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Wednesday, December 30, 2015

Own Your Own DPC practice in Tampa Bay, FL

Beginning in July 2016 PGY3 family medicine residents will have the opportunity to come to the Tampa Bay area and have their own direct patient care (DPC) practice.  There is no need to start with a hybrid model; there is no need to be on any insurance plans or be a Medicare provider.  Spend your career working only for your patients, not insurance companies.  In Tampa Bay you will have the unique opportunity to participate in a network of DPC docs in order to grow your membership quickly enough that enrolling in insurance plans or Medicare will not be needed.  

My DPC practice has grown to 350 members after 16 months. Concurrently, small business owners (<50 employees) in Tampa Bay are realizing they have the ability to provide their employees access to their own personal physician with no out of pocket cost no matter how often they seek care, keeping them healthier and more productive.  Be a “preferred physician” in MyDPCnetwork and grow your DPC practice in Tampa Bay quickly.  Contact me at if you are interested in being your own boss as a family physician and never file a claim to a health insurance company or Medicare from the first day you start in your practice.  

Saturday, June 6, 2015

The 21st Century Employee Retention Tool -- Direct Primary Care

It has taken 60+ years to finally undo the employee retention strategy that has largely contributed to the spiraling cost of health insurance.  Since the IRS allowed companies to deduct expenses on health insurance for their employees back in the 1950s, that became a dominant employee retention tool; and the more comprehensive the insurance, the greater the "benefit".  It became so common to get full health insurance through our employers that we really didn't even stop to question how little sense that made.  It wasn't until the cost of offering that coverage became prohibitive that we have stopped to contemplate what we have been doing all these years.

The purpose of insurance is to insure against high cost, low probability events.  If you know you are going to have certain expenses over the course of the year related to everyday health needs -- acute illnesses as well as the care of any chronic illnesses you already have -- why would you use insurance to pay for that care?  If we used our car insurance to pay for oil changes, tire care and car maintenance, the extra cost of submitting all those claims to the car insurance companies would drive up the cost of auto insurance to unaffordable levels.  Sound familiar?  Look at the irony of our situation.  This employee retention strategy has become so expensive that companies near the 50-employee level are actually laying off employees to avoid tax penalties for no longer offering the expensive employee-retention strategy of the last century.  And offering a group health insurance plan that carries a high deductible (the only way that group plan is affordable) is no longer really a benefit to the employee because their out-of-pocket cost for receiving care is so high that they often delay seeking care or avoid it entirely.

The new employee retention strategy is to offer "access to care".  Direct Primary Care (DPC) is lost cost, high access care.  A small business owner can purchase, for $40-$50 per employee per month, the ability for his employees to see their own personal primary physician as often as they like, at no cost to them.  There are no co-pays for office visits and all the tests and procedures that are performed in the primary care physician's office are included in the monthly membership.  The employee has access to care 24/7 so he can stay healthy, recover from illnesses more quickly, and miss work less often.  In addition, in a DPC practice, there are many opportunities to receive care without even going to the doctor's office (UTI, rashes, skin infections, stress-related problems) by doing a "virtual visit" over the phone, face-time, Skype, etc.  Again, less time away from work.  This is a true benefit for employee as well as the business owner.  There are many different ways for the employee to get coverage for catastrophic illness at reduced cost to themselves and the employer -- individually or through a less expensive small group plan.  I would be happy to discuss this is greater detail with any interested business owners.  #group-to-individual strategy

River Jordan Direct Family Medicine has rebranded itself to more effectively do B2C and B2B marketing, and to emphasive the fact that you are getting your own personal physician.  We are now myDPCdoc Family Medicine!  For individuals and families who have questions on how having a DPC physician can benefit them, you can email me at  Business owners can reach me at
You can also follow me on twitter for regular updates on info related to health care and health benefits.  #myDPCdoc   #myDPCnetwork

Thursday, May 28, 2015

The Cost of Not Having a DPC Physician

The most common question I hear from prospective new patients who already have insurance, and don't yet understand the DPC model, is "Why would I pay you $40 a month when I already have insurance?"  In many cases, a DPC practice saves more than the amount of the membership fee.  The following is a sampling of the many opportunities DPC affords for savings:

-- there are no costs, such as co-pays, when you see the doctor
-- there is a lower likelihood of expensive urgent care services due to the accessibility to the doctor
-- there is a lower likelihood of expensive imaging tests being ordered due to the extra time that the physician has to determine the cause of symptoms, using less expensive and less invasive diagnostic tests
-- The physician will proactively look for the least expensive medications, when medications are needed.
-- you are less likely to be referred out for expensive specialist evaluation due to the extra time the physician can spend looking for the root cause of your problems
-- when testing is needed outside of the office, the physician proactively looks for the least expensive way to get testing done using very economical cash pricing options when possible
-- you are less likely to miss time away from work due to same-day accessibility and the opportunity to get well quicker.
-- you are less likely to miss time away from work due to the possibility of alternative visit models such as phone visits or virtual visits when possible
-- some visits can be avoided by the opportunity to ask the doctor questions by text message or email

And finally, the insurance can be changed to a higher deductible, catastrophic plan that carries a lower premium that saves more than the membership fee.  Or changing 1 or 2 costly prescriptions to a cheaper equivalent can save more than the membership fee. So all these benefits essentially cost nothing if the net health cost goes down each month. 

Ultimately it's not just about cost but, rather, the opportunity to have a partner in helping you enjoy better health.  When your physician has the time to explain the pros and cons of diagnostic testing rather than just giving you an order to have it done, you may be spared the harmful effects (of radiation, for example).  When you understand the benefits and risks of prescription drugs, as well as the alternatives such as "therapeutic lifestyle change," you are less likely to experience the toxic effects of medication.  

In the end, it is generally I who asks, "How can you afford not having a DPC physician?"

Saturday, April 18, 2015

The group-to-individual strategy

In the interim since my last post, my practice has made leaps and bounds towards the realization of its goals.  The time spent working on the practice, as well as in the practice, has led to increasing attention by local media, business owners and individuals/families for whom the DPC model is an ideal complement to their high deductible plan, cost-sharing plan or no plan.  My enrollment had risen to 280 patients by the end of the eighth month; there has been no single month with fewer than 30 new patients.  I have hired a nurse to complement my receptionist who works primarily as a care manager.  I have begun to enroll groups of patients whose monthly fee is paid by their employer.  

The most important development in my DPC transformation has been the recognition of an ideal strategy for employer engagement in the DPC model: the group-to-individual strategy.  An employer (with fewer than 50 employees) who wishes to provide coverage as a health benefit for his employees has several good options when combined with a DPC physician/group of physicians.  The expensive group insurance coverage can be discontinued, allowing the employees to purchase individual coverage with subsidies if they qualify, since their employer no longer offers them coverage.  The employer can, if he chooses, increase the employees pay by an amount that allows them to purchase their coverage, with or without also paying for their direct primary care.  The end result, even if the employer provides both benefits, is greater than 50% reduction in the cost per employee (more if the employees qualify for subsidized coverage) and unlimited access by their employees to a physician, keeping them healthier and happier with less missed work due to illness.  Everyone wins!  Even lobbyists for the insurance industry should be happy because insurance still needs to be purchased.  

As I engage more employers, I will be able to hire a small network of physicians, at guaranteed salaries, who will start with a panel of patients.  The network will then be able to engage larger employers, allowing a larger network, etc. etc. This will be the model that delivers on the promise of a reformed healthcare system.

So family medicine residents who are in their second or third year, who would like to practice DPC in Tampa/St. Petersburg/Clearwater FL at a guaranteed minimum pay, with a path towards "franchise ownership" of their own practice, should contact me to begin early discussions about the opportunity.