Direct Primary Care Podcast

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Dr. Paul Thomas on the Soul of Enterprise Podcast

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Dr. Paul Thomas on the Soul of Enterprise

In February 2022, Dr. Paul Thomas was featured in an episode of The Soul of Enterprise with Ron Baker and Ed Kless. In the episode we discuss all things Direct Primary Care! and they plug my book, Startup DPC:

Dr. Paul WROTE THE BOOK on Direct Primary Care. It’s called Startup DPC. Ron recommends this book because you can learn a lot from Dr. Paul’s experience. Here’s the Amazon link.

Here’s the full interview.

Dr. Paul Thomas is a family medicine physician who started Plum Health DPC in 2016, right out of residency. He is a board-certified Family Medicine Physician.

Direct Primary Care (DPC) is a model of primary care that is growing in popularity as an alternative to the traditional fee-for-service model. In a DPC practice, patients pay a monthly or annual membership fee for access to comprehensive primary care services. This fee typically covers all office visits and DPC practices offer at-cost medications, lab work, and imaging services to lower the cost of care for patients.

One of the benefits of DPC is that it allows for more time for the physician to spend with each patient. This is because DPC practices typically have fewer patients than traditional practices, which allows for more personalized care. Additionally, DPC patients often have direct access to their physician through phone or email, which can lead to quicker resolution of health concerns.

Another benefit of DPC is that it can help to lower healthcare costs for patients. By eliminating the need for insurance and reducing the number of unnecessary tests and procedures, DPC can save patients money in the long run.

Dr. Paul Thomas has been offering DPC services for the last 6 years and has seen positive results in the health of his patients. He believes that the DPC model allows for better continuity of care and a stronger physician-patient relationship, which leads to better health outcomes.

A big thanks to Ed Kless and Ron Baker for highlighting the work of Dr. Thomas and Plum Health DPC on The Soul of Enterprise!

-Paul Thomas MD with Startup DPC

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Dr. Paul Thomas on Primary Care Cures with Ron Barshop

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Recently I was interviewed by Ron Barshop on his podcast, Primary Care Cures. Here’s what he wrote about the show:

In this episode Ron gets the chance to chat again with Direct Primary Care expert, Dr. Paul Thomas of Plum Health DPC. In this episode he talks about how we went directly into primary care out of college and what his work week looks like, including blogging and youtubing the DPC message. He stressed the importance of relationships with small businesses and reaching the public via social media. Paul touches on how he has been successful in growing his business without brokers so far. He discusses what it takes start a DPC practice, the importance of a good name, creating a SEO course for DPC docs. He addresses Fears physicians have about going into DPC. Here Paul also shares his thoughts around end of life care and end of life care planning.

Paul is a board-certified family medicine physician practicing in Southwest Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. His mission is to deliver affordable, accessible health care services in Detroit and beyond. He has been featured on WDIV-TV Channel 4, WXYZ Channel 7, Crain’s Detroit Business and CBS Radio. He has been a speaker at TEDxDetroit. He is a graduate of Wayne State University School of Medicine and now a Clinical Assistant Professor. Finally, he is an author of the book Direct Primary Care: The Cure for Our Broken Healthcare System.

Listen to the full interview here.

Here’s an excerpt from the interview (below) and the full transcript is here.

How I decided to start my direct primary care practice

Yeah. Well, in my last year of medical school, I actually heard Josh [inaudible 00:04:50] on a podcast and I kind of filed that idea in the back of my brain because I thought I was going to be a professor at a teaching hospital and seeing patients and working with the residents and students, but the deeper and deeper I got into my residency, the less and less time I had with my patients. And I found myself really unsatisfied in the level of care I was able to deliver to my patients simply because I didn't have enough time. Page 3 of 13 And then I got to see Clint Flanagan, Dr. Clint Flanagan of NextEra in Michigan. He was speaking in a conference in Michigan. And so, I talked to both of these physicians and I asked if I could visit their practices. And so in my last year of residency, I wrote a curriculum, a direct primary care curriculum, and I drove out to these two practices and I took the best of their ideas and I brought it back to my hometown in Detroit. And that's where I started Plum Health. And that's three years later from that moment, I'm full with 500 patients and I've brought on a second doctor to help me meet the additional demand.

What’s a Typical Day Like for a Direct Primary Care Doctor

Well, typically most busy on Mondays and Fridays and I'll typically see about five to eight patients each day. Typically, one hour for new patients and 30 minutes for followups. I'll do a lot of texting and phone calls with my patients. I typically field about 20 to 30 text messages each day and just answering some simple questions or coordinating appointments or texting my patients and asking them, "Hey, I saw you on Wednesday with a runny nose and cough. How are you feeling today now that it's four or five days later?" So, that's a workflow that I have and I'm typically in my office 9:00 AM to 5:00 PM.

The other part of it is like on a weekly basis, I'm working on blog posts. I write a blog post and shoot a short YouTube video and post that onto my blog. And then on a weekly basis, I reach out to a small business in my community and ask them, "Would you like to enroll your people into our membership model?" And so, there's different hats that I wear. I'm of course always checking the finances of the business and making sure that our profit and loss statement is lining up each month. So, there's other things beyond patient care and I just fit those between my patient visits so that my business remains healthy as well.

Paul Thomas interviewed by Ron Barshop on Primary Care Cures. See the original post, here.

Paul Thomas interviewed by Ron Barshop on Primary Care Cures. See the original post, here.

How do you attract new patients to your Direct Primary Care Practice?

Yeah, I think it's important to develop relationships with small businesses because I really believe that if you're a small business and you're not offering some sort of health care benefit, you would be doing your employees a great service by offering something like this, even if you can't afford health insurance. This is something where offering like direct primary care can help employees maintain a good level of health and have something where they can actually access a physician and have guidance through their illnesses and injuries. And then, I'm also really focusing on social media and reaching the general public. That's where 90% of my members are coming from. So, I try to strike a balance of landing some larger groups, some larger customers, and also maintaining an outreach to individuals.

As for employer groups, I mostly am focusing on those employer groups that are fewer than 50 full time equivalent because those are the folks that aren't mandated to provide health insurance for their employees and they often end up in this messy middle where they're not doing anything because they don't know what's out there.

How Do I Start a Direct Primary Care Practice?

Well, I actually get this question so much that I decided to put all of my knowledge into a website that I recently created and it's in a soft launch right now. It's called startupdpc.com. And folks can go through and read how to, how to start a direct primary care practice. There's a long form blog post that I put there where you can read through, okay, do I have the right mentality to start this? Am I willing to give up the paycheck? Do how to come up with a great name for my practice? How to develop a website? How to build out social media channels? And that kind of gives you a broad overview of if this is something that you want to tackle on your own or with a partner or with some help. And then, I take it one step further and I take a really deep dive into individual topics. And I put together some courses that people can take to really cement their knowledge and become proficient in the skills that you need to become a great direct primary care physician with a thriving successful practice.

A lot of people in medicine have no business experience. And one of the things I often tell people is business is relationships. So as a primary care doctor, we are the most friendly, outgoing doctors that there are. And so how do you cultivate good relationships with people in your community, with small business owners, to create a practice that works for you and works well for your patients?

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE Practice?

If you enjoyed reading this blog post and if you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have begun compiling some of the best content available on this blog and in our courses.

The best place to start is to take our Direct Primary Care Business Plan course, available here. From there, you can learn how to attract new patients to your direct primary care practice and how to find the perfect location or build out the practice of your dreams.

Thanks for reading and watching, and best of luck in your direct primary care journey!

- Dr. Paul Thomas with Startup DPC

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Dr. Paul Thomas Featured on the Soul of Enterprise Podcast

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This month, I was featured on the Soul of Enterprise Podcast and we had a great conversation around the Direct Primary Care Model and some of the challenges and opportunities therein. They also give a shoutout to the new Startup DPC platform, and how to start and grow your own Direct Primary Care practice. Here’s what they wrote:

WHAT HAPPENS WHEN A SMART DOCTOR RECOGNIZES THAT THERE IS A BETTER WAY?

Is it possible for family physician to operate under a subscription-based business model, priced below what you pay for your mobile phone service? What about services not covered by the subscription? Could those be priced with full certainty and transparency?

For episode 269, we had the pleasure of interviewing Dr. Paul Thomas, founder of Plum Health DPC. Dr. Paul Thomas is a board-certified family medicine physician practicing in Corktown, Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. His mission is to deliver affordable, accessible health care services in Detroit and beyond. He has been featured on WDIV-TV Channel 4, WXYZ Channel 7, Crain's Detroit Business and CBS Radio. He has been a speaker at TEDxDetroit. He is a graduate of Wayne State University School of Medicine and now a Clinical Assistant Professor. Finally, he is an author of the book Direct Primary Care: The Cure for Our Broken Healthcare System.

Below are show notes and questions we asked our guest. Use these to help guide you along when listening to the podcast (embedded above).

Ed’s Questions

  • What is Direct Primary Care?

  • Based on an interview I saw you do, there’s no wait time for patients?

  • Why did you go this route—Direct Primary Care?

  • You were burned out in your residency. What was the moment that you said I can’t do what most people are signing up to do?

  • Most time patients do get with their doctors is spent with the doctor typing and facing a screen.

  • What are some of things that are covered in your clinic?

  • What you are capable of doing in your practice is probably 80-90% of what a healthy patient would need in a given year?

  • It would cost me personally about $840 in your practice. If you’re so cheap, why is healthcare so expensive?

  • It’s said America pays more than the average OECD country, but there’s no price transparency in the system, which inflates those prices, correct?

  • What are some of the barriers you see that are still in the way of physicians getting into DPC and patients being able to access DPC?

  • When you did start, did you consider other pricing models? Yours is based on age, but did you consider, for example, response times, or different services you would include and exclude?

  • Do you have any jumpers, and by that I mean people who pay for a month and then leave, then come back six months later?

  • You’re now also offering rates to small businesses in your area?

  • And the companies pay your membership as part of the employees benefit package?

  • You believe that patients should also have a catastrophic health insurance plan?

  • We don’t expect our auto insurance to pay for gasoline but we do expect our health insurance to pay for a blood test. It’s absurd?

  • I was struck that in your TedX talk you used the phrase “living my truth,” take us through that, what does that phrase mean to you? 

Ron’s Questions

  • In your book, Direct Primary Care: The Cure for Our Broken Healthcare System, you cite a 2016 study performed by Medscape found 51% of physicians experience burnout. Burnout is defined as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. You felt this in your residency. How long did it take you to work up to 500 patients?

  • How did you market your practice, was it social media, word-of-mouth, press. I know you did a Tedx talk.

  • I know DPC is in the same family of Concierge Medicine, which has the reputation of being just for the elite, which isn’t true. But the DPC prices are usually less than a mobile phone bill.

  • On the cover of your book there’s a picture of you trying to catch sand through your hands. Can you explain that analogy?

  • You talk about technology and how there’s too much borrowing from Henry Ford’s assembly line, treating customers like commodities rather than human interaction. It’s not very efficient to sit and listen to your patient read you poetry. It is, however, highly effective. Would you agree with that?

  • You also talk how the average of GP doctors have 2,400 patients. Do you think this DPC model will alleviate this GP doctor shortage?

  • You talk about the growth of urgent care centers in the US is a symptom of a failed primary care system.

  • Do you feel that people who are not licensed could do some of the work now being done by physicians? What’s your view of occupational licensing and how it folds into this model/

  • You mentioned to Ed that insurance companies try to get as many dollars passing through the hands. They don’t seem to like the concierge or DPC models, not because they compete with actuarial based insurance but because they compete with pre-paid medical care. Did Michigan pass a law that made it clear that DPC is not an insurance product?

  • Just seems to be like insurance companies would like to block this model. Is that a fair statement?

  • There’s obviously some education going on with doctors with respect to DPC, but we also need to re-educate patients to see you even when they are healthy, not just when they are sick. Has that been an educational process to get patients to see you even when they don’t have an issue?

  • We talk a lot about the market share myth, that growth for the sake of the growth is the ideology of the cancer cell, not a sustainable, profitable business. You phrase it in your book as “Value over volume.” You must be asked a lot that healthcare is different than any other product or service we buy, how do you explain to people that it can be priced like other things we buy

  • Your model is restoring the sacred relationship between the patient and doctor. You’re bringing this back to the days of Marcus Welby.

  • I’ve read that most calls (82%) are received during normal business hours, that patients don’t abuse your time off. Has that been your experience unless there’s been an emergency?

  • Tell us about your new venture, www.startupdpc.com.

  • If you could wave a magic wand to reform healthcare, what would you do? [Price transparency and quality scores was Dr. Paul’s answer].

How To Listen to the Podcast:

How To get more Media Coverage for your direct primary care practice?

DPC Docs often wonder how they can get more media attention and more media coverage! Media coverage is crucial because it can amplify your message by one thousand fold. To be honest, this can be a tough process, as virtually every business wants to be featured in the media. But there are several steps that you can take to be featured in a big news outlet.

One of the first steps that you can take is to become Media Ready. What do I mean by Media Ready? You have to be ready to speak eloquently on air and therefore you have to practice. A great way to practice is by being interviewed on a local podcast. Speaking to reporters, being interviewed, and interacting with journalists is a skill that can be honed, and you can build that skill by working with podcasters. The more touches that you get, the better you'll become.

Action step: reach out to a local podcaster and ask if they'd be willing to feature you on their show. Repeat weekly until you sound amazing. Sometimes they will reach out to you, but more often you’ll have to reach out to them. Ask if they’d be interested in talking with you on their podcast. If so, great! If not, move on to the next opportunity.

Then, when a big media or show Program Producer is looking for a guest, they can listen to your previous material and decide if you'll be a good fit.

I’ve included our latest podcast interview (above) to illustrate that every podcast is a great opportunity - every interview helps me to be better and better, and every interview is an opportunity to reach the next customer, so I make time for as many interviews as possible.

Thanks for reading and listening! And, if you like this content, you’ll probably enjoy our course on Building a Sales Funnel. This course walks you through how to get more eyeballs to your website and therefore how to get more people to sign up for your Direct Primary Care practice.

Thanks again,

-Dr. Paul Thomas with Startup DPC