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Transcript

Why I Built My Own Direct Primary Care (DPC) Practice And What I Learned · Doctor Turned Health Coach

• 0:21
  Today, I want to introduce to you guys my direct primary care practice.
• 0:28
  It's called DPC, and I'm going to tell you why I decided to start one,
• 0:33
  how it works, and what it means for you as a patient.
• 0:36
  So the traditional primary care model is insurance-based. You go to whatever
• 0:43
  physician is in your network.
• 0:44
  You have appointments with them that are 7 to 10 minutes,
• 0:48
  maybe 2 to 3 times a year oftentimes unfortunately
• 0:51
  when you really need your primary care doctor if
• 0:54
  you get sick it's unlikely that you'll get an appointment in time so you end
• 1:00
  up either in the urgent care or emergency room but what's good about this style
• 1:06
  of primary care is that they can order tests for you that are covered by your
• 1:10
  insurance saving you time headaches.
• 1:14
  What's missing from this is that deeper connection you have with your doctor,
• 1:20
  the ability to have longer, deeper discussions, being able to text, email anytime you want,
• 1:27
  kind of that old-school primary care doctor feel that we see on TV,
• 1:33
  that concierge-level feel where your doctor advocates for you and helps you
• 1:39
  understand certain things.
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  If you end up in the hospital, they'll come visit you or they'll have a phone
• 1:45
  call with you and discuss what's going on.
• 1:47
  That is what I always imagine to be the best way to run a primary care practice.
• 1:53
  The direct part of the name of DPC or direct primary care is that I contract
• 2:00
  with you, the patient, directly.
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  I'm not in any insurance network. I don't get paid by an insurance company to
• 2:08
  do something for you or to you or get denied anything that I think you really need.
• 2:14
  That's the beauty of it. And I really like it that way. I prefer to be able
• 2:18
  to take care of my patients in a way that I think is best fit for their health
• 2:22
  without really having to navigate some insurance company telling me what I can and can't do.
• 2:27
  I directly contract, meaning the patient pays me. And the way we do it is through a membership model.
• 2:35
  Now, I also have a 30-minute appointment slot that somebody can buy.
• 2:41
  Right now, my rates are somewhere around $75 for a 30-minute appointment.
• 2:47
  I don't prioritize those. I always prioritize my patients who are part of my
• 2:51
  practice, whom I've gotten to know for a long time, and they always will take priority.
• 2:57
  They pay an average of $150 a month, depending on their income and their ability to pay.
• 3:04
  I'm very flexible with payments. If one of my patients loses their job,
• 3:09
  of course, I'm going to cut their monthly fees.
• 3:13
  I'm not going to charge them anything some months. That's the beauty of having
• 3:16
  my own medical practice.
• 3:18
  But on the other hand, if I was in an insurance practice, I wouldn't be able
• 3:22
  to cut their fees because the insurance company wouldn't allow me.
• 3:25
  For example, in Medicare, it is actually not, it's completely prohibited to not collect the copay.
• 3:33
  I'm not allowed. So I'm not even allowed to see a Medicare patient for free.
• 3:38
  Even Medicaid, if you are enrolled in Medicaid, you're not allowed as a physician
• 3:42
  to see somebody. There are reasons for that.
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  I don't find them to be very good reasons. And for those important,
• 3:49
  those are the factors why I decided to go completely out of it.
• 3:53
  So I don't take insurance. I don't bill insurance. I have a contract directly with you.
• 4:00
  You pay me every month and there are no other fees. You don't pay for anything
• 4:06
  else when it comes to my care for you.
• 4:08
  Now, if I refer you to a specialist, you will pay for the specialist.
• 4:12
  If I refer you for lab tests, you'll pay for the lab.
• 4:15
  If I refer you for imaging studies, you'll pay for the imaging studies.
• 4:20
  However, in the insurance model, you're sent to whatever doctor is first available
• 4:26
  or in the insurance network.
• 4:28
  The downside with that is that this doctor wasn't really vetted by your own primary care doctor.
• 4:33
  In my DBC practice, all of the specialists are vetted by me.
• 4:39
  I know them. I have their cell phone.
• 4:42
  I highly recommend them. They're fantastic doctors, people who I've worked with for a long time.
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  And these are, I consider, the best of the best. And the reason this is important
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  is because not all doctors are the same.
• 4:56
  Each of us have special skills. And I need to know whether my patient needs
• 5:01
  to go to a neurosurgeon who can immediately perform surgery or go to a neurosurgeon
• 5:06
  who can give them a really good consultation of why they don't need a particular surgery.
• 5:13
  These specialists are not only the best of the best, but I think their prices
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  are incredibly fair for what they do.
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  Now, if you do happen to have insurance and you want to bill your insurance
• 5:25
  for medications or labs or seeing a specialist, you can certainly do that. But that is on you.
• 5:30
  That is something that you have to figure out with your insurance company.
• 5:33
  Most insurance companies have a policy where you can submit a bill if you had
• 5:38
  a test done. but most of the tests that I order lab tests, imaging studies are
• 5:44
  so affordable because they're cash out of pocket,
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  that you don't need to. I can get an MRI instead of $2,000 that you would pay
• 5:52
  with your insurance company for $350.
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  Lab tests that normally cost $500, I can get for $60.
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  Medications that are $1,000 a month, like Celsept, which was a great example
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  for one of my patients, you can get for $19 a month.
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  And that's the advantage of cash-based care.
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  It's transparent pricing, it's fair it's honest now
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  hopefully you're not ever going to need an mri or you
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  know really serious autoimmune medications but it is
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  good to know that these options are available the way it works is i you and
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  i sign a contract which is legally required in most states now i'm currently
• 6:32
  only licensed in california so my patients have to be residents of california
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  meaning to have to live in California.
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  And I become your doctor. As long as you pay the monthly membership,
• 6:44
  you and I will have a patient-doctor relationship.
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  I am your go-to primary care doctor.
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  If you have questions, if you need a referral, if you need prescription medications,
• 6:53
  if you have any health related issues, I am your go-to guy.
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  The beauty of my practice is you'll never have to wait for an appointment.
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  I have same day appointments, same hour appointments.
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  I'm always available for my patients because I keep a small panel of patients
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  and that allows me the time necessary to see somebody if they really need me,
• 7:17
  if they catch a cold, if they're about to go to the emergency room, if something happens.
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  My appointment slots are 30 minutes to one hour long.
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  We can have deep, deep discussions over things without feeling rushed.
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  There's no 7 to 10 minute appointments. I never book patients back to back to back.
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  And when necessary, we text, we leave voice messages, email,
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  whatever we need to do to keep you healthy, of course.
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  And I coordinate with your specialists. If you are admitted to the hospital,
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  I will talk to the doctor taking care of you in the hospital.
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  If you go to the ER, I will take care of communicating with that doctor.
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  That's the kind of concierge-level service that I offer.
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  And for $150 a month, I consider that an incredible deal.
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  And that's what you get in my practice that you probably wouldn't get in a traditional
• 8:13
  insurance-based practice.
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  Currently, I enroll anybody under the age of 65. and the reason for that is
• 8:19
  they can't be in Medicare because I'm not allowed to take Medicare patients.
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  And I take anybody over the age of 13, generally 16.
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  So if you want to enroll family members, you're welcome to do that.
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  One question that comes up often is, well, what do you do when somebody needs a physical exam?
• 8:38
  Because my medical practice is completely online.
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  And the reason it is online is because I want to save my patients money.
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  The whole point of me having a medical practice like this is to be able to offer
• 8:52
  a lot of value to my patients.
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  So if you need a physical examination, yes, I will send you in to a urgent care
• 9:00
  or one of my recommended physician colleagues in your area who can see you in person.
• 9:05
  And of course, I will do all of the research of making sure that we pick the
• 9:09
  best of the best doctors or if somebody's already in my network in your area,
• 9:13
  I'll refer you to that person.
• 9:16
  In all these years that I've run my practice, I've never had to send somebody
• 9:21
  to a clinic in person to be seen. That's the good news.
• 9:27
  If somebody had a very acute or serious situation going on, of course,
• 9:31
  they had to go to the urgent care or emergency room.
• 9:33
  Even if I had a physical practice, if it's beyond what I'm capable of managing,
• 9:38
  you would still have to go to a higher acuity center.
• 9:42
  That's the standard of care. And that's for your own safety.
• 9:46
  But when it comes to colonoscopies, I can refer you for that,
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  or we can do a stool sample test once a year, which has been shown to be just
• 9:54
  as effective for colon cancer screening.
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  Mammography, I can send you to a mammography center.
• 10:00
  If you need a pap smear, we can send you to a lab where you can do what's called
• 10:03
  a self-collection. You no longer need the actual pelvic exam.
• 10:08
  That's the advantage of technology.
• 10:11
  And yeah if you need blood pressure testing done i can
• 10:14
  always send you a blood pressure device or tell
• 10:17
  you places where you can go get it done for free or of
• 10:20
  course you can purchase a blood pressure machine and do that yourself if
• 10:23
  you want to sign up for my direct primary care practice the easiest
• 10:26
  thing is just reach out to me on my phone number
• 10:29
  or on my email hello at drashori.com you
• 10:33
  can also go to my website and sign up there for the
• 10:36
  monthly membership again remember that i
• 10:39
  can only prescribe medications and tests in the
• 10:43
  state of california and i'd be honored to have you as my patient there is an
• 10:48
  option to do a free 15-minute phone call with me all of the all of that information
• 10:52
  is in the show descriptions and just to get to know me and have a little chat
• 10:56
  about your overall health and to make sure that i'm the right fit.