Gen Med

How Paying Out of Pocket Can Reduce Your Expenses and Get You Better Care!

September 11, 2020

Featured Physician: Paul Thomas, MD

Featured Book: Direct Primary Care: The Cure for Our Broken Healthcare System

Dr. Paul Thomas is a board-certified family medicine physician practicing in Corktown, Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. His mission is to deliver affordable, accessible health care services in Detroit and beyond. He has been featured on WDIV-TV Channel 4, WXYZ Channel 7, Crain’s Detroit Business and CBS Radio. He has been a speaker at TEDxDetroit. He is a graduate of Wayne State University School of Medicine and now a Clinical Assistant Professor. Finally, he is the author of two books, Direct Primary Care: The Cure for Our Broken Healthcare System, and Startup DPC: How to Start and Grow Your Direct Primary Care Practice.

What Is a Good Doctor – Patient Relationship?

myDoqter:  Dr. Thomas, thank you for joining us to discuss Direct Primary Care, or DCP, as it is often called. We would like to talk first about relationship. The foundation of myDoqter is to build connectivity between patients and doctors and promote the sanctity of the patient-doctor relationship, that has been systemically eroded over the past several years. Your book is an excellent guide for patients to learn about the issues that are seriously breaking our healthcare system, information that they do not otherwise have access to. Can you explain how things have changed over the past few decades in Medicine such that the environment has strained, devalued, and compromised this important relationship?

Dr. Thomas:  First of all, thank you for having me here to discuss these important issues. Second, thanks for shouting out our book Direct Primary Care: The Cure for Our Broken Healthcare System. To answer your question, when doctors are paid by insurance companies, and not directly by their patients, doctors begin servicing those insurance companies, and not their patients. In our clinic, we ask that our patients pay us directly for our primary care services, thus Direct Primary Care or DPC, and in exchange for that monthly payment we deliver excellent, patient-centered, affordable, accessible health care with an emphasis on care.

Physician Wellness Translates to Patient Wellness

myDoqter: On top of the damage to the patient-doctor relationship, we are seeing dramatic increases in physician burnout. Do you have any thoughts on factors contributing to this?

Dr. Thomas: Yes! Physician burnout affects over 50% of physicians each year. It contributes to medical errors and compromises patient care. Often times, doctors are directed by their hospital administrators to seminars and yoga sessions and meditation weekends to treat their burnout. Now, if 50% of the light bulbs in your house went out at the same time, you wouldn’t try to fix each individual lightbulb, would you? No. You would recognize that there’s a problem with your switch box or the wiring in your house or the power grid – there’s some kind of systemic issue at play causing all of those lightbulbs to burnout. The same goes for the healthcare system. There are huge systemic flaws causing doctors to burn out, and we need to actively recognize and change those underlying issues.

myDoqter: In our country, we spend between 15 and 20% of our GDP on health care, yet patients and doctors are both struggling and the health of our people is not optimized. What do you think contributes to this phenomenon?

Dr. Thomas: Actually, I think it’s 17%, and that’s higher than the typical 10% for other Western Industrialized nations. The issue is that there is no incentive for hospitals, health care providers, or insurance companies to lower costs. The people who lose in our current system are the uninsured patients, the small business owners who have to pay for insurance for their employees, and the American people as our national debt continues to climb.

Can I Pay Out of Pocket for My Doctor?

myDoqter: What is DPC and how do you see it helping to add cost savings and efficiency to the marketplace?

Dr. Thomas: Direct Primary Care allows patients to have a direct relationship with their doctor. For the equivalent of a monthly cell phone bill, patients can receive direct, primary health care services that are tailored to their individual needs. From annual check-ups to urgent care needs to general questions about staying healthy, Direct Primary Care offers people access to care across a spectrum of needs from an independent doctor that cares for them, not an insurance company.

myDoqter: We at myDoqter often discuss a hybrid model of healthcare in which all outpatient care, whether primary or specialty care, could be provided on a direct pay basis. This would significantly reduce huge administrative costs and inefficiencies. At the same time, higher-cost catastrophic care could be managed by risk pools and the insurance market. What are your thoughts on such a hybrid care model, even beyond primary care?

Dr. Thomas: There are a number of successful cardiologists, rheumatologists, and dermatologists engaging in the direct pay model. I only see this model of care growing overtime as a cure for the inefficiencies in the health insurance system. Hopefully, the insurance marketplace will respond with affordable and tailored wrap-around insurance products that fit well with direct primary care offerings.

myDoqter: In closing, would you like to share your thoughts on how you built and incorporated the DPC model into your practice, Plum Heath? Do you have advice for young doctors and their patients who may be interested in this model?

Dr. Thomas: I started Plum Health DPC as a direct primary care practice, so I didn’t incorporate these ideas into an existing model, we were DPC from the jump. I advise young doctors who want to be excellent clinicians and who want to have enough time to fully address the needs of their patients to engage in the DPC model. If you need help getting this done, I have written a book on this subject and it’s a Best Seller on Amazon: Startup DPC: How to Start and Grow Your Direct Primary Care Practice

For more information about Dr. Paul Thomas and Plum Health, visit:


doqter's lounge

A place to gather and discuss hot topics in medicine. You must be an MD or DO to enter. To view and submit patient content, click here.

Latest posts

Hair Love: A Celebration of Black Girlhood….and Hair Covid, Mind-Body Medicine, and Cancer The Link Between Sleep and Health Stress, Connection, and Wellness in Our Kids Sports Medicine Meets Lifestyle Medicine: Latest Trends
What is this?

Procial Feed

06/23/2023 06:40 AM

Would you be comfortable with Alexa in your patient or family member's hospital room?


AI in medicine is happening faster than we can keep up. Physicians will need to have a voice. In the doctor's lounge you can have one without Facebook, Instagram, TikTok owning your data and thoughts. This is where we come together to have safe discussions. Let's make the transition together.

UK doctors began a 3-day strike yesterday, in response to prevalent burnout and abuse, inadequate pay, and understaffing.

The walkouts will put more pressure on the NHS, which is already experiencing waves of strike action by nurses, ambulance workers and other staff.

My former residency program matched 3 women this year. For those of you who don't know Orthopaedics currently has less than 5% of women in practice with current resident statistics at 11%. I'm grateful to see more women choosing #orthopaedicsurgery. It's time to #change the landscape.


Please note: The content of this site is for informational and/or entertainment purposes only, and is not a substitute for professional healthcare, medical guidance, diagnosis, and/or treatment provided by a personal physician. Always seek the advice of your physician with any questions you may have regarding a medical condition, and for emergencies, please contact emergency services by dialing 911.