Archive for November 2015

Direct Primary Care information

Just two quick reminders about Direct Primary Care.

1.  The next DPC informational meeting and open forum will be this Saturday, December 5th at 10am in the main lobby of Trinity’s Fort Sanders West office.  I’ll present an overview of the program as well as why Trinity built this program for our community and offer a time to ask questions.  We’ve had a great set of questions at prior meetings so I encourage everyone interested to attend.

2.  Don’t forget on this Cyber Monday that patients signing up before January 1st will have the registration fee of $125 waived.  You can sign up at




So, how are you feeling, Bobby?”

Well, really I feel pretty great… certainly better than I deserve!

As a physician, I don’t get that answer a whole lot.  Most of my time is spent either tracking down what’s causing someone to feel poorly, or at least trying to correct unhealthy pathways that are leading toward sickness.  But having some sense of the countless things that can potentially go wrong with the human body does give me an appreciation for what an amazing apparatus it is and how much is going right at any given time.

A sentence in the New Testament of the Bible says, “Every good thing given and every perfect gift is from above, coming down from the Father of lights….”  The human body is one of those remarkable good gifts, and this time of year is a good time to stop a moment and be amazed and thankful for it.

Consider just a few of its stunning qualities:

  • There are 2.5 trillion red blood cells in your body at any moment. To maintain this number, about two and a half million new ones need to be produced every second by your bone marrow.
  • Overall, 25 million new cells are being produced by your body each second
  • As you read this article, nerve impulses are traveling to and from your brain as fast as 170 miles per hour
  • You have 60,000 miles of blood vessels tucked inside of you. End to end they could go around the earth twice and have 10,000 miles to spare.
  • The acid in your stomach is strong enough to dissolve razorblades.
  • Fortunately, you get a new stomach lining every three to four days to keep you protected from that harsh acid bath.
  • The surface area of a human lung is equal to a tennis court, allowing for plenty of surface area for oxygen to be absorbed into the blood stream.
  • So far researchers have counted over 500 different liver functions.
  • Your nose can remember 50,000 different scents and many are strongly tied to memories.
  • Even earwax production is necessary for good ear health. It’s actually a very important part of your ear’s defense system protecting the delicate inner ear from bacteria, fungus, dirt, insects and dehydration.
  • Tears and mucus contain an enzyme (lysozyme) that breaks down the cell wall of many bacteria. And so the mucus that lines your nose and throat, as well as the tears that wet your eyes are helping to prevent bacteria from infecting those areas and making you sick.
  • In one day, your heart beats 100,000 times; about 3 billion beats in a typical life time.
  • The ear has over 25,000 tiny hair cells to help us hear each and every sound
  • As you look around, your brain is almost effortlessly translating the 2-dimensional light patterns hitting the back of your eye into a full color 3-dimensional world for you to enjoy and interact with.
  • It takes 17 muscles to smile and 43 to frown; give your face the easier job today.

We have been created with an amazing servant, our body.  As we approach this Thanksgiving I hope you’ll take a moment to be thankful for this amazing gift, to steward it well,  and to use it to serve your Creator and your fellow creatures.


DPC presentation schedule

Good crowd today at our DPC presentation. I appreciate all those that attended and participated. 

The next presentation is scheduled for Saturday December 5th at 10am in the main lobby of Trinity Medical Associates. 

Feel free to come and hear about the program. 

Email us at or


Does Direct Primary Care hate insurance?

In a word, no.

Insurance is a good thing.  Insurance is used to cover the cost of an event for which we don’t want to or can’t pay out-of-pocket.  For instance, we carry car insurance in part to cover the replacement price of a car in the event of a car accident.  If my car is in a wreck and is undrivable I want to be able go buy another car.  As a car goes down in value it becomes easier to replace and the car insurance coverage (collision anyway) goes down.  At some point we may elect to drop coverage as replacing it isn’t hard because it doesn’t cost much.  Also, we don’t generally carry insurance on minor things.  For instance, when my son buys a used video game they offer an addition fee to cover accidents that might damage the disc.  This is a form of video game insurance.  If the game breaks for any reason they’ll replace it.  Even though the fee is small, we never purchase the added protection for two reasons.  First, it’s just a video game and he could live without it, but primarily because he can afford the $19 to buy a another one if desired.

Insurance is great at helping us protect against the financial loss of an unexpected costly event.  However, it was never designed to cover the cost of things that are guaranteed to happen.  You can’t buy gambling insurance because the house always wins.  We all know that.  In healthcare, primary care is virtually a given.  Everyone will eventually need to see a pediatrician, an internist, or a family doctor.  We all end up with a cough, a sprained ankle, or a question about our cholesterol.  Yet we insure against that inevitability with a monthly premium and high deductible.

Admittedly, health insurance is more tricky than car insurance because it’s hard to say ‘no’ to something concerning our health.  One of the basic needs is to have good health.  In fact we have a saying, “Well, at least you have your health.”  Modern health insurance takes all our health concerns from the minor sore throat to the appendicitis to the brain tumor and lumps them together in one big package of coverage.  Do we really need to prepare against the expense of a strep test?  We end up preparing against some tragedies while prepaying for others.  The unexpected gets some protection while the expected only gets a price inflation.

We believe people have a basic need for food and offer many different community based and government run programs to help people obtain food who have been deemed at risk for not being able to buy it themselves.  That may be the approach health care should take.  We expect those who can to buy their own food and those who are unable we try to support.  As such, food remains one of the lowest margin industries.  The price of groceries is typically only 1.3% higher than the cost to provide the groceries.  Our society has lots of grocery choices so it doesn’t tolerate high prices or poor service for very long.  With healthcare many people feel stuck. They have one choice so neither the price nor the service matter.

The Direct Primary Care movement encourages all patients to be appropriately insured against health tragedies and certainly to obtain all the coverage required by law.  However, DPC also realizes that it is cheaper to buy your healthcare directly when the chance you’ll need it is high and the cost of that healthcare is low.  DPC wants insurance to be used for what it is always intended.  I heard it said yesterday that ‘Catastrophic Insurance’ is an oxymoron because all insurance is by nature catastrophic.  Let’s move health insurance back to that realm.  Let it cover the catastrophe and leave the ordinary to the free market.  The free market affords the best chance for the most people to get the care they need.