Imagine a healthcare model that emphasizes meaningful relationships, provides quality care without delays, and saves you money on essential services. Our conversation with Dr. Mike Freedman brings you just that as we uncover the revolutionary concept of Direct Primary Care. Dr. Freedman, a trailblazer in primary and urgent care, shares his inspiring journey from his work at the Stanton Center, one of the nation's busiest free clinics, to pioneering the Direct Primary Care model.
Join us as we discuss the potential of Direct Primary Care in revolutionizing healthcare by offering an alternative to the insurance paradigm. Through Dr. Freedman's experiences and insights, we'll explore how this innovative model fits seamlessly with holistic services such as therapy and classical Chinese Medicine. Learn how doing away with long waits and unnecessary visits allows for more accessible, patient-focused care that empowers individuals to take control of their health.
Don't miss our deep dive into the advantages of Direct Primary Care, even for those with insurance. We'll explore how this model can help reduce costs, improve access to care, and offer a more patient-centered approach to healthcare. We also touch on the role and challenges doctors face to insurance companies' requirements and the ongoing research that further demonstrates the effectiveness of Direct Primary Care. Tune in for this enlightening conversation with Dr. Mike Freedman and gain valuable insights into the future of healthcare!
https://evolvemedicalclinics.com/
info@emc4me.com- Email
844-322-4222
Videos on our YouTube Channel:
https://www.youtube.com/@RecoveryCollective
Visit our website!
Recovery Collective — Annapolis, MD (recoverycollectivemd.com)
Zaw Maw — Recovery Collective — Annapolis, MD (recoverycollectivemd.com)
Luke DeBoy — Recovery Collective — Annapolis, MD (recoverycollectivemd.com)
New Episodes are released every Monday.
Please send your questions to: luke@recoverycollectivemd.com
Thanks for listening, and please subscribe/comment/review/follow/like; if you think others would benefit from the podcast episode, share with others, as COLLECTIVELY, we can find solutions to all things health and wellness.
Check us on Social Media:
Facebook: @RecoveryCollectiveMd
YouTube: @RecoveryCollective
Instagram: @recovery_collective_md
TikTok: @lukederecoverycollective
The episodes contain content, including information provided by guests, intended for perspective, informational and entertainment purposes only. The content is not intended to replace or substitute for any professional medical, counseling, therapeutic, legal, or other advice. If you have specific concerns or a situation in which you require professional advice, you should consult with an appropriate
Sign up for our Newsletter
https://www.recoverycollectivemd.com/newsletter
Say Thank You, Leave a Review for the Recovery Collective
Google Review
YouTube Channel
Watch/Listen
Our Website
Rec
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:11):
Welcome to a therapist in Buddhist in you,
the podcast where we embark on ajourney of self-discovery and
collective growth.
I'm your host, luke Deboe, atherapist passionate about all
things health and wellness.
Joining me on this enlighteningadventure is my co-host and
beacon of serenity.
How's?
Speaker 2 (00:28):
that for a couple.
What an introduction, zomal.
What's going on, luke?
This is Zaw Good to be hereagain.
Speaker 1 (00:33):
Zaw is a wise and compassionate Buddhist
practitioner, and together weexplore the intersections of
psychology, spirituality andbasically, all things health and
wellness, offering practicalinsights and, if not by us, our
guests will offer, i think, someprofound wisdom to enhance your
overall well-being.
So thanks for turning in andjoining our community.
Please communicate with usthrough all the platforms,
(00:56):
whether it's Facebook, instagramand YouTube.
We'll make sure to put links inthe description notes, so we're
here to provide you withvaluable tools and perspectives
that can transform your life.
If you find our podcast helpful, we greatly appreciate your
support and, since we do nothave a donate option yet, please
feel to rate and share ourpodcast and with others.
(01:18):
It's a wonderful way to supportus.
So please subscribe, comment,review, follow and any of those
potential options, depending onthe platform you're on.
Remember it's through ourcollective efforts that we can
uncover solutions to all thingsrelated to health and wellness.
So thanks for listening andlet's embark on this
transformative adventuretogether, where holistic
well-being is within everyone'sreach.
(01:39):
Sounded pretty good, didn't it?
Great, yeah.
I felt good about it.
So today we have the privilegeof speaking with Dr Mike
Friedman.
I certainly I certainly see himas a trailblazer in the field
of primary and urgent care.
Dr Friedman is the owner andvisionary behind Evolve Direct
Primary Care and Urgent Care inAnnapolis, maryland.
It's a health care practicethat is transforming the patient
(02:00):
experience.
With a remarkable careerspanning, i think, well over two
decades, dr Friedman has earneda reputation for his unwavering
commitment to delivering highquality, patient-centered care.
See a pattern here.
Yet, as a passion forrevolutionizing the health care
industry has led him to pioneerthe Direct Primary Care model,
(02:21):
offering patients a morepersonalized and accessible
approach to health care.
Join us today as we delve intoDr Friedman's incredible journey
, explore his innovativecontributions to the field and
gain viable insights into thefuture of health care.
Dr Friedman, thanks for joiningus.
Speaker 3 (02:37):
Thanks for having me.
Speaker 1 (02:38):
Yeah, thank you for joining us.
So before we get into thepotential flaws of the health
care, kind of tell us about yourprofessional journey a little
bit.
Speaker 3 (02:49):
Yeah, so I started out from fairly humble
beginnings.
I was the first person in myfamily to go to college.
I really wasn't sure that Iwanted to become a doctor who
had a medical school.
Towards the end of undergrad Ieventually decided to get a
master's in physiology and whiledoing that I really fell in
(03:09):
love with medicine and thescience of medicine.
Somewhere through the course ofthat, when I was working in
Philadelphia during med school,i had an opportunity to work
with a lot of homeless folks.
Just walking back and forth toschool every day I crossed
dozens of people in Philadelphiato Center City.
(03:30):
I just couldn't walk pastpeople without finding out who
they were and what was going onand how they got there.
So I really got to know somepeople pretty well.
So I got my first taste ofhelping an underserved community
in that setting while I wasthere.
(03:51):
And then I went to residency andwhen I came back here I started
practicing more of atraditional medical practice a
matter of fact, a block fromwhere we're doing this podcast
right now and was prettystandard four or five people an
hour and just rushing peoplethrough.
(04:11):
But I found another underservedcommunity that was there was a
clinic that had opened up onesat the Stanton Center at Clayton
, washington, and so I foundthat I could go there on
Thursday afternoons, which wasmy day off, and take care of
folks, and it was just much morefulfilling than feeling like I
(04:34):
was working for the insurancecompanies And then fast forward
to about 2012 to 2014 timeframe,when it just became
unsustainable to practicetraditional medicine for me And
I ended up moving into this newarea that I guess we'll talk
(04:54):
more about.
Speaker 1 (04:55):
So, besides the active service at the Stanton
Center, why did that feel sorewarding?
Speaker 3 (05:01):
Yes, the Stanton Center.
first of all, there was noinsurance.
no one had insurance, And sothere was no strict time limits
on how long you could be withsomeone.
We didn't have guidance of whatwe could or couldn't do, just
had to be affordable, which waseasier to do than stay within
(05:27):
the insurance framework, But youjust felt like you could do
what you're trained to do.
You didn't feel like you hadall the constraints and barriers
that are built into a busymedical practice.
Speaker 1 (05:44):
Now, I don't know if you're downplaying it, but did
you develop that program?
Speaker 3 (05:49):
Yes, so I started.
A couple of guys Bernstein andRich Colgan had started a year
or two before me And I think itwas the first year that they
actually had a.
I can't remember if they had orwe started, but shortly after
that I joined them.
(06:09):
We ended up expanding it prettydramatically.
Speaker 1 (06:16):
So much so, even though, compared to other
centers that weren't free, yougot to spend this time with the
clients a lot more than in yourprivate practice.
But wasn't it one of thenation's busiest free clinics?
There was Over 6,000 patientsper year, correct.
Speaker 3 (06:34):
Okay, yeah, 6,500 per year, all free.
And the nice thing was we had acommunity on both sides.
We had the community of folksthat needed help, but we had
this awesome community of thelocal docs from Anarundal And
(06:55):
almost everyone was willing todonate time, whether it was to
do a hernia repair, anorthopedic surgery, a
dermatology consult, whatever weneeded.
We had someone that was willingto see one of our patients for
no charge.
Speaker 2 (07:15):
If you don't mind, i'd like to hear a little bit
more about that experience thatyou had when you were in
Philadelphia before we get intowhat you do today, because I
have a sense that that was kindof like an influencing
experience for what you do, andwanted to hear more about your
interaction with homeless folksand some kind of empathy from
within.
Speaker 3 (07:34):
Yeah, I mean it was.
I still kind of don'tunderstand how people can just
walk by people every day.
I mean I shouldn't I take thatback, because I'm a busy person
now And I think life heartensyou the more you see that kind
(07:55):
of thing.
But it was new to me coming outof suburbs and where I'd gone
to school it was university inArbor, michigan.
It was cold.
There wasn't a lot of homelesspeople there, not to
Philadelphia, it was much warmer.
(08:16):
But just that constantly seeingthe same faces as you're walking
home and then starting to talkto people and getting to know
their stories, it's just, youknow, there, before the grace of
God, go I number one.
And number two is just, youknow most of these people who
come to realize there's asegment of our society that
(08:40):
would say, oh, you just need toget a job and work harder.
But if you live outdoors andyou don't have access to a
shower and you don't have cleanclothes, it's not that easy to
get a job.
And even if you could do allthose things, chances are, you
know there's a good percentageof the population that have, you
(09:03):
know, mental health issues,substance abuse issues, things
of that nature that you knowreally requires some help.
In the 1980s Ronald Reagandeinstitutionalized all the
inpatient psychiatric places.
So we used to, you know, havethese big psychiatric inpatient
(09:26):
places where people would stayfor their life if they couldn't
function in society, andbasically all these were shut
down and without a plan as towhat to do with the folks.
Speaker 1 (09:37):
They didn't reallocate services for them.
Speaker 3 (09:39):
Correct.
Yeah, yeah.
So these guys, you know a lotof them.
You know they either fell in ahard time, they got caught
between rock and hard plays, orthey, you know, may not have had
enough of, you know, functionalstability to stay stable and
(10:01):
pay their bills regularly and beable to keep their place.
And you know, i think a lot ofus have gone through periods of
time in our life where weweren't the most stable or the
most mentally healthy.
And, you know, particularly inprivileged communities, a lot of
(10:21):
times you have a family,brother to mom, dad, brother,
sister, someone that comes inhelp you out.
You can go, stay at their place, something like that.
Speaker 1 (10:31):
Yeah, i think it's fair to say in my experience,
whether it's been personal orprofessional, what I can look
back at all my successes I'vehad some sort of support and
help.
It wasn't just driven just byme, that's for sure.
And being able to do that andit sounds like you shared that
(10:52):
you felt like you were able togive a certain level of care,
whether it's in Philadelphia atthe Stanton Center.
That might have been evenbetter or more quality time with
these clients at the time.
So how did that help direct youwith your creation?
Speaker 3 (11:07):
Yeah, well, i mean that hits the nail on the head
is that every Thursday afternoonI'd go to the Stanton Center
and I just would love it.
I'd love the time I wasspending with these folks and it
I felt like they were gettingmuch better care, because I
could spend the time to listento them and get the correct
(11:30):
diagnosis and explain thediagnosis in a way that they
understood it And in a way thatthey were motivated to do
something about it, instead ofjust saying you have high blood
pressure and you're going to dieif you don't take this pill.
You know you can explain whathigh blood pressure is doing
specifically and you can givethem options.
(11:52):
You know you can lose 40 pounds.
You can walk.
Speaker 1 (11:56):
You know you can see a therapist for stress.
Speaker 3 (11:58):
Right, that's right.
That's right, there's a lot of,there's a lot of other options.
But if you're not going to doall those, then you're between
two options die prematurely ortake what I got.
But.
But when you can sit down withsomeone and explain to them why
you're recommending a course ofaction and give them options,
(12:20):
it's a whole different thingthan just the traditional
medicine where you oh, you gotheartburn, here's a pill.
You got depression here's apill.
You got this, here's a pill.
Speaker 1 (12:30):
Isn't it unbelievable ?
it's come to this.
It's almost like the humaninteraction and I'm generalizing
in the healthcare industry hasbecome paperwork.
Yeah, it's a number.
Speaker 3 (12:44):
Yeah, and it's the providers and the people doing
it are really good people, youknow they're.
just you end up with like sixminutes of time with the person
and in that time you have todocument your visit thoroughly
enough to justify whatever codeyou're sending to the insurance
(13:04):
company to hope that they'llreimburse you, which they
automatically don't 30% of thetime, just to make things
difficult.
Speaker 2 (13:11):
So you can work for it.
Speaker 3 (13:12):
Yep, and and you also have to document it well enough
that you don't get sued, or,when you do get sued, that you
can cover yourself.
that's right.
And so there's a lot of otherfactors that have nothing to do
with the interaction and thewell-being of the person.
Speaker 1 (13:35):
So do you feel part of the paradigm shift is the
insurance, is I don't know ifyou'd say it this way mandating
the type of treatment as opposedto the professional, or is it
just part of the context?
Speaker 3 (13:50):
I, yeah, I think that the insurance is the, is the
outfit in the room, the cultureof it at least.
Yeah, yeah, i mean they're well, they're reimbursing a rate, of
say, $30 a visit and in orderfor a standard primary care
(14:13):
practice to cover their overhead, the overhead's around $100 to
$120 an hour.
So that means you got to seefour people an hour to break
even, and if you're running reallean you can maybe do it at
three.
But real lean means when youcall their office the phones
(14:34):
ring, you can't get anyone, thatno one returns your calls, and
if they're seeing five an hour,that means you rush through.
Speaker 1 (14:43):
So the whole business aspect behind it.
Speaker 3 (14:45):
Yeah there's.
it's a no win situation.
This is what I finally came tounderstand.
There's just no way of doing itin the insurance paradigm.
Speaker 1 (14:55):
The way you would like to treat and we're able to
treat.
Speaker 3 (14:58):
The way anyone would want to, quite frankly.
Speaker 1 (15:01):
Good to know.
Speaker 2 (15:02):
Yeah, i really like what you said about your
experience at the center onThursdays.
You know, which also makes meappreciate what we're doing here
too, is that I truly believethe stories inspire people.
Stories connect people And whenyou connect at that level, you
don't need to like motivate themor force them to do something.
They just feel inspired to dothat.
(15:23):
And which is also what I heardin Luke's description about what
you do, about the directprimary care focusing more on
the patient, oriented Like whatdo they need?
Speaker 1 (15:33):
and then fulfilling the need, finding out instead of
like oh, here's the formulathat I will use and then make it
fit, you know so I really likethat And which kind of fits with
what we do with recoverycollective too, in a way that
yeah, Collectively, we want tohelp these people, whether it's
seeing myself for therapy orZoll or Jonathan of classical
(15:58):
Chinese medicine, that we get tospend quality time for them to
help themselves.
You know, it's a good model.
Speaker 3 (16:04):
Yeah, yeah.
So I think, at the end of theday, if step one is, you have to
want to help yourself, but we,you know, all of us can help
people get to that place wherethey because sometimes you have
just been beaten down so much bylife, you know, you've kind of
(16:26):
given up, and so I think we canhelp people get to the place
where they want to helpthemselves, and then we can, you
know, at least lay out a pathfor them.
We can't walk it for them, butwe can, you know, and lay out a
few paths, you know.
So, hopefully, something that'spalatable, that isn't like a
terribly high cliff or burningcoals, do-able.
Speaker 1 (16:48):
Do-able.
Thank you, and we need help todo that sometimes.
Speaker 2 (16:51):
Yeah.
Speaker 1 (16:53):
So how would you define direct primary care, this
model?
Speaker 3 (16:58):
Yeah, so so direct primary care.
When I first started it, therewas a couple in the nation doing
something similar.
I later found out, andsubsequently the concept is,
which is really interesting.
It's just it's sprouted up in alot of different places almost
(17:22):
independently simultaneously,which you know is a good idea
when that kind of thing ishappening.
Absolutely.
But.
But yeah, i looked at it and Isaw you know places, like you
know I'd be driving home andthere's a nail salon, or you
know I don't know a placeselling art.
(17:42):
You know I'm like they're notmoving a hundred twenty dollars.
You know an hour of goods.
There's got to be a way to dothis in a way that's affordable,
and so the idea of, instead ofstructuring it, that I get paid
(18:03):
or the provider gets paid bydoing more, seeing you more
often, i wanted it to make it aseasy as possible.
I didn't want to feel like Iwas doing what I was doing to
boost my income A la carte.
So, in other words, if you'vegot high blood pressure and
(18:25):
you're checking your bloodpressures with a good cuff at
home, you should be able toemail me that or text me that
And I can see the numbers.
They look great.
You don't need to come in forme to.
Speaker 1 (18:34):
You're in the range.
You're a red flag right now.
Speaker 3 (18:37):
Yeah, you don't need to sit in somebody's office for
an hour or two hours waiting and, you know, pick up some other
disease while you're there.
You said as a billable codeYeah right, you take off a half
a day.
You know it's a hassle.
A lot of us don't have time forthat, you know.
Likewise, if you've got athyroid condition and you just
(18:59):
have to get your blood testsevery four months, six months or
something, we're cholesterolAnd you know you don't
necessarily need to sit downwith someone and go through all
that regular And you may nothave the time to do it.
So I think a lot of people endup not getting the care that
they need because of the hassles.
So a membership model whereit's just a monthly amount
(19:25):
transitions from, you know, paya la carte, pay for increased
visits to a value-based, youknow so you're just.
You know it's similar to Netflixor streaming services or the
gym, yeah, you use it as much oras little as you need And
(19:50):
there's just no penalty fordoing that.
So those that need it more atdifferent times, you know, might
use it more, and those who needit less at different times can
use less.
But we also don't have tocoerce people to come in.
You know someone has a urinaryinfection and they know it's a
(20:11):
urinary infection and they'vehad 20 this year.
You know they don't.
And nowadays CVS sellsurinalysis kits.
You can find out if you have aurinary infection.
But most offices you know my oldoffice we couldn't have treated
you for that because we're notgetting paid And it's not.
(20:34):
It's not.
I want to pull my hair out,yeah, but it's not it.
And it's not an insult to thatoffice, because that office
could spend literally you couldhave a doctor spending all day
long just doing that and notgetting paid a penny for all the
work.
And just like none of us wantto go to work and not earn
anything, Because what theinsurance would reimburse the
(20:55):
office wouldn't be enough.
They don't reimburse at allunless you have a face-to-face
visit with somebody.
Yeah, So since COVID there'sbeen some more virtual work.
But if you have a phone visit,if you drop the video from the
audio, then you can't getreimbursed.
If you have an asynchronousvirtual visit like email or text
(21:19):
, you can't get reimbursed.
Speaker 1 (21:22):
What about the platforms that your community,
that doctors communicate, ornurses, or yeah, does that count
?
No, yeah, yeah, yeah, yeah, itall makes sense.
Speaker 3 (21:32):
No, it has to be it has to be.
Speaker 1 (21:35):
That's the back and forth, the unspoken Yeah.
Speaker 3 (21:39):
Right, you have to have a video component,
apparently, to make it a virtualvisit.
And even then a lot ofinsurances are covering virtual
visits at a steep discountcompared to in-person visits.
Speaker 1 (21:52):
It almost makes me think that they don't want their
clients to get better at theinsurance companies.
That's just me saying it, yeah.
Speaker 3 (22:03):
I'll abstain from that comment.
Speaker 2 (22:05):
I do want to hear more about the part of the.
I know because the beginningsare always difficult, especially
for what you are doing, becauseit's kind of against the stream
, right.
It's not like a standard we aredoing, but also probably very
valuable challenges as well.
So were there any experiencesin the beginning days where it
was quite challenging but also,in a way, reassure your
(22:28):
unwivering Desired to make thissuccessful?
Speaker 1 (22:30):
and, if I can piggyback off that, the example
that we just gave a monthlymembership seems to be Valuable
to do that with, like theanalysis.
But then there's the Theperspective of wait.
I got to pay a monthlymembership right, so that must
have been one of the Hardships.
We'll go ahead.
Speaker 3 (22:49):
Yeah, so You know, at the beginning it was really
difficult.
So if you come up with an ideathat isn't being done and people
have, never heard of it.
It's very difficult because notonly Are you having to try to
recruit people to come join you,you know, as patients, but at
the same time you're you'retrying to Educate them about how
(23:14):
this entirely different thingworks, and I think you know
people associate What they know.
The next closest thing, and sounfortunately the next closest
thing to What we were doing,where you're paying a X amount
cash Separate from yourinsurance, is concierge medicine
(23:37):
.
So everyone there's still a lotof people who think that what
we're doing is concierge and thedifference There is concierge
is more like two thousand tofour thousand a year.
It's it's a much more expensiveundertaking and They also will
then still charge your insurancecompany and You know, bill you
(24:02):
for a lot of other.
You know procedures andwhatever that you might have
done.
Speaker 1 (24:07):
So you're paying for the availability correct.
Speaker 3 (24:10):
Yeah, it acts as in essence.
But I also, you know, wanted toset a price that I thought was
affordable, which we started outto way too low, and we had to
eventually work our way up to 49a month, which still seems like
(24:31):
, you know, like a buck and aquarter a day or something like
that like.
Speaker 1 (24:37):
Isn't every subscription, at least that I
know.
Speaker 3 (24:40):
I know It is roughly the average streaming price.
But you know I try to compareit with cell phone bills which
at that time, ten years ago,were not what they are now, and
Streaming services, which alsowere cheaper Yeah, cable.
(25:00):
You know the, the many thingsthat we have in our lives that
we don't think much aboutspending money on in high-speed
internet.
You know cable.
Or you know access for TV andstreaming, all those things.
You know we do that way, butthe idea of doing it in this
area was very confusing.
(25:21):
So it was.
It was very challenging in thebeginning.
Speaker 1 (25:27):
So with that subscription, what does that
include?
What does that entail?
Speaker 3 (25:32):
So It it's a little different in the state of
Maryland and for evolve than itis for basically the other 49
states.
So the state of Maryland has ithas had in insurance
commissioner and a CongressionalSenate group that have not been
(25:56):
Interested in reallyunderstanding what we're doing,
and so there's strict rules andregulations about not appearing
like an insurance company.
So if it's, if you pay 49 amonth and I tell you it's all
the primary care you can eat for49 a month, then they consider
(26:18):
you an insurance company.
So you have to be smart aboutit and You know so we have.
You can either have a setnumber of visits per year or a
set number of interactions peryear, or you can have, in
essence, you know, a charge,another amount When someone
(26:41):
comes in, which we do, we charge25 per visit.
Okay, because the other optionof trying to track how many
visits you've had and say, okay,you're over your visits, like
then and then what you know, andthen charge them 100 hours of
it, like I kind of defeats thepurpose of the access that you
exactly I really want to like.
(27:03):
We want to encourage people tocall us Texas.
Emails come in.
Like you know, we're happy ifyou're using our service.
Speaker 2 (27:13):
So if also a simple scenario that I have in mind is
that if a patient comes and they, if there's like a specific
Problem that requires specialistattention, is there like a
referral system to or otherspecialists in the At your care
as well?
Speaker 3 (27:31):
So We don't have other specialists that are doing
what we're doing, because it's,you know, if you need a hernia
surgery, only near once, so it'sharder to find those folks, but
There are.
There's a small Group ofspecialists, like there is a
(27:51):
surgeon in Rockville that doescash only Surgery, and and and
for a set amount.
But we found Folks locallywhether it's GI or surgery or
you know whatever that havewanted to work directly with us
and They're able to give us adiscount of price that the
(28:12):
patient then presents.
So, whether it's you know,getting imaging done for an MRI
or, you know, seeing aparticular specialist, but we
have access to all thespecialists and a lot of our
patients have insurance.
It's, it's really designed well.
(28:33):
There are some people that don'thave insurance, though we
encourage everyone to haveinsurance, you know, for
catastrophic stuff.
But there's a lot of peoplethat have a high deductible
health plan.
But you know folks that are Notsickly.
That's, that's not the rightword.
You know the don't.
They don't have chronic medicalillness.
(28:53):
It's they're not spending sixthousand hours a year in an
average year to meet that.
Yeah, so they're not gettinganything out of their insurance.
You know they're.
They go see their primary care.
They go see a specialist.
They're gonna get a hundredpercent of that bill and they're
gonna have to pay it all untilthey get six thousand.
I remember reaching out.
Speaker 1 (29:15):
Looking at it's all right now, not during peak covid
, maybe.
Maybe it was last year, 2022,end of 2021, covid was pretty
Happening and spreading and Iwent to one of the other urgent
cares in Annapolis, and I wasthere for seven hours.
I remember Texting dr Friedman.
(29:37):
I said why didn't I come to you?
What was I thinking?
Because I could have used yourservice.
Speaker 3 (29:42):
Yeah.
Speaker 1 (29:44):
Absolutely, because you guys are a covid testing
center, mm-hmm.
Take us through how that wouldwork with one of your
subscribers or not subscribers.
Speaker 3 (29:52):
Yeah, just for covid, just for I mean.
So Now, the way it works, andprobably for the last year or
nine months, you know the covidat home tests have gotten good.
Yeah, so it's rare that we haveto send off a covid PCR, you
know, to the lab.
So most people call up and theysay I just tested positive for
(30:13):
covid, what should I do?
and we jump on a either virtualcall, phone call Or, you know,
sometimes they'll just, you knowThey provide enough information
by text and we text back andsay you know Fevers and how sick
are you.
And a lot of people areUnderestimated it you know, by
(30:34):
providers.
You know, i think you can trustpeople a lot more, so to know
if they're about to die or not.
You know most people say I amreally so, i'm sicker than I've
ever been, i'm having troublebreathing.
The volunteer of these thingsthat our textbooks say you have
to ask.
You know all these questions toget all these numbers, just
basically see why I.
(30:55):
But then we can just make adecision with them if they Are
gonna take a medication likepaxil fed or something, and then
we just send it in.
They don't have to leave theirbed, you know so and then you
know, back earlier in the covidPCR days we had a drive-through
that was in the back of thebuilding and we would just Have
(31:20):
a virtual visit with them, havethem go through the drive
through, get their PCR done, andwe had the result back the next
day.
And again, you know all thatbilling went through for a long
time.
You know the government waspaying for all those tests And
the same thing.
Speaker 1 (31:37):
I guess the same thing goes for anything.
If someone has the sore throat,they might think a strap, or
you know, you have a, yourprotocol that is less intrusive
and time demanding than, yeah,where to go to.
Speaker 3 (31:51):
But it's.
It's.
I'll tell you, like along thespecialist question.
It's amazing for like, forinstance, labs.
So one of the benefits of beinga member of Evolviva is we have
discounted labs And if you wereto get a vitamin D test at, you
(32:13):
know, quest or LabCorp, it's$200.
If you get it through us, it's$20.
If you got a complete bloodcount it could be $60.
Through us, it's four.
Complete metabolic panel, againlike 60 or so, our price is
like six.
So there's a.
(32:36):
The prescription model helpswith.
There's so much money thatthese The labs, the pharmacies
there's so many ways to savetons of money.
I guarantee you every one ofour patients is saving At least
what they're paying inmembership, unless they have
(32:56):
like Some kind of a plan wherethey get no deductible, no
co-pay, you know no, orco-insurance.
I should say a lot of someplans have 80, 20, where you
know you're going to pay 20% ofthe bill.
But we, you know, we, have waysof helping them find you know
(33:18):
their medications for You knowpennies compared to what they've
been paying.
And sometimes it's thisidentical medicine, sometimes
it's like such a minor shift,like it could be going from like
you know, charmin to Sure Youknow some other brand, you know
(33:39):
good brand, named Toilet Papers,like no difference and nobody
would care at all.
And they can take it from 400 amonth to $4 a month.
But they wouldn't know that.
No, yeah.
Speaker 2 (33:51):
There's something very attracting about like
meaningful relationships, right,like, especially when it comes
to this healthcare system.
Because you know my parents mydad was a doctor, my mom was a
nurse and I have greatadmiration for healthcare
profession.
I truly believe that it's avery noble profession, and but
(34:11):
then everybody needs access tothat, right, because that's also
one of the training that I get,because I work as a medical
interpreter, and then one of thetraining talks about doctors or
healthcare professionalsbelieve that life is precious.
You know so, which is true,like life is precious, so you
will do anything that is withinyour power to keep to maintain
(34:31):
that life, you know.
But then there's also adifference between doing it as a
system and doing it like withheart in it.
You know, right, And that'swhat I'm hearing from your
practice that your members feelunderstood and you know them,
they know you, they know you,and that it creates that
meaningful relationship.
I suppose, oh, this is what I'msupposed to do.
Speaker 3 (34:51):
Yeah.
Speaker 2 (34:51):
I suppose no, this is what I want to do for my help.
Speaker 3 (34:54):
Yeah, yeah, i think that you know seeing four people
an hour.
You know 25, 30 people a day,it's, it's really hard not to
burn out and to start to gethardened because you just don't
have time to be as empathetic asyou want to be And you're
(35:17):
really being taxed.
You know you, most docs arefeeling burn out and you know,
as a statistically speaking,when you're feeling burned out
and you feel like your society's, you know, squeezing you that
hard, it's really hard to beempathetic and and put your
heart out there for other people.
You know putting your heart outthere and really listening and
(35:41):
really carrying it takes, youknow your own personal wellness
And I always emphasize, you knowmy office, like our patients
are not going to be happy if ourstaff is not happy, if our
providers are not happy, if wedon't feel like we have the time
(36:01):
to do what we need to do, if wefeel like we're rushing around
and we can't do what we need todo, it's not going to work.
So but it's.
You know it's hard in.
You know Western society as awhole to not try to go as fast
as possible and jam the systemand squeeze every penny out.
(36:22):
This seems to be the I hopelast century's model, but you
know, maybe this will be thefuture.
Speaker 2 (36:30):
Yeah, happiness is contagious.
It can be contagious.
Yes in a good way.
Yeah, yeah.
Speaker 1 (36:35):
I think that's part of the culture and for people I
don't send links to Dr Freeman'spractice, but his waiting room
and we've used it for communitymeditations at his practice It's
.
It's a hybrid, it's a mixbetween coffee shop and art
studio, so it's very welcomingand doesn't feel like a sterile,
(36:56):
cold medical office, whetherit's in a high rise or a strip
mall or you know.
It's engaging, it's welcomingAnd I also think part of the
unfortunate culture is stigma,like you just said, the doctors.
As someone that's seeking theseservices, it feels like the
doctors don't care for some ofthe reasons that we mentioned,
(37:19):
but to me it's so valuable.
I look, i look for people thathave the spirit of the heart of
a teacher And it sounds like yougive the time and the ability
to teach these clients thatmight need something.
And if you're not thespecialist, you have this
referral source that you knowand trust and use.
(37:39):
Whether it's for X-rays that Idiscounted rate medications, but
providers that you collaborateand connect with.
So many doctors that I go see, ifeel like you know if my
daughter needs a specialist,that I just feel like what?
either they don't care, theydon't know or they don't have
the time to educate me on whatmy child needs, and it's
frustrating, yeah, but you havethe ability and time and you,
(38:03):
you do have the heart of ateacher, you do have the
referral sources and theknowledge to do that, and I
think we're getting so far awayfrom that in general.
In terms of the medical field,yeah, i would agree.
To me that can be valuable.
The subscription weight I cango to this person as an anchor
and if I need something moredirect primary and urgent care
(38:23):
has the ability to refer me in aplace that, oh okay, i trust
that they know where they'resending me, as opposed to I
better do more research.
Yeah, that cycle.
Speaker 3 (38:33):
Well, and it's funny because there are some, a number
of things we do that you knowwe don't market or advertise
because I think they're hard toconvey.
But one of the most importantthings I think is if we do need
to refer you to someone, we'regoing to send you to someone
that we know is the best of thebest And we're going to really,
(38:56):
if it's something that is alittle atypical, we're going to
research it and figure out whereis the best place to go.
But and if you call and theycan't get you in for four months
, we're going to help facilitatethat when possible.
Not always possible, but youknow, sometimes there's brick
walls at the Hopkins and soforth, but it's that warm
handoff.
Speaker 1 (39:16):
It's.
we do it here when someone'snot here, When someone calls me
for mental health therapy and ifthey have a specific niche that
I feel like I can help.
but I don't specific specialize, But I know two or three people
that do.
Speaker 3 (39:30):
Right Really.
Speaker 1 (39:31):
You want to do.
of course I'd be glad to OrZoll with these.
you know they're a bit ofBuddhism and knowledge, whether
it's working with Zoll oroutside of our practice.
Yes, Zoll is a wealth ofknowledge in that, why not Not?
collective solution to healthand wellness.
That's what it's about.
Speaker 2 (39:50):
Yeah, yeah.
The thing I want to go back towhat you said earlier too, which
is a good lesson for life ingeneral the difference between
time and value that we have,like everybody has only 24 hours
a day, which is, you know, allwe have, but then there's a big
difference between making abetter value out of a limited
time, which beats the money,which beats everything else,
(40:13):
because it becomes more aboutthat meaningful relationship.
So I love that, because thevalue is in that meaningful
essence that is created, asopposed to within this time
we're going to fill in thisamount of people.
Do squeeze the most benefit outof it, you know.
Speaker 3 (40:29):
It's funny you should say that because it's taken me
five years to figure it out.
But when we first started Ithought, like the fact that you
could do virtual visits, thatyou could communicate, you know,
by email or text, you know alot of those conveniences I
thought would be the big drawand they weren't.
(40:50):
I thought the fact that wewould save them a lot of money
would be a big draw.
That wasn't.
And it turns out that it wassame day access, the fact that
they can always get in and seeus unless and we're open from
eight to seven, but if they callit like six or five, then it's
more challenging.
Same day And you know, quickphone access, etc.
(41:15):
So it's more the value stuff,the availability, the time, the
listening.
You know people seem most happywith the fact that we really
listened to them.
A lot of the reviews say, youknow, i felt listened to for the
first time in 20 years, so thatprobably can't be understated,
(41:39):
how important that is, how sadit is that they're not getting
it otherwise.
Speaker 1 (41:44):
I think you certainly answered a lot of the
misconceptions already that Inoted down The lack of access to
specialists.
Well, you have that, you knowthe costly aspect.
I guess the one thing thatstill jumps in my mind is what
is the my mind?
the call to action with peoplethat do have insurances?
(42:07):
How does it make sense in theirmind in terms of conveniences
there?
Why would they still do it?
Speaker 3 (42:16):
Yeah, so I would say, you know, with the high
deductible health plans, again,you know they're going to save
money with people even if theyhave, you know, as I said, no
deductible like we have us, inaddition to what I was
describing, a cadre ofspecialists that we really trust
(42:37):
.
We also have an online servicewhere we can consult with
specialists.
It's a service we pay for, butyou know, we can take pictures
of your skin rash Instead ofsending you to dermatology.
We just send the pictures andthen they tell us it could be
this or this.
This is what I would do first.
(42:58):
If that's not getting better,bring it back to a biopsy.
You know, take a little pieceof skin or something or try, you
know, something else.
So there's a lot that we can doto save folks even more time
and add value.
But we've seen a big growth inMedicare age folks and Medicare
(43:23):
is probably the one insurancewhere they stand to benefit the
least as far as financially.
You know, because Medicare payswell for visits, labs et cetera
.
But most of the folks that arecoming to us, it's because they
just can't access care when theyneed it.
(43:44):
You know, especially with COVID, they were saying you know I
was sick.
They told me that they couldtalk to me in two days.
You know where they could talkto me the next day.
But you know, if you're sickwith COVID you don't want to
wait a day or two, or they getthe message.
You know we're fully bookedtoday.
So either go to ER or an urgentcare, you know and you'll just.
(44:09):
You won't hear that from usunless you know.
You call and say your arm ismissing.
We might say go.
Speaker 1 (44:18):
What percentage of your clients are primary care
and what percentage are kind ofthat urgent care model.
Speaker 3 (44:27):
Maybe 95% primary care and 5% urgent care.
So we don't, it's not our focus.
The problem is, as far asgrowth, at least in the early
days.
We're not so worried about itnow because there's a lot of
(44:47):
word of mouth, but in the earlydays, you know, just people
aren't looking for a doctorunless they're not feeling well,
and so it's really the only wayyou can, you know, build and
see more people as if you'reavailable in that way.
(45:09):
But you also don't want to havebecause it's a new model.
You don't want to say, well,you can join us, you know, for
this amount per month.
They're like well, i've justgot a urinary infection, can I
just get this treated?
They may not want to do that,but then they come in and they
get listened to for the firsttime And they see how different
(45:31):
it is.
Speaker 1 (45:33):
Yeah, for example stitches right.
Speaker 3 (45:35):
Right, yeah, i got you.
Speaker 1 (45:38):
Well, where do you see the healthcare industry
going, whether it's for you orjust the general?
Speaker 3 (45:45):
Yes.
So the idealistic, optimistside of me feels that, you know,
insurance is an evil player andI hate the term evil because no
one's really bad.
You know these are lost in someway.
(46:06):
That's generous, go aheadthough.
We won't get into that.
I really don't believe itanyway.
So but I do think you know theinsurance system and the way
things are oriented currently isvery perverse.
(46:27):
It's set up in a way that is,you know, not well functioning.
And you know the latest attemptat changing the insurance
industry with, you know thequote unquote Obamacare limited
insurances to like six or sevenpercent profit, something like
(46:48):
that per year, so they can'tmake more than six or seven
percent.
I forget how the whole thingworks, but what it's skewed,
what it's skewed them into doing, is, you know, buying these
pharmacies and pharmacy chainsso that they can bill more and
create more billing.
(47:09):
So they're actually driving upthe cost at the same time.
Speaker 1 (47:15):
Is that why there's shortages with medications and
mental health meds?
Speaker 3 (47:20):
No, that's, that's a different thing.
Yeah, we won't get into that,but there's a lot of us out
there now.
There's over a thousand directprimary cares And we usually,
you know, get together as acouple of conferences a year And
more and more there are a cadre.
There's now health shares,which are similar to insurance
(47:46):
but where it's usually afraction of the price of
insurance And it will cover youfor catastrophic care and
usually mandates.
You know that you work with adirect primary care because they
know our job is to add value.
Our job is to avoid emergencyroom visits, avoid surgeries
where unnecessary, avoidunnecessary MRIs and testing.
(48:10):
You know that's where we givethe most value is is not sending
you to a million differentpeople in order to get the
diagnosis, actually listeningand figuring out what the
problem is and figuring out howto treat you.
So we're hoping that that willtake over and insurances will
(48:31):
disappear.
Speaker 1 (48:34):
I guess that can certainly happen if there's
research being done on it.
All right part of that thousand, are you guys beginning to get
in that mindset or already do?
Speaker 3 (48:43):
Yeah, there's a lot of great research, you know,
showing reduction in emergencyroom visit, reduction in
surgeries, reduction inhospitalizations.
So there's just it's no secretthat being having access to your
primary care when you need themis critical.
Speaker 1 (49:06):
What sounds like this is already being skilled,
because you opened up Evolvewhich year 2014.
And how many were there thencompared to you, say, over a
thousand now?
Yeah, it's growing.
Speaker 3 (49:18):
Yeah, it's really picking up.
It's pretty amazing.
Speaker 1 (49:23):
It's good to hear.
Speaker 3 (49:24):
Yeah.
Speaker 2 (49:25):
Yeah, you didn't mention this specifically, but I
gather that you know healthcareis noble, but also like there's
some kind of spiritualityaspect to it, the way you're
doing it, especially that partabout being listened to.
You know which is not somethingvisible, which is something
that cannot be marketed or likedescribed by something that can
(49:46):
be experienced.
Speaker 3 (49:47):
Exactly.
Speaker 2 (49:47):
So I love that.
I also want that to be part ofthe vision for the upcoming
decades or years in thehealthcare, because you know
healthcare need is not goinganywhere Because people are sick
, people are dying.
you know that's always going tohappen.
But if there is more of thatbeing cared for, that connection
, meaningful relationship, themore there is, the more people
(50:09):
are going to be happy andhealthy as well, you know.
Speaker 3 (50:12):
Well, and I'll take another step, zaw, in that I
think that you know what we'refocusing on and I think the
future is is not just treatingsick people and not just
preventing disease states, butactually helping people to find
wellness, happiness, peace.
You know figuring out how toplay.
(50:35):
You know this actual study ofhappiness and how to help people
get there that you know want toget there, and even people that
don't know that they want toget there.
Music to our ears.
Speaker 1 (50:50):
I bet Music to our ears Yeah.
Well, dr Friedman, is thereanything else you'd like to
share with our listeners beforewe go?
No, well, I'd greatlyappreciate it.
Dr Friedman has given us agreat insight into the benefits
of direct primary care and howit can revolutionize the
healthcare industry.
So thank you, dr Friedman, forjoining us today and sharing
(51:11):
your experience on this criticaltopic.
We'll give links in our notes,but how could they potentially
reach or in terms of evolve?
Speaker 3 (51:20):
Yeah, they can always email us at info at EMC, the
number four me me dot com.
They can text us or call844-322-4222, where our website
is, emc, the number four ME dotcom.
(51:41):
So that will be in the notes,don't worry.
Speaker 2 (51:46):
Yeah, thanks again, dr Friedman.
Yeah, it's a pleasure, reallyenjoyed the conversation Yeah.
Speaker 1 (51:50):
Thanks everyone for listening and, once again,
please subscribe, comment,review, follow the like.
If you think others wouldbenefit from this podcast
episode, share with others, ascollectively we can find
solutions to all things.
health and wellness.
My name's Luke DeBoy.
This is Zoff.
See you next time.
Welcome to a therapist in Buddhist in you,
the podcast where we embark on ajourney of self-discovery and
collective growth.
I'm your host, luke Deboe, atherapist passionate about all
things health and wellness.
Joining me on this enlighteningadventure is my co-host and
beacon of serenity.
How's?
Speaker 2 (00:28):
that for a couple.
What an introduction, zomal.
What's going on, luke?
This is Zaw Good to be hereagain.
Speaker 1 (00:33):
Zaw is a wise and compassionate Buddhist
practitioner, and together weexplore the intersections of
psychology, spirituality andbasically, all things health and
wellness, offering practicalinsights and, if not by us, our
guests will offer, i think, someprofound wisdom to enhance your
overall well-being.
So thanks for turning in andjoining our community.
Please communicate with usthrough all the platforms,
(00:56):
whether it's Facebook, instagramand YouTube.
We'll make sure to put links inthe description notes, so we're
here to provide you withvaluable tools and perspectives
that can transform your life.
If you find our podcast helpful, we greatly appreciate your
support and, since we do nothave a donate option yet, please
feel to rate and share ourpodcast and with others.
(01:18):
It's a wonderful way to supportus.
So please subscribe, comment,review, follow and any of those
potential options, depending onthe platform you're on.
Remember it's through ourcollective efforts that we can
uncover solutions to all thingsrelated to health and wellness.
So thanks for listening andlet's embark on this
transformative adventuretogether, where holistic
well-being is within everyone'sreach.
(01:39):
Sounded pretty good, didn't it?
Great, yeah.
I felt good about it.
So today we have the privilegeof speaking with Dr Mike
Friedman.
I certainly I certainly see himas a trailblazer in the field
of primary and urgent care.
Dr Friedman is the owner andvisionary behind Evolve Direct
Primary Care and Urgent Care inAnnapolis, maryland.
It's a health care practicethat is transforming the patient
(02:00):
experience.
With a remarkable careerspanning, i think, well over two
decades, dr Friedman has earneda reputation for his unwavering
commitment to delivering highquality, patient-centered care.
See a pattern here.
Yet, as a passion forrevolutionizing the health care
industry has led him to pioneerthe Direct Primary Care model,
(02:21):
offering patients a morepersonalized and accessible
approach to health care.
Join us today as we delve intoDr Friedman's incredible journey
, explore his innovativecontributions to the field and
gain viable insights into thefuture of health care.
Dr Friedman, thanks for joiningus.
Speaker 3 (02:37):
Thanks for having me.
Speaker 1 (02:38):
Yeah, thank you for joining us.
So before we get into thepotential flaws of the health
care, kind of tell us about yourprofessional journey a little
bit.
Speaker 3 (02:49):
Yeah, so I started out from fairly humble
beginnings.
I was the first person in myfamily to go to college.
I really wasn't sure that Iwanted to become a doctor who
had a medical school.
Towards the end of undergrad Ieventually decided to get a
master's in physiology and whiledoing that I really fell in
(03:09):
love with medicine and thescience of medicine.
Somewhere through the course ofthat, when I was working in
Philadelphia during med school,i had an opportunity to work
with a lot of homeless folks.
Just walking back and forth toschool every day I crossed
dozens of people in Philadelphiato Center City.
(03:30):
I just couldn't walk pastpeople without finding out who
they were and what was going onand how they got there.
So I really got to know somepeople pretty well.
So I got my first taste ofhelping an underserved community
in that setting while I wasthere.
(03:51):
And then I went to residency andwhen I came back here I started
practicing more of atraditional medical practice a
matter of fact, a block fromwhere we're doing this podcast
right now and was prettystandard four or five people an
hour and just rushing peoplethrough.
(04:11):
But I found another underservedcommunity that was there was a
clinic that had opened up onesat the Stanton Center at Clayton
, washington, and so I foundthat I could go there on
Thursday afternoons, which wasmy day off, and take care of
folks, and it was just much morefulfilling than feeling like I
(04:34):
was working for the insurancecompanies And then fast forward
to about 2012 to 2014 timeframe,when it just became
unsustainable to practicetraditional medicine for me And
I ended up moving into this newarea that I guess we'll talk
(04:54):
more about.
Speaker 1 (04:55):
So, besides the active service at the Stanton
Center, why did that feel sorewarding?
Speaker 3 (05:01):
Yes, the Stanton Center.
first of all, there was noinsurance.
no one had insurance, And sothere was no strict time limits
on how long you could be withsomeone.
We didn't have guidance of whatwe could or couldn't do, just
had to be affordable, which waseasier to do than stay within
(05:27):
the insurance framework, But youjust felt like you could do
what you're trained to do.
You didn't feel like you hadall the constraints and barriers
that are built into a busymedical practice.
Speaker 1 (05:44):
Now, I don't know if you're downplaying it, but did
you develop that program?
Speaker 3 (05:49):
Yes, so I started.
A couple of guys Bernstein andRich Colgan had started a year
or two before me And I think itwas the first year that they
actually had a.
I can't remember if they had orwe started, but shortly after
that I joined them.
(06:09):
We ended up expanding it prettydramatically.
Speaker 1 (06:16):
So much so, even though, compared to other
centers that weren't free, yougot to spend this time with the
clients a lot more than in yourprivate practice.
But wasn't it one of thenation's busiest free clinics?
There was Over 6,000 patientsper year, correct.
Speaker 3 (06:34):
Okay, yeah, 6,500 per year, all free.
And the nice thing was we had acommunity on both sides.
We had the community of folksthat needed help, but we had
this awesome community of thelocal docs from Anarundal And
(06:55):
almost everyone was willing todonate time, whether it was to
do a hernia repair, anorthopedic surgery, a
dermatology consult, whatever weneeded.
We had someone that was willingto see one of our patients for
no charge.
Speaker 2 (07:15):
If you don't mind, i'd like to hear a little bit
more about that experience thatyou had when you were in
Philadelphia before we get intowhat you do today, because I
have a sense that that was kindof like an influencing
experience for what you do, andwanted to hear more about your
interaction with homeless folksand some kind of empathy from
within.
Speaker 3 (07:34):
Yeah, I mean it was.
I still kind of don'tunderstand how people can just
walk by people every day.
I mean I shouldn't I take thatback, because I'm a busy person
now And I think life heartensyou the more you see that kind
(07:55):
of thing.
But it was new to me coming outof suburbs and where I'd gone
to school it was university inArbor, michigan.
It was cold.
There wasn't a lot of homelesspeople there, not to
Philadelphia, it was much warmer.
(08:16):
But just that constantly seeingthe same faces as you're walking
home and then starting to talkto people and getting to know
their stories, it's just, youknow, there, before the grace of
God, go I number one.
And number two is just, youknow most of these people who
come to realize there's asegment of our society that
(08:40):
would say, oh, you just need toget a job and work harder.
But if you live outdoors andyou don't have access to a
shower and you don't have cleanclothes, it's not that easy to
get a job.
And even if you could do allthose things, chances are, you
know there's a good percentageof the population that have, you
(09:03):
know, mental health issues,substance abuse issues, things
of that nature that you knowreally requires some help.
In the 1980s Ronald Reagandeinstitutionalized all the
inpatient psychiatric places.
So we used to, you know, havethese big psychiatric inpatient
(09:26):
places where people would stayfor their life if they couldn't
function in society, andbasically all these were shut
down and without a plan as towhat to do with the folks.
Speaker 1 (09:37):
They didn't reallocate services for them.
Speaker 3 (09:39):
Correct.
Yeah, yeah.
So these guys, you know a lotof them.
You know they either fell in ahard time, they got caught
between rock and hard plays, orthey, you know, may not have had
enough of, you know, functionalstability to stay stable and
(10:01):
pay their bills regularly and beable to keep their place.
And you know, i think a lot ofus have gone through periods of
time in our life where weweren't the most stable or the
most mentally healthy.
And, you know, particularly inprivileged communities, a lot of
(10:21):
times you have a family,brother to mom, dad, brother,
sister, someone that comes inhelp you out.
You can go, stay at their place, something like that.
Speaker 1 (10:31):
Yeah, i think it's fair to say in my experience,
whether it's been personal orprofessional, what I can look
back at all my successes I'vehad some sort of support and
help.
It wasn't just driven just byme, that's for sure.
And being able to do that andit sounds like you shared that
(10:52):
you felt like you were able togive a certain level of care,
whether it's in Philadelphia atthe Stanton Center.
That might have been evenbetter or more quality time with
these clients at the time.
So how did that help direct youwith your creation?
Speaker 3 (11:07):
Yeah, well, i mean that hits the nail on the head
is that every Thursday afternoonI'd go to the Stanton Center
and I just would love it.
I'd love the time I wasspending with these folks and it
I felt like they were gettingmuch better care, because I
could spend the time to listento them and get the correct
(11:30):
diagnosis and explain thediagnosis in a way that they
understood it And in a way thatthey were motivated to do
something about it, instead ofjust saying you have high blood
pressure and you're going to dieif you don't take this pill.
You know you can explain whathigh blood pressure is doing
specifically and you can givethem options.
(11:52):
You know you can lose 40 pounds.
You can walk.
Speaker 1 (11:56):
You know you can see a therapist for stress.
Speaker 3 (11:58):
Right, that's right.
That's right, there's a lot of,there's a lot of other options.
But if you're not going to doall those, then you're between
two options die prematurely ortake what I got.
But.
But when you can sit down withsomeone and explain to them why
you're recommending a course ofaction and give them options,
(12:20):
it's a whole different thingthan just the traditional
medicine where you oh, you gotheartburn, here's a pill.
You got depression here's apill.
You got this, here's a pill.
Speaker 1 (12:30):
Isn't it unbelievable ?
it's come to this.
It's almost like the humaninteraction and I'm generalizing
in the healthcare industry hasbecome paperwork.
Yeah, it's a number.
Speaker 3 (12:44):
Yeah, and it's the providers and the people doing
it are really good people, youknow they're.
just you end up with like sixminutes of time with the person
and in that time you have todocument your visit thoroughly
enough to justify whatever codeyou're sending to the insurance
(13:04):
company to hope that they'llreimburse you, which they
automatically don't 30% of thetime, just to make things
difficult.
Speaker 2 (13:11):
So you can work for it.
Speaker 3 (13:12):
Yep, and and you also have to document it well enough
that you don't get sued, or,when you do get sued, that you
can cover yourself.
that's right.
And so there's a lot of otherfactors that have nothing to do
with the interaction and thewell-being of the person.
Speaker 1 (13:35):
So do you feel part of the paradigm shift is the
insurance, is I don't know ifyou'd say it this way mandating
the type of treatment as opposedto the professional, or is it
just part of the context?
Speaker 3 (13:50):
I, yeah, I think that the insurance is the, is the
outfit in the room, the cultureof it at least.
Yeah, yeah, i mean they're well, they're reimbursing a rate, of
say, $30 a visit and in orderfor a standard primary care
(14:13):
practice to cover their overhead, the overhead's around $100 to
$120 an hour.
So that means you got to seefour people an hour to break
even, and if you're running reallean you can maybe do it at
three.
But real lean means when youcall their office the phones
(14:34):
ring, you can't get anyone, thatno one returns your calls, and
if they're seeing five an hour,that means you rush through.
Speaker 1 (14:43):
So the whole business aspect behind it.
Speaker 3 (14:45):
Yeah there's.
it's a no win situation.
This is what I finally came tounderstand.
There's just no way of doing itin the insurance paradigm.
Speaker 1 (14:55):
The way you would like to treat and we're able to
treat.
Speaker 3 (14:58):
The way anyone would want to, quite frankly.
Speaker 1 (15:01):
Good to know.
Speaker 2 (15:02):
Yeah, i really like what you said about your
experience at the center onThursdays.
You know, which also makes meappreciate what we're doing here
too, is that I truly believethe stories inspire people.
Stories connect people And whenyou connect at that level, you
don't need to like motivate themor force them to do something.
They just feel inspired to dothat.
(15:23):
And which is also what I heardin Luke's description about what
you do, about the directprimary care focusing more on
the patient, oriented Like whatdo they need?
Speaker 1 (15:33):
and then fulfilling the need, finding out instead of
like oh, here's the formulathat I will use and then make it
fit, you know so I really likethat And which kind of fits with
what we do with recoverycollective too, in a way that
yeah, Collectively, we want tohelp these people, whether it's
seeing myself for therapy orZoll or Jonathan of classical
(15:58):
Chinese medicine, that we get tospend quality time for them to
help themselves.
You know, it's a good model.
Speaker 3 (16:04):
Yeah, yeah.
So I think, at the end of theday, if step one is, you have to
want to help yourself, but we,you know, all of us can help
people get to that place wherethey because sometimes you have
just been beaten down so much bylife, you know, you've kind of
(16:26):
given up, and so I think we canhelp people get to the place
where they want to helpthemselves, and then we can, you
know, at least lay out a pathfor them.
We can't walk it for them, butwe can, you know, and lay out a
few paths, you know.
So, hopefully, something that'spalatable, that isn't like a
terribly high cliff or burningcoals, do-able.
Speaker 1 (16:48):
Do-able.
Thank you, and we need help todo that sometimes.
Speaker 2 (16:51):
Yeah.
Speaker 1 (16:53):
So how would you define direct primary care, this
model?
Speaker 3 (16:58):
Yeah, so so direct primary care.
When I first started it, therewas a couple in the nation doing
something similar.
I later found out, andsubsequently the concept is,
which is really interesting.
It's just it's sprouted up in alot of different places almost
(17:22):
independently simultaneously,which you know is a good idea
when that kind of thing ishappening.
Absolutely.
But.
But yeah, i looked at it and Isaw you know places, like you
know I'd be driving home andthere's a nail salon, or you
know I don't know a placeselling art.
(17:42):
You know I'm like they're notmoving a hundred twenty dollars.
You know an hour of goods.
There's got to be a way to dothis in a way that's affordable,
and so the idea of, instead ofstructuring it, that I get paid
(18:03):
or the provider gets paid bydoing more, seeing you more
often, i wanted it to make it aseasy as possible.
I didn't want to feel like Iwas doing what I was doing to
boost my income A la carte.
So, in other words, if you'vegot high blood pressure and
(18:25):
you're checking your bloodpressures with a good cuff at
home, you should be able toemail me that or text me that
And I can see the numbers.
They look great.
You don't need to come in forme to.
Speaker 1 (18:34):
You're in the range.
You're a red flag right now.
Speaker 3 (18:37):
Yeah, you don't need to sit in somebody's office for
an hour or two hours waiting and, you know, pick up some other
disease while you're there.
You said as a billable codeYeah right, you take off a half
a day.
You know it's a hassle.
A lot of us don't have time forthat, you know.
Likewise, if you've got athyroid condition and you just
(18:59):
have to get your blood testsevery four months, six months or
something, we're cholesterolAnd you know you don't
necessarily need to sit downwith someone and go through all
that regular And you may nothave the time to do it.
So I think a lot of people endup not getting the care that
they need because of the hassles.
So a membership model whereit's just a monthly amount
(19:25):
transitions from, you know, paya la carte, pay for increased
visits to a value-based, youknow so you're just.
You know it's similar to Netflixor streaming services or the
gym, yeah, you use it as much oras little as you need And
(19:50):
there's just no penalty fordoing that.
So those that need it more atdifferent times, you know, might
use it more, and those who needit less at different times can
use less.
But we also don't have tocoerce people to come in.
You know someone has a urinaryinfection and they know it's a
(20:11):
urinary infection and they'vehad 20 this year.
You know they don't.
And nowadays CVS sellsurinalysis kits.
You can find out if you have aurinary infection.
But most offices you know my oldoffice we couldn't have treated
you for that because we're notgetting paid And it's not.
(20:34):
It's not.
I want to pull my hair out,yeah, but it's not it.
And it's not an insult to thatoffice, because that office
could spend literally you couldhave a doctor spending all day
long just doing that and notgetting paid a penny for all the
work.
And just like none of us wantto go to work and not earn
anything, Because what theinsurance would reimburse the
(20:55):
office wouldn't be enough.
They don't reimburse at allunless you have a face-to-face
visit with somebody.
Yeah, So since COVID there'sbeen some more virtual work.
But if you have a phone visit,if you drop the video from the
audio, then you can't getreimbursed.
If you have an asynchronousvirtual visit like email or text
(21:19):
, you can't get reimbursed.
Speaker 1 (21:22):
What about the platforms that your community,
that doctors communicate, ornurses, or yeah, does that count
?
No, yeah, yeah, yeah, yeah, itall makes sense.
Speaker 3 (21:32):
No, it has to be it has to be.
Speaker 1 (21:35):
That's the back and forth, the unspoken Yeah.
Speaker 3 (21:39):
Right, you have to have a video component,
apparently, to make it a virtualvisit.
And even then a lot ofinsurances are covering virtual
visits at a steep discountcompared to in-person visits.
Speaker 1 (21:52):
It almost makes me think that they don't want their
clients to get better at theinsurance companies.
That's just me saying it, yeah.
Speaker 3 (22:03):
I'll abstain from that comment.
Speaker 2 (22:05):
I do want to hear more about the part of the.
I know because the beginningsare always difficult, especially
for what you are doing, becauseit's kind of against the stream
, right.
It's not like a standard we aredoing, but also probably very
valuable challenges as well.
So were there any experiencesin the beginning days where it
was quite challenging but also,in a way, reassure your
(22:28):
unwivering Desired to make thissuccessful?
Speaker 1 (22:30):
and, if I can piggyback off that, the example
that we just gave a monthlymembership seems to be Valuable
to do that with, like theanalysis.
But then there's the Theperspective of wait.
I got to pay a monthlymembership right, so that must
have been one of the Hardships.
We'll go ahead.
Speaker 3 (22:49):
Yeah, so You know, at the beginning it was really
difficult.
So if you come up with an ideathat isn't being done and people
have, never heard of it.
It's very difficult because notonly Are you having to try to
recruit people to come join you,you know, as patients, but at
the same time you're you'retrying to Educate them about how
(23:14):
this entirely different thingworks, and I think you know
people associate What they know.
The next closest thing, and sounfortunately the next closest
thing to What we were doing,where you're paying a X amount
cash Separate from yourinsurance, is concierge medicine
(23:37):
.
So everyone there's still a lotof people who think that what
we're doing is concierge and thedifference There is concierge
is more like two thousand tofour thousand a year.
It's it's a much more expensiveundertaking and They also will
then still charge your insurancecompany and You know, bill you
(24:02):
for a lot of other.
You know procedures andwhatever that you might have
done.
Speaker 1 (24:07):
So you're paying for the availability correct.
Speaker 3 (24:10):
Yeah, it acts as in essence.
But I also, you know, wanted toset a price that I thought was
affordable, which we started outto way too low, and we had to
eventually work our way up to 49a month, which still seems like
(24:31):
, you know, like a buck and aquarter a day or something like
that like.
Speaker 1 (24:37):
Isn't every subscription, at least that I
know.
Speaker 3 (24:40):
I know It is roughly the average streaming price.
But you know I try to compareit with cell phone bills which
at that time, ten years ago,were not what they are now, and
Streaming services, which alsowere cheaper Yeah, cable.
(25:00):
You know the, the many thingsthat we have in our lives that
we don't think much aboutspending money on in high-speed
internet.
You know cable.
Or you know access for TV andstreaming, all those things.
You know we do that way, butthe idea of doing it in this
area was very confusing.
(25:21):
So it was.
It was very challenging in thebeginning.
Speaker 1 (25:27):
So with that subscription, what does that
include?
What does that entail?
Speaker 3 (25:32):
So It it's a little different in the state of
Maryland and for evolve than itis for basically the other 49
states.
So the state of Maryland has ithas had in insurance
commissioner and a CongressionalSenate group that have not been
(25:56):
Interested in reallyunderstanding what we're doing,
and so there's strict rules andregulations about not appearing
like an insurance company.
So if it's, if you pay 49 amonth and I tell you it's all
the primary care you can eat for49 a month, then they consider
(26:18):
you an insurance company.
So you have to be smart aboutit and You know so we have.
You can either have a setnumber of visits per year or a
set number of interactions peryear, or you can have, in
essence, you know, a charge,another amount When someone
(26:41):
comes in, which we do, we charge25 per visit.
Okay, because the other optionof trying to track how many
visits you've had and say, okay,you're over your visits, like
then and then what you know, andthen charge them 100 hours of
it, like I kind of defeats thepurpose of the access that you
exactly I really want to like.
(27:03):
We want to encourage people tocall us Texas.
Emails come in.
Like you know, we're happy ifyou're using our service.
Speaker 2 (27:13):
So if also a simple scenario that I have in mind is
that if a patient comes and they, if there's like a specific
Problem that requires specialistattention, is there like a
referral system to or otherspecialists in the At your care
as well?
Speaker 3 (27:31):
So We don't have other specialists that are doing
what we're doing, because it's,you know, if you need a hernia
surgery, only near once, so it'sharder to find those folks, but
There are.
There's a small Group ofspecialists, like there is a
(27:51):
surgeon in Rockville that doescash only Surgery, and and and
for a set amount.
But we found Folks locallywhether it's GI or surgery or
you know whatever that havewanted to work directly with us
and They're able to give us adiscount of price that the
(28:12):
patient then presents.
So, whether it's you know,getting imaging done for an MRI
or, you know, seeing aparticular specialist, but we
have access to all thespecialists and a lot of our
patients have insurance.
It's, it's really designed well.
(28:33):
There are some people that don'thave insurance, though we
encourage everyone to haveinsurance, you know, for
catastrophic stuff.
But there's a lot of peoplethat have a high deductible
health plan.
But you know folks that are Notsickly.
That's, that's not the rightword.
You know the don't.
They don't have chronic medicalillness.
(28:53):
It's they're not spending sixthousand hours a year in an
average year to meet that.
Yeah, so they're not gettinganything out of their insurance.
You know they're.
They go see their primary care.
They go see a specialist.
They're gonna get a hundredpercent of that bill and they're
gonna have to pay it all untilthey get six thousand.
I remember reaching out.
Speaker 1 (29:15):
Looking at it's all right now, not during peak covid
, maybe.
Maybe it was last year, 2022,end of 2021, covid was pretty
Happening and spreading and Iwent to one of the other urgent
cares in Annapolis, and I wasthere for seven hours.
I remember Texting dr Friedman.
(29:37):
I said why didn't I come to you?
What was I thinking?
Because I could have used yourservice.
Speaker 3 (29:42):
Yeah.
Speaker 1 (29:44):
Absolutely, because you guys are a covid testing
center, mm-hmm.
Take us through how that wouldwork with one of your
subscribers or not subscribers.
Speaker 3 (29:52):
Yeah, just for covid, just for I mean.
So Now, the way it works, andprobably for the last year or
nine months, you know the covidat home tests have gotten good.
Yeah, so it's rare that we haveto send off a covid PCR, you
know, to the lab.
So most people call up and theysay I just tested positive for
(30:13):
covid, what should I do?
and we jump on a either virtualcall, phone call Or, you know,
sometimes they'll just, you knowThey provide enough information
by text and we text back andsay you know Fevers and how sick
are you.
And a lot of people areUnderestimated it you know, by
(30:34):
providers.
You know, i think you can trustpeople a lot more, so to know
if they're about to die or not.
You know most people say I amreally so, i'm sicker than I've
ever been, i'm having troublebreathing.
The volunteer of these thingsthat our textbooks say you have
to ask.
You know all these questions toget all these numbers, just
basically see why I.
(30:55):
But then we can just make adecision with them if they Are
gonna take a medication likepaxil fed or something, and then
we just send it in.
They don't have to leave theirbed, you know so and then you
know, back earlier in the covidPCR days we had a drive-through
that was in the back of thebuilding and we would just Have
(31:20):
a virtual visit with them, havethem go through the drive
through, get their PCR done, andwe had the result back the next
day.
And again, you know all thatbilling went through for a long
time.
You know the government waspaying for all those tests And
the same thing.
Speaker 1 (31:37):
I guess the same thing goes for anything.
If someone has the sore throat,they might think a strap, or
you know, you have a, yourprotocol that is less intrusive
and time demanding than, yeah,where to go to.
Speaker 3 (31:51):
But it's.
It's.
I'll tell you, like along thespecialist question.
It's amazing for like, forinstance, labs.
So one of the benefits of beinga member of Evolviva is we have
discounted labs And if you wereto get a vitamin D test at, you
(32:13):
know, quest or LabCorp, it's$200.
If you get it through us, it's$20.
If you got a complete bloodcount it could be $60.
Through us, it's four.
Complete metabolic panel, againlike 60 or so, our price is
like six.
So there's a.
(32:36):
The prescription model helpswith.
There's so much money thatthese The labs, the pharmacies
there's so many ways to savetons of money.
I guarantee you every one ofour patients is saving At least
what they're paying inmembership, unless they have
(32:56):
like Some kind of a plan wherethey get no deductible, no
co-pay, you know no, orco-insurance.
I should say a lot of someplans have 80, 20, where you
know you're going to pay 20% ofthe bill.
But we, you know, we, have waysof helping them find you know
(33:18):
their medications for You knowpennies compared to what they've
been paying.
And sometimes it's thisidentical medicine, sometimes
it's like such a minor shift,like it could be going from like
you know, charmin to Sure Youknow some other brand, you know
(33:39):
good brand, named Toilet Papers,like no difference and nobody
would care at all.
And they can take it from 400 amonth to $4 a month.
But they wouldn't know that.
No, yeah.
Speaker 2 (33:51):
There's something very attracting about like
meaningful relationships, right,like, especially when it comes
to this healthcare system.
Because you know my parents mydad was a doctor, my mom was a
nurse and I have greatadmiration for healthcare
profession.
I truly believe that it's avery noble profession, and but
(34:11):
then everybody needs access tothat, right, because that's also
one of the training that I get,because I work as a medical
interpreter, and then one of thetraining talks about doctors or
healthcare professionalsbelieve that life is precious.
You know so, which is true,like life is precious, so you
will do anything that is withinyour power to keep to maintain
(34:31):
that life, you know.
But then there's also adifference between doing it as a
system and doing it like withheart in it.
You know, right, And that'swhat I'm hearing from your
practice that your members feelunderstood and you know them,
they know you, they know you,and that it creates that
meaningful relationship.
I suppose, oh, this is what I'msupposed to do.
Speaker 3 (34:51):
Yeah.
Speaker 2 (34:51):
I suppose no, this is what I want to do for my help.
Speaker 3 (34:54):
Yeah, yeah, i think that you know seeing four people
an hour.
You know 25, 30 people a day,it's, it's really hard not to
burn out and to start to gethardened because you just don't
have time to be as empathetic asyou want to be And you're
(35:17):
really being taxed.
You know you, most docs arefeeling burn out and you know,
as a statistically speaking,when you're feeling burned out
and you feel like your society's, you know, squeezing you that
hard, it's really hard to beempathetic and and put your
heart out there for other people.
You know putting your heart outthere and really listening and
(35:41):
really carrying it takes, youknow your own personal wellness
And I always emphasize, you knowmy office, like our patients
are not going to be happy if ourstaff is not happy, if our
providers are not happy, if wedon't feel like we have the time
(36:01):
to do what we need to do, if wefeel like we're rushing around
and we can't do what we need todo, it's not going to work.
So but it's.
You know it's hard in.
You know Western society as awhole to not try to go as fast
as possible and jam the systemand squeeze every penny out.
(36:22):
This seems to be the I hopelast century's model, but you
know, maybe this will be thefuture.
Speaker 2 (36:30):
Yeah, happiness is contagious.
It can be contagious.
Yes in a good way.
Yeah, yeah.
Speaker 1 (36:35):
I think that's part of the culture and for people I
don't send links to Dr Freeman'spractice, but his waiting room
and we've used it for communitymeditations at his practice It's
.
It's a hybrid, it's a mixbetween coffee shop and art
studio, so it's very welcomingand doesn't feel like a sterile,
(36:56):
cold medical office, whetherit's in a high rise or a strip
mall or you know.
It's engaging, it's welcomingAnd I also think part of the
unfortunate culture is stigma,like you just said, the doctors.
As someone that's seeking theseservices, it feels like the
doctors don't care for some ofthe reasons that we mentioned,
(37:19):
but to me it's so valuable.
I look, i look for people thathave the spirit of the heart of
a teacher And it sounds like yougive the time and the ability
to teach these clients thatmight need something.
And if you're not thespecialist, you have this
referral source that you knowand trust and use.
(37:39):
Whether it's for X-rays that Idiscounted rate medications, but
providers that you collaborateand connect with.
So many doctors that I go see, ifeel like you know if my
daughter needs a specialist,that I just feel like what?
either they don't care, theydon't know or they don't have
the time to educate me on whatmy child needs, and it's
frustrating, yeah, but you havethe ability and time and you,
(38:03):
you do have the heart of ateacher, you do have the
referral sources and theknowledge to do that, and I
think we're getting so far awayfrom that in general.
In terms of the medical field,yeah, i would agree.
To me that can be valuable.
The subscription weight I cango to this person as an anchor
and if I need something moredirect primary and urgent care
(38:23):
has the ability to refer me in aplace that, oh okay, i trust
that they know where they'resending me, as opposed to I
better do more research.
Yeah, that cycle.
Speaker 3 (38:33):
Well, and it's funny because there are some, a number
of things we do that you knowwe don't market or advertise
because I think they're hard toconvey.
But one of the most importantthings I think is if we do need
to refer you to someone, we'regoing to send you to someone
that we know is the best of thebest And we're going to really,
(38:56):
if it's something that is alittle atypical, we're going to
research it and figure out whereis the best place to go.
But and if you call and theycan't get you in for four months
, we're going to help facilitatethat when possible.
Not always possible, but youknow, sometimes there's brick
walls at the Hopkins and soforth, but it's that warm
handoff.
Speaker 1 (39:16):
It's.
we do it here when someone'snot here, When someone calls me
for mental health therapy and ifthey have a specific niche that
I feel like I can help.
but I don't specific specialize, But I know two or three people
that do.
Speaker 3 (39:30):
Right Really.
Speaker 1 (39:31):
You want to do.
of course I'd be glad to OrZoll with these.
you know they're a bit ofBuddhism and knowledge, whether
it's working with Zoll oroutside of our practice.
Yes, Zoll is a wealth ofknowledge in that, why not Not?
collective solution to healthand wellness.
That's what it's about.
Speaker 2 (39:50):
Yeah, yeah.
The thing I want to go back towhat you said earlier too, which
is a good lesson for life ingeneral the difference between
time and value that we have,like everybody has only 24 hours
a day, which is, you know, allwe have, but then there's a big
difference between making abetter value out of a limited
time, which beats the money,which beats everything else,
(40:13):
because it becomes more aboutthat meaningful relationship.
So I love that, because thevalue is in that meaningful
essence that is created, asopposed to within this time
we're going to fill in thisamount of people.
Do squeeze the most benefit outof it, you know.
Speaker 3 (40:29):
It's funny you should say that because it's taken me
five years to figure it out.
But when we first started Ithought, like the fact that you
could do virtual visits, thatyou could communicate, you know,
by email or text, you know alot of those conveniences I
thought would be the big drawand they weren't.
(40:50):
I thought the fact that wewould save them a lot of money
would be a big draw.
That wasn't.
And it turns out that it wassame day access, the fact that
they can always get in and seeus unless and we're open from
eight to seven, but if they callit like six or five, then it's
more challenging.
Same day And you know, quickphone access, etc.
(41:15):
So it's more the value stuff,the availability, the time, the
listening.
You know people seem most happywith the fact that we really
listened to them.
A lot of the reviews say, youknow, i felt listened to for the
first time in 20 years, so thatprobably can't be understated,
(41:39):
how important that is, how sadit is that they're not getting
it otherwise.
Speaker 1 (41:44):
I think you certainly answered a lot of the
misconceptions already that Inoted down The lack of access to
specialists.
Well, you have that, you knowthe costly aspect.
I guess the one thing thatstill jumps in my mind is what
is the my mind?
the call to action with peoplethat do have insurances?
(42:07):
How does it make sense in theirmind in terms of conveniences
there?
Why would they still do it?
Speaker 3 (42:16):
Yeah, so I would say, you know, with the high
deductible health plans, again,you know they're going to save
money with people even if theyhave, you know, as I said, no
deductible like we have us, inaddition to what I was
describing, a cadre ofspecialists that we really trust
(42:37):
.
We also have an online servicewhere we can consult with
specialists.
It's a service we pay for, butyou know, we can take pictures
of your skin rash Instead ofsending you to dermatology.
We just send the pictures andthen they tell us it could be
this or this.
This is what I would do first.
(42:58):
If that's not getting better,bring it back to a biopsy.
You know, take a little pieceof skin or something or try, you
know, something else.
So there's a lot that we can doto save folks even more time
and add value.
But we've seen a big growth inMedicare age folks and Medicare
(43:23):
is probably the one insurancewhere they stand to benefit the
least as far as financially.
You know, because Medicare payswell for visits, labs et cetera
.
But most of the folks that arecoming to us, it's because they
just can't access care when theyneed it.
(43:44):
You know, especially with COVID, they were saying you know I
was sick.
They told me that they couldtalk to me in two days.
You know where they could talkto me the next day.
But you know, if you're sickwith COVID you don't want to
wait a day or two, or they getthe message.
You know we're fully bookedtoday.
So either go to ER or an urgentcare, you know and you'll just.
(44:09):
You won't hear that from usunless you know.
You call and say your arm ismissing.
We might say go.
Speaker 1 (44:18):
What percentage of your clients are primary care
and what percentage are kind ofthat urgent care model.
Speaker 3 (44:27):
Maybe 95% primary care and 5% urgent care.
So we don't, it's not our focus.
The problem is, as far asgrowth, at least in the early
days.
We're not so worried about itnow because there's a lot of
(44:47):
word of mouth, but in the earlydays, you know, just people
aren't looking for a doctorunless they're not feeling well,
and so it's really the only wayyou can, you know, build and
see more people as if you'reavailable in that way.
(45:09):
But you also don't want to havebecause it's a new model.
You don't want to say, well,you can join us, you know, for
this amount per month.
They're like well, i've justgot a urinary infection, can I
just get this treated?
They may not want to do that,but then they come in and they
get listened to for the firsttime And they see how different
(45:31):
it is.
Speaker 1 (45:33):
Yeah, for example stitches right.
Speaker 3 (45:35):
Right, yeah, i got you.
Speaker 1 (45:38):
Well, where do you see the healthcare industry
going, whether it's for you orjust the general?
Speaker 3 (45:45):
Yes.
So the idealistic, optimistside of me feels that, you know,
insurance is an evil player andI hate the term evil because no
one's really bad.
You know these are lost in someway.
(46:06):
That's generous, go aheadthough.
We won't get into that.
I really don't believe itanyway.
So but I do think you know theinsurance system and the way
things are oriented currently isvery perverse.
(46:27):
It's set up in a way that is,you know, not well functioning.
And you know the latest attemptat changing the insurance
industry with, you know thequote unquote Obamacare limited
insurances to like six or sevenpercent profit, something like
(46:48):
that per year, so they can'tmake more than six or seven
percent.
I forget how the whole thingworks, but what it's skewed,
what it's skewed them into doing, is, you know, buying these
pharmacies and pharmacy chainsso that they can bill more and
create more billing.
(47:09):
So they're actually driving upthe cost at the same time.
Speaker 1 (47:15):
Is that why there's shortages with medications and
mental health meds?
Speaker 3 (47:20):
No, that's, that's a different thing.
Yeah, we won't get into that,but there's a lot of us out
there now.
There's over a thousand directprimary cares And we usually,
you know, get together as acouple of conferences a year And
more and more there are a cadre.
There's now health shares,which are similar to insurance
(47:46):
but where it's usually afraction of the price of
insurance And it will cover youfor catastrophic care and
usually mandates.
You know that you work with adirect primary care because they
know our job is to add value.
Our job is to avoid emergencyroom visits, avoid surgeries
where unnecessary, avoidunnecessary MRIs and testing.
(48:10):
You know that's where we givethe most value is is not sending
you to a million differentpeople in order to get the
diagnosis, actually listeningand figuring out what the
problem is and figuring out howto treat you.
So we're hoping that that willtake over and insurances will
(48:31):
disappear.
Speaker 1 (48:34):
I guess that can certainly happen if there's
research being done on it.
All right part of that thousand, are you guys beginning to get
in that mindset or already do?
Speaker 3 (48:43):
Yeah, there's a lot of great research, you know,
showing reduction in emergencyroom visit, reduction in
surgeries, reduction inhospitalizations.
So there's just it's no secretthat being having access to your
primary care when you need themis critical.
Speaker 1 (49:06):
What sounds like this is already being skilled,
because you opened up Evolvewhich year 2014.
And how many were there thencompared to you, say, over a
thousand now?
Yeah, it's growing.
Speaker 3 (49:18):
Yeah, it's really picking up.
It's pretty amazing.
Speaker 1 (49:23):
It's good to hear.
Speaker 3 (49:24):
Yeah.
Speaker 2 (49:25):
Yeah, you didn't mention this specifically, but I
gather that you know healthcareis noble, but also like there's
some kind of spiritualityaspect to it, the way you're
doing it, especially that partabout being listened to.
You know which is not somethingvisible, which is something
that cannot be marketed or likedescribed by something that can
(49:46):
be experienced.
Speaker 3 (49:47):
Exactly.
Speaker 2 (49:47):
So I love that.
I also want that to be part ofthe vision for the upcoming
decades or years in thehealthcare, because you know
healthcare need is not goinganywhere Because people are sick
, people are dying.
you know that's always going tohappen.
But if there is more of thatbeing cared for, that connection
, meaningful relationship, themore there is, the more people
(50:09):
are going to be happy andhealthy as well, you know.
Speaker 3 (50:12):
Well, and I'll take another step, zaw, in that I
think that you know what we'refocusing on and I think the
future is is not just treatingsick people and not just
preventing disease states, butactually helping people to find
wellness, happiness, peace.
You know figuring out how toplay.
(50:35):
You know this actual study ofhappiness and how to help people
get there that you know want toget there, and even people that
don't know that they want toget there.
Music to our ears.
Speaker 1 (50:50):
I bet Music to our ears Yeah.
Well, dr Friedman, is thereanything else you'd like to
share with our listeners beforewe go?
No, well, I'd greatlyappreciate it.
Dr Friedman has given us agreat insight into the benefits
of direct primary care and howit can revolutionize the
healthcare industry.
So thank you, dr Friedman, forjoining us today and sharing
(51:11):
your experience on this criticaltopic.
We'll give links in our notes,but how could they potentially
reach or in terms of evolve?
Speaker 3 (51:20):
Yeah, they can always email us at info at EMC, the
number four me me dot com.
They can text us or call844-322-4222, where our website
is, emc, the number four ME dotcom.
(51:41):
So that will be in the notes,don't worry.
Speaker 2 (51:46):
Yeah, thanks again, dr Friedman.
Yeah, it's a pleasure, reallyenjoyed the conversation Yeah.
Speaker 1 (51:50):
Thanks everyone for listening and, once again,
please subscribe, comment,review, follow the like.
If you think others wouldbenefit from this podcast
episode, share with others, ascollectively we can find
solutions to all things.
health and wellness.
My name's Luke DeBoy.
This is Zoff.
See you next time.
Popular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Therapy Gecko
An unlicensed lizard psychologist travels the universe talking to strangers about absolutely nothing. TO CALL THE GECKO: follow me on https://www.twitch.tv/lyleforever to get a notification for when I am taking calls. I am usually live Mondays, Wednesdays, and Fridays but lately a lot of other times too. I am a gecko.