Posted by: AtlasMD

February 15, 2016

Hitting Measurements and Failing Patients

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We recently posted about The Virtual Quality Myth, so we were really excited to see this New York Times article about how measurements are failing our doctors and teachers.

When Measurements Don’t Cut It

Most of the doctors that we talk to on a daily basis understand this basic principle: measurements that are based on outdated standards can’t possibly lead to positive patient results. The NYT brings up a good point: With all the rules and paperwork and documentation, doctors still speak to their patients — they still consult and provide treatment, but now they have to be really accurate with how and when they mark this information down. It becomes nearly impossible to have a long conversation with a patient when you’re worried about tracking every issue, instance, and idea. Once the systems entered the game, the personal interaction and connection moved out of sight.

We saw this as a problem many years ago, though it seems like the idea is spreading a little quicker now that we’re seeing the failure of the “measurement method,” as we’re calling it.

“…the objections became harder to dismiss as evidence mounted that even superb and motivated professionals had come to believe that the boatloads of measures, and the incentives to “look good,” had led them to turn away from the essence of their work. In medicine, doctors no longer made eye contact with patients as they clicked away.” (New York Times)

We’re obviously behind Robert M. Wachter, the author of the New York Times article, and we were excited to read this quote in particular, since it’s exactly what we try to do with our DPC:

“Last week, Andy Slavitt, Medicare’s acting administrator, announced the end of a program that tied Medicare payments to a long list of measures related to the use of electronic health records. ‘We have to get the hearts and minds of physicians back,’ said Mr. Slavitt. ‘I think we’ve lost them.”

The best part about this is that DPC doctors are already doing exactly what this NYT article is hoping for:

“In health care, [minimization of measurement burdens] will come through advances in natural language processing, which may ultimately allow us to assess the quality of care by having computers “read” the doctor’s note, obviating the need for all the box-checking. In both fields, simulation, video review and peer coaching hold promise.”

Sometimes it’s good to know that we’re doing the right thing. And we think other DPC doctors will be excited to hear that their choices are not only positive, but they’re measuring up! Check out some more ideas and see how our EMR can help you get your practice moving.

Posted by: AtlasMD

January 18, 2016

The Virtual Quality Myth. How DPC Changes the Game.

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Quality seems good, right? Quality seems the like thing that we’re all after, right? Well, sort of! When it comes to EMRs, we’re on the right track. While the rest of the EMRs are tripping over themselves to comply with government regulations over quality, we’re able to pursue actual quality medicine above all.

It turns out that what has been a speculation for years (that government regulations distort quality by making overtesting and distortion of informed consent and overmedication – to name a few – a regular part of a doctor’s work day), has been proven to be a pervasive and perverse issue in the medical world, according to PLOS Medicine.

Virtual Quality Doesn’t Promote Health

This phenomenon is so common that it has a name — “virtual quality,” and it relates to the fact that applying rigid standards, regulations and “guidelines” might make sense statistically but they don’t actually apply to patients, and these rigid guidelines can actually produce harmful effects on patients. It seems counterproductive because it is. The whole point of guidelines should be to ensure a positive standard of practice, but the reality is that guidelines and PQRS’s actually reduce patient quality. According to Peter C. Cook, M.D.,

The notion that PQRS promotes quality care rests on the flawed assumption that a bloated federal bureaucracy, CMS, can be nimble enough to produce quality measures that keep up with the rapidly evolving state of scientific evidence. Reality contradicts that assumption. Published reviews in JAMA have determined that ‘most guidelines become outdated after 5 years.’ (Medical Economics)

Return to True Quality Care

And if that wasn’t enough to make you change your mind, consider the study published in PLOS Medicine, Quality Care that Matters, which states that the “current quality measures should be abandoned.” Obviously “quality measures should reflect meaningful health outcomes. Surrogate measures do not satisfy this principle. Clinical trial results are often not attained in the real world, and there should be evidence that quality measures do, in fact, substantially improve health outcomes across various locales and practice settings.”

DPCs Make a Real Difference

While this is bad news for standard medicine, it’s good news to all of the doctors and patients who subscribe to DPC. We believe in actual quality, not virtual quality, and that’s more meaningful to us than “Meaningful Use” could ever be!

When you’re ready to take the next step in starting your DPC practice, take a look at our curriculum to see how you can get started.

Posted by: AtlasMD

December 25, 2015

Proud to Work on Christmas.

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It’s Christmas Day, and pretty much everyone you know is spending time with family and friends. They’re opening presents, attending a church service, sledding, and lounging by the fire after another giant meal. But you experience holidays a little differently. You’re hanging with your family and partaking in all the usual holiday traditions, sure. But you’ve had one eye on your phone all day, and not because you’re a social media addict.

You see, as Jack was opening presents he sliced his finger open with the scissors. Rather than spending the rest of the day sitting in the ER and stressing over the money that would have cost, he called you. You met him at your office and stitched him up – in just a few minutes, and for just a few bucks. He left with a big smile on his face; an hour later he sent you a picture of his young son sailing down the hill on his new sled for the very first time. His text said he’d have missed that moment if it weren’t for your quick action and availability.

Across town, Jill was shuffling her family into the car on the way to brunch when she slipped on the ice. Her ankle swelled up in a hurry, but not before she punched in your phone number. After walking her though a verbal questionnaire about her symptoms and the severity of the fall, you were able to determine it was just a sprain and that some Ibuprofen would do the trick. Jill let her husband take over the shuffling, and while kicking her feet up after brunch as you instructed, she and her daughter had a fantastic conversation that might not have happened if Jill had been ultra-mobile as usual.

In the Swinkle home, Grandpa Bob snuck into the pantry and devoured the rest of the jalapeño sausage… which gave him instant heartburn. When he confessed to his thievery, his daughter called you immediately to make sure the heartburn relief pill she planned on giving him wouldn’t interfere with his other medications. You reviewed his chart, did some cross referencing, and advised her to stay away from that particular heartburn relief pill. Instead, you recommended one that wouldn’t interfere with his existing med list – saving him a trip to the hospital later, and possibly even his life.

So yes, you are a teeny bit distracted today. But you’re grateful for the chance to care for your patients. Thankful for their trust. You might get a few calls on Christmas that pull you away from the holiday task at hand, but you wouldn’t have it any other way. They’re family, too. Your patients needed you, and because you truly understand the value of Direct Care, you were there for them today. Today and every day.

Merry Christmas to all you Direct Primary Care warriors. May you be ever reminded of the value you offer your patients, the medical community, and society as a whole.

Posted by: AtlasMD

November 6, 2015

Meet Dr. Phil Baker, the Direct Care Pharmacist.

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Are you a Direct Care doc in a state where in-house pharmacies are prohibited? (Looking at you Massachusetts, Montana, New Jersey, New York and Texas…) Or maybe you’ve just elected not to embrace the in-house pharmacy aspect of DPC? Either way, this article is for you. Introducing Dr. Philip Baker of Good Shepherd Health. He’s the answer to your prayers, the alternative to dealing with local pharmacies when you want to dispense, and quite literally a seamless extension of your Direct Care practice.

Okay, so here’s how it works. His pharmacy has adopted the DPC business plan; Dr. Baker’s model offers a membership. For a low monthly fee, members are privy to wholesale prescription prices — no mark-up and no extra fees (ahem, red tape) to get wrapped up in. It’s literally a Direct Care Pharmacy! He’s got the benefit of everyone in mind as he makes pharmacy services available to those who might not otherwise be able to afford them. Some of what he offers includes:

  • Prescriptions, vitamins and supplements at wholesale prices.
  • Around the clock access to your pharmacist. Seriously, call or text anytime.
  • Prescription assistance programs to those who quality. (They’ll even do all the paperwork!)
  • They dispense 280 different medications for free to qualifying members.
  • The opportunity to work 24/7 directly with Dr. Baker on pharmacy consults. (That’s how much he cares about your patients’ care!)

Read more

Posted by: AtlasMD

November 6, 2015

Introducing Direct Career Placement on IAmDirectCare.com.

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You’re only as strong as the team surrounding you, right? Well in that case, let’s give you an advantage over all the rest! Introducing Direct Career Placement, where IAmDirectCare.com helps connect you with the DPC family that’s right for you. Because let’s face it – a brighter future is right around the corner with Direct Care. Who does Direct Career Placement apply to? So glad you asked.

Is your practice looking to add a team member?

That’s great, congratulations! You’re probably talking around, getting a feel for who’s interested. After all, choosing the right addition to your team is a decision not to be taken lightly. So why not choose from a pool of candidates who are already actively interested in Direct Care? They know what it’s about and want to join your team. They’re individuals who are qualified and can’t wait to start their career with you providing excellent patient care using the Direct Care model. Take advantage of existing DPC connections by submitting your practice information on IAmDirectCare.com – interested individuals will be able to contact you directly. You can reach out to listed individuals, too! (Bonus: when you submit your listing you’ll even receive a unique URL you can share via social media to get the word out even further.)

Are you an individual looking for a DPC family of your own?

Also fantastic! If you’re transitioning out of the traditional healthcare setting, or even transitioning out of residency, you might already know for sure Direct Care is perfect for you. Read more

Posted by: AtlasMD

September 24, 2015

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.

Posted by: AtlasMD

September 22, 2015

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!

Posted by: AtlasMD

September 16, 2015

Are You Registered Yet? DPC Workshop in Irving, TX on October 24th.

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This workshop isn’t until the end of October, but you can save on the registration fee if you sign up by September 30th! You know we’re all about saving money and bettering ourselves, so naturally we’re passing this information along to you. And anyway, you should really think twice before passing up a chance to network with other DPC professionals, learn from those who have gone before you, and get relevant information on starting a DPC clinic from scratch versus transitioning from a traditional family practice. If you ever think you’re done learning, that’s when you’re in real trouble!

Get the details and sign up over here >

Can’t make this workshop? Don’t worry — there’s another one in Detroit in April 2016. 

Posted by: AtlasMD

August 6, 2015

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. >

Posted by: AtlasMD

July 17, 2015

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!

Read more