principal of our practice at Plum Health DPC.

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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

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Dr. Raquel Orlich is a Family Physician in Detroit Michigan

Dr. Raquel Orlich is a Family Physician in Detroit Michigan

Dr. Raquel Orlich is a family medicine physician in Detroit, Michigan. She takes care of a broad range of conditions out of her office in Corktown Detroit. She’s building a reputation as an excellent primary care physician and family medicine doctor. One of her patients recently left a glowing review on Google:

I have been a patient at Plum for a little under one year now. Since the moment I was greeted at the door by Chris, I felt very welcomed and comfortable. Changing doctors can sometimes be scary because you hope they have your best interest at heart, but sometimes that doesn't always end up being true. That is not the case with Plum Health. Dr. Raquel is hands down the best Dr. I've ever had (and I've had a lot). She addressed every issue and concern with meticulous solutions. Dr. Paul was also very attentive any time Dr. Raquel was away. What I love most about Plum Health is how you can text or call them at all hours if the matter is urgent or if you have random health questions. They respond in a timely manner, it's awesome. I would recommend Plum Health to every person who does not have access to health insurance. It's the next best thing. OH! Getting your prescriptions at wholesale price saved me a lot of money which was a huge plus!

2020 Raquel Orlich DO Plum Health DPC.jpg

Raquel Orlich, DO is a Family Medicine Doctor Accepting New Patients

Currently, Dr. Raquel Orlich is accepting new patients at her office in Corktown Detroit. She takes care of people from Detroit and the surrounding communities, including Royal Oak, Ferndale, Southfield, Dearborn, Taylor, Redford, Southgate, Grosse Pointe, and many more.

In the above photo, Dr. Raquel Orlich is using an osteopathic manual medicine technique - she uses her hands to help people with musculoskeletal pain and discomfort. If you’d like to see Dr. Raquel Orlich, you can schedule an appointment with her, here.

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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:

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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 D…

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…

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.

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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/

LinkedIn: https://www.linkedin.com/in/paulthomasmd/

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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.

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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

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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.

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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.”

Wayne State University School of Medicine Dean Margit Chadwell with Dr. Paul Thomas, MD, guest lecturer and Clinical Assistant Professor.

Wayne State University School of Medicine Dean Margit Chadwell with Dr. Paul Thomas, MD, guest lecturer and Clinical Assistant Professor.

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Last week, I 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. I gave my “Welcome to Detroit” lecture to the incoming medical students that emphasized the significant history and culture of the City of Detroit - the city’s founding, our flag, the Arsenal of Democracy, the 67 Rebellion, municipal bankruptcy, coffee shops, restaurants, Belle Isle, bike lanes, and volunteer opportunities. 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 to teach reading and healthy behaviors, and the elderly by visiting nursing homes and providing enrichment, and by volunteering at food banks and soup kitchens. I shared my favorite quote from Jeanette Pierce, “Detroit is big enough to matter in the world, and small enough for you to matter in it.” Here’s to these incoming student doctors, the future leaders and innovators in medicine. May your time here in Detroit teach and enrich you, and may your presence here reciprocate that gift. #WayneState #WSUSOM #ClassOf2024 #detroitdoctors #plumhealth #directprimarycare #detroitmedicine #chevroletplaza

A post shared by Paul Thomas MD (@plumhealthdpc) on

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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

Connect with me on LinkedIn:

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Plum Health Takes Care of Patients of All Ages and Stages

Doctors at Plum Health DPC take care of Patients of All Ages and Stages

This week we welcomed the newest member of the Plum Pack, Zaya! 👶 We saw this bundle of joy for her newborn appointment and she was healthy and had a great cry (a sign of vitality).

At Plum Health, we take care of patients of all ages and stages. Our youngest member is now 4 days old and our oldest member is 93 years young 😊

We’re family medicine doctors 🥼 and we’re trained to take care of people as they age and transition through life’s many challenges

Happy birthday Zaya 🎁 🎈 🎂 and here’s to your health!

Thanks for letting us share this moment, and 📸 photo cred to @goodlifedetroit

Patient Ages at Plum Health DPC

At Plum Health, the vast majority of our patients are ages 18 to 39 (55% of our panel) or ages 40 to 64 (32% of our panel). However, we take care of children or pediatric patients ages 0 to 17 (9% of our panel) as well as geriatric patients ages 65 and above (4% of our panel). See below:

At Plum Health, the vast majority of our patients are ages 18 to 39 (55% of our panel) or ages 40 to 64 (32% of our panel). However, we take care of children or pediatric patients ages 0 to 17 (9% of our panel) as well as geriatric patients ages 65 …

At Plum Health, the vast majority of our patients are ages 18 to 39 (55% of our panel) or ages 40 to 64 (32% of our panel). However, we take care of children or pediatric patients ages 0 to 17 (9% of our panel) as well as geriatric patients ages 65 and above (4% of our panel).

If you’d like to sign up to be one of our patients, you can enroll here - all ages welcome!

- Dr. Paul Thomas with Plum Health DPC

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Family Medicine Doctor Accepting New Patients in Farmington Hills Michigan

Dr. Jamie Qualls is a Family Medicine Doctor practicing in Farmington Hills Michigan with Plum Health DPC. She is accepting new patients.

Dr. Jamie Qualls is a Family Medicine Doctor practicing in Farmington Hills Michigan with Plum Health DPC. She is accepting new patients.

Dr. Jamie Qualls is a family medicine doctor accepting new patients in Farmington Hills, Michigan. She is a Board Certified Family Medicine doctor who completed her residency here in Southeast Michigan at Ascension Providence Hospital. She is a graduate of Michigan State University College of Osteopathic Medicine.

Dr. Jamie Qualls practices full time at the Plum Health DPC office in Farmington Hills, Michigan - the address is 25882 Orchard Lake Road, Suite 200B, Farmington Hills, MI 48336.

As a family medicine physician, Dr. Jamie Qualls has a broad scope of practice. She helps patients manage chronic conditions like diabetes, high blood pressure, depression, anxiety, mood disorders, asthma, COPD, and many more. Dr. Qualls is also proficient in caring for urgent concerns, like urinary tract infections, laceration repairs, ingrown toenails, strep throat, viral gastroenteritis, and others.

Finally, Dr. Qualls excels at integrating plant based nutrition into her care plans to produce optimal health outcomes for her patients. Dr. Qualls can collect blood work in the office to test for cholesterol levels, thyroid disorders, electrolyte imbalances, and kidney or liver disorders. She can also coordinate imaging studies that may be needed to make an accurate diagnosis.

To become a patient of Dr. Qualls, please sign up here.

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Plum Health Featured in The Jewish News

Plum Health DPC Featured in The Jewish News

This week, Plum Health DPC was featured in The Jewish News by writer Ben Falik. My favorite excerpts are as follows:

It’s simpler to describe how direct primary care works than how — let me count the ways — traditional fee-for-service, even with “good” insurance, does not:

I am a member of Plum Health Direct Primary Care. Membership costs $49 a month. Raquel Orlich is my doctor.

I guess she’s other people’s doctor too.  But I can call, email or text (from my $50/month phone) Dr. Orlich anytime I’m having an issue and, if she can’t solve it remotely, she can always see me that day or the following.

At one point, there were some balloons celebrating Dr. Orlich’s 300th patient. Ultimately, she’ll have around 500. That seems like a lot, I thought, especially compared to my prior impression that I was her only patient.

The writer, Ben Falik, discusses when his daughter got a splinter in her finger and she was brought to our Plum Health DPC office for care:

Phoebe got a splinter in her finger recently. We texted “Dr. Raquel.” She wrote me right back with her availability. I brought Phoebe to the office at Michigan and Trumbull. Free street parking. Splinter gone. Respectable Band-Aid selection.  No charge. And now Phoebe wants to be either a doctor or Great Dane when she grows up.

Dr. Raquel Orlich removes a splinter within 24 hours of being notified of said splinter.

Dr. Raquel Orlich removes a splinter within 24 hours of being notified of said splinter.

Thanks for reading and have a wonderful day,

-Dr. Paul Thomas with Plum Health DPC

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Plum Health Office Vandalized, but we will continue to serve

Plum Health Office Vandalized

Saturday, our medical office was vandalized by a man with a can of spray paint.

This is an unfortunate event, but it doesn’t define who we are. We are a family medicine practice and we believe that health care should be affordable and accessible. We exist to actively lower the cost of healthcare for our neighbors in Detroit and beyond. We are successful because we’ve met an unmet need in the community and we’ve been embraced by people in the community.

In response to seeing the vandalism on Twitter, I replied in a tweet: “While we respect your right to protest, and we agree with the reasons why you’re protesting, please don’t vandalize the office where we lower the cost of healthcare for Detroit residents #PlumHealth.”

On Sunday, we’ll wash off the graffiti and on Monday we’ll continue to see our patients and continue to serve our community. Paint washes off easily, but the journey to justice in our country and the healing of racial injustices will take more intentionality and sustained effort.

Thanks for reading, and have a wonderful day.

-Paul Thomas, MD

P.S. Some people have reached out and asked how they can help. Here’s a few ways:

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