Archive for October 2015

Direct Primary Care presentations and discussion forum

Every couple of weeks I host another presentation and discussion on Direct Primary Care.  It’s an opportunity to hear about the program details as well as the reasons Trinity developed this new paradigm of primary care.  At the end I try to answer some of the common questions about Direct Primary Care and then field questions from the audience.  Our previous meetings have yielded good conversation and discussion on the value of putting the patient back in control of their own health care decision making.

The next two meetings will be:

  • Thursday, November 5th at 6pm
  • Saturday, November 7th at 1pm

Both meetings will be held in Trinity’s main lobby at our Fort Sanders West office located at 280 Fort Sanders West Blvd Suite 101.





DPC Member Benefits: increased access

A couple weeks ago, one of my patients was up in the middle of night taking care of their child and had a question.  It wasn’t urgent by any means but definitely was weighing on their mind.  As a Direct Primary Care member she sent me an email and I was able to respond to it by 8am the next day.  We didn’t need to schedule an appointment or even have to play phone tag trying to have a conversation.  It was great to have the time and flexibility to answer her question in the manner that seemed best for that situation.

Direct Primary Care programs allow for patients and physicians to have better lines of communication to allow for ongoing conversations.  Life and health concerns don’t ever seem to happen in straightforward predictable ways.  Having a means to follow up and adapt to the ongoing changes of life can be the best way to help patients manage their concerns.

Patients at Trinity Medical Associates of Hardin Valley office benefit from email communication with me for non-emergency issues.  Also since the practice will have a smaller patient panel we’ll also be able to have more direct phone access during the business day.  I want to be able to directly connect with my patients as often as possible.  I’d love to be the one to answer the phone on the first ring.  After hours, patients will still utilize the on call phone number for advice on urgent matters.  Finally, we will continue Trinity’s tradition of being able to provide same day and next day appointment availability.  All three lines of access should provide less worry and more assurance for members of the Direct Primary Care program.



Some things are lose-lose

Good article on the trying times forcing experienced physicians out of practice too early.  Worth the read. 

When a Physician Leaves, We All Lose

Here’s a companion article from across the pond where UK physicians lost the freedom to work directly for their patients long ago.  Now they’re having some career ending struggles meeting the demands of the NHS. 

I’m sorry, I can’t face being a doctor any more

Let’s make a stand now to keep patients at the center of the healthcare discussion. 



DPC member benefits: office visits that make sense

In the next series of posts I’m going to be highlighting and explaining the various benefits that are available to members of the Direct Primary Care program.

The first benefit for members, which for many people is the most drastic difference from traditional fee-for-service (FFS) offices, is the nearly unlimited number of visits available.  As long as the visits are medically necessary members are encouraged to come in as often as is needed.

The idea behind this benefit is to free up patients to receive care as often or as frequent as is necessary to their situation.  Why should we penalize sick people who are struggling through a concern by forcing them to deal with complex medical issues in fifteen minute allotments?  When I first meet a patient that has diabetes that isn’t under control it usually results in a very long conversation.  It often needs to be divided up into segments that they can process over time.  If they feel pressured get it all done in one visit because coming back is so burdensome, they miss out on really important bits of information.  Their success is slowed.

I’ve been told by people in the industry that I’m going to get flooded by “high utilizers”.  Other Direct Primary Care physicians tell me that there certainly will be some people who come in frequently just because they can, however most people have better things to do with their lives than show up at a doctor’s office every day.  The majority of people who will use the service regularly will likely be those who are holding back now.  They have questions and concerns but hesitate to spend the money to come in to ask about them.  All of us have a need for experts from time to time.  Even today I had an unexpected question about my house.  I sent an email to my go to guy (shout out to Mike Ballinger of Rock Creek Construction) and he’s already been out and given me an idea of what to do.  One of the best stress reducers out there is a rolodex full of good people to call in time of need.

People ask me all the time “Can I really come in as many times as I need?” The answer is yes.  Tennessee is still somewhat of a grey state for DPC programs since it has not enacted any legislation declaring how Direct Primary Care works and what it is.  DPC practices are left up to their own designs to show the state that we aren’t trying to be an insurance plan or company.  One of the ways we do that is to define the number of visits patients get with membership.  We had to pick a realistic and reasonable number.  I decided on 25 visits per calendar year.  Two visits a month seems like more than most anyone is going to need and yet isn’t absurd.  After that, patients are still welcome to come in as much as they want but a per visit fee will be applied.

So that’s the first and probably the most dramatic benefit available to members.  Let’s take the fear and high cost out of dealing with life’s issues and develop a program that allows patients the freedom to address all their concerns over multiple visits.

Next, I’ll address the plan for increased access.

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