Direct primary care Podcast

[AtlasMD]

We have set up a podcast with about 20 episodes to help answer common questions

itunes.apple.com/us/podcast/atlas-md/id674138661

And our blog http://atlas.md/blog/tag/how-to/

I'm always happy to answer any questions.

Feel free to contact me directly anytime either by email or cell. [email protected] and C 316.734.8096

---

Members don't see this ad.

 

[bronx43]

We have set up a podcast with about 20 episodes to help answer common questions

itunes.apple.com/us/podcast/atlas-md/id674138661

And our blog http://atlas.md/blog/tag/how-to/

I'm always happy to answer any questions.

Feel free to contact me directly anytime either by email or cell. [email protected] and C 316.734.8096

Thanks for the link, Atlas.

One question I have for you is do you have business relations with specialists to perform simple procedures or diagnostic testing on your patients at a discount? If a person needs an echo or a stress, it would add great value to have a network of specialists that would take cash from patients at a steep discount to do them.

 

[AtlasMD]

Thanks and yes we work with specialists die discounts when ever we can.

 

[bronx43]

Thanks and yes we work with specialists die discounts when ever we can.

How do you go about doing this? Are specialists open to this type of business transaction? And how big of a discount are we talking about for most simple procedures/testing? Thanks.

 

[AtlasMD]

Yes they are often open to this. We usually look for a 50% at least. Cash is king so if they are going to get paid for their work, they'll be flexible to discounts.

 

[bronx43]

Yes they are often open to this. We usually look for a 50% at least. Cash is king so if they are going to get paid for their work, they'll be flexible to discounts.

But is that 50% off "tag price" (aka BS price) or is that 50% off "insurance-negotiated" price? 50% off tag price is still about 300% too high.

 

[AtlasMD]

Just depends. Usually they'll negotiate down to ins payment or lower (less work, fewer forms).

 

[bronx43]

Just depends. Usually they'll negotiate down to ins payment or lower (less work, fewer forms).

Idk if you know this, but do you know what price patients pay for these same procedures/testing before they hit their deductible?

 

[AtlasMD]

Yes Bc we'll ask what the list price is and what the discount is. But also we'll compare bw providers like surgery centers to make sure we are getting a fair price.

 

[bronx43]

Yes Bc we'll ask what the list price is and what the discount is. But also we'll compare bw providers like surgery centers to make sure we are getting a fair price.

but do you also ask what the insurance price is? The point I'm trying to make is that if the price you negotiate is not lower than what the pt pays towards their deductible, then there is no reason not to go through their insurance and pay towards their deductible.

 

[AtlasMD]

Ah yes. I understand what your asking. Yes we try to find out what their deductible would be for, example MRI, and see which is cheaper bw a cash rate and their deductible/copayment.

 

[bronx43]

Ah yes. I understand what your asking. Yes we try to find out what their deductible would be for, example MRI, and see which is cheaper bw a cash rate and their deductible/copayment.

Do you find that more often than not, the cash rate is cheaper or the copay/deductible? I'm sure this is geography-related as well - not only from a price variability standpoint, but also a "desirable" region with tons of specialists would probably yield lower cash prices given the intensity of competition among these specialists. Imaging services may be a bit different...

 

[AtlasMD]

Depends on the insurance and the service/consult but yes often cheaper

 

[bronx43]

Depends on the insurance and the service/consult but yes often cheaper

What do you do about basic imaging like CXR, or even CT? Have patients pay out of their deductible?

 

[AtlasMD]

What do you do about basic imaging like CXR, or even CT? Have patients pay out of their deductible?

We typically see an 80% discount when the patients pay cash

CXR $20-40, CTs $200

 

[bronx43]

We typically see an 80% discount when the patients pay cash

CXR $20-40, CTs $200

Who do you contact to get these kinds of discounts? Would it be feasible to own your own imaging equipment and charge patients out of pocket for studies?

 

[AtlasMD]

We called up the imaging centers directly to see what their cash price to the physician would be. That is one of the tricks is to have the imaging center bill the physician directly and then you build the patient. That way they can give you a better price and they are not worried about collecting. Also for plain films we talked with specialist like orthopedics that can do those studies for us affordably in quickly. Also it's like getting an orthopedic consult at the same time.

This week I had a doctor in ChicagoArea who could not find a cash price on an MRI for less than $2700. I connected her with the director of one of our participating imaging centers and they helped her find a radiologist that was willing to work with them for 80% plus discounts.

 

[Dharma]

@AtlasMD thanks for posting the podcasts. I finally got started on listening to them; only a few episodes in but really like it!

I have been talking with a few FM residents on the verge of graduation. A few of them have expressed the opinion that one would need an MBA to pull off private practice these days, especially DPC. Not sure I completely buy that, although I'd imagine that the knowledge that comes with an MBA would put one at an advantage. I'm NOT paying for another degree, but I would be more than willing to put in the extra work to educate myself on relevant topics. That said, do you recommend any resources for medical students looking to educate themselves about business?

Thanks for your time Doc! Keep up the great work!

 

[AtlasMD]

HI Dharma,

i'm glad you're enjoying the podcasts and i think we started having more fun with them after the first couple

I can promise you that you do NOT need an MBA to do this. Common sense, maybe, but not another degree. I do recommend reading some business books. I have an audible.com account so i can listen to books while i drive to understand how to add value and improve customer service etc.

We've made it as turnkey as possible with sample contracts, enrollment forms, vendor relationship, wholesale lab / medication / imaging pricing, checklists and more. And i'm happy to email that to anyone that is interested.

We do offer all of our consulting free of charge b/c we're passionate about growing the dpc movement. Rising tides raise all ships and we need every dpc doctor to be successful so that we can continue to attract the support of patients, employers and insurance companies.

Feel free to contact me directly anytime either by email or cell. [email protected] and C 316.734.8096

 

[Dharma]

That's great @AtlasMD. I'll definitely be contacting you in the future.

Any business books that you recommend in particular?

 

[AtlasMD]

Charles Koch - the science of success
Atlas shrugged
the tipping point
blink
the lean startup
the Art of possibility
the Icarus deception
contagious
outside in
how to win friends and influence people
the checklist manifesto
free: the future of a radical price
the power of habit
think and grow Rich
3 feet from gold
the speed of trust
great by choice
good to great
delivering happiness, zappos
good boss bad boss
blue ocean strategy
exceptional service for exceptional profit
the emyth– physician
the innovators prescription
the Starbucks experience
9 ½ things you'd do different if Disney ran your hospital

okay that's a pretty decent list

 

[Dharma]

WOW!!! Thanks!

 

[AtlasMD]

Anytime!

 

[KLycos]

Great list of books, I've ordered a couple of them to start.

 

[SpinalFusion]

Atlas, I gotta say I'm loving the podcasts. Started listening while flying to interviews. Keep up the good work!

 

[AtlasMD]

Ah that's fantastic!!

 

[msd195]

Thanks for all of the great info, Atlas.

I'm a PGY2 in an academic east coast IM residency and am in the early planning stages of setting up a DPC practice following graduation. I've been following your progress very closely and truly appreciate all of the advice you have provided on these forums and elsewhere.

One of the concerns I have about starting a practice so soon after the completion of my training is being viewed by would-be-patients as either "too young", or worse, "too inexperienced". Did you encounter any of this when you were first starting out? If so, how did you overcome it?

 

[AtlasMD]

hi MSD195, thanks for the support and i'm glad your considering DPC.

To answer your question, no, i don't think its a major hurdle that you're young. I was young (and looked younger) and it wasn't an issue. I remember one older patient who joined and told me that he only wanted gray hair on his pilots and his priests hilarious. Many patients see younger doctors as more flexible, with fresh training, and who still enjoy medicine. Of course, you can find pros and cons to be a consider a doc that is too old or too young. But in general, its not a problem that will keep you from being successful.

plus, you can't do much about it either way

This is similar to the question i get a lot - what if they want a female doc - well......about that....hard to switch teams... but a female doc can't be a male doc, and not all docs are equally skilled in all aspects of medicine....take home point is that you can't be all things to all patients, you just aim to be the best you can be for the patients who chose you.

if you need any help with the start up, we have a whole packet of information and made it very turnkey (free too).

Feel free to contact me directly anytime either by email or cell. [email protected] and C 316.734.8096

 

[AFMD]

Thanks and yes we work with specialists die discounts when ever we can.

I really appreciate all you guys do for DPC. I got to spend a day in a DPC office near my school, and it was really an amazing experience!

Talking to other physicians in a more traditional practice, I've been told offering cash prices that are lower than insurance prices are against contracts some practices have with insurance companies. Is there any truth to this? Also, how easy it is to find an insurance plan that compliments a DPC practice well?

 

[AtlasMD]

Hi AFMD, thank you and i appreciate the feedback. We love helping to see how we can support the DPC movement b/c of how its benefiting doctors and their patients.

I find it a little comical that every doc that is not doing dpc, is an expert in all of the ways it can't work....ahh such is life.

happy to answer your question and set the record straight.

If you're taking insurance - YES - you have a contract with the insurance and most of those contracts (like medicare) will say that its a violation of your contract to charge anyone less than you charge them. But i don't really think you can call yourself DPC if you're taking insurance (fine line). B/c most DPC practices don't take any insurance, they are free to charge what ever they want to whom ever they want.

Its getting easier to find insurance companies that will work WITH dpc practices b/c they are starting to learn how DPC is a win/win for them.