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Direct Primary Care: The Cure for Our Broken Healthcare System
They said it couldn't be done. It wouldn't be possible to fix our broken healthcare system. It wouldn't be possible to fix a healthcare system that undervalues primary care and human relationships. But here we are, a courageous group of primary care doctors, tirelessly working to create value for our patients in communities across the country. This is the story of the Direct Primary Care movement, and how it could revolutionize not only primary care, but the entire healthcare system. The book begins by describing the current crisis in primary care and goes on to define the scope of Direct Primary Care. It closes with concrete examples of how the Direct Primary Care model is working at Plum Health DPC in Southwest Detroit.
86 pages, Kindle Edition
Published November 19, 2018
21 people are currently reading
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Displaying 1 - 5 of 5 reviews
July 15, 2019
This slim volume is about Direct Primary Care, where a doctor sets up shop, restricts his or her practice to about 500 patients, and charges each one about $65/month (on average). Once you do this, a number of things happen:
* The care model is about relationships, not fee-for-service transactions.
* The doctor is less burned out, because instead of seeing 2,400 patients (24 visits/day), she sees just those 500 over the year, and can do hour-long appointments.
* Because insurance isn't in play for primary care, you don't have to play the game of diagnostic and procedure codes: Indeed, it seems that Paul Thomas doesn't even need an electronic medical records system (though I bet that in fact he does use one).
* Once out of the system, the clinic can negotiate for wholesale prices from drugs and imagining.
The tone of this book is great, and it puts its cards on the table honestly and with simple language. Still, the book is too short. It needs an appendix with more about the economics. 500 x $65 x 12 = $390,000, but how do you survive your first year when you only have 50 or 100 patients? And what are the costs of setting up? If you go to the author's web site, you see that the costs are tiered by patient age. OK, but explain that. Similarly, the book says that he has gone after small businesses: I'd like to hear more about that. Finally, how big is his staff? Does he have a nurse? A receptionist? The book indicates in the Acknowledgements that he got a lot of mentoring setting up his business: All of that should be in the body of the book.
If you're in health care, you're not going to learn a lot that's new in the book. But the emotional appeal and the idea that you can do family care outside of the edifice of American health care is refreshing. The cost is so low you could easily see some middle class families who have insurance use their insurance only for big ticket items, and pay the extra cash for this kind of dedicated primary care. (And it's not "concierge" medicine: Thomas targets poor people because it's the right thing.)
* The care model is about relationships, not fee-for-service transactions.
* The doctor is less burned out, because instead of seeing 2,400 patients (24 visits/day), she sees just those 500 over the year, and can do hour-long appointments.
* Because insurance isn't in play for primary care, you don't have to play the game of diagnostic and procedure codes: Indeed, it seems that Paul Thomas doesn't even need an electronic medical records system (though I bet that in fact he does use one).
* Once out of the system, the clinic can negotiate for wholesale prices from drugs and imagining.
The tone of this book is great, and it puts its cards on the table honestly and with simple language. Still, the book is too short. It needs an appendix with more about the economics. 500 x $65 x 12 = $390,000, but how do you survive your first year when you only have 50 or 100 patients? And what are the costs of setting up? If you go to the author's web site, you see that the costs are tiered by patient age. OK, but explain that. Similarly, the book says that he has gone after small businesses: I'd like to hear more about that. Finally, how big is his staff? Does he have a nurse? A receptionist? The book indicates in the Acknowledgements that he got a lot of mentoring setting up his business: All of that should be in the body of the book.
If you're in health care, you're not going to learn a lot that's new in the book. But the emotional appeal and the idea that you can do family care outside of the edifice of American health care is refreshing. The cost is so low you could easily see some middle class families who have insurance use their insurance only for big ticket items, and pay the extra cash for this kind of dedicated primary care. (And it's not "concierge" medicine: Thomas targets poor people because it's the right thing.)
November 24, 2019
An inspiring look at what healthcare should be from Paul Thomas, MD, founder of Plum Health DPC. It's a slim volume, but does a fantastic job explaining how a Direct Primary Care practice operates, and the philosophy behind it, and why doctors are increasingly exploring this type of practice. A great antidote to burnout, and the feeling that you didn't become a doctor to push paper but to have a positive impact on the lives of others.
December 14, 2022
I am also a DPC physician and I found Dr. Thomas' book to be a fantastic overview of direct to consumer care. The unique delivery system in today's world for DPC practices leaves a variety of options open to physicians and patients for designing what health can look like. Great book with multiple details, financial arguments for DPC, and just plain compassion expressed for patients. I recommend the book to anyone.
September 27, 2021
Very Helpful
I have my own DPC practice. It helps to know I am still in line with other practices of this kind and I would really like to get involved in helping improve health care in the US.
I have my own DPC practice. It helps to know I am still in line with other practices of this kind and I would really like to get involved in helping improve health care in the US.
May 4, 2025
Great overview of a new and innovative system!
Displaying 1 - 5 of 5 reviews