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Direct Primary Care Update: Feb 2014

Yesterday, I had the opportunity to meet someone in person whom I've been a fan for a long time. Ryan Neuhofel, DO, MPH, is a Family Physician in Lawrence, Kansas. He is opened NeuCare Family Medicine two years ago using the model of patient care called "Direct Primary Care." In this model, they do not utilize traditional insurance, and patients pay a monthly subscription fee for their medical care.

In the interview above, Dr. Neu reflects on his two years in practice using this innovative model of patient care. One of the main themes of our chat is something that I've heard other Direct Care Physicians say as well. When these physicians open their practices, they spend a majority of their time making the case why Direct Care is a better model, and now the questions he gets from potential patients is more how Direct Care works. You'll hear that in this clip below from the first ever Direct Primary Care Summit a few months ago...

Something else has really struck me from talking with Dr. Neu last night, and talking with other Direct Primary Care physicians in the past. They are exceedingly happy about this career choice that they made. Yes, trying to convince patients and employers about a paradigm shift like this is very difficult. Yes, it is very challenging not only building a practice from scratch but also building it with an innovative model of care. But, these physicians are satisfied that they are really making a difference now, and this is the reason they went to medical school.

Finally, another physician I've known for a while celebrated an anniversary this week. Our pal Dr. Rob celebrated One Year after opening his Direct Primary Care practice which has the tagline "Old Fashioned Health Care Made New." It's been fun following his success. In the player below, you'll hear our interview a few months before he opened his practice. (You can also download the audio podcast here) Hopefully, I'll be able to do a follow-up interview to reflect upon the past year and see what he thinks about the future....

2014 AAFP Winter Committee Meetings

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Sometimes you just have to get out of town and get recharged. This is one of those occasions. I'm on my way to Kansas City (where it currently feels like -9F wind chill) to hang out with other Family Medicine Physicians and to be advocates for our patients.

Committee meetings for the American Academy of Family Physicians will take place over the next few days. They affectionately call this the "Winter Cluster" meetings designated on twitter by the hashtag #AAFPWC. For some reason, I've never liked using the term "cluster" but that's just me.

There are currently seven AAFP Committees (actually called Commissions) and they cover areas like Medical Education, Governmental Advocacy, Quality and Practice, Health of the Pubic and Science. The Commission I was appointed to is called Membership and Member Services.

Why would very busy Family Physicians take time away from their families and away from their practices to take part in these discussions? For me, it gets back to trying to make a difference for my patients and for my community. There is nothing like getting together with your friends and colleagues to brainstorm and to put into action - those ideas that will make a big impact for our patients. Being with this group of people and talking about these ideas really recharge me.

I had big plans to social media promote this weekend, but, as always happens, life got in the way, and I just ran out of time. I hope to possibly record some interviews for the podcast and to take lots of pics to try to generate some buzz and to recharge our Family Medicine friends at home and let them know our organization of Family Medicine docs are working for them. Stay tuned, especially on twitter with #aafpwc and #FMRevolution

Family Practice Center of Salem visits The Banquet In Salem

Kudos to the fabulous staff of the Family Practice Center of Salem who gave us the opportunity to participate in The Banquet in Salem which has been around for almost 10 years in the community and continues to serve hundreds of area residents with good food and good company.

There is a great description of The Banquet in this October 15, 2013 article from The Salem News. "Anyone wanting to stop in and have a good meal is welcome. There are no stipulations based on need or anything of that sort. It is void of any shame factors. It is not a stereotypical soup line replete with accompanying aspersions - however wrong - cast on those participating. It is akin to a social event, often removing loneliness out of the day for many. For some, it is even their day's highlight."

I've participated in The Banquet on a couple of other occasions, and I very much agree with this description. Not only is it a social event where some families and friends gather, but I have never seen people be more appreciative of the work that is done here and the food that is served. We saw patients from our practice there. Some saw friends there. And, the article is right, there are no shame factors at The Banquet.

Finally, this was a great way for the office to gather is a non-office setting, and still work as a team. The grind of day-to-day work, in whatever industry you are in, can really get to you sometimes. Yes, party settings like the Christmas party are fun times to get together with your co-workers. But, there is nothing like being in a situation to give back to your community with the team that you work with day in and day out. Kudos again to our great staff for giving me the opportunity to "Pay It Forward" to our Salem, Ohio community!  Enjoy the pics below...

Salem Regional Medical Center Bed Tower Dedication

It was so much fun being part of today's Bed Tower Dedication for Salem Regional Medical Center. Because of my position on the hospital Board of Directors, I had a unique point of view close to the speeches and close to the great choir for the event.

Below are my personal photos from today's activities. With this new Bed Tower and the name change, I think this emphasizes us as an independent hospital, owned & operated by the local community, and not needing to answer to an out of town organization. I believe that today's events and next week's move-in solidifies the future of Salem Regional Medical Center. Enjoy the pics below!

TedX comes to Youngstown, Ohio

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The first ever TedX event is going to be January 24, 2014 on the campus of Youngstown State University in Youngstown, Ohio. I am proud to be part of the sponsorship team for this event. Please check out the website for the event at this link.

Can't attend the event in person? That's ok. The event will be live streamed over the internet at this link. Because of work obligations, I will be unable to attend the event this year. But, I will definitely be watching the live stream. I hope to participate next year. I'm very happy TedX is coming to Youngstown!

Primary Care Advocacy in New Jersey

The Executive Vice President of the New Jersey Academy of Family Physicians, our pal Ray Saputelli (please follow him on twitter), was interviewed yesterday on a bill in the New Jersey state legislature for a program that would reimburse up to $200,000 for Primary Care and Family Medicine physicians' schooling, over four years, for those who stay in the state.

In the interview above from NJ TV Online, Saputelli states that New Jersey is one of the least attractive states for medical students to stay in because of issues like lack of physician payment/reimbursement. Here's a quote from the interview...

“I can’t tell you how many times I speak with medical students who are from New Jersey, who tell me that the situation here is just untenable to consider practicing primary care. When you look at what the environment is, both in terms of payment and lifestyle, in almost any other state in the nation, it’s very difficult”
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Our pal Ray put this on his Facebook page yesterday. Well done, my friend! We need everyone from the Family Medicine community and #FMRevolution out there on television, radio, print, the internet, and everywhere else telling the Family Medicine story!

Finally since this will probably be the last post before the holidays, I just wanted to wish everyone out there a Merry Christmas and Happy New Year! I've been 2014 strategic planning for the website and for my "social media brand," and I'm looking at some big plans next year. It's going to be very exciting. Hope you stay tuned to see what happens!

"Doc Fix" Debate 2013 Begins

It's only been a couple of days since the announcement of the bipartisan budget compromise. But, it's now the job of the Congress, like it typically does, to avoid the crisis of being in Washington DC for Christmas, by debating other financial issues. According to The Hill, today's items include a one-month farm bill extension, the National Defense Authorization Act, and a three month "Doc Fix."

"Doc Fix" is the euphemism used as a piece of legislation to avoid double digit cuts in Medicare payment to physicians. This topic has been written about on this website many times in the past. This time, I believe this will be around 25% congressionally mandated cuts to Medicare physicians. The graph below from politisane last year shows the proposed negative direction of medicare payments to the positively growing cost of inflation to keep a practice open.

Physician advocacy groups, like my own American Academy of Family Physicians, have been doing a lot of lobbying on Capitol Hill. They have been talking to legislators not only about avoiding the short term cut, but also coming up with a long term solution to fix the broken Medicare payment system (#fixSGR on twitter).

Current Congressional debate will be changing an approximate 25% cut in Medicare payment to a whopping 0.5% increase (that's zero point five percent) increase in Medicare payment - just through March 2014 - when we'll have to go through this political exercise again (possibly attached to the debt ceiling debate).

So, semi-political junkies like me will be viciously following sites like The Hill for the latest updates. But, all of us know what is going to happen. With the 2014 midterm elections just around the corner, neither political party is interested in any kind of long term solutions to things like the broken Medicare payment system.

Manufactured political crises, short term political deals, and pundits like me will continue to use phrases like "bandaid solution" and "kicking the can down the road."

Where will it end? Well, you're already seeing proactive people just getting out of this broken health care system with health care solutions like Direct Primary Care and concierge care. Is this the future? The one thing all of us can agree on is that our current path is unsustainable. If government doesn't solve the problem, grassroots medicine will...

Deeper Than Digital Connections

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I don't know about you, but I find some of the best times to write are at the airport waiting for a flight. It's a good time to reflect back before the realities of home start to hit you. 

This past weekend I was in Las Vegas at a Family Medicine educational course. At these events, I really try to focus on learning, and try not to socialize that much or draw attention to myself. However, at one of the lecture breaks, the two gentlemen above came up to me and said, "Hey, Mike! It's been a while, how are you doing?"

I haven't seen these guys (pictured above) for 2 years, but our connection is a leadership and advocacy meeting for our Family Medicine speciality. We've been peripherally "following" each other on social media platforms, but haven't talked in person for a long time. We only had limited time together, but it was like old times, and I have not laughed like that in a long time. 

I mean, it's not rocket science, and I know that I'm not the first person to say this. Digital connections are great, and networking is fabulous using social media. But, there really is nothing like In Real Life (or as my friend Meredith Gould says, In The Flesh) meet ups that go deeper than digital connections...

My Cancellation Letter on KevinMD

Thanks to KevinMD for sharing my post on their site entitled, "Doctor Quits AMA and State Medical Society." The original post on this site is entitled "My Cancellation Letter."

Welcome to those of you who are visiting from the KevinMD site. I invite you to take a look around here including My About Page, and My Media Links including local TV interviews. If you like what you see on the blog, I encourage you to subscribe to the blog here.

I also invite you to check out my other social media sites including My Podcast, twitter, you tube, facebook, linked-in, google plus, and others. Enjoy!