Research Shows Top 10 States And Top 25 Cities To Practice Insurance-Free Medicine

Are you curious if your state or city made one of the lists? Keep in mind, we’re having a great time practicing direct care here in Wichita, KS, and get this–we didn’t make either one! On top of that, not all of these states are eligible to dispense prescriptions (New York, Montana, Texas, and Utah prohibit it). In our experience, the real value in running a direct practice comes from offering wholesale prescription discounts. Over time the savings add up, especially for patients with chronic conditions (diabetes, thyroid disease, asthma, migraines, etc.) where it becomes cheaper to subscribe to your clinic and stop using insurance to pay for prescriptions.

Given these facts, we’re not treating this as the ultimatum for who or where one should or shouldn’t open a direct care clinic. However, the research brings up some good reminders. According to Dr. Chris Ewin, Founder and physician at 121MD in Fort Worth, TX:

“Direct practices should be successful in most cities and states where there is an inadequate supply of primary care physicians.” He adds, “… Most important, a physician needs to have social skills to sell him/herself and their new practice model to their patients and their community.”

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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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Vermont Internists Are An Endangered Species

Vermont Internists Are An Endangered Species

A press release announced Dr. Alicia Cunningham’s new infographic. It visually explains the “quiet exodus” of internal medicine doctors from the State of Vermont. She’s convinced the doc shortage is a quiet pandemic, caused by two diverging forces — an aging population, and declining education. What’s happening is that older internists are going to retire at 65, or retire early, or just get out of the speciality altogether. On top of that, students are not majoring in internal medicine because it pays less than sub-specialties, and does not gain respect amongst peers. And, Vermont is the 4th oldest country in the nation, with a median age of 41. That means the demand for internists will grow somewhat exponentially.

CHECK OUT DR. ALICIA CUNNINGHAM’S INFOGRAPHIC HERE

However, Dr. Cunningham believes that a direct care/concierge medicine approach could help alleviate the doctor shortage. For one, a direct care practice introduces the element of autonomy, the absence of which has been propagating the brain drain in our country. On top of that, the possibility of higher salary is promising, too.

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Dr. Rob Lamberts Knows What Direct Care Docs Need In Their EMR

One primary care physician has spelled out EXACTLY what he’s looking for in an EMR. He made a comparison between what current EMRs offer versus what he actually needs in his practice. We’re excited to hear his frustrations, because it proves once more what we’ve been saying for months–Atlas MD is the FIRST EMR built specifically for direct primary care physicians. And there’s nothing on the market like it.

READ THE COMPLETE BLOG POST HERE

Atlas MD is an EMR made to tell your patients story, so that you can find what you need, when you need it. It’s focused on work-flow, not billing codes (although they are included for reference if need be). It functions on ANY device you’d use in the office, not a clunky machine you paid thousands of bucks for. Atlas MD is like the innovative apps you see across other industries; it lets the user curate the experience so that what’s useful is immediately accessible.

The benefits of Atlas MD go on and on. And we’re looking forward to hearing what direct primary care docs have to say. Which, speaking of, raises an important question — do YOU want a sneak peak into our new EMR software? Would you be interested in writing about it? If so, send us an email. We can make that happen.

You’re Going To Love Direct Care Even More

We’ve heralded the Atlas MD-style of direct care for years now. Mostly for its simplicity — you get rid of the most aggravating part of practicing medicine, the insurance billing; you start spending more time with patients, who actually pay you; you make more money, doing the enjoyable part of your job. Then add on the benefits to your local community, such as decreased ER visits. This means emergency staff can focus on legitimate trauma, and not be burdened by cases that yes, might be painful, but can be quickly remedied by your on-call physician. Oh, and by providing 24/7 access to a doctor for a yearly fee of around $600 patients actually make appointments (by the way, $600 equals less than two months of a typical full coverage, PPO health insurance plan, an expensive plan you won’t need since your doctor visits are now free, along with copious other procedures). And, to top it off, things like MRIs and other costly procedures have been negotiated at reduced costs. Don’t forget downstream benefits of proactive care for insurance companies who won’t dole out payments to treat preventable conditions like high blood pressure and type II Diabetes.

Oh, right, but we had something to add to the snowballing benefits of direct care. Practicing physicians can also cut their malpractice insurance premium in half *. Yep, that’s right. Even the insurance agencies know that when patients come in to see a direct care physician, their doctor has time to make proper diagnoses, and provides more reliable care. Therefore, the chances of something being overlooked or mistreated are reduced.

* According to Brian Forrest, MD

Dr. Josh Breaks Down Every Facet Of Direct Care In His Latest Interview

The Objective Standard spoke with Dr. Josh and captured a comprehensive, and digestible, overview of direct care. The conversation was conducted and transcribed by journalist Ari Armstrong and is currently available as a PDF file for private use and distribution. We’re excited to share it personally through this week’s Atlas MD newsletter (will be included as an attachment). If you haven’t signed up for our weekly direct care updates, you can do so here (make sure to check the newsletter box). Or, if you like, email hello[at]atlas.md to request your copy of the interview.

The Objective Standard is a quarterly periodical written from an Objectivist perspective (Objectivism being Ayn Rand’s philosophy of reason, egoism, and laissez-faire capitalism). Josh’s interview is slated for Fall publication.

LISTEN: Atlas MD Podcast, Ep. 4

LISTEN: Atlas MD Podcast, Ep. 4

The next installment of the Atlas MD podcast is now available on iTunes. You can stream it here. Drs. Josh and Doug drove out to Kansas City last week where they spoke both at a private clinic, as well as on the campus of a local medical school. Some of the students had visited Atlas MD recently, so it was a chance for them to follow-up with new questions. Doug and Josh were impressed how these MBA and D.O. students were already so attuned to the business aspects of medicine.

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A Direct Care Venture Capitalist Finds An Obamacare Silver Lining

A Direct Care Venture Capitalist Finds An Obamacare Silver Lining

We mentioned New Atlantic Ventures (NAV) earlier in the month. They’re an investment firm backing, amongst many endeavors, direct care entrepreneurs who are helping hospitals insure their own employees. Evidently we’re not the only ones who think Obamacare will increase demand for cash-only medicine. The Managing Partner of NAV, John Backus believes there is a silver lining to forcing states to open a health insurance market and offer price transparency, increased costs due to all the red tape. And with this increased cost will come demand for more affordable options. It turns out that direct care sans middleman is exactly that kind of option.

You can read John Backus’ complete op/ed on Huffington Post.

Even Satisfied Patients Think Direct Care Is “Too Good To Be True”

Even Satisfied Patients Think Direct Care Is “Too Good To Be True”

Dave Chase continues his Forbes expose awakening business and industry types to the benefits of direct primary care (DPC). Now having interviewed more and more DPC consumers, the recurring theme to their comments is something like “it’s too good to be true.” That’s a concern we had. You have this straight-forward, commonsense approach that saves everyone time, cuts insurance expenditures, cuts downstream high-cost treatments and can make doctors more money… The people who experience it love it. But how do we convince other people that it’s really happening, when happy patients can’t even believe it?

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