Why Transition to DPC? This Cardiologist Says ‘Practice Enjoyment and Quality.’

Who says DPC doesn’t work with specialties?

Making the switch from practicing invasive cardiology in a traditional healthcare setting to practicing Direct Primary Care was an easy decision for Dr. Kahn in Detroit. His new world doesn’t involve insurers, ICD-10, or billing fees. But it does involve a whole lot more happiness as of October 1! But let’s take a quick look at his “before:”

Generally, I was seeing more complex cases of heart disease compounded by obesity, metabolic disorders, and poor lifestyle. Trying to manage or at least give advice to patients was getting more complex and time consuming. In addition, the advent of advanced labs with inflammatory, oxidative, and genetic markers was taking more time to analyze and offer advice. Phone calls for pre-authorization first for invasive procedures, then for nuclear procedures, and now for just echocardiograms waste more and more time during the day. They say that if you love what you do, you will never work a day in your life. I was finding that what I was doing was starting to feel suspiciously like work.

He describes his activity with some of his patients as “the four minute smile” because he had to dart in and out of appointments that quickly just to stay on time. Unfulfilled and well, rushed, Dr. Kahn knew there had to be a better way. But he didn’t want to just follow suit of others around him who had thrown in the towel on medicine. Instead, he created his own solution and in turn his own opportunities.

So what does his “after” look like? We can’t wait to find out, but we imagine he won’t be sorry to leave “the four minute smile” in the dust.

The New ICD Billing Codes Have Launched… But We’re Still Celebrating!

Some establishments are still scrambling to make ICD ends meet. Some are just trying to recover from the bumps in the road uncovered during the October 1 launch. But Direct Care practices around the country reported smooth sailing so far – and even had some time to show off their support for DPC!

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We’ll continue to celebrate freedom from red tape and billing codes – you can, too! We’re still offering #IAmDirectCare T-shirts so you can wear your support all year round. We even heard some patients wanted shirts! Now that’s a party. Get yours over here, and see how Direct Care looks on you!

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Cheers to happy docs and happy patients.

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.

Atlas MD Podcast 23 – Addressing the Scalability of Direct Care.

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In the latest podcast episode, the high school sweethearts of Atlas MD discuss what they’ve been up to lately, address the scalability of Direct Care, and make a connection between ICD-10 and Fight Club. You’ll be glad you listened!

Listen here! Atlas MD Podcast 23 >

Is Direct Care scalable? Yes!!
As you grow, adding a new doc to your practice can do more than just open you up to helping more patients. It also frees you up for a little extra vacation or weekend coverage and gives you access to instant second opinions! But you have to make sure your new addition is the right fit, or you’ll be backpedalling from day one.

Is your practice ready to add a new location? That’s fantastic! In this episode, Drs. Josh and Doug address how Atlas MD is adding an additional location, what to look for in new space opportunities, and answer common questions about the scalability of Direct Care.

A little fight can go a long way…
As you know, we recently launched our Direct Care Curriculum, where we share the knowledge we’ve amassed over the past ten years – for free. This isn’t just for everyone who’s already heard about Direct Care and wants to learn more… we’d like to challenge that particular group, though. We know you know people. Those people are stuck in their traditional healthcare setting and honestly they don’t see a way out. They’re facing a career change, or retirement — but that’s not what they really want. So reach out to those people. Help them use the fight they have left in the best way possible. Direct Care is waiting to give them the invigorating career they always thought they’d have.

The biggest mess you’ll ever avoid…
The launch of ICD-10 is right around the corner, and we’re hearing a collective sigh of relief from DPC practices around the country as they sit back and watch the madness from the sidelines. Those same practices are wearing their support for Direct Care. Are you? Check out www.IAmDirectCare.com/dpc-holiday to learn more! Oh, and don’t forget to tag your social media posts #IAmDirectCare!!

See you next time!

Listen here! Atlas MD Podcast 23 >

Announcing the Atlas Direct Care Curriculum!

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Announcing the Launch of a Tool that Teaches Everything about DPC.

We’re big believers in doing things the right way, which is why we’ve put together a comprehensive curriculum teaching about Direct Care. And since we don’t think you should have to pay for doing your homework, we’re offering the curriculum completely free of charge – just like our consulting services!

Okay, so let’s dive in. What’s this curriculum all about anyway? It covers all the most important aspects anyone considering DPC would wonder about:

• What is Direct Care?
• What Does it Mean to Cut Out the Middleman?
• Is Direct Care Right for You?
• How Much Will it Cost to Start a DPC Practice?
• What Technology Will I Need to Run a Smooth Practice?
• The Ins and Outs of Insurance in the Direct Care Model.
• Charging and Billing for Direct Care Services.
• Running an In-House Pharmacy.
• Making the Transition: How to Approach Patients About Your Decision to Switch to DPC.
• Marketing Your Direct Care Practice.
• Creating Value for Your Patients.
• Staffing Your Direct Care Clinic.

Additional Resources Galore.

Each lesson features additional resource links so you can continue your education if you so choose. Plus, we’re including our starter packet, stuffed full of templates and real life examples you can actually put to use in your Direct Care practice. We’re talking things like price comparison, Medicare agreements, conversion letters to patients, labs pricing spreadsheets and more.

Who Do You Know?

So, who do you know who might be interested in Direct Care? This curriculum covers multiple angles, including someone starting their practice right out the residency gate and someone transitioning from a long career in traditional healthcare. Send them to the curriculum where they can learn everything there is to know about Direct Care – at your own pace. All the information is available online, or you can have lessons delivered weekly to your inbox.

Less Talk. More Action!

Alright, now that you know the curriculum exists it’s time to check it out. Delve into it yourself, or pass it on to a colleague you think would benefit from Direct Care. Go, go, go!

Visit the Atlas Direct Care Curriculum. >

Be Poised to Scale Gracefully.

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We want you to start your Direct Care practice the right way — without cutting corners or having to sacrifice quality because you think you can’t afford it. It’s why we do the things we do. You know, like offering all our consulting services absolutely free. Or traveling the country to help spread the word about DPC nationwide. Things like offering an EMR specifically built for Direct Care clinics that will do more than just meet intrinsic startup needs.

Let’s pause there for a second – that’s a really good point. When you’re starting off, you might only be thinking in terms of the near future. And that’s fine for the most part. But you’d do yourself well to expect expansion. And when you use the Atlas.md EMR, you’re making a smart short-term decision, but you’re also planning for long-term growth.

This EMR is unique because it fits a small clinic with just a few practitioners running the show. But as you grow (from two docs, to four docs with two nurses, to a second, third, tenth location, etc.) the Atlas.md EMR will scale accordingly. Let’s take a look at how that’s possible.

Calendars

Your calendar view can display just your appointments, the appointments for the entire practice, or any combination of the two. This flexibility gives you complete control over what happens within your practice walls.

Task Assignment

The ability to assign tasks to others makes it possible to communicate cross platform, cross patient, or even cross location. Task assignment coupled with notification reminders ensures you’re not letting anything slip through the cracks. Your team will actually operate as seamlessly as they appear.

Billing Reports

The billing reports you can pull for your practice break things down so simply for an accountant that it wouldn’t matter how many providers are contributing. The reports show the patient’s MRN or company name (for privacy), the amount of the payment made, processing status, the type of payment and the date. You can also filter to show a specific timeframe, and export to a CSV file anytime you need. We’ve thought ahead for you!

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Direct Care is a Slow Tsunami.

Overwhelming. Unstoppable. Enveloping.
Direct Care is taking the nation by storm, but unlike a tsunami, it’s not of the destructive variety. Rather than water, the country is being steadily blanketed with a refreshing alternative to traditional family medicine. As it slowly (but oh, so surely) spreads from town to town, city to city, more and more people realize how much they truly benefit from the patient-centric healthcare model.

Docs are getting excited, too. Every time they hear from a happy patient they wonder why it took them so long to transition in the first place. But even better, all the great feedback they’re hearing just validates they’ve done the right thing – not only for their patients but for themselves as well. Their quality of life skyrockets and their passion for medicine reignites. Once they’ve transitioned, it’s hard to look back at their old lives and remember how negatively they felt way back when.

Dr. Catherine Krouse has gone Direct Care precisely because of the difficulty of that old life. “You just end up getting drained and drained and drained. And then when your cup is completely empty, then you just get guarded and angry. And then you put up walls, and that really creates barriers.” Read her full story here and learn about the newest Direct Care practice in Falmouth, Maine called Lotus Family Practice.

 So as this #slowtsunami continues to commence with many more stories just like Catherine’s, the Direct Care community expands with confidence and the staying power to make patients and physicians happy for the long haul. 

Direct Primary Care Awareness Happens in December!

Have you heard? Direct Primary Care Awareness now has its own official month, and what better time of year than when we’re already buzzing with love for, well, everything? Bring it on, December!

So, what does that mean for your clinic? It means you get to continue doing what you’ve been doing all year – promoting DPC to everyone you meet on the street, in the grocery store checkout line, and at the car wash. Okay, the car wash might be a bit of a stretch, but you catch the drift. Because Direct Care Awareness now has a month associated with it, that makes it the perfect time to hold community events and staff activities. You still have some time to plan these events and we’ll remind you when it’s not quite so hot outside but it’s never too late to start brainstorming how you can make more of an impact on those around you. The DPC Journal has some ideas to kickstart your creativity.

Here’s something to remind your patients about… 

The holidays tend to be absolutely insane. For patients, getting in to see the doc during those busy months can be nearly impossible in a traditional healthcare environment. A trip to the ER could set them back precious shopping hours, not to mention thousands of dollars. Thank goodness there’s an alternative! With many DPC physicians offering 24/7 availability, house calls and the ability to handle most “ER” type visits right in their own clinic (at no extra cost!!!), your patients can check “the possibility of needing to see the doc” right off their list of things to stress about. Make the decision to switch to Direct Care easy for them by presenting sanity during a time when sanity can usually be found flying right out the window.

Academic DPC: Where Direct Primary Care and Academics Meet.

As physicians and healthcare providers around the country continue to see success with their Direct Primary Care endeavors, they’re spreading the word. Sometimes it’s through social media. Other times it’s through speaking engagements. And yet other times, as is the case with Dr. James Breen, it’s digging deeper into areas previously untapped by DPC. His new blog explores something called Academic DPC:

Academic DPC is the brainchild of Dr. James Breen, an academic family physician with a clinical background in both rural and urban Federally-Qualified Health Center (FQHC), multi-specialty and academic practices.  This site is an attempt to address the ‘blind spot’ that DPC currently holds in the world of academic medicine, offering a host of information, links and resources to help academic physicians and trainees grow in their knowledge of Direct Primary Care.

Thus, the mission of Academic DPC is twofold:

1. To foster awareness of Direct Primary Care in medical education and to support DPC curricular development among academic physicians and learners; and

2. To assemble a community of academic and community physicians and other educators, as well as residents and medical students, who share a common interest in Direct Primary Care.

So let’s cheer Dr. Breen on as he continues to enlighten people in academia about the immense benefits of Direct care!

The Truth in Numbers. It’s a DPC Thing.

The Truth in Numbers. It’s a DPC Thing.

We talk a lot about the services Direct Care practices offer. We also talk a lot about how DPC docs have the time and resources to put their patients first. And then there’s the ever present mantra of how DPC cuts out the middle man, taking healthcare back to two key embodiments: quality and simplicity.

That’s all well and good, but it’s time we talked more about the numbers. They don’t get nearly enough attention, and they’re starting to feel left out. And they definitely deserve it.

Dr. Josh of Atlas MD recently talked to the Vermont Watchdog about some of the savings his clinic is able to pass along to their patients:

“I just stitched up a kid, one of our patients, who fell at the ice rink and needed six stitches in the chin. That could be $2,000 in an emergency room or $500 at an urgent care center. But I can do it for free.”

Beyond that, though, there are savings around nearly every corner.

“MRIs cost about 80 percent less than what hospitals charge. Blood tests costs $3, not the hundreds of dollars charged in the hospital system. Migraine medicines that cost more than $100 per month at a pharmacy cost just $6 at Atlas MD.”

The savings extend to companies, too. Dr. Josh explains:

“We have an employer with 17 employees in a local company. In 2013, they paid $98,000 for their health insurance. By the end of 2014, they were paying $48,000 because of how we helped restructure their plan in combination with us.”

Of course Atlas MD isn’t the only clinic who can offer these types of savings – it’s a DPC thing. Dr. Ryan Neuhofel of Neucare gives an example of the savings his Direct Care practice can offer in the way of affordability.

“I also recently managed a forearm fracture in an uninsured patient for a total cost of $45 ($10 for a splint, $25 for an X-ray, and $10 for cast a few days later).”

The savings are everywhere – even in prescription medications. We talked about that a while back, remember? Many Direct Care clinics have an in-house pharmacy which not only makes things incredibly convenient for the patient, but brings wholesale prices to the forefront. That’s right – prescription medications at wholesale prices. Oh, and if the DPC clinic can’t offer you the prescription in-house, they’ll probably send you out the door with a @GoodRx coupon for additional savings at the pharmacy.

They say there is strength in numbers. With Direct Primary Care, we also find the truth.