By Michael Tetreault, Editor-In-Chief, The DPC Journal
JUNE 18, 2014 – Our mission is to communicate news and relevant educational information about the growing industry’s of direct-pay, primary care (DPC) to an audience en-mass who does not yet understand the importance of this innovative healthcare delivery model — a public relations and informative news outlet. DPC, now distinguished by its engagement with patients through affordable, transparent means and its disconnection or very loose connection with insurance, is becoming increasingly more popular among consumers (i.e. prospective patients), employers, primary care physicians and the media alike.
The DPC Journal serves as a public relations advocate and educational resource for the media, consumers (i.e. patients/prospective patients), curious physicians and industry practitioners. As we continue our public relations, news and keep developing more educational resources for these markets, we are at this time, pleased to have such great friends and colleagues in these evolving healthcare industry’s that work with us each day to help us educate, influence and guide outsiders about what these two very different healthcare delivery models are all about. At this time, we’d like to say ‘thank you’ to many of these industry-influencers and innovative physicians by highlighting some of their most popular quotes that have educate, persuade and guide others to a more satisfying career in medicine and helped thousands of our readers better understand how-to achieve better patient-physician outcomes in a difficult and at times, political economy.
50 Inspirational Quotes From Doctors and Industry Influencers:
“I didn’t become a doctor to bankrupt my patients …” ~Dr. Jordan Grumet
“Direct Primary Care (DPC) is quickly becoming an important contributor to the transformation of our nation’s healthcare system.” ~ Dr. Erika Bliss, a Family Physician at Qliance Medical Group of WA and President/CEO of Qliance Medical Management Inc.
“Business is tough,” says Dr. Chris Ewin of 121MD in Fort Worth, TX. “If you are doing something just for the money, you are never going to enjoy it. You will be the hardest boss you have ever had. So, find something you love and pursue it. Follow this advice and you will set yourself up for an enjoyable future in medicine.”
“The challenges of medical center concierge-style programs are very different than those experienced by concierge physicians in private practice. All hospitals/medical centers have special perks and usually enhanced access to specialists for their donors and patrons, often a special number they can call. Most have an informal “private banking” approach where there is no established fee, just an expected level of donation. Despite the proliferation of individual concierge practices and now organized networks, concierge medicine programs INSIDE medical centers are quite unusual – there may be only 20-25 in the entire country.” ~ John Kirkpatrick, MD Seattle, WA
“The people who can pull this off are often people who already have long-term existing practices,” says Internist Garrison Bliss, MD, a movement pioneer, sits on the board of the Direct Primary Care Coalition and is Founder and Chief Medical Officer of Seattle-based Qliance Medical Management, the nation’s first direct primary care practice. “You need to have 10-15 years in practice, so you have an established base of patients who trust and like you. It also matters if you have people with chronic illnesses, or who are older, who just don’t want to go through the heartbreak and complexity of finding another doctor,” he continues. “And it depends on whether you really do provide extraordinary service already. The practices that do great work, have large patient populations, have been around for a long time, and have great reputations can often make this transition without difficulty.”
“I made the switch many years ago into concierge medicine, or at least a form of it, and I couldn’t be happier. I can provide better care and build a strong relationship with my patients. It definitely can be challenging since I make myself available 24/7, however if you can develop a good support structure of other like-minded MDs you can maintain a successful business with less stress than a traditional practice.” ~Las Vegas Urgent Care Doctor, Facebook.com/24HourVegasDoctor
“Instead of viewing the status quo PCP model as the center of the universe. Maybe we should take some plays from the Retail Clinic playbook before we become obsolete.” ~Direct-Pay Physician, Dr. Robert Nelson of Cumming, GA.
“It’s common for physicians, particularly those with long-standing patients, to significantly underestimate ‘ramp-up time’ – how long it takes to get new people enrolled,” said Helen Hadley, Founder and CEO of VantagePoint Healthcare Advisors in Hamden, CT.
“Insurance is the business of risk management via coverage for rare, expensive events. Nearly every industry in this country uses insurance in this manner — except health care. In health care, in addition to covering for rare events like surgeries and accidents, insurance is also used to cover common medical events as routinely encountered in primary care. Whenever insurance is used to cover common events, premiums go up due to claims being filed more frequently. Unfortunately, routine primary care is expensive in the current state, and society is forced to seek health insurance for this as well. This drives up health care costs across the board. Direct Primary Care is able to make primary care relatively affordable, and thus eliminate the need for costly insurance. Health insurance is reserved for rare, expensive events, like in all other industries. By removing the need for insurance from primary care, which is a significant portion of health care, costs are driven down.” ~Samir Qamar, MD, MedLion, Founder
“We recognized back in 2000 that health care was moving from personal to a more institutionalized form, and it wasn’t what we wanted to do,” said Dr. John Blanchard of Premier Private Physicians, a concierge medicine practice with offices in Troy and Clarkston. “We felt we needed to have time with our patients, to have the excellence to have the time with patients. Health care has been cutting reimbursement to doctors, which has forced doctors to see more patients, so the time doctors have with their patients have declined. The average time today with patients for most doctors is only 10 minutes.”
“Don’t apologize to your patients for the business changes you’re making. This new process will help them. Inform them that this is a positive change and will help you maintain more secure patient-physician communication on a timely basis and offers them a much more affordable payment system with routine and convenient access to their doctor.” ~Mike Permenter, Executive Vice President and Chief Development Officer at MedFirst Partners LLC
“When doctors talk about concierge medicine being “the oldest, new form of medicine,” they’re not speaking figuratively—they are trying to reframe the identity of their practice and an over-worked industry.” ~Catherine Sykes, Author, Publisher, Speaker
“Concierge medicine is, at its most basic, a return to the age when doctors made house calls and were paid directly by the patients they treated.”~Paul Sisson, UT San Diego
“The concierge model is a great option for physicians seeking more control over their time, their professional lives, and their ability to care for patients. But it is by no means a financial cure-all. My life is so much better now. It’s a big improvement. I’m enjoying the benefit of more time for my family and my kids, more time to do administrative stuff during the workday rather than after-hours. But it’s not like my financial woes suddenly disappeared, especially during the first year.” ~Marcela Dominquez, MD, family physician in Mission Vejo, CA
“This primary care business model [direct primary care] gives these type of providers the time to deliver more personalized care to their patients and pursue a comprehensive medical home approach,” said Norm Wu, CEO of Qliance Medical Management based in Seattle, Washington. “One in which the provider’s incentives are fully aligned with the patient’s incentives.”
“I received a phone call the other day from a physician in Winter Park Florida,” says Tiffany Sizemore-Ruiz, D.O. of Choice Physicians of South Florida. “She was calling just to thank me for answering her questions about [this industry] a few months ago, and encouraging her to start her own practice. Today, her practice is thriving and she said that ‘she is happy with her schedule, her life, and being able to practice medicine that way it is meant to be practiced.’ I was so happy to hear that I helped a fellow physician and colleague, and even more happy to hear that she was doing so well!”
“This primary care business model [DPC] gives these types of providers the time to deliver more personalized care to their patients and pursue a comprehensive medical home approach,” said a spokesperson at Qliance Medical Management based in Seattle, Washington. “… In which the provider’s incentives are fully aligned with the patient’s incentives.”
“Direct Primary Care (DPC) is not insurance, does not strive to replace health insurance, nor is it adversarial to it. On the contrary, many DPC practices are eager to work with insurance carriers to co-create blended plans which integrate DPC with high-deductible insurance and ultimately correct the perverse incentives which are rife in the traditional fee-for-service system.” ~Dr. David Z. Tusek, Nextera Healthcare, Colorado
“The anti-aging and medical home delivery model fits well inside a concierge medicine [and direct care] practice. The nutritional component, the wellness solutions, the anti-aging and team-focused health care delivery professionals led by a concierge [or direct care] doctor are providing comprehensive and continuous health care services to patients year after year that they simply can’t find elsewhere. This combination is increasing patient retention and patient interest in the concept. The goal here is healthy outcomes for patients followed by increased patient retention outcomes for the physician year after year.” ~Michael Tetreault, Editor, CMT, The DPC Journal
“Direct practices should be successful in most cities and states where there is an inadequate supply of primary care physicians,” says Dr. Chris Ewin, Founder and physician at 121MD in Fort Worth, TX. “This may be true in the country with the correct practice model. Most important, a physician needs to have social skills to sell him/herself and there new practice model to their patients and their community.”
“I had to do this to be able to do my job,” says Dr. Marcy Zwelling, who has been an concierge internist since 1987. “I get to practice the way I think I can practice best. It’s capitalism at its best.”
“Until just a few years ago, people mostly based choosing a doctor on the personal recommendation of a trusted friend or relative,” says Michael Tetreault, Editor-In-Chief of Concierge Medicine Today and its healthcare trade journal companion, The Direct Primary Care Journal. “Now with the advent of social media, word of mouth marketing is changing from a spoken word referral to a social media link referral. When you think of Andy Griffith-style medicine, the doctor had a clinic in the local town. It’d be strange for him to say, ‘What kind of insurance does Opie have?’ The people you entrust to help your practice grow must be aware of how to effectively promote this new, old-fashioned message and delivery model of healthcare.”
“It’s about believability. Would it work for me? Could it work for me?” says Richard Doughty, CEO of Cypress Concierge Medicine, a Louisiana-based company helping doctors move into this industry. “Where physicians have taken an early leap of faith, if you build it they will come, overwhelmingly they have been satisfied. As a result, physicians now have many examples of colleagues experiencing the benefits of concierge medicine for themselves and their patients. In those areas, we see momentum continuing to build.”
“Young doctors are refusing to go into primary care medicine,” notes Dr. Steven Knope of Tucson, Arizona in his writings about The Myths of Concierge Medicine. “This is due to the fact that practicing primary care medicine in our current broken system, seeing 30 patients per day, making only one-third to one-fourth of what a specialist makes, have created an understandable shortage of doctors willing to practice primary care medicine. Over the long run, the only way to increase the number of qualified primary care doctors is to make the profession more attractive, both from a professional and financial perspective. It is our current broken system that has caused a shortage of primary care doctors; and if we stay on the old path, it will only get worse.”
“Doctors carrying a medical bag and coming into a patient’s home was standard into the late 1960s. Look at The Andy Griffith Show. That’s what our grandparents did. Medicine became government regulated and that started to end. It came in for a reason — there did need to be some amount of administration. But now regulation and administrative tasks have frustrated doctors. Be intentional with your excellence, don’t be normal.”~Michael Tetreault, Editor, Author, Speaker, Concierge Medicine Today
“Slow and steady growth is ideal in this type of practice because it allows you to offer patients a personalized experience,” says Joel Bessmer, MD, FACP of Omaha, Nebraska’s Members.MD. “I’ve found that the word-of-mouth aspect (vs. a billboard advertising approach) has been the most consistent factor in building my practice. I consistently have patients recommending their family members and friends. Getting word of mouth referrals based on high quality care, staff service and patient satisfaction has been a much more effective tool than traditional marketing. And the slow and steady approach ensures that staff can keep up with new patients, as opposed to getting a rush of new caseloads that would be more difficult to manage all at once.”
“In today’s healthcare culture, the 55-plus audience hasn’t been entirely abandoned, but the advertising aimed at this population segment is simply aimed at maintaining brand loyalty and establishing that the products they love are still good, still function and most likely being improved. Conversely, you can watch any prime-time television show that’s targeting the 25-54 demographic, and you will learn what those people think is cool, hip, and where our culture is trending. You will not see advertising aimed at the 55-plus demographic population that’s designed to get them to switch brands. The advertising aimed at 25-54 is all about that. And, by the way, most doctors, consultants and advertising agencies know that. This is just one of the many helpful topics you’ll learn about at this conference.” ~Michael Tetreault, Editor-In-Chief, Concierge Medicine Today and its healthcare trade journal companion, The Direct Primary Care Journal
“The road was much more difficult than I expected, but also much more satisfying. I spent much of my time learning what doesn’t work, but in the end learned that most good ideas grow out of the remains of a hundred bad ones that didn’t survive.” ~Rob Lamberts, MD, Augusta, GA
“I remember when I started my direct-access, home-based primary care practice (www.MetroMedicalDirect.com) in 2009,” says Raymond Zakhari, NP and CEO of Metro Medical Direct. “Patients were skeptical and reluctant because of how accessible and convenient the service was. They expected to be kept waiting on hold. Some seemed puzzled by the fact that when they called I answered the phone and knew who they were. One patient even inquired as to how come they only had one form to fill out. Direct-access primary care patients who have been referred post hospital discharge, have not been readmitted to the hospital in the last 4 years because I can see them without delay or red tape. In NYC, despite the high number of physicians per patient, particularly on the upper east side of Manhattan, direct-access primary care can still be a viable practice solution for patients and providers. It helps patients cut through the red tape that has become expected in accessing health care.”
“What I found interesting was that when I left my old practice — I had a 10% Medicare population. That fraction has grown to almost half, suggesting to me that some of the folks most interested in this model are older patients.” ~Dr. Alexa Faraday
“The biggest mistake in my opinion is charging too low,” says Mike Permenter, Executive Vice President and Chief Development Officer at MedFirst Partners LLC. “Conversions [into this private-pay marketplace] will eventually be unnecessary as the public becomes more aware of the benefits of these types of memberships. The big challenge is continuing growth after the initial conversion. Customer service, as described by some physicians, is the number one way to grow [this type of] practice. Linking the service to local self-insured employers is a good way to grow but certainly requires expertise with regards to structuring the appropriate benefit, usually a high-deductible plan with an HSA plus a membership.”
“There was a time when patients valued their family doctor, trusted our opinion and called us after hours to help decide if symptoms needed urgent attention or could wait,” says Dr. Ellie Campbell of Campbell Family Medicine in Cumming, GA in an interview with Concierge Medicine Today. “Our phone trees, answering services, and after hours call-sharing doctors make it unlikely that any given patient will actually speak to their own doctor. So they don’t bother, and they seek care wherever it is most convenient.”
“To those who say concierge doctors are hurting the system by diminishing the number of patients we can care for, my reply is: if you keep doing the same thing year after year, you are going to get the same results!” said Dr. Joel Bessmer of Members.MD based in Omaha, NE. “If we don’t focus on salvaging the doctor-patient relationship and allowing the appropriate time for each patient’s care and follow-up, patients will begin to feel their primary care is a waste of time.”
“We believe that Direct Primary Care (DPC) Models reaffirm the central role of the physician-patient relationship which lies at the heart of an effective health care delivery system,” said Laurence Bauer, MSW, Med, CEO of FMEC. “Direct Primary Care incentivizes the physician to respond effectively to the needs of his/her patients.”
“We try to make it fit into your lifestyle instead of disrupt it,” said Iowa physician, Dr. Ingram. “You call the office, you call my cellphone, you text me, email me and we set something up.”
“The conversion process is not an easy one,” said Jeffrey S. Gorodetsky, M.D. of Stuart, FL. “My staff and I are cognizant of the fact that we must consistently communicate the benefits of this choice in care, with the challenge to increase my [memberships] numbers and convert other patients.”
“Patients value speed and low cost most of all for most minor complaints,” notes Dr. Ellie Campbell of Cumming, GA. “Even my patients who pay a membership fee for all of their covered and non-covered services including 24-hour access to my personal email and cell phone number, and whose care for these complaints would be covered without additional cost, still use these [retail medicine style] health providers [i.e. CVS, MinuteClinic, TakeCare Clinic, etc.]. Many patients say, ‘I just did not want to bother you on the weekend, and I was near there anyhow.’ As long as we live in a world of drive-though windows, ATMs, and garage door openers, patients are going to value and pay for any service that gets them in and out quickly, on their time schedule, with their desired objective. We [Concierge Medicine and Direct-Pay Doctors] need to learn to adapt, as this delivery model of care seems here to stay. Unless we offer on site dispensaries, extended hours, and no appointment needed delivery, we will be deferring more urgent issues to these models. Perhaps then we will have more time to devote to preventing disease and reversing the burden of chronic conditions, if only we can convince third party payors that there is value in that.”
“We also had to acknowledge that, while our services were extensive [at our physical practice], certain activities couldn’t be performed at North Vista Medical Center,” said Drs. Clint Flanagan and David Tusek of Firestone, CO. “We’ve always believed in being a patient’s ‘healthcare quarterback,’ so we negotiated highly competitive rates for lab and imaging services within our market. We determined the services most crucial to our patients, educated ourselves about available resources in our community, and created a list of options with full cost transparency.”
“Typically, there’s a period after start-up when income goes way down as patients decide whether to stay,” said Allison McCarthy, a senior consultant in the northeast office of Corporate Health Group, a national consulting firm. “It often takes a good two years to bring the patient level up to where it should be.” At that point, physicians do better financially. In the interim, they are likely to struggle, particularly with those large start-up costs, which range from $50,000 to over $300,000.
“My focus is on being a trusted advisor and I don’t want to have any potential conflict of interests,” said Shira Miller, MD of Sherman Oaks, CA. “For example, a lot of doctors make money on supplements, for me I take that out of the equation. In terms of my practice, I just want to focus on providing the best advice I can give my patients, not worrying about making money off retail.”
“Direct Primary Care (DPC) allows doctors to provide better care, more often, at a fraction of the cost to patients, while increasing their income and offering greater satisfaction … why would anyone stay in a broken insurance-based model?” ~Doug Nunamaker, M.D.
“You will never regret being a doctor IF you work only for patients. But if you don’t work only for patients, you will regret your decision in the end.” ~Dr. Thomas LaGrelius, California
“My real joy is spending time with patients and trying to help them improve their health. In many practices, the high volume of patients that must be seen reduces the time clinicians can spend with each patient. Our model increases the time available for each patient encounter. I spend about 30 minutes with a patient during our average visit. This is the main reason that most patients give for returning to our practice. People are willing to spend money on something they value, and they value time with the doctor.” ~ Dr. Brian Forrest, Apex, NC
“The ‘concierge’ term gets people to imply high value, which is good. We want them to feel like they’re coming to a high-quality place,” says Dr. Josh Umbehr of Atlas MD in Wichita, KS. “But it also gets them to assume high cost. That’s OK, though, because I can show you my costs are affordable.”
“This new practice has been truly liberating. I am working harder than ever getting it of the ground but my time with patients is wonderful. And I get to be creative again in how I develop the practice, something that was lost from my previous office.” ~Dr. Alicia Cunningham, Vermont
“Concierge medicine must be treated seriously by physicians and patients alike because it is a concept that is here to stay. Paying a set annual fee for “special services” may appear to some to focus on money and greed but to others it may be redirecting the focus of medicine back to preventing disease and seeking wellness. If concierge physicians are successful in preventing illness and keeping patients healthier then it is in the best interest of patients, physicians and society as a whole.” ~Peter A. Clark SJ, PhD Professor of Medical Ethics and Director, Institute of Catholic Bioethics, Saint Joseph’s University
“In selecting only a small population of clients and providing dedicated counseling sessions, sometimes as often as weekly, allows clients to actively participate in their care plan and to move goals forward at a real-time pace. This enables all of us to realize that healthcare can be a positive experience.” ~Dr. Carrie Bordinko of Consolaré Primary Care in Paradise Valley, AZ
“The distinctions between concierge medicine, private medicine, and direct primary care may be ultimately meaningless, since some doctors call themselves whatever they feel sounds better, and there are so many practice variations, many overlapping, that it often isn’t clear which is which.” ~Neil Chesanow, Medscape/WebMD, May 2014
“It’s a different type of busy … My day is just as long now, if not longer. But, I’m spending a lot more time with all of my patients. In between visits, I’m on the phone checking on people at home.” ~MDVIP-Affiliated Physician in FL
“If you possess excellent communication skills, around the clock dedication and the desire to promote optimal health in pursuit of excellent medicine, then concierge medicine is for you. It’s the best career choice I’ve ever made.” ~Brian Thornburg, MSM, DO, PA, FAAP Innovative Pediatrics