Three Ways Your Direct Care Practice Can Tell A Better Story. Part One: What You Do Matters.

1-WhatYouDoMattersAs a Direct Care practitioner, you’re doing so much more than practicing medicine. You’re telling one of the most important stories our country, and perhaps the world, needs to hear today. You’re telling the story of happiness. Of freedom. Of satisfaction. Of care. 

Your story paints a picture for healthcare patients. This picture isn’t abstract nor is it intangible. It’s vivid with color, the depth of its honesty and transparency reaching into their souls and telling them that better is possible.

In this three-part series, we’ll dig deep into some ways you can step outside your medical mindset and tell your patients a more engaging story. In return, they’ll keep coming back and sing your praises to

What you do matters.

Every interaction you have with your patients tells the story of what healthcare should look like. In it’s simplest form, this step is just about taking advantage of the foundation Direct Care was built on. It’s sticking to your word and putting your patients first in the following ways:

If you offer same day scheduling, make it happen.
Remember, your patients are probably used to waiting three weeks for an appointment, spending an hour in the waiting room, and then being shuffled right back out the door 10 minutes later. You can show them they don’t have to put up with that nonsense for another minute.

Respond in a timely fashion.
You’ve chosen to keep a limited patient count in order to make time for everyone. So since you don’t have back to back to back appointments scheduled 15 minutes apart, you likely have some form of downtime throughout your day. Use it to keep on top of patient correspondence. You might have six patients to deal with in one day, but they’re only concerned with one doctor… they want to know they’re just as important to you as you are to them. A simple response can go a long way to prove that.

Staff your office appropriately.
You don’t need a whole crew of people to man your DPC practice. You might be the only physician in it! But if you’re behind closed doors with a patient, who’s manning the front desk? The phones? Read more

The Pen and Paper Era was Accident Prone. How is Medical Tech Better?

The Pen and Paper Era was Accident Prone

“A study from the pen-and-paper era showed that 1 in 15 hospitalized patients suffered from an adverse drug event, often due to medication errors. A 2010 study (using data collected during the pre-digital era) estimated the yearly cost of medication errors in U.S. hospitals at $21 billion.” – Medium.com

Whoa.

When you look at those stats, it’s no wonder the industry couldn’t wait for a better way. Technology has done so much good in the way of standardization and reducing the margin of human errors. EMRs and the like have made it easier for docs to spend less time charting and more time actually with their patients. The benefits far outweigh any negatives, but that’s only if you use technology responsibly.

We can’t leave our jobs totally up to technology, as the story over on Medium.com illustrates perfectly. If we do, we’ll miss things like a massive accidental overdose (patient needed one pill, got 39 instead) and nobody wants to feel the guilt Nurse Levitt experienced so intensely. We’ll miss dangerous drug interaction warnings and potential allergy notifications. We’ll miss the opportunity to avoid life-threatening situations. Whether we’re in a hospital setting, or a clinic setting, this kind of attention to detail still matters. Immensely.  

We know this. And we, as Direct Care professionals, have adopted a business model that wholeheartedly embraces the very two things that can prevent errors like this from happening — even in the technology era. 

1. We’ve gotten rid of red tape and policy that does nothing but convolute the simplest of tasks. In fact, we’ve taken it upon ourselves to build the EMR that we want, and have thus turned it into a product incredibly useful for hundreds of other Direct Care practices, too. It’s based on accuracy, simplicity and ease of use. There are people working around the clock to make sure these things work together in tandem. 

2. We have time. Time to think through every prescription we order and dispense. Time to double check dosage. Time to actually pay attention to the alerts that fire when an irregularity has been electronically recognized. This gift is not something we take lightly. 

Technology can certainly make our jobs — our lives — easier and more efficient. For that we’re thankful on a daily basis. But we mustn’t forget that we are the threshold for which all medical decisions must pass. We can’t check common sense at the door in lieu of an app that thinks for us. And because we have a business model that allows us to work to the best of our abilities, we love our jobs… and therefore don’t want to just go through the motions. 

So thanks to technology, for all you do for us. But more importantly, thanks to Direct Care, for existing so that we may also operate as the best versions of ourselves. 

Medical Economics: The Rise and Fall of the Patient-Centered Medical Home.

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On paper the idea of a patient centered medical home (PCMH) sounded great. But it’s gotten so bogged down with red tape that the only thing sticking to it is doubt. At least that’s the case for PCMH early adopter John L. Bender, MD, who recently contributed his perspective to Medical Economics.

“This year I am considering not maintaining PCMH recognition. It is basically a marketplace decision. The payments from insurers to maintain my care coordinators on payroll, to continue externally reporting from my large data registry, and all the other trappings of robust PCMH just are not sufficient.”

Dr. Bender is well aware of the rise of Direct Primary Care, but he has his doubts about that, too. He warns that you don’t want to be the first, or the last to adopt a new payment model. We might argue that at this point you’ll be neither, indeed. The payment structure is working brilliantly for DPC clinics around the country, and continues to adapt to the flexibility needs of patients. Maybe its success is partially to blame for its “cult following!”

But there’s another point Dr. Bender mentioned that we’d like to address. “Whether DPC will create a reduced standard in the delivery of healthcare quality remains to be seen, and the concern for quality is perhaps the largest hurdle DPC must overcome.”

We’ll go ahead and speak on behalf of the DPC community when we say – Challenge Accepted! We know DPC presents a lot of opportunities for us, as healthcare providers, to live the life we want while providing the kind of care we always imagined – while at the same time avoiding bureaucratic policies that seem to do little more than add paperwork to the stack at the end of the day. And we didn’t go to medical school to fill out paperwork…

So we’ll press on in hopes of proving to Dr. Bender that quality is the very pinnacle of what we wake up to do every day. We make ourselves available to our patients nearly 24/7, and via nearly every communication outlet available (Skype chat, anyone?). We’ll continue to make house calls as needed, and go above and beyond to save our patients money at every turn of the bend, including on medications and procedures. We’ll develop relationships with our local medical communities to negotiate the best deals possible on external procedures like labs. We’ll continue to use our spare time to sit extra minutes with patients during their appointments, do extra research to help with their preventative care, and further spread the concept of Direct Care to everyone who will listen. We’ll continue to walk patients through their invoices line by line if they want, explaining exactly where each cost comes from (they’ll continue to not be surprised, though, because they typically know the cost in advance!).

We hope not only patients, but other physicians considering a transition to Direct Care will continue to see the value in our business model. It might seem too good to be true, but there are practices all over the country who are living proof of its validity.

Hard for You. Easy for Your Patients. Perfect.

This article over on HelpScout’s blog is all about how to write well. How easy reading is damn hard to write. Well, you’re not writers, you’re healthcare professionals… but the concept still applies.

It applies in the most basic of ways — how you communicate with your patients. You have to translate medical terminology into something your patients can understand (they didn’t go to medical school at all, remember?). You have to break it down into simple, everyday words. What you say must be easy to digest. That means getting rid of all the excess stuff. Stuff like phrases that only repeat your point rather than further illustrating your point — there’s a difference.

Like the article says, “Great writing moves you effortlessly through the words; reading becomes as quick as thought.” Which is why it’s more than what you say or don’t say. It’s how you say it.

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This whole “easy reading is damn hard” concept also applies on a deeper level of Direct Care. A level that stretches beyond writing, actually. This level is why your patients love you so much. It’s why they feel the need to tell people in the supermarket line about you. It’s because you make healthcare easy for them. You make them feel good about the decision they made to be part of the Direct Care movement. You make them feel empowered by their choice to ditch red tape and middle men. You make them healthier and more confident as they leave the tangled web that is health insurance behind.

So as you continue to provide excellent care for your patients, you’ll also continue to find your own style. Your own writing style, your own bedside manner style, your own practice style.

“Novelist Neil Gaiman once said that writers find their own voices only after they’ve sounded like a lot of other people. On the road to writing your own seminal sentences, start by studying those that have stood the test of time.”

We want to help make all this easier on you. We’ve done the legwork, the really hard stuff. We, and many others, have built Direct Care practices which have stood the test of time. So while you’re busy finding your own voice, it’s okay to use ours for a while. Get it in the DPC Curriculum. Get it through our free consulting services. We’re standing by at hello@atlas.md, excited to hear how you’re working hard to make life easier for your patients!

We Should Aim for “Crazy and Oldschool”

If being crazy means we know our patients backwards and forwards, show up at the hospital when they’re admitted, and help fill in the blanks of their medical history when our patient is unable, then sign us up.

If being old school means our doctor-patient relationships are rock solid, cradled in trust, and wrapped in endless care, then we’re on board.

Like the experience in this story told by Dr. Dhand over at KevinMD, we’re totally up for letting DPC take us back to basics.

A couple of weeks ago I was on-call and had to go down to the emergency room to see a patient. Before I entered the room, I was told that the patient was accompanied by her long-time physician who was a bit “crazy and old school.”

“Hmm … that’s strange … why would her physician be in the room with her?” I thought to myself. When I went in to introduce myself, sure enough sat next to her was an elderly physician probably in his late 70s or early 80s. After he greeted me with a warm and friendly handshake, he told me that he had practiced medicine in the local area for the last several decades. I still continued to wonder exactly what he was doing there, and this thought persisted for the next few minutes.

However, as I got further into the interview, I quickly realized just why he was sitting by his patient’s side. This doctor had cared for the patient for at least the last 30 years, was in the process of winding down his practice, but felt compelled to come and visit his patient (with no financial incentive to do so) as soon as he heard she was being admitted to the hospital. The patient — elderly herself and hard of hearing — wasn’t able to give me a complete history. But that was OK, because her doctor knew her inside out. Every little detail.

Read the full story over here and after you do, a little personal reflection of your own might be just what the doctor ordered.

Posted by: AtlasMD

April 10, 2015

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Selling Your Vision

Are you starting your own Direct Care practice? Maybe just thinking about it? Either way, if you’re interested in Direct Care you have a vision in mind, right? The big picture, the overarching purpose, the ultimate goal.

Then there’s the part where you lose sight of that goal and get lost in the details. That’s okay, too… to a point.

Kevin Rose, founder of Digg, has some invaluable advice on aligning the details with your vision – and what can happen when your entire team is on board.

A team aligned behind a vision will move mountains. Sell them on your roadmap and don’t compromise — care about the details, the fit and finish. Only work with those that have (as Larry Page puts it) “a healthy disregard for the impossible,” and push everyone on your team until it’s uncomfortable.

So go. Start your Direct Care practice and do your part to change the face of healthcare. Just don’t forget to sell your vision along the way. 

Is Social Media Closing the Gap it Created in the First Place?

Technology is good for so many positive purposes when it’s put to use for the right reasons. But when it’s abused the results can be catastrophic. Take online bullying for example. It’s been linked to low self esteem, actual fights, and worst of all – suicide.

There’s a lot you can ignore while looking down at your mobile device. But can we really ignore the gap that separates the technology generation from real life eye contact? One social media platform is attempting to bridge the gap society says it created in the first place. Read more

Posted by: AtlasMD

March 2, 2015

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Texting Could be Good for Your Health.

The Direct Care community is totally on board with embracing unconventional methods of communication. It’s why our patients text, email, Skype, and Tweet us in addition to making the tradition phone call. Turns out we’re on the right track.

Text messaging is a fixture in modern culture. In two separate studies, U-M Family Medicine researchers have shown that in addition to facilitating everyday conversation, texting can help people adopt healthier behaviors, and can make it easier for health researchers to gather information.

Companies are apparently using texting campaigns to send messages to people in an attempt to raise their awareness about type 2 diabetes risks. And it turns out people are pretty darn receptive to it. In fact, not only is texting turning out to be an effective way to promote healthy habits, but a new study even suggests that it could replace direct mail campaigns in urban areas where researchers are trying to conduct surveys.

Think this seems like a no-brainer? Texting has been around for a while, right? Nothing new about the technology itself, but now researchers are able to extract information – collect data that tells whether or not the campaign is working. That, friends, is new and exciting. Out with the old and in with the new, right?

Read the full article on how texting could be good for your health. >

Technology is great, but the DPC community needs to look past it to stay grounded in truly patient-centric objectives. What we’re really using technology for is to go back to the basics – before the fancy stuff even existed. The idea is to create a more personalized experience, to develop a real relationship between doctor and patient. One that never underestimates the value of a face-to-face conversation or house call.

Posted by: AtlasMD

February 23, 2015

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Six Abilities DPC Docs Should Have, Plus One More.

In a recent article over at the DPC Journal, it’s suggested that DPC docs must know a set of six things in order to be successful with the Direct Care business model. Those traits and abilities include tenacity, passion, management of fear, failure and uncertainty, vision and task-specific confidence, planning and flexibility, and finally, rule-breaking.

Those are all crucial, and very telling characteristics of someone running their own practice, but we think they left one out. We’d like to add a #7 to this list.

Refusal to Settle

The healthcare industry has set so many precedents and standards; it’s tough to break the mold. Medical students are immediately overwhelmed by rules and regulations; it’s no wonder they feel trapped right out of the gate. But those who succeed in Direct Care are perpetually striving for better. Working toward improvement. Cutting through red tape to get where they want to go. Their vision for the kind of practice they always hoped existed drives them forward and they refuse to settle for what’s not working.

If we’re honest, the list of great characteristics of DPC docs is much longer than six or seven. The takeaway from all this is that the Direct Care movement is opening doors to physicians everywhere, allowing them to be the best version of themselves. Which directly results in the best version of their patients. And that’s what it’s all about.

Getting Patients to Take Their Meds is a Work in Progress.

A while back, we told you about a new method aimed at getting patients to take their meds – this one revolved around video games. But gaming isn’t a motivator for everyone, and researchers are trying to find the trouble spot surrounding the lack of adherence to doctor’s orders.

Dr. Steve Leuck, PharmD is a pharmacist and founder of AudibleRx. Dr. Leuck is excited that more research is being done to get to the bottom of the issue, but he thinks success might revolve around patient education.

“When patients understand why they are taking their medications, and importantly, what the consequences are of not taking their medication, they are much more likely to be adherent to their pharmaceutical regimen,” he said.

The studies that have already been conducted looking at things like utilizing pill box organizers, having the pharmacist talk to the patient about the medication, text reminders, even web-based support. But a lot of variance in how the studies were conducted and the sheer lack of studies in general prevented them from coming to any conclusions we can run with.

The case isn’t cracked… yet. But those in the field aren’t done trying.  Read more