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So let's talk Dr. Harris. Tell me about Cross Care Direct, how I
can refer people to you. Tell me exactly what you do and why it's different and how all that stuff works.
So Cross Care Direct is a traditional outpatient family medicine clinic so I
do family medicine as you recognize any other family physician
(okay) so primary care visits chronic illnesses acute care prevention and just
we cover the gamut (right). We even do small-scale procedures (okay now when you say
small-scale?) Things like removing moles, taking skin tags off, small lacerations when you cut yourself we suture you up. We freeze off
warts very basic procedures that nowadays you often don't have time to
get done (right) in the primary care office you have to get referred out to
someone else (okay so do you need a referral to come to you do you handle all that?)
I'm your front face (okay) I'm as some in the medical world will call your gate
opener (okay) so I'm a gate keeper and you're gate opener (okay) and what I mean by
that is you come to me for your services without permission from anyone else (okay)
because you choose to come here and see me as your primary care physician person
(okay) you want me to look at you, evaluate your health, see everything
that's going on with you and decide do I need to go out to a specialist is that
something together that you as a patient and me as the doc can talk about and
decide what happens next (right). In addition to that what makes the model
unique because you could argue what I've described so far is...sounds like a normal doctor, right? But the key
difference in this model is the pay, the way it's paid. Everything else about it is unique
so there's a method to that madness of the name direct care or
direct primary care (okay). That means there is a direct financial relationship
between the patient and the doctor (okay) so there are no insurance companies
there are no third party people involved there's no Medicare, no Medicaid
there's no claims there's no get a bill here at the office get another bill when you get home
None of that! It's direct care meaning we have a conversation you agree to pay a
monthly or annual fee retainer (okay) to have me as your provider to have me to
have access to me to have access to my knowledge to have access to the care that I provide.
(Wow) That keeps it simple (yeah) and what people never think about is from a
doctor's perspective the beauty of that and the benefit to you as a potential
patient I don't have to decide how to take care of you based on your insurance - or your lack of insurance
I can literally say to you I'm gonna take great care of you based on the
current standards and I'm gonna take great care person B based on the
standards and I don't ever even have to know what the insurance says or does we
don't care (right) that discussion is strictly between the two of us we get to
decide what happens to your health and how to make it happen that's a very free
way to practice (right) it's a very safe way to practice (It seems like it benefits the
customer a whole lot.) Completely! You get a hundred percent attention without any
distractions without any input or anyone else everything we decide is because I
from a medical standpoint think this and you from a personal standpoint think
that (right) so we put our heads together and figure out the best way to care for
you nobody else has anything else to say about it with that said you might say
well okay I pay you this monthly or this annual fee you serve as my doctor what
happens if I do need something else something that's not covered under these
plans as it stands that's when we have a discussion once again it's a direct
discussion between the two of us and I'll say Mr. Jamison I need you to get
test A test B and oh by the way I need to send you the specialist number
one. We have a discussion about exactly what that cost (okay) no where in
medicine doesn't happen (right) that's part of the issue now (right) with the rising
costs (the surprises) surprises (yeah). There are no surprises here! You know exactly
what a test costs which by the way any test that you get done through this
office is offered at wholesale that I don't have to make profit. (I was thinking that because you don't have that middleman it's got to be cheaper in the long run.)
Significantly cheaper! I'll give you a prime example. I went to see my own physician year before last
By the time they got through doing the testing, filed it through my insurance
I received a bill where I owed $150 all right it's about five tests five lab
test I decided let me take it to my office
I'm curious based on my wholesale prices what would I've gotten those labs done
for in my office without dealing with any third party - $50! (Wow!) That's without
filing insurance that's without anybody paying anything upfront nothing it was exactly $50. (So a third) of the cost. We think
sometimes we're getting the benefit because we have the insurance but people
have to keep in mind (there's a profit there). Everybody has to make their cut (right) but if you don't have as many layers in
there (yeah) and you offer the exact cost savings you
pass it on down to the patient they realize wow that's pretty reasonable (right)
I can do that period and I'm not disturbing anybody else I'm not having
to use insurance I'm not having to go look somebody else I'm not having to
take out a second mortgage out on my house (right) you know none of that stuff
and these things get taken care here in the office and you furthermore you
know exactly what's getting done to you and why (right, because I'm talking to you) you're
talking to me and I tell you exactly why I'm recommending this this and this
(right) we talk about what potentially can happen we also the other benefit and
that goes back to not only good access but great quality of care and an open
line of communication when you leave the office if I'm recommending the
specialist and you've agreed to see that specialist we make sure before you walk
out that door we call and say what is it gonna cost if it's not gonna cost
anything here's their insurance is it okay they use the insurance there and
what is it gonna cost them so before you leave my office not depending on what somebody else
tells you (right) before you leave the office I make sure you're set if you
want me to set that appointment before you go I do that I don't send you out the
door and say "call 'em". Call Dr. So and So and get yourself in there that's our
responsibility that's what you're paying for in terms of access (that's amazing) it's a true blanket of care that we take care of
the bases (right) we schedule it all if there's something going on I have a lady
now who's having an issue with seeing one provider it's a lot easier for her
to see a provider that's closer so we're on the phone down trying to get
that patient transferred to this other physician and if it takes me getting on
the phone with that physician to explain the circumstances we will do that
because the better care for this patient is gonna be right here where she can
best be seen (right) we're gonna make sure that happens the beautiful thing about
this setting in this model I'm your physician but more important I'm your advocate (right) that's a big
deal (right) as people get lost in the healthcare system (right) my patients go
in the hospital I know exactly what happened to them I know what's going on
I'm an affiliate through Piedmont if they say I've been hospitalized I simply go in the system and pull the records (okay) I look at it
I follow that along the way there are some that I even go and visit in the hospital (right) depending on what's going on
they don't have to fear I have to actually tell my patients you do know you could've call me right? Um and that's
the other difference significant difference in this setting and another one you have access to me 24/7
and what I mean by that is in a
normal setting that doc goes home you may get an answering service you may get a
backup doc you may get a nurse bottom line is you may not most cases you will not get
your physician directly our patients here there's a private app a HIPAA
compliant app that they are able to reach me after hours if they are from
afar they may text they may send a picture they may reach out to me by
whatever means they need to and the phone doesn't ring here it doesn't ring
to my assistant it doesn't ring all over the place it reads directly to my phone
(right) so they have the access and sometimes it's just reassurance in the
middle of the night that no you don't need to go to the emergency room (right)
I'll see you in the office the next morning that's the beautiful thing about the way this
works it could be something to happen or late on a Friday afternoon
rather than wait until Monday you can call there have been
occasions I come back up here and I meet you and we deal with it I've had to
suture folks at seven o'clock nine o'clock on a Saturday evening it's whatever
the need is to keep you out of other systems that are more costly not only to you but to the healthcare system as a whole. (Now
outside of the money aspect why do why does the general public not know
about this as a whole I would say?) As a whole (yeah) I would say for two primary
reasons number one we're creatures of habit
(okay) so if someone comes along with something new and it sounds too good to
be true (right) we're like yeah right there's something not
right about this (right) so we're a little leery in terms of being able to listen
to and open up and accept that this is indeed a way that we can take care of
many of our healthcare issues (right) that's number one number two there are others
who would argue this is not a fair way to handle health care in the sense that
people still need insurance and we don't disagree with that
matter of fact we encourage our patients to take on us as their primary care
physicians because they want the best quality care but tack on a catastrophic
coverage plan (okay) so that they indeed they are covered for the times they
absolutely must end up in an emergency room and end up being hospitalized
that's a necessity for all folks our thought is why pay an arm and a leg for
that same coverage when you either A barely utilizing the services (right) or B you
really just need the attention along the lines of primary care (yeah) primary
care is inexpensive if we do our job (right right) so why are we paying for
this souped-up policy to cover primary care ER all these catastrophic issues
(yeah) when we can simply pay for a catastrophic plan tag on a Cross Care
Direct and the other primary care docs for a less expensive fee the annual cost to
us the annual expense is ultimately a lot less (right) if you do it that way but we
have a weird way of thinking about I don't know about that you know that's a typical response
(yeah) and I like to share it as it's what I tell a lot of women how many times have
you ever put on an outfit and everything about that outfit came from the same
store (right) it's the same way with healthcare (right) you're looking for the best
bargain the best quality the best look the best fit for the best price (right)
that is healthcare we have to see it the same way there's no set way of either you
have insurance or you don't and if I have insurance I'm getting good access
and great care they're not synonymous anymore (true) if you haven't noticed deductibles are going up, premiums are going up coverages are
going down (yes) well this is a good response it's not the only answer but
this is a primary response to that (right) here's a way you can say you know what
I'm not gonna be a victim to this I get what's going on and I'm gonna work
within there and make sure I have some insurance but I'm also gonna make sure I
got good quality of care I'm not gonna get lost in that shuffle of now doctors
are having to see 20 or 30 patients a day (right) and here we see 12 to 15. (That's what I was gonna ask you've got probably a
lot less patients coming through here could you give them more time.) Cause you
give them more time you give more attention and patients why not they
deserve that because what we've learned even as physicians if we're able
to dedicate more time as a whole in general often times you can find out
what the root of the problem is not just write a prescription most people
are looking for you to show that kind of attention (right) not everybody wants you
to write a pill for every little thing that goes wrong (right) but that's what you're left
doing if you don't have the time to get to the root of what the concern is and
how to deal with it in this setting we have the time to sit and talk about
alternatives the first choice is not always going to be a medication (right)
but unlike before in a traditional setting I didn't have time to sit and
talk to you about that if I'm sitting in a 15, 20 minute slot let's get to the
problem boom here's a script (and that's what it feels like when you go to the doctor) that's what it feels like
(You're in and out they got this little shuffle that they give you you go get your blood
pressure put you in the room and then bam bam bam the doctor's boom boom boom and here's your prescription
doesn't work like that (okay) doesn't ever have to work like that here (yeah) you come here and you barely see
other folks sitting here in the room with you (right) there's no
double booking folks on top of one another your slot is your slot your
time is your time it doesn't matter if you want to come in and talk about one
item or if you literally got five things you need to deal with we have the time
slot to address that and as a result you feel comforted and reassured my
doc's actually listening to what I have to say for a change and not just going
by what the book told them to tell me so that's the beauty again of this model
this model has so many benefits (sounds like it) just they're just people will
sit and go are you serious (and the name of this model is direct care) is direct
some refer to direct care (okay) it's also known nationally as direct primary care (direct
primary care okay) literally for those interested you can Google direct primary
care and you'd be amazed at what comes up in terms of the definition the number
of practices that are growing across the country doctors are fine going this is a
better way to take care of my patients there's nothing wrong with keeping up to
date with current technology current ideas what the current studies recommend
in terms of treating patients but what should never have changed is the old way
that we really reached out and took care of our patients (like the house calls) if patients have a
specific issue and there's something that won't allow them out special
circumstances you know I have some older patients that if push comes to shove and
a family can't get them here then guess what they get a house call visit that's unheard of but that's an old way and it worked very well (right) cause you'd be
amazed what we learn from each other when I come to your house (right) as opposed to here (in the atmosphere)
(so you see okay) you see a lot more and anything I'm able to see and learn about
you it helps me take better care of you
(right) that's at the end of the day the more I know about you what your desires
are your goals are in terms of your health your stressors the better job I
can do taking care of you I can literally say I bet you we can fix this
you know I have one patient that I knew part of her issue she wanted to she
wanted something very particular to happen but her family wanted her to do
this other thing and I didn't have to say a word I knew her well
enough to say you want to do XYZ don't you and she dropped her head she's like I kinda yeah cause the family
really was pushing for this other so literally because it was a different way
of caring that family was in the room that she was in the room we're sitting
here going what's a good compromise and what am i okay with in terms of your
health that you can live with and your family will be okay (right) that
doesn't happen in a traditional sense (right) there's no time for that meeting
of the minds (right) so this this is a beautiful way to do it you know we're a
lot more satisfied at the end of the day and the patient's walk away going oh my
god yeah why has it been this way for a long time (right now when you started your practice and
started that training and going towards medicine did you look towards direct
care okay so you stumbled across that how did you) fumble into it if you will (yeah) no I started
out as a traditionally employed physician for a big hospital system
uh-huh you know all bright-eyed and bushy- tailed going in thinking oh wow I got a good
salary life is good this is what I want to do is I want to be a doctor at some
point very quickly probably within the first year I started thinking oh my god this is getting a little overwhelming
but but maybe I just need to get used to it you know let me get a feel for it and
as time grew and the more I grew accustomed of what was expected the less I
liked it so I slowly in the back of my head didn't know that potentially I
might walk away had no idea what direction to go in but literally was at
a point that I said if I can't make things better and do them a little differently I
may not stay what medicine (Wow) that's how serious it had gotten for me so I started going to
various conferences and I started talking to other colleagues and as I
reached out I found the first thing I learned about was concierge medicine (alright you're throwing another one at us)
yeah so when people hear about concierge from from a layman's standpoint (okay) the one major
difference between concierge and direct care or direct primary care is the way that
they pay concierge physicians file insurance as well as have a small
percentage of their patients that have pulled over to the concierge side (okay)
so the concierge aspect of their practice is direct care (okay) but they
pay the patients have to pay more for concierge because those doctors are also
seeing their traditional insurance (so it's kind of a hybrid model) it's kind of a
hybrid model so when you hear concierge and direct care that's gonna be your difference (okay) the
other thing you should automatically think when you hear those two terms is
concierge is automatically on average around the country gonna run you
anywhere from 1,500 to 2,000 dollars a year (okay) that's on average most direct
primary care practices will run you approximately seven eight hundred
dollars a year so significant difference in cost and the reason is direct care
docs don't have to worry about pulling finances through the insured patient
right because they don't use insurance anymore
(so obviously their overhead is down they don't have a biller & coder) exactly (their staff isn't dealing with claims all day long) that's why more people
are paying attention (okay) cause they're thinking in this effort to get health care cost down why not go
with a leaner system and that's what this presents this presents leanness
and this presents transparency (right) so in doing that what you're able to drive
those costs down if we keep things very transparent so when I've said all that
going back to that was the first model I learned about outside the traditional setting so
there that trickled on down I learned a little bit more about hybrid the real
hybrid because true hybrids are DPC plus insured like they still offer that true
cost but they have even fewer of these insurance (so the ratio is different they got
more DPC's) and that's because of the financing of it all so and then finally there's direct primary care who says we're just
not going to deal with any of the insurance policies at all with the
notion that we want our patients to have some insurance coverage because you do need
it in place for when you really need it in place (right) so bottom line is
what was funny about the whole development is I ended up I remember
when I first left residency and one of my attendings very wise gentleman he'd
say you've got to figure out what you wanna do when this is over and you're looking at him thinking I wanna be a doctor what are you talking about the first job you have we're thinking
this is what I wanna do (yeah right that's why I'm here) he goes
no 75% of you when you leave here you're not gonna keep the first job you have
and we're thinking yeah right you know we're gonna get out get these great jobs is gonna keep them and he
proceeded to tell us about different things other alum had done when they left the program well one of the alum
as I later find out is one of the gurus of direct primary care he was one of those who went out did it before it was
okay and he stepped out and I remember this attending telling me the story
about this gentleman and I went who in the world does that (right) you can't make any money doing that down the
road as I began to attend all these conferences I keep running into this one
gentleman and I listen to where he came from I think that's the alumni that's
the gentleman "right" so sure enough anyway bottom line is he now serves as a mentor
to me (okay) we ended up talking communicating and he says yeah I did it
16 years ago I've never looked back in then he said and here's why and he tells a
very similar story to what I told you earlier in terms of I don't have any
distractions in terms of my patients doesn't matter what status they are when
they come in they all get the exact same care (right) and that's the way medicine
should be (right) he says that's how I know I've been doing this thing right
and and that resonated with me as in that's it (right) that's my out and so as
a result I prepared myself to leave that traditional setting did as much research
as I possibly could and decided you know we're gonna step out on faith
and we're gonna try this (right) and see what happens here and here is Cross Care Direct (yeah) hence the name came from I literally I
will kid you across the street at the light (okay) and the name I wanted I'd
already checked with the state and the name was taken (okay) and I said man I was all hype had my name all down
so yeah yeah that's gonna be perfect and they disappointed me and so I
sat at the traffic light there one morning and I was like Lord I don't know what to name this practice
may name ain't there and I they don't have it and then it hit me he said at the cross
you're at the cross Cross and Care
why not (yeah) and that's how and the direct so you know it's a cause again my mentor put on the direct part because
his thought was I feel that direct primary care it's a movement (it sounds like it) that you have to
embrace (yeah) if we're gonna make some improvements in the health care system
it's not it's not the you know the answer to all but it is a very clear
part of what the solution is going to be about and that's transparency and that's
access and that's the reassurance that hey I have a doctor that truly cares
about what I am and not what I bring to the table (right) and that's the best way
to describe how this model works (that's amazing that's amazing) I'm telling you
it warms my heart everyday it's like yesss this is the way it was supposed to work
(and unfortunately I'm sure the insurance companies don't like it) yeah they don't (it cuts their margin I mean they still get the
the tragic care) yes (but they probably make their money I'm
sure off the little doctor's visits) and the way we're tying to appeal to them as a group is ultimately don't look at is we're cutting into your first your first
line look at how much savings we have on the bottom right and what we're gonna
do because these patients can get to us so readily and so easily we're keeping
them out of those emergency rooms where the costs are much more for those insurance companies we're keeping them out of
the hospitals cuz you're gonna pay more for that so it's very hard obviously to
change that mindset (yeah) but that's how we're trying to appeal to them we're not
trying to replace you we never could we can't afford to do it that's not what we
do but we are we think complimentary to insurance and we are part of that
problem to put insurance on board with us gives patients the best access the
top quality the most cost effective way to have great primary care plus
coverage when they really need it so that's how we're it's been a
challenge but that's how we're trying to appeal (right) to the insurance companies
as well as employers many of these employers who same thing they
look just like the individual person and go what in the world is that (yeah) how can I
be assured that you are gonna offer my employees good quality health care I
don't know what this is I don't even know what this is about (right) so we
currently have some efforts of working on a bigger scale with brokers and some
others who are willing to service in terms of volume as opposed to
saying my commission is going to come off of me something that bigger more
expensive plan we want them to get into the interest of their who they serve the
employers that are coming to them saying create me build me a good plan (right)
something that I know I can rest assured folks (my employees are going to be take care of)
right and the cost of insuring employees is growing so employers are
looking for other ways (always, every year) so we're trying to reach out and say brokers hey
we're here guys learn about us research about us a little bit
(right) this is a good way to build a plan for your employers (right) um there are
some areas of the country where they're putting this together where employers
have huge cost savings because they decided to say and they "what is that agin"
let's try that let's give that a shot one year and they can't believe
the cost savings to the company and their employees are more than satisfied
they're like hmm we've been recently been to a conference
where they talk about there's a hospital system that jumped on board (Wow) that
said you know we kept looking at that and we kept thinking how are they doing
that and they decided to do a pilot one year with the employee with what a
certain percentage of the employees and they're like now everybody we're
changing everybody over (right) there's no point in paying all this money when our
employees are more than satisfied with going through direct primary care for
their primary care services (right) as long as we're providing them with
catastrophic coverage through traditional insurance (right) they're like
and it's a huge cost savings to the hospital system (right) all right but people think
it's too good to be true you know there's nothing too good to be true but
it's very simple and very basic we we don't have to put all these extras and
put that low fluff on it it's a very simple way of doing business it's a very
simple way of providing health care and most important it brings
transparency back to the table that's where your that's where that's where
we're gonna make that difference it's one of a few industries where
transparency is almost taboo (yeah) that just doesn't make sense I mean not when people are losing their homes
(not when I'm dealing with my health) and people are losing their homes because catastrophically they don't know they thinking they're
walking out with a thousand bill and they end up with a ten thousand dollar bill you know it's so unnecessary
(right) this is so easy in terms of how to handle that (now you mentioned
something that was pretty interesting about them the employer and the plans
obviously there's no network there's no PCP or you know so how does
in that situation how does an employer give their employees a list of people do
they send them to a website is there a central location we're all direct care physicians are located?) so that's in the works there are
some listings like that and many of them come from DPC.org direct primary
care journal access health has a list of DPC's across
the country there are a number of them where you can go directly and it will
give you a list of the right primary care physicians in the country (okay) one
of the things that's happening with this movement is in various segments of the
country we're coming together as DPC docs saying let's form these
alliances and we're having a discussion about what if we were to come
together we each keep our own practices with our own separate names but we serve
as an alliance so that if an employer is looking to see how many places or how
many physicians will be available for my employees where can they go (right) and if
we settle this alliance in along the terms of we all are going to be offering
this standard of care this level of services then that that employer will
comfortably be able to say yeah I'm gonna go with the right primary care
with Dr. Harris with the reassurance that I can go and see Dr. XYZ down in
Savannah and receive the same level of care (right) that's what's being
worked on now in various regions of the country and that
seems to be expanding very well right now in the Midwest and the Northwest (okay)
so we're working on it here in Georgia as well as some of the surrounding
states (right) but that's in the works that's in the making but if it's someone
that says now I'm looking I'm really curious to do this now because I will
tell you most of us provide corporate rates so it's more than reasonable if
you're sending X number of employees over to get them covered for a fraction
of the cost tag on a catastrophic plan so those
employees are covered and it's huge cost savings to the employer (right) you could
do that now literally by going to some of those websites and hey direct primary
care doctors Google you can just google that even and there are multiple
listings that come up there are several companies one right here in metro
Atlanta that has a list of the direct primary offices across the state so there are
a number of resources to do that but again most employers are reluctant to try and
see through this hence the reason we need to get the brokers onboard so that
they're able to best describe what they get because you want to make sure you're
comparing apples and apples whenever you're looking at policies for your
employees (right) so again that's part of this movement of let's get them in the
conversation let's get them to the table and that's already started (okay) in terms
of let's get them to understand why this is beneficial and don't look at it from
the fact that yes maybe I sell a plan that's less expensive and my
commission is less but look at it from the standpoint but I'm gonna sell more
of those plans (it's going to be about volume) because the person you're serving right it's gonna be a volume issue
but again as we know changing those habits (right) that mindset is gonna take some time so that's where we are in that process (okay)
(then finally as you were talking I thought of one other thing somebody who's coming up and thinking about being a
doctor or somebody's going through residency or even a child who's saying I
want to be a doctor when I grow up (okay) how what would you recommend the route
that they take to get to where you are now should they go to regular route like
you went through residency and then going through you
know working for a big you know company or can you they jump right into the
direct care? What's the trajectory you recommend they take?) And so I will say
my journey's a little different this is a second career for me (okay) I left the US Postal Service (okay) to become a physician
a little non-traditional (okay) and so with that said it takes all kinds
there is no specific path to follow the obvious the younger you are you follow
that path to A to determine do I really want to do medicine that's the biggest
deal you know because in the end of the day going through college finishing
college going through X number of years of medical school and then going through X
number more years of training as a resident that is not something you're
gonna want to do on a whim and you will not stick with it if your heart is not
truly into it it is not your calling forget it you will quit on a drop of a
dime (right) they have too many mechanisms in place to weed out so with
that said obviously the younger up you go you follow up get yourself into
college decide what you want to major on and keep in mind you don't have to be a
science major you know I've met many colleagues that have majored in a
number of other things way off the beaten path but decided they wanted to go to
medical school so they made sure they had the additional course work which
will prerequisites and get into medical school so already be prepared for four
years of college already be prepared for four years of medical school there's no
getting around that what you decide to do after that obviously depends on what
you grow an attraction to in medical school (okay) in terms of the specialty
(okay so I will tell you that's where most doctors kind of figure out) right they
figure it out and that's because during the latter few years of the medical
school you're spending more time in clinics and hospitals getting a taste of
almost everything that there is out there (okay) that's where you develop that
that love or not so much love for certain specialties at that point you
have a couple of options you can say you know what I'm gonna follow the
traditional path I'm gonna get in get into residency and get out and take a
standard job with a hospital systems excuse me that's where the vast majority
of doctors do young doctors that's the course they normally follow I will tell
you that is slowly kind of changing a little bit as was represented in a
meeting I was just in a meeting full of Georgia direct primary care docs two
and a half weeks ago one young lady just finished residency and she said I don't
think I can do it (yeah) she immediately says I've been researching direct care I
think that's where I want to go but I'm a little afraid I don't know how this is
gonna work another one is in residency and will not
finish until June she's already decided that she's already putting together her
practice she has decided I want to follow the path where I go directly into
it I will tell you that it is a harder road to follow because you're coming in
from scratch you're brand new you already putting the burden of hey I've
gotta make this work on my own you've invested a lot of you into it and you're
hoping that with the help of your colleagues that you make this successful
so that's probably the road less traveled it doesn't mean it's not
possible the more typical way to do it is to go out accept the position whether
it's through an employee at a hospital system or as I've recommended to
somebody recently come out and do what's called locum and locum is basically
temporary doc so you're not committed to anybody for any extended period it pays
very well it is depending on your home setting as
to whether or not you need certain benefits cause they typically don't come with benefits so that has to be calculated into what you're gonna make
(that's why they pay more) that's why they pay more it pays better because you gotta go get your own coverage you gotta go get most places your own malpractice you gotta get all these other things
(okay) that's a great way to go though because what it does it gives you an
opportunity to explore all the different ways that they aren't to do what you do
and so you could agree that I'm gonna take a job in a standard outpatient
clinic nope I'm gonna take a job in a hospital setting nop I'm gonna take a job
maybe even through another DPC doc that temporarily needs somebody (okay)
nope I'm gonna take a job in an urgent care nope I'm gonna take a job up in
Timbuktu Alaska it lets you explore so that you get to see without any
long-term commitment what's out there what will work for you and what
absolutely is not a part of your DNA that's a great way to start if you
really are afraid to commit to any one thing (right) and with that said you do
that for as long as you feel comfortable doing that you do whatever research you
need to to figure out what direction to go in and then you pull the trigger
and say I'm gonna go direct primary care or no I really see how this works now
I'm gonna go into the traditional setting so it just depends on how it
goes I will tell you now a large number of the younger physicians coming out are
very dissatisfied and it has a lot to do with the fact that non-medical folks
the bean counters if you will are dictating how you see patients how long
you see patients and what you can see them for (right) and most of us will tell
you we did not go to medical school for that (yeah) and so it's very frustrating
they feel that their care is inept they're not having the time they would
like to have with these patients just as I've described to you earlier they don't
have that there in 15 or 20 minutes time slots keep in mind it's already
taking 5 or 6 minutes to get the person to the back to get the vital signs so
(so that's part of the 15?) that's part of the 15 -20 minutes so now sometimes you're left with
between 8 to 10 minutes to actually discuss an issue with your patient hence
the reason when you go to your doctor's office oftentimes they'll tell you all
right son we're gonna talk about one issue two if you lucky because they've
got to get you in and out cuz there's a whole waiting room of people that's got
to be seen and remember their incentive is the more of these I see the more I
make or the company's incentive the more of these you see the more I make versus
when you come here the money's already been paid through your monthly or in
your annual stipend so it doesn't matter if it's 1 issue versus 10 (right) it's
to my benefit to keep you healthy keep you out of here so that you don't have
to have any specific issues and it doesn't affect my bottom line one way
the other (right) that's that's one of the things that's critical and docs newer
docs are getting smarter and wiser about they're looking at what what's
gonna be the demand what's gonna be the pressures if I do it this way versus
this way don't get me wrong going into direct primary care comes
with risk (right) because you literally probably started from the
ground up there's a handful of us that were able to break away and take
patients with you I wasn't one of them I had a non-compete clause and most
doctors do (right) so you literally started from scratch you're starting on
that faith that okay I'm gonna be able to convince folks hey this is an ideal
way of doing it with the notion that they understand this is unique so they're
gonna look at you as though you have that third eye (right) but it's up to you
to sell who you are and it's up to the patients who will serve as personal
testimonies when they experience what goes on here in this office and the way
in which is handled they truly are the best in terms of word of mouth they will
go back and say oh yeah I'll never to back (yeah) yeah not at all. I had a patient not long ago he became eligible for Medicare
he said doc do I have to he literally did not want to leave the system (right)
and we explained to him no you don't have to leave
you can still utilize Medicare just not in the office but when I send you out
somewhere else if I need to send you to a specialist or you need to go get your
x-ray you can use your Medicare that's perfectly ok you just don't need to here we get to do what we
need to do here (right) and you can feel reassured that we're taking the best
care of you (right) and that's all most docs want even the newer docs coming out they're
looking for a way to satisfy that desire to help folks and unfortunately the
current system the way it keeps pushing you through the way it keeps demanding
that you enter metrics into the computer while the patient sitting there yeah (I was wondering why they're sitting there) instead of talking
(or you're talking to their back) talking to their back it's the demands of the way the
current system sits this allows them to get away from that and they really truly
feel like they're back to practicing medicine so there's no set way for
anyone to follow this path you have to sort of find your own way there are
certain standards that have to happen college degree, medical school, residency those are a must (so you gotta go those routes?)
you gotta go those routes and it'll vary depending on how you do it in terms of how many years but
college likely is gonna be four for most people med school is gonna be four for
most people unless they're adding on a master's degree very popular now is to
do a five-year program where you get your medical school degree as well as
either the MPA or MPH (okay) and then those you're not getting past and then
residency would vary anywhere from three years sometimes up to seven to ten years
depending on the specialty so that those three those three sessions you
cannot skip that's just that's the law yeah that is the required training
(and as a customer I feel good as a patient) exactly! knowing that I have that many years behind all of this
so yeah and so what they decided the end of all of that is what dictates whether
they decide to go directly into direct primary care (right) or tread those waters
carefully an go with a traditional setting or go out here on this locums
path but they sort of get to taste and feel a little bit of everything without
the benefits of some of the the perks that come with that (right) so there are
multiple ways to accomplish that and then at the end they have to sort of
figure out how they want to do it I will tell you again especially having had
that recent meeting with the Georgia DPC docs they followed a number of
different paths there were again I told you one in the room that just finished
residency one still not done most of us have been in a profession for a few
years I will tell you most of my colleagues have been out there at least
10 years (okay) I was one of the newer ones in the room I had only been out
there three years when I said that's it I can't do it anymore so it really does depend on how you kind
of get to that point others had other types of practices and
they broke away some formed urgent cares and then decided that wasn't quite it and
kind of moved on over there are a number of pathways to get there but it's all
about deciding what you as a provider are comfortable doing and what level of care
do you want to offer to your patient (right) if you're okay don't get me wrong
if you're okay seeing the 23, 25 patients a day and you're able to get through
it comfortably and your mind is all right and life is good you do it there's a place
for everybody but for a lot of a lot of a lot of new docs
especially the newer docs you know they want their lives they want happiness in
terms of their personal lives they've committed a lot of years to that
training (right) they don't wanna have to spend a whole bunch more years
struggling (right) in terms of not being happy with their career choices (yeah)
(Well you have absolutely blown my mind on how this whole system works I mean I had no idea
even in our weekly meetings) yeah (you give us some nuggets every week it's still not
encompassing every that we just talked about that that is
absolutely amazing) and that's why you hear in some of those meetings some of
them even though I talk about very real illnesses and conditions and how I
handle them but you notice that it's somewhat unorthadox
about a lot of the ways that I handle some of the things that I do (yeah)
because this setting provides that (right) I'm able to actually go through and do that yeah you missed the one last week where I don't remember you might
have been known if you missed it the first time I did the plate (yes yes) I redid it
(okay) but last week I redid it in terms of the different diets people like
to try and so (okay okay I gotcha) each person got a diet and you had to lay out
what your diet would be and what kinda food you would eat and
I did all that to prove the point of here again this is a
traditional segment that a patient may have it's a very real session that a
patient will come in and say look doc I don't know what to do in a traditional setting no doctor is gonna
have that time to sit down and sort of walk through that process (and almost
meal plan with you) and forget a meal plan they're gonna refer you to a nutritionist they're
gonna tell you go see your personal trainer or whoever at the gym and that's gonna be your set of
generic instructions versus this is one very real of
I know exactly what your health issues are I know what your goals are I know what your
concerns are we can go through maybe three or four of those top diets that
you're considering and tell you why I think this one's better or this is worse
there's time in that setting something very unique that you don't get in the
standard setting (right) who does that what the doctor (yeah)
so that that's what makes this you you hear the snippets but the snippet is
all derived from very real cases of folks that come through and the manner
in which we're able to handle them the creativity that we can use to get people
to understand what works for them (right) you don't get you know my one you know
my one bill fits all you know speech because you're very unique and person
so and so is very unique and they like that we reach out to them and we
meet them where they are (right) so it works wonderfully and we tend to get
much better responses because of that they don't feel I ran them out yeah go
lose some weight go exercise you know same old (inaudible) cut down on your fat cut down on your sugar
(yeah) those are generic statements (right) now because if you were me and I was the
patient I need you to tell me how (right) you know that's I feel better if you
explain to me how and maybe you even come back to me and say I can't do that
and that's very real I need to know that so we can figure out what can you do
(right) here's how we're gonna get you where you need to be so here's what you
can do I had one patient who said I'm not
giving up rice she didn't care what I tell her (yeah yeah) she's not giving up rice and (then you could
adjust it) I can adjust accordingly instead of sending her out saying get rid of the starches not
knowing she was never gonna give up rice "right" so it makes a huge difference (that sense of defeat that hey I couldn't
accomplish it now just throw in the towel) and here I am I'm a doctor
frustrated because you didn't listen to what I told you in those two minutes
(right) so (right right) yeah exactly so that's that's the beauty of what this is
and the reason I'm able to give those little tidbits about how this works and
why it works are very well yeah yeah (any any anything else that we should know
about direct care and if not wrap it up and tell us about you you know your
practice how we get in touch with you how we how you set an appointment how
you get information about getting on a plan you know bring all that to a
close) so in terms of just anything else I recommend I highly encourage you to go
research the model it doesn't have to be Cross Care Direct right now I want you to
research the model because I like informed patients I want patients
informed so you can decide what's the best way to put something together to
cover healthcare or health services for both you and your family so that's first
and foremost research the model online just Google direct care or direct
primary care the other thing I recommend obviously go to our website which is www.crosscaredirect.com
on that website it gives you an idea of how we got here a little bit of the background that we talked about today
how I came to the conclusion that this is a very good way to care for you
it also gives you an idea of deciding whether or not this is a potentially good model for you
and your family in addition it lists the plans that are there the cost of what
those plans are and a generic overview of what's covered under
those plans if there are additional questions almost always call the office here the
office supervisor's Chanell that's the other beautiful thing there's not a lot
of turnover in the office so you get to know the two people that work here in
this office so you can literally call her and ask her any questions and no
question is stupid it's whatever hey how does this work
wait a minute do I get to pay this so you can pick up the phone very easily
the other offer we have for any potential patient is anyone is entitled
to a free 15 minute consultation so you can literally come in call schedule
whatever the case may be to the office and say I don't know much about this better
yet I don't even know how I'm gonna like Dr. Harris (right) you can come
in for 15 to 20 minutes and we sit down and we go over whatever's wrong with you
whatever your concerns are whatever your goals are and you get a feel for once
you see the place you visit it you get to decide whether this is a good fit for
you and your family potentially and very easily you can always reach out to us
we're here in Tyrone 56 Carriage Oaks Drive Tyrone 30290. And again you can
call us at 678-827-9799 and we'll
gladly answer any questions that you have. (Awesome! Great information today
thank you very much Dr. Harris for sharing the model sharing you sharing Cross Care
Direct. I hope you guys got some real good information I hope you come see Dr.
Harris because this is a wonderful model and the office is beautiful so
come see Dr. Harris Cross Care Direct take a look at the comments I'll
have some links to her website address and everything like that) so make yourself at home find a new family {laughter}
(Thanks again Dr. Harris. Do you have a little motto or anything that you'd like to share about Cross Care Direct? Something that)
yeah, you know keep in
in mind when you look at us again WE FOCUS ON YOUR CARE, NOT YOUR COVERAGE
that's the most important aspect of Cross Care Direct (there you have it Dr. Harris
Cross Care Direct. Thank you very much. Appreciated {applause}
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