AtlasMD

Direct Primary Care means Evidence Based Medicine

This week, @SecKennedy, @DrOzCMS, and HHS Senior Advisor Chris Klomp joined @POTUS to announce a HISTORIC expansion of TrumpRx.gov, adding 600+ prescription drugs to help Americans access affordable medications. 💸💊

@drdanchoi The direct care model is the answer

The only fix for this is to bring back private practice What nobody is talking about in a healthcare fix: how to address a generation of physicians so jaded by healthcare consolidation and loss of autonomy that they are all looking to get out? Reverse the provisions of ACA that have made it impossible for doctors to control their own destiny and prioritize the patient/physician relationship Bring back private practice Bring back physician owned hospitals Stop the early retirement of physicians

@pmarca @elonmusk For his next achievement - fixing healthcare

Co-sign.

The Direct Primary Care Farmer dpcnews.com/dpc-motivation… - i love this way of thinking. We need direct care practices to be the best they can be so that future direct care practices are as good or better > a continuous cycle of improving.

This is a dying profession.

What if direct primary care became the highest-paid specialty in medicine? Dr. Josh Umbehr, family physician at Atlas MD (@AtlasMD), makes the case that the U.S. primary care "shortage" isn't really a shortage at all: it's a desirability problem driven by how we pay (and burn out) the specialty. 🎥 Watch the full discussion on Vumedi: buff.ly/SNgXLCo Register for #Vumedi: buff.ly/zVqDbdd It’s free for healthcare professionals and designed to support lifelong learning across specialties.

@DanMunro @DrDiGiorgio I think thats strawmanning the problems in other countries - Alberta's Supreme court said that access to wait lists weren't the same as access to healthcare and canadian long wait times violated their human rights treaty.

@AtlasMD @DrDiGiorgio All HC systems are rationed. They just don't result in: ~1/3 GoFundMe listings = med related ~27M uninsured (RISING) ~60-70M underinsured ~$200+B med debt in active collections ~$30K/yr = Avg ESI cost (family of 4/PPO coverage) I strongly recommend ... a.co/d/0iKaTtKj

Low-acuity care isn't our BIG fiscal challenge and Direct Primary Care (DPC) has a fatal flaw b/c it REDUCES the # of patients seen by 1 MD. So, DPC takes an already constrained resource (PCPs) and makes it even MORE constrained. Bigger problem = HUGE PCP shortage b/c of this:

@DanMunro @DrDiGiorgio "figured out" should be in quotes as well as "affordable" - these other countries are still struggling in lots of ways. I strongly recommend amazon.com/Weve-Got-You-C…

@AtlasMD @DrDiGiorgio Not true. 32 out of 33 countries have figured out "affordable" health insurance by collapsing tiered coverage into monopsony pricing. Our flaw is tiered coverage - which only serves 1 purpose. To support tiered PRICING. That's not how HC should be priced ... or financed. 1/2

@DanMunro @DrDiGiorgio Before we can make health insurance affordable, we need to first make most healthcare too cheap to ensure.

@DrDiGiorgio @AtlasMD FWIW ... I'm very supportive of the idea of FREE MedEd - which has proven to be scalable. For example - MDs in France graduate w/ ZERO debt. Total cost here? Maybe $4-5 billion/yr - but WELL worth it to FUNDAMENTALLY shift incentives at graduation.

@DanMunro @DrDiGiorgio And Direct Primary Care reduces, specialty visits, decreases the cost of radiology, pathology, durable, medical equipment, etc. All of that combined can help to decrease the cost of premiums by 50 to 70% or more.

Primary care may not be expensive, but Direct Primary Care Coalition influence the cost of primary care, urgent, care, emergency room visits, eliminates, co-pays, provides procedures for free, maximally reduces the cost of medication by dispensing wholesale, providing lab testing wholesale, both of which are up to 95% less than the current system and all without government regulations or PBM‘s or insurance red tape.

Yes, Primary care is not the most expensive aspect of our healthcare spend. But I think the Blindspot there that many economist, including one of my favorite, Amy, Finkelstein and MIT economist and author of we’ve got you covered and risky business why insurance companies fail, both make the same mistake on.

Maybe the analogy is not perfect, but I think it’s like blaming water for sinking the Titanic when it was the iceberg’s fault. The current system created the problems that are burning physicians out and causing patients to be frustrated. Direct Primary Care Coalition and is Farr better for the system versus a physician going into administration or part-time work or retiring early.

I also understand the common concern or argument that Direct Primary Care Coalition Patients being seen per physician, but I would say we actually are right sizing the Dr. patient relationship ratio. We don’t have a Dr. shortage but rather we have an efficiency issue when you consider that a physician needs to spend two hours on documentation for every hour of patient care.

@DanMunro @DrDiGiorgio I appreciate the sentiment, but I’m not sure if that is the driving factor that it gets hyped to be. I think it’s a factor in overhead and startup cost but is not a reason that people don’t go into Medicine or choose specific specialties quite as much.

@DrDiGiorgio bingo - i think thats consistent with serious economics study over the decades like milton friedman.

Why in the world would we need an insurance company or government bureaucracy to access primary care when it’s so cheap? If someone can’t afford $50/mo for primary care, just give them a “food stamps for healthcare” card and let them choose one that works for them.

#DirectCare - keep it simple. keep it affordable. keep it valuable.

@DrDiGiorgio Well #DirectCare is the costco of medical care - $50/mo for unlimited visits, no copays, free procedures, free telemedicine, meds and labs wholesale for up to 95% savings...yeah, then you can start to see a savings > than the cost of primary care.

It's a little concerning that the head of a major health policy think tank treats the idea of "free primary care" as an accounting problem. He fails to even acknowledge the second-order effects when you make a scarce resource "free" at the point of sale. We have multiple studies (RAND, Oregon) and real-world examples (Canada) that show an increase in demand for healthcare when prices drop. Nothing about this proposal increases supply, so you're inviting shortages. So you'll need to manage utilization. That will require a bureaucracy. Now you're running a relatively cheap service (primary care visits) through a massive government bureaucracy which determines price, utilization, and access. This will increase the cost of the service, increase administrative burden for both doctor and patient, and decrease the overall quality. And, of course, the people it's meant to help will be worse off. Those with connections or resources will circumvent the system. They'll pay cash for direct primary care (if that's still allowed) or use connections to jump in line. Primary care needs more supply, more competition, and more direct patient physician relationships. Not another layer of third party control dressed up as compassion. Larry should know this.

@DrDiGiorgio For example - @costco would want you to feel that you save enough on your purchases that your annual membership is "free". Free because of the total savings.

@DrDiGiorgio Not that he was implying this type of thought experiment - but i'd welcome how to make healthcare so affordable that the savings are greater than the cost to supply the primary care.