DPC is growing with all generations

This morning I enrolled my 500th patient to the Direct Primary Care program.  I’m thrilled to have crossed this milestone.  It has been a rich blessing to meet new patients every week who participate with us in a vision for better healthcare.  I’ve met and cared for patients from all walks of life, from all backgrounds, and from all demographics.

affection-baby-baby-girl-377058My youngest patients and their parents share with me that DPC offers easier access for those sudden illness like fevers and strep throat both in appointment scheduling and communication with me.  Even today I’ve been able to address several issues with young mothers about their children which kept them from coming in for an office visit.  When we can appropriately deal with the concern remotely there is no need for them to pile everyone into the minivan and drive down to the office.  I can communicate and care for my patients in ways that simplify their busy lives.

Tachievement-adult-business-937481he young adult and middle age group see DPC as a way to address their growing list of minor (and not so minor) health issues.  So often they only need someone to counsel them on making good health decisions as they plan for their family’s future.  An unusual chest pain or new onset heartburn often enough is harmless but, occasionally, concern sets in and they need someone to evaluate their symptom with an eye for resolution.  Spending time addressing issues of nutrition, exercise, and sleep management yields large dividends for adults interested in choosing a future full of health and vitality.  With many of our labs included in membership and the time to review them with each patient in person, I get to teach them how to manage their own health without the need of many ‘experts’ in their life and at a fraction of the cost.


Today’s 500th patient is now my 5th oldest patient.  My elderly patients express to me that they value having someone with whom to sit and spend adequate time on their complex issues of multiple concerns, multiple medications, and multiple specialists.  Modern insurance based care often runs too short on time for patients more deliberate in their movements and conversation.  The extra time and energy to go the extra mile for these patients is so satisfying.  Medical training teaches us what the right answer is but DPC let’s me provide the right answer for my patient in the right way.

If you’ve been following along with our progress over these last 2.5 years but haven’t jumped on board yet, now is the time to join.  Come be part of a better healthcare world.  DPC is a model where patients are the focus again.  Call today at 244-1800 or sign up at trinitydpc.com.  Feel free to email me directly at mbmccoll@trinitymedical.net if you have questions.  We’re always happy to help.  We are healthcare without hassles, built for you.

35% of Americans have been surprised by an imaging bill

Fifty-seven percent of adults in the United States have received a surprise medical bill for services they thought would be covered by their insurance, according to a new survey from NORC at the University of Chicago. For 35 percent of adults, that surprise bill was for imaging services.
— Read on www.radiologybusiness.com/topics/healthcare-economics/surprise-billing-imaging-services-survey

At Trinity DPC we put all our prices in plain view and talk about them before anything is ever done. I’ll be honest though, I feel like some people get a little annoyed at me when I keep telling the price of stuff. ‘Mr. Jones, I recommend we do these five blood tests. Four of them are free with membership but the last one is $9. Does that sound okay to you?’

I do this for imaging services that coordinated for you too. If I recommend a CT scan for a suspected kidney stone, I know the price is going to be $250 which is about 90% off the full charged price elsewhere. However, when Kristen calls to schedule it she always reconfirms the price. No surprises from us and, as far as we can help, no surprises from anyone with whom we work. That’s just the way Primary Care should be.

We are healthcare without hassles, but for you.

Small businesses benefit from big solutions with Trinity Direct Primary Care

I’m a big fan of small businesses.  As a small business owner myself, I go to work everyday with the understanding that I’m working to benefit my community, my staff, and my family.  If I lose sight of these responsibilities, then everyone will suffer.

Trinity Direct Primary Care offers other small business owners an option to care for their staff members through sponsored memberships.  We all want team members who are healthy but have access to good quality care when needed at an affordable price.  For the month of September I’m offering other small business owners a discount on sponsored membership.  If an owner signs up their business which includes themselves and at least one non-family staff member then we’ll discount the registration fee to $35 per person and offer 10% off membership for everyone signed up.*

adult-business-commerce-375889The sponsored membership plan works much like an individual plan does.   The employer can purchase a membership plan for their employee which gives them full access to all the benefits of membership including no cost office visits, discounted labs, full access to their physician by phone and email during the business day, discounted medications mailed to their house, and discounted advanced imaging.  Anything not covered by the membership would be the shared responsibility of the employee.   For instance, if the employee needed a B12 injection the cost would still just be $6.40 to the employee billed at the time of service.  This keeps the costs fixed and known to the business owner and allows the employee unparalleled access to exceptional, low cost care.  Nothing fishy or hidden.  We offer straightforward healthcare at transparent prices.

brainstorming-business-plan-close-up-908295If you are a SBO and have been trying to figure out how to offer a competitive benefit to your staff, then this is a great opportunity for you.  If you have any questions or if you need to sign up then please contact me directly at mbmccoll@trinitymedical.net

*Discounts apply only to new employer sponsored membership contracts and for one year as long as at least one non-family staff member remains enrolled.



I hate it when patients get ripped off

As so many of us are aware, the cost of healthcare, basic primary care, is skyrocketing.  Patients are at the mercy of the industry pricing and they rarely know the cost before deciding to seek care.  Many times the charged price is 10 times as much as the negotiated rate set by insurance companies and 20 times as much as the lab test actually costs to perform.

I joined the Direct Primary Care movement in 2016 to help patients find lower cost options for their healthcare.  TDPC’s parent company, Trinity Medical Associates, has been innovating new ways to lower the cost of care for our community for years.  Direct Primary Care has become a powerful force benefiting patients regardless of insurance coverage.  When we are able to push the price lower everyone benefits.

In our program, we’ve been working with our national lab vendor to seek out lower cost prices.  How has this worked out?  So far we’ve been able to secure 60-90% savings off most all labs and many common labs are now so inexpensive for us to purchase, we provide them for free with membership.

For instance, the standard labs I use to manage diabetes like a Hgb A1c, a lipid panel, a kidney and liver function panel, and an insulin level are all free four times a year.  That’s the normal follow up schedule for diabetes.  These labs are so inexpensive it felt like the right thing to do to give them to patients without cost.  I mean, I don’t charge for checking your blood pressure either.

Recently, one of my colleagues showed me a price list for common labs available to his patients.  Generally, these prices are already at a discount from what is charged by medical practices so retail pricing might be even higher.  I’ve overlaid the prices for my practice for comparison.

Lab price comparison


Well, you can see for yourself the cost differences in what you might pay somewhere else and the savings you’ll get through the Trinity DPC program.  By lowering the cost of labs, patients have better access to primary care services regardless of insurance coverage.  They can monitor and manage their chronic illnesses easier and, maybe, those illnesses become a little less chronic.  Complications of these illness could improve which would lead to less death and disability in the people about whom I care.  How much better would it be to not need dialysis or an amputation?


If you take this price list in total, the cost of all the labs through the Trinity DPC program is only $165.  Through the regular, insurance based system the cost is $2562.74.  Imagine meeting your deductible every year just because of the cost labs.  We can offer patients a  $2397.74 discount, a savings of 93.6%, just by avoiding the price fixing scheme of modern healthcare.  What would you do with an extra $2397.74 in your pocket each year?

-Dr. Mark B McColl













































































































Knee pain: Urgent treatment or virtual visit?

Knee injuryLast week one of our patients suffered a knee injury while testing the terminal velocity of his slip and slide.  The circumstances and timing of the injury were such that they couldn’t be seen in the office immediately and the advice by a well meaning allied health professional on scene at the time of the injury was to be evaluated in an urgent treatment center.  So off the family went.

The patient’s father contacted me from the UTC waiting room for advice.  He sent me some pictures of the injury and we discussed the child’s symptoms.  After taking a history and asking about level, location and quality of his pain as well as any functional limitations, it was safe to recommend that they start with conservative measures at home overnight and follow up if symptoms didn’t resolve.  With a little rest, ice, and elevation he was feeling better and spent the next day at Dollywood.  I hope the $200-300 they saved on the UTC visit offset the cost of parking.

Trinity DPC strives to make conversation a part of primary care again.  We want to connect patients to their physicians so that long term care has meaning.  Come see what we are about and how our month to month membership will benefit you.  We are healthcare without hassles, built for you.

Can’t Afford Health Insurance? Americans Rig Their Own Safety Net – Bloomberg

Consumers frustrated by high costs are bypassing the bureaucracy with patchwork plans.
— Read on www.bloomberg.com/news/features/2018-08-22/priced-out-of-health-insurance-americans-rig-their-own-safety-nets

I’ll say it again, ‘Health insurance is not the same as healthcare.’

It’s not just the uninsured — it’s also the cost of health care

It’s not just the uninsured — it’s also the cost of health care

We still have an uninsured problem in the U.S., but we have a far broader health care affordability problem that hits sick people especially hard.

Why it matters: It’s time to think more broadly about who’s having trouble paying for the health care they need. The combination of lack of insurance and affordability affects about a quarter of the non-elderly population at any one time, but almost half of people who are sick.

Now that the Affordable Care Act has expanded health coverage, the percentage of the non-elderly population that is uninsured is now just under 11%, the lowest level ever recorded. But as the chart shows:

  • Another 15.5% who have insurance either skipped or delayed care because of the cost or reported that they or someone in their family faced problems paying their bills in 2017.
  • That brings the total percentage of non-elderly people with insurance and affordability problems to 26.2%.

More striking: nearly half of all people in fair or poor health — 46.4% — are uninsured or have affordability problems despite having coverage.

  • That includes 13.5% who were uninsured and in fair or poor health — arguably the worst off in the entire system — and another 32.9% percent who have insurance but said they or a family member have had a problem affording care in the last year.

It’s not surprising that people who are sicker and need more care would have more problems paying for it. But arguably an insurance system should work best for people who need it the most.

All this says a lot about current health care politics.

  • It helps explain why so many people name health their top issue, despite the progress that has been made in covering the uninsured. And everyone who’s sick and can’t afford medical care has family members and friends who see what they are going through, creating a political multiplier effect.
  • It is also why health care is substantially an economic issue as well as an issue of access to care. When people have trouble paying medical bills, it’s a hard hit to their family budgets — causing many people to take a second job, roll up more debt, borrow money, and forego other important family needs.

For as long as I have been in the field, we have used two measures more than any others to gauge the performance of the health system: the number of Americans who are uninsured and the percentage of GDP we spend on health. Both measures remain valid today.

The bottom line: If we want a measure that captures how people perceive the system when the number of uninsured is down and overall health spending has moderated, we need better ways of counting up the much larger share of the population who are having problems affording care.

And whatever big policy idea candidates are selling, from single payer on the left to health care choices on the right, the candidate who connects that idea to the public’s worries about paying their medical bills is the one who will have found the secret sauce.

The ER, the Urgent Care Center, and the DPC

Ever wonder what the cost difference is between going to the ER or the Urgent Care Center?  It’s no surprise that the UTC is less expensive.  Often the UTC is about 20% the cost of the ER.  Now, if you compare the cost of a UTC to a DPC membership you’d save even more.

All of the issues listed here would be covered at no charge within the DPC membership.  So for a kid with an earache, you don’t pay anything for the visit itself.  Simple to schedule, easy communication and follow up, and no additional cost.  That’s a good deal.

The adult with bronchitis can be treated at no additional charge too.  Since acute bronchitis is most commonly caused by a virus, many of those patients don’t even need to be seen in the office.  I will treat them over the phone when appropriate.  Pink eye is similar.  Send me a picture of your kid’s eye and if the story is clear enough then topical treatment can be sent in without missing a beat of home life.

Not only does DPC lower the cost of care, it improves patient’s access, and hopefully keeps their lives rolling along a little easier.

Top six myths about direct primary care

Direct Primary Care offers unparalleled access to your doctor for everyone.

https://www.twinehealth.com/blog/top-six-myths-patients-believe-about-direct-primary-care by


Among patients, direct primary care (DPC) is treated a bit like a unicorn. A beautiful idea that exists only in our imaginations. Except this unicorn is very real. The DPC movement is gaining traction across the country with new practices sprouting up every day.

Yet even presented with the facts, the mythology around DPC practices persists. From disbelief about a physician’s increased availability to fears around abandoning traditional insurance, patients perpetuate these superstitions as the truth. Yet of all the myths patients believe in the DPC space, these six are the most common:

Myth #1: It doesn’t exist

The most common untruth patients believe about DPC practices is that they don’t exist at all. Many patients are accustomed to the concept of primary care doctors acting as mere gatekeepers for referrals and antibiotics. The concept of a PCP diagnosing, treating and monitoring many of their health issues sounds like something from the past.

Myth #2: It’s more expensive than traditional insurance

Once patients learn that direct primary care is, in fact, real, they move on to the second most common fallacy: “It’s probably way too expensive.” However if patients added up the cost of their insurance premiums, deductibles and co-pays, they would see that direct primary care is still more affordable than traditional insurance. And yes, that includes the cost of a wraparound plan to cover emergency care and complex procedures.

Myth #3: Specialists are out-of-reach

Another common misconception is that patients will suddenly be walled off from specialists. They think if their DPC doctor is managing their care, they won’t be able to get tailored treatment from specialists. However thanks to must-have referral services like Rubicon MD, DPC physicians can offer on-demand specialist consults as needed.

Myth #4: Tests and procedures won’t be included

Similarly, patients don’t understand the expanded scope of services their DPC physician can offer. From dermatology to gynecology, membership in a direct primary care practice includes many procedures and tests that the patient previously had to undergo at another facility.

Myth #5: The doctor will be less available

The most bewildering DPC myth of all? That their doctor won’t be as responsive. Many patients believe that their physician will suddenly be out of reach under this new model of care. However, it was the insurance companies that were disincentivizing physicians from communicating with their patients between visits. Remove those pesky middle men and patients can expect a much more communicative relationship with their doctor.

Myth #6: It’s only for rich people

Beyond just the affordability issue, many patients assume direct primary care is only for rich people. The source of this particular myth? Concierge medicine, which typically caters to higher income populations who can afford insurance alongside monthly practice fees. Although concierge medicine is more widely known than direct primary care, the latter is a movement for the general population, rather than just the privileged few.

Our bet? In a few years, this unicorn won’t seem so imaginary.


Eat real food.

Anyone that’s looked at my Wellness Prescription handout knows that the first step of good nutrition is to eat real food. After that, we need to engineer a low enough carbohydrate diet to achieve our health goals. Typically, I recommend newbies start at 100gms per day, but I always individualize that level with each patient at their office visit and adjust it as they grow in experience and success.

With all the reaction to the new ‘low carb is killing you’ study, I liked what cardiologist Aseem Malhotra, MD had to say about it during a recent interview. Essentially, eating fake food is always not good for you even if you are generally low carb. However, real food that is low carb is the best of all. If you don’t know what that is or how to implement it in your life, come see us at Trinity DPC. We talk about this stuff all the time.

We have two upcoming ‘Food as Medicine’ discussions that are free for members and $20 a person for non-members.  Carly Slagle, RD and Dr. Hone are hosting a meeting in Maryville on August 23rd from 12 to 1pm.  In Hardin Valley, Carly and I will be hosting a discussion on September 4th from 1 to 2pm.  Call our office you have any questions.