Posted by: AtlasMD

October 17, 2013

Obamacare? Let CNBC Explain…

President Barack Obama has passed his landmark healthcare reform law. It’s referred to by several names—the Patient Protection and Affordable Care Act, or just the Affordable Care Act—but even the president uses the critic’s name: Obamacare.

Sure, the name is simple. But this is a complicated law. It wants to tackle two problems: first, it seeks to provide affordable health insurance to just about every American, and second, it wants to slow down the rate of inflation of healthcare costs, which account for nearly one-fifth of America’s economy (you saw John Green’s brilliant video, right?).

Okay, insurance for everyone sounds nice. We’re not going to argue with that sentiment, although the methodology might backfire. However, this second point sounds ludicrous.

“Add red tape to curb American healthcare costs? That’s like pouring gasoline on a fire because it’s liquid.” – @AtlasMD [CLICK TO TWEET]

Oh, and “the ACA will cost the government $1.36 trillion to implement over the next decade, according to estimates by the Congressional Budget Office,” says CNBC. Excellent. That’s just another tab that’s going to have to be picked up by someone, most likely someone who works and pays taxes.

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Posted by: AtlasMD

October 17, 2013

Is Chris Dorster Allergic To Red Tape?

Yes, New York resident Chris Dorster suffers from occasional allergies, so he’s been known to sneeze a bit. However, there’s more than just pollen to sneeze at in his blog post. That’s because Chris currently doesn’t have prescription medication coverage. When his allergies flared up recently, he went in to see his doctor. There he was given a sample of a medication. The brand name nasal spray did the trick.

But the plot thickened. When Chris ran out of his sample he figured he’d pay cash for another tiny bottle of nasal spray. It can’t cost that much, he thought, maybe forty dollars?

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Posted by: AtlasMD

October 12, 2013

The Spirit Of Direct Primary Care: Entrepreneurship And A Drive To Serve

We’ve been harping the benefits of running a direct care practice. And we’ve admitted that it takes ambition to get yours off the ground. We, as advocates of direct care, are reacting against the complacency of the majority, against the headaches of seeing thousands of patients, of making patients wait for hours to see us for mere minutes. However, Dr. Neu’s ambition takes entrepreneurialship and creativity to a whole new level.

In order to raise capital for his direct primary care practice in Lawrence, Kansas (we’re neighbors practically!), he is offering lifetime primary care for just $5,000. In his words, “Considering $5,000 would only fund the average person’s ‘middle of the road’ health insurance premium for 15 months (with access to pay $40 co-pays and for $12 band-aids), it’s a bargain.” Go, Dr. Neu! His practice is running a model very similar to ours, with ~$40 monthly payments and small copays for additional lab work and procedures. He performs house calls and a variety of services.

READ MORE ABOUT DR. NEU’S CREATIVE FUNDING

Or, if you’re in the neighborhood and feel like investing in your health and Dr Neu’s practice’s future, click through to donate here. There are only twenty lifetime membership packages available.

Posted by: AtlasMD

October 10, 2013

AAFP Releases Detailed Projection Of Primary Care Physician Shortage

The AAFP reported on a recent study outlining the projected family doctor shortage that is facing our nation. According to the organization, “The projections rely on a combination of factors to gauge current and future workforce needs on a state-by-state basis, focusing heavily on increased patient demand that is likely to result from an aging population, overall population growth and coverage expansions due to the Patient Protection and Affordable Care Act.”

The projections are very specific. For example, according to the projection for Arizona, the state demands an additional 1,941 primary care physicians by 2030. This is 150 percent of the current number of doctors. According to the research, 1,466 primary care physicians are needed because of population growth, 360 because of increased utilization, and 115 because of insurance expansions that occur as part of the Affordable Care Act.

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Posted by: AtlasMD

October 10, 2013

Welcome to Atlas.md EMR

Meet direct care’s first EMR and Practice Management software, envisioned by our doctors and in use here in our Wichita clinic. Drs. Josh and Doug will show you around the app in a series of How-To videos.

VIEW THE FIRST ATLAS.MD EMR TUTORIAL VIDEO > DASHBOARD

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Posted by: AtlasMD

October 9, 2013

NPR Breaks Down Obamacare’s Effect on Insurance Rates

NPR published an article reviewing introductory rates on policies offered through state-run insurance exchanges. The report examined 36 different states. So what’s the verdict? A resounding “it depends.” In Oklahoma, premiums are going for as low as $96/month. Meanwhile, in Wisconsin, the lowest rate on a bronze plan is well over $300. The reporter echoed our direct care mantra, saying, “Competition equals lower prices.” They explained how in regions with only one insurance company selling through the subsidized exchange, the average monthly premium for a 21-year-old buying the lowest cost bronze policy is $186, before any subsidies are applied. However, in regions with 10 or more rival carriers, the average cost is $132 or less.

How will Obamacare’s varying premium rates affect direct care practices?

Actually, there are two wins happening. If you’re a doctor looking to move to open a cash-only clinic, you’ll bode well in regions with only one insurance plan offered through the exchange. Lower competition tends towards higher insurance rates, meaning that wrap-around plans and your direct care offering can add tremendous value. Secondly, in areas with fewer insurance plans offered on the exchange, there is another effect: increased premiums for existing subscribers. In this case, because of the lack of competition, and the fact that Obamacare is forcing insurance companies to expand their offerings, rates might reach an exorbitant level for the subscriber. This is another patient who would benefit greatly from switching to a wrap around plan (remember, Obamacare means that insurance plans can’t raise their rates for pre-existing conditions) and enrolling in your direct care clinic.

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Posted by: AtlasMD

October 9, 2013

Direct Care is Not the End of Empathy

If you’re currently running an insurance-based fee-for-service primary care facility, and planning to switch to direct care, you should read this op/ed from the Wall Street Journal. Jerald Winakur practiced internal and geriatric medicine for 36 years and is a clinical professor of medicine at the University of Texas Health Science Center at San Antonio. His cousin Irene, a 90-year-old woman living in Queens, was recently notified that her internist was joining the concierge medicine ranks.

Winakur’s thoughts are less than enthusiastic about profit-focused decision making. But, they actually don’t contradict our own belief in Atlas MD-style of direct care. Why is that? Because concierge medicine is not the same as direct care. According to Winakur:

“What Irene learned was that her internist was converting her fee-for-service office into a ‘concierge practice.’ For a yearly retainer of $2,200 (in addition to the usual charges that would still be billed through Medicare and supplemental insurance), Irene would receive “value-added” services. These include same-day appointments, electronic access to her medical records and lab reports, shortened waiting times, and other ‘frills’ that Irene said her doctor always provided anyway.”

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Posted by: AtlasMD

October 9, 2013

Preserving Doctors Means Preserving the Patient-Doctor Relationship

David Bornstein is making a career of empowering, thought-provoking articles on the emotional state of healthcare. In his New York Times op/ed “Medicine’s Search for Meaning” he advocates that as the patient-doctor relationship vanishes, so too will the doctors. He says, “Medicine is facing a crisis, but it’s not just about money; it’s about meaning.” Adding that, “As administrative and documentation burdens have exploded in the past three decades, doctors find themselves under pressure to work as quickly as possible. Many have found that what is sacrificed is the very thing that gives meaning to the whole undertaking: the patient-doctor relationship.”

Bornstein’s piece is powerful, weighing in on the manner with which we doctors handle grief. In his opinion, med school is where the doctor burnout is first felt. Students are pushed to absurd extremes–losing sleep, and being trained to approach medicine in a distant, compassion-less manner, even reprimanded if they break down and cry in the presence of a patient. So is it okay to cry in the presence of a patient? You have to decide for yourself. However, reprimanding a student for doing so is pure Vulcan, cold. But, according to Bernstein, almost half of medical students get burned out during their education. He claims that, “medical education has been characterized as an abusive and neglectful family system.” It places unrealistic expectations on students.

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