Scenarios

Scenarios

Media:

The Middle Ground tv show, 8/2014: https://m.youtube.com/watch?feature=youtu.be&v=mLVAC5YtfzU
Why DPC? article for Kempton Group/FMMA 1/2015: http://www.kemptonpremierproviders.com/pdf/Why%20Become%20a%20DPC%20Doc-Revised.pdf
News9 report 4/1/2014: http://m.news9.com/Story.aspx?story=28615555&catId=112032
Interview with Dr Keith Smith @ Surgery Center of OK part 1:  https://www.youtube.com/watch?v=jA8n6O2Eb9s
     part 2:  https://www.youtube.com/watch?v=i9uf8V33Vi0


Scenario 1: Sick Kids

Imagine a scenario… you’re a stay at home mom with 3 children ages 6, 4, 1½. They are all three vomiting and having diarrhea. There is a GI bug going around town. You call your doctor, but you can’t speak to him and only get the staff. They want you to bring all three of them in. They can't treat any of them if they don’t see them. You’d rather stab yourself in the eye than get out with 3 puking children…

But wait…this scenario is different.

You call your doctor who has a direct-to-patient practice. The doctor answers the phone, and you are talking to him immediately. He makes some recommendations over the phone. He also prepares some anti-emetic suppositories for your husband to pick up at lunch and bring home to you and the kids. He calls you the next morning to check on the family. The vomiting has stopped and they are holding fluids down. He gives you some warning signs about dehydration to watch for, and tells you to call him with any concerns. You are so thankful for the relationship you have with your doctor…


Scenario 2: Lab Work

Imagine a scenario…you’re a 56yo man with high bp and cholesterol in for your routine visit. You’ve been noticing lately that you have some low back pain, stress at work is making your stomach hurt, and you wonder about your testosterone level because of the commercials. You’re doctor quickly reviews your lab saying it looks good, and he’ll refill your meds for you. He gets up to go and you quickly mention your concerns about testosterone and tell him there are a couple of other things you’d like to talk about. He says he’ll be glad to check your testosterone level and have you come back. You’re frustrated because that means another copay, another visit, and another half day off work because your doctor is very busy and is NEVER on time…

But wait…this scenario is different.

Your doctor draws lab in his direct to patient practice that costs you $8. Your copay at the lab used to be $40. 20 minutes into the visit you are done talking about the cholesterol and bp and the screening procedures for cancer that are recommended. You want to ask about the other things, and he says, “Sure, we still have 40minutes. Tell me what’s going on.” He then covers all of your concerns and answers all your questions. In the last 10 minutes of the hour you talk football and tell him about your grandson and his games. You are so happy to be able to spend time with your doctor so you can get to know each other…


Scenario 3: Bug Bite/Infection

Imagine a scenario…(true story) you’re a 26yo woman who notices what you think is a bug bite on your right low abdomen. You think about calling the doctor but you know they will just want you to come in and you don’t have time. So you decide to wait. The next day, it looks worse and has gone from itching to sore. You call in and they want to see you, and they schedule you for tomorrow afternoon. Day 3 its gets significantly worse. Much more painful and now there’s a knot and an opening in the middle that begins to drain. You end up at the urgent care and they have to cut it open to drain it. You follow up at your doc’s office 3 days later. He tells you that things are going well, but you will have to continue to squeeze it to get the puss to drain. That sucks because it is very tender. You also will have an open wound for probably a couple more weeks…

But wait…this scenario is different.

You notice the bump that you think is a bug bite. You take a picture of it and text it to your doctor. He texts back in 15 min and says it looks like a bug bite. The next day it looks worse and you send another pic by text. He says it looks worse, and he says he thinks it’s a skin infection and wants you to run by the office to pick up some bactrim. The bactrim costs you a dollar. Because of the rapid communication with your doctor, you improve over the next few days. You never even realize that you avoided an abscess because it gets better. You are so appreciative of the open communication and access you have with your doctor…

Scenario 4: Aging Parents

Imagine a scenario…you’re a 60 yo person who’s parents are pushing into their eighties. Their health is declining, and you are taking a much more active role in their healthcare. They love their doctor, but she’s overworked, and you never feel like you get all of your questions answered. You feel like they’re overmedicated and you’d like to begin to remove some of their meds, but there never seems to be the time to discuss some of these issues. You wonder if you’re doing what’s best for your parents…

But wait…this scenario is different.

You enroll your parents in a direct to patient practice. So now you have instant access to their doctor by phone, text, email, etc. The doctor encourages you to call any time you have any concern. You rarely even have to take your parents in because he talks to you over the phone. And when you do need to get them in, there are always hour long openings in the doctor’s schedule. This saves you a lot of trips and you always get all of your questions answered. You realize now that there is a better way to take care of your parents, and you are so glad you found it…

Scenario 5: Unlimited Family Access

Imagine a scenario…you’re a hard working man in your 30’s. You make your living with your hands. You aren’t a rich man, but you pay your bills and are proud to earn what you get. You really never get ill and even when you do, you get up and go to work anyway because that’s what a man does to provide for his family. Your company doesn’t provide medical insurance, and the private insurance you are paying for is absolutely killing you. You’d like to drop it all together but with a wife and 3 children, you know you need to keep some kind of coverage for them. You wonder how you can possibly take care of your family’s insurance needs and still put food on the table…

But wait…this scenario is different.

You hear about a direct to pt practice in your town. You investigate and find out that the five members of your family can join the practice for only $130/month. You, your wife, and children can have unlimited access to the doctor, immediate visits when needed, and ALL of their primary care needs are met. You decide to get catastrophic coverage just in case something were to happen to one of you, and you decide to pay for the membership because it’s affordable and the treatment your family gets is unlike anything you’ve ever heard of from any other doctor…

Scenario 6: Making Your a Priority

Imagine a scenario…you’re a 65 yo old man coming in for your yearly preventive exam. Your doctor reviews all of the preventive medicine topics on with you. During the exam he feels a mass in your abdomen that he is concerned about. He tells you that you should get a CT of your abdomen to evaluate it. You agree, and he writes the order and gives the chart to the nurse on your way out the door. The staff calls to setup the CT scan, which is in 3 days. You then follow up for the results after that. Unfortunately you are crushed when you get the bad news that it’s a colonic mass. You get a referral to a general surgeon a week later. He evaluates you and recommends surgery which they schedule 3 days later. You wonder why it takes so long to get anything accomplished these days…

But wait…this scenario is different.

(True story) Your doc feels the mass. Recommends a CT. You agree, so he steps out of the room and calls the radiology clinic directly and explains the situation. They agree to see you today. You go over and get the CT. The radiologist then calls your doctor back who has the time to get the report verbally and asks them to send you back over. He then sits down and talks with you about the diagnosis. You are crushed, but he promises to help you fight like hell. You agree and he gets up and calls the surgeon explaining the situation on the phone. The surgeon asks to have you come straight to the hospital after you pick up a few things so they can medicate and hydrate you. He puts you on the schedule for surgery the next day. You prepare for the fight of your life and you are happy to have a doctor that makes you such a priority during this time…

Scenario 7: Small Business Care

(Are you paying attention small business owners? This is a TRUE STORY!) Imagine a scenario…you’re a small business owner of a lawn/gardening company. You want to do what’s right for your people, but your insurance premiums have gone up 20% each year for four years. The math just doesn’t add up and you cannot keep doing it the same way. You call a meeting with your employees and explain to them that you are going to have let 2 people go or not provide medical coverage for the employees any more. You just want to vomit every time you think of the situation and the impossible choice you have to make…

But wait…this scenario is different.

Before you have to make such a horrible choice, you hear about a new type of primary care practice. It’s a direct to pt practice, and you investigate. They have an insurance expert that helps you to hammer out a high deductible catastrophic policy and an ERISA health insurance plan for the company. You offer to pay half of the employees’ monthly fee of $50 to the practice while they cover the other half. Your group of approximately 50 people covered by this plan then go THREE YEARS(!) without an insurance claim. No claims for doctor visits, urgent care, ER, meds, labs, nothing. Your insurance premiums correspondingly drop SIXTY PERCENT. And you take an average of 70 thousand dollars of the yearly 100k in the ERISA plan and roll it over year to year to help re-fund it every year. Which allows you to take the $70,000/year you don’t use to fund it and put it somewhere else. Like the profit side of the ledger. You wonder why no one else has done this before…

Scenario 8: Medication Savings

Imagine a scenario…You’re a middle aged person with a few illnesses. You take 5 or 6 medications and you are quite stable on them and lab work is looking good. But the cost of the meds is wearing you down. Even with your insurance, you have copays that average $140/month on those 6 meds. That’s a lot of money for your meds, but you don’t want to quit taking them because your illnesses are well controlled. It does make you wonder what the heck you pay your insurance premiums for to begin with if you have such large copays for the medications that keep you healthy…

But wait…this scenario is different.

(true story) You enroll in a direct to pt practice that costs you $75/month. You get premium quality care with unprecedented access and interaction with your doctor. On top of that, he sells wholesale medications out of the office. When he tells you what your meds actually cost at wholesale prices your jaw drops. The total cost out of pocket without any insurance claim is only $40/month, which is the cost the doctor charges you because that is part of the membership package. You realize that by joining the practice, you’ve saved $100/month on your meds. That covers the membership fee and leaves you $25 left to put in your pocket each month. You haven’t even counted the lab savings that the practice arranges for its patients on your quarterly labs. You can’t fathom how it’s possible to get this care just by eliminating insurance from the equation. Sometimes you wonder if it’s really true at all…but it is