Reasons # 2 and 3: Happy Birthday

Best work I have ever done
Best work I have ever done

I want to dedicate this entry to my now 6 year old twins- Cameron and Isabella. It is amazing to me that time is going by so quickly and that you two are already 6 years old! It seems like just yesterday we were learning how to give you your first baths, and now you are in Kindergarten learning how to write and count. You are now talking back instead of just screaming….although often there is still some screaming. Your are playing soccer, learning how to skate, tumbling, building legos, and all of these other amazing things that are so enjoyable to watch. Yet, most importantly, you are constantly inspiring me to be a better person.

You are a significant part of the reason why I left a well-paying job as an employed physician to put us in debt and start this practice. I know its often hard when I am working many hours trying to take care of patients or working to grow this business, but I want you to know that you are why. I love when when you both ask questions like “how was your patient?, are they ok?, did you get any new patients today?” It shows me that we have taught you to care! In the crazy world we live in we are often bombarded with ugliness and what people are doing wrong. I want you to have a dad who shows you what is right. I want you to see that doing the right thing is not always easy and that people may act like you’re crazy, but to keep doing it. Do not give in to naysayers and fight for what you know and believe to be right. If you do these things you will never fail. You may have to “regroup” and find other solutions sometimes, but you will never fail.

As one of my boyhood idols Wayne Gretzky once said: “You miss 100% of the shots you never take.”

So always take the shot- or at least pass it to someone who has a better scoring chance. And thank you for driving me to be the type of doctor, father, and person that I want to be. As much as I love medicine, I will always love you guys more. I hope you always know that. So Happy Birthday and enjoy the gifts that you will play with for 5 minutes and then never touch again ūüôā

September 11

120912023918-9-11-ud-02-horizontal-large-gallerySo this is a quick and short post, but I just wanted to write something today and dedicate it to all of the people and families who lost loved ones on 9/11. The first responders that day- the police, firefighters, EMTs, doctors, nurses- and really everyone that helped others out that day, showed the good side of people in this country.  They showed the side that cares for others and that risks their own wellbeing to help others in the face of tragedy. Too often all we see in the media is the bad side of people, but there is a really good side that sadly often gets overshadowed.

So my hope is that we find ways to “Never Forget” every day- not just 9/11. Remember what you felt like that day and try to nourish the kindness and good you witnessed on a DAILY basis -not just when tragedy strikes. That is what I hope we are doing with this type of medicine- bringing back the humanity. We need more in medicine and we need more in our daily lives. Thanks for reading and never forget.

 

The Real Reason

Yahrzeit Candle
Yahrzeit Candle

Today, July 15, is a really important day to me- for both happy and sad reasons. This day in 1993 is when I physically lost my best friend. My grandmother, Bella, was and is a large part of who I am as a person. She taught me about hard work, determination, unconditional love, and empathy. She is also the main reason why I not only became a Family Physician, but also why I left the insurance-based system behind for this new endeavor of Direct Primary Care. I knew people deserved better because I knew she always deserved better.

My grandmother was stricken by early onset dementia at the age of 62 and rapidly declined over the course of my high school years until her death in the summer of 1993 following my graduation. Although her death was a finality, it was also a blessing. She never wanted to live her life the way she was at that time, nor did she want to be a burden on anyone. My family struggled to get her approved for Medicaid after she worked her entire life. As a result, we were unable to get her coverage for a nursing home. We cared for her at home until it was simply unsustainable. As awful as it was, it taught me what people deserve when they are ill. It taught me that we treat our animals better than we do our loved ones. The system was screwed up even back then. So she lived in the nursing home until her money ran out after which she died peacefully in her own home with me by her side.

I have always used this experience to guide me through college, medical school, residency, and now my career. I miss her guidance and love every single day, but I know that I am finally happy as a physician because of her. I will always look back at her and my relationship with her, but I will never look back at a system that prevents doctors and physicians from caring for each other and does nothing to secure the sanctity of the physician-patient relationship. Is that not what medicine was based on in the first place? Hopefully she is fully resting in peace knowing that her only grandchild is happily doing the right thing and being the doctor she knew I could be.

 

My grandmother Bella and I
My grandmother Bella and I

Value and Perspective

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So the main question we get asked a lot by former and prospective patients regarding ¬†DPC is “why should I pay you when I already pay insurance”? ¬†This is a very good question and I think I have a very good response- what value¬†does insurance give you? Insurance value should be that you pay as little as possible upfront (the premium) in the hope that you never have to use it. That way, ¬†you get to keep more of your hard-earned dollars in your pocket rather than in the hands of an insurer. You then have the money in your bank account if– god forbid- something catastrophic happens. Yes, you may have to pay a deductible but this is again a “what if. ” Insurance is supposed to protect you when the big unexpected stuff happens not the everyday stuff. Think of it this way: do you pay your contractors, plumbers, landscapers, etc with your home insurance?? Do you pay for gas, oil changes, mechanical issues, tire rotations, etc with car insurance?? The easy answer is no! So my question is why are we paying for affordable, routine primary care with 3rd party insurance? Instead, why not:

1. pay a Direct Primary care doctor an affordable monthly fee to cover all of your primary care needs (no copays, no deductibles, no hidden fees).  Even better we have negotiated cash pricing on routine labs, imaging studies, and most common medications (our cholesterol panel cost $4.00)

2. Carry a lower premium high deductible plan with an HSA account (tax free savings in your bank!) and be protected against the big stuff if and when it happens- i.e. hospital, surgery, cancer, heart attack, accidents, etc

3. Have your own personal primary care physician available to 24/7 through any form of technology- text, cell, Skype, even twitter! We work for you- not insurers or the government. And I include visits to the hospital and do home visits for 30-50 dollars. 

So there is the value now lets look at the perspective. Our maximum monthly rate is $125 for age 65 and over. Here are some examples of “value/perspective” to ponder:

1. This year the average household cable TV bill in the USA is $123 per month

2. Average cell phone bill $73.00 per month

3. Dinner at Uno’s for four averages $60 without tip

4. Going to a movie averages out to a minimum of $60 including tickets and food for a family of four

5. A filet at Abe and Louis is $48

and here are the final two- which¬†people have daily- that amazes me….

6. A regular size latte at Starbucks is 3-4 dollars. 

7. A medium hot coffee with bagel and cream cheese combo at Dunkin Donuts is $3.69

I will leave the math to you the readers. Hopefully, my analogies and the value that we provide for people are clear. What is more important than your health?

If you wish to read further about what a typical family of four pays out of pocket in the USA for their “employer-based” insurance premiums, copays, deductibles, coinsurance, etc please read the following link below. Or I can save you the time and tell you: $23,215.00. I think we provide high value, transparent, affordable care to our patients. So I leave you with a final question: Does your insurance provide this?

Milliman Medical Index 2014