1 00:00:01,040 --> 00:00:05,520 Speaker 1: Welcome to the Rogue Recap. Hot takes, cold facts and 2 00:00:05,680 --> 00:00:09,800 Speaker 1: zero respect for the official narrative. Sit back, roll your 3 00:00:09,800 --> 00:00:12,760 Speaker 1: eyes and let's recap rogue style. 4 00:00:15,400 --> 00:00:18,000 Speaker 2: What's up, everybody, and welcome to the Rogue Recap. I 5 00:00:18,000 --> 00:00:20,720 Speaker 2: am Linda McLachlin, your host. Please follow us at Roague 6 00:00:20,720 --> 00:00:23,960 Speaker 2: Recap at Lindamickrogue recap dot com. I have an awesome 7 00:00:24,000 --> 00:00:26,680 Speaker 2: guest today. This guy's a friend, but he's wicked smarts. 8 00:00:26,680 --> 00:00:28,920 Speaker 2: We brought him on. I know I say that about everybody, 9 00:00:28,920 --> 00:00:31,560 Speaker 2: but this time it's true. I swear so. Doctor Josh 10 00:00:31,640 --> 00:00:33,199 Speaker 2: is with us. He has a super weird name, so 11 00:00:33,240 --> 00:00:35,680 Speaker 2: we don't say it. But his company is the more 12 00:00:35,720 --> 00:00:40,720 Speaker 2: important part. It's called Atlas MD, and he does concierge 13 00:00:40,800 --> 00:00:44,519 Speaker 2: medicine and now has over a thousand practices across the 14 00:00:44,600 --> 00:00:48,320 Speaker 2: United States. Partnering with all these other physicians, they're really 15 00:00:48,400 --> 00:00:51,680 Speaker 2: helping people. And for those of us that have families, 16 00:00:51,720 --> 00:00:54,800 Speaker 2: have kids, you know, care about the cost of healthcare, care, 17 00:00:54,800 --> 00:00:58,560 Speaker 2: about affordability, accessibility, don't want to make an appointment to 18 00:00:58,600 --> 00:01:00,880 Speaker 2: have an appointment, to have a conversation about the appointment, 19 00:01:00,960 --> 00:01:04,160 Speaker 2: we couldn't get This is the solution to all those things. 20 00:01:04,200 --> 00:01:05,680 Speaker 2: So doctor Josh, welcome the show. 21 00:01:05,680 --> 00:01:07,560 Speaker 3: What's up man, it's great being here. 22 00:01:07,600 --> 00:01:13,480 Speaker 2: Thank you, You're welcome. So doctor Josh has this amazing concept. 23 00:01:13,640 --> 00:01:17,120 Speaker 2: It's called actually practicing medicine. It's a new thing. I 24 00:01:17,120 --> 00:01:20,479 Speaker 2: think it's really going to catch on. And he sees 25 00:01:20,520 --> 00:01:24,280 Speaker 2: his patients, he talks to his patients, he has twenty 26 00:01:24,319 --> 00:01:28,080 Speaker 2: four to seven accessibility, he does telemed. He also has 27 00:01:28,200 --> 00:01:31,480 Speaker 2: access to his own pharmaceuticals, so he can give you 28 00:01:31,520 --> 00:01:34,320 Speaker 2: the prescriptions for pennies on the dollar as opposed to 29 00:01:34,360 --> 00:01:36,520 Speaker 2: you getting some jacked up costs that you don't need. 30 00:01:36,720 --> 00:01:39,720 Speaker 2: He can mail them to your house. All these interesting, 31 00:01:40,360 --> 00:01:44,080 Speaker 2: unique narratives that are about patient care. And for those 32 00:01:44,120 --> 00:01:47,080 Speaker 2: of you who remember the book Patient Power by John Goodman, 33 00:01:47,400 --> 00:01:49,320 Speaker 2: if you haven't read it, I suggest that you do. 34 00:01:49,920 --> 00:01:52,520 Speaker 2: It really is all about that. It's putting control of 35 00:01:52,560 --> 00:01:54,920 Speaker 2: your body, your health, what matters to you and your 36 00:01:54,920 --> 00:01:58,000 Speaker 2: family back in your hand. So doctor Josh kind of 37 00:01:58,000 --> 00:02:01,120 Speaker 2: personifies this. And as we head into the midterms and 38 00:02:01,160 --> 00:02:03,720 Speaker 2: people are talking about the issues that matter, I said 39 00:02:03,760 --> 00:02:05,880 Speaker 2: to joshuamac you should come on and talk to the 40 00:02:05,920 --> 00:02:08,639 Speaker 2: audience so that they can hear that there are people 41 00:02:08,639 --> 00:02:12,079 Speaker 2: out there that have real answers, and whether you're a 42 00:02:12,160 --> 00:02:15,200 Speaker 2: Republican or a Democrat, you still need a doctor. You 43 00:02:15,280 --> 00:02:18,040 Speaker 2: are still a patient, and doctor Josh does not care 44 00:02:18,120 --> 00:02:20,680 Speaker 2: about your politics, but he does care about his patients. 45 00:02:20,880 --> 00:02:22,760 Speaker 2: So I wanted him to talk a little bit about 46 00:02:22,800 --> 00:02:25,960 Speaker 2: this and explain how he is able to do this. 47 00:02:26,040 --> 00:02:27,520 Speaker 2: He's going to tell you what he charges a month. 48 00:02:27,520 --> 00:02:29,160 Speaker 2: I'm going to let him give you that big bang moment, 49 00:02:29,200 --> 00:02:32,280 Speaker 2: because it's ridiculous how he does it for that cost, 50 00:02:32,520 --> 00:02:36,360 Speaker 2: what the subscribership is about, and what he offers, and 51 00:02:36,520 --> 00:02:38,760 Speaker 2: what he thinks about medicine today. So go ahead, tell 52 00:02:38,840 --> 00:02:39,840 Speaker 2: us about your practice. 53 00:02:40,240 --> 00:02:43,200 Speaker 3: Well, you know, this was a dream of ours. You know, 54 00:02:43,400 --> 00:02:46,320 Speaker 3: we saw going through training how kind of broken the 55 00:02:46,360 --> 00:02:48,800 Speaker 3: system was. And the story I like to tell is, 56 00:02:48,800 --> 00:02:51,359 Speaker 3: growing up, my dad was a trash man. He's a 57 00:02:51,440 --> 00:02:54,079 Speaker 3: lawyer now, so we still tell people he's a trashman 58 00:02:54,160 --> 00:02:58,200 Speaker 3: because it's less embarrassing, you know, shout out to all 59 00:02:58,240 --> 00:03:02,040 Speaker 3: the lawyers out there. Now he's our lawyer. But the 60 00:03:02,080 --> 00:03:04,240 Speaker 3: funny thing is it was a great business model. You 61 00:03:04,320 --> 00:03:06,440 Speaker 3: paid once a month, we picked up once a week. 62 00:03:06,480 --> 00:03:09,040 Speaker 3: It just made sense. And then as I went through 63 00:03:09,080 --> 00:03:12,000 Speaker 3: the med school and undergrad and residency training. You saw 64 00:03:12,160 --> 00:03:14,919 Speaker 3: how the sausage got made and it made no sense. 65 00:03:15,400 --> 00:03:17,840 Speaker 3: Patients weren't happy with it, Doctors weren't happy with it. 66 00:03:17,880 --> 00:03:20,600 Speaker 3: Employers weren't happy with it. So it was funny that 67 00:03:20,639 --> 00:03:22,840 Speaker 3: it wasn't working for anybody, but we kept doing it 68 00:03:22,840 --> 00:03:25,880 Speaker 3: in a broken way. So we were watching, you know, 69 00:03:25,960 --> 00:03:29,680 Speaker 3: other practices that are doing interesting things, whether that was 70 00:03:30,000 --> 00:03:33,640 Speaker 3: concierge on the very high end no insurance, or fee 71 00:03:33,680 --> 00:03:36,520 Speaker 3: for service on the very low end no insurance, and 72 00:03:36,560 --> 00:03:38,120 Speaker 3: we wanted to kind of make the best of both 73 00:03:38,160 --> 00:03:41,120 Speaker 3: worlds there. We wanted to have our proverbial cake and 74 00:03:41,160 --> 00:03:44,440 Speaker 3: eat it too, So we created this in twenty ten. 75 00:03:44,840 --> 00:03:46,760 Speaker 3: We had no idea what we were doing, but that 76 00:03:46,880 --> 00:03:49,480 Speaker 3: was nice because it was the imperson new clothes. We 77 00:03:49,520 --> 00:03:52,040 Speaker 3: didn't know what we were supposed to do, right, and 78 00:03:52,160 --> 00:03:54,880 Speaker 3: it gave us that flexibility to really design a new system. 79 00:03:55,840 --> 00:03:58,560 Speaker 3: But yeah, it was It's fifty dollars a month for adults, 80 00:03:58,560 --> 00:04:01,640 Speaker 3: ten dollars a month for kids, or unlimited home visits, 81 00:04:01,760 --> 00:04:06,000 Speaker 3: work visits, office visits. All the telemedicine is free because 82 00:04:06,000 --> 00:04:09,880 Speaker 3: it's just an extension of the office. So calling, texting, emailing, 83 00:04:10,000 --> 00:04:13,160 Speaker 3: video chat. The goal really is to meet patients where 84 00:04:13,160 --> 00:04:15,520 Speaker 3: they're at. It was kind of this broken idea that 85 00:04:15,560 --> 00:04:17,960 Speaker 3: you only got paid if you brought the patient through 86 00:04:18,279 --> 00:04:21,200 Speaker 3: the door, because then at least insurance had some sort 87 00:04:21,240 --> 00:04:24,760 Speaker 3: of bottleneck on how much money could be spent. But 88 00:04:25,520 --> 00:04:28,719 Speaker 3: we appreciate that so much of the care happens outside 89 00:04:28,760 --> 00:04:32,719 Speaker 3: of the exam room, and we eliminated copays. We don't 90 00:04:32,760 --> 00:04:35,520 Speaker 3: need them. They're not part of the financial business model. 91 00:04:35,800 --> 00:04:39,599 Speaker 3: They're more of a psychology business model. It was the 92 00:04:39,600 --> 00:04:42,480 Speaker 3: insurance giving you a speed bump before you spend their money, 93 00:04:43,040 --> 00:04:46,000 Speaker 3: and so we just kept innovating on ways to bring 94 00:04:46,040 --> 00:04:49,080 Speaker 3: more value to the patient. The doctors don't like billing insurance, 95 00:04:49,120 --> 00:04:51,200 Speaker 3: they don't like red tape. It doesn't help the patient. 96 00:04:51,320 --> 00:04:55,120 Speaker 3: So yeah, we just and you know, twenty or sixteen 97 00:04:55,160 --> 00:04:57,240 Speaker 3: years later, it's still going strong. 98 00:04:57,960 --> 00:05:01,200 Speaker 2: It's interesting, you know that you talk about the copays, right, 99 00:05:01,360 --> 00:05:05,920 Speaker 2: because I feel one of the things that I hate 100 00:05:05,920 --> 00:05:08,119 Speaker 2: the most as a mom and as a patient myself 101 00:05:08,120 --> 00:05:09,520 Speaker 2: when I have to go in for myself is when 102 00:05:09,560 --> 00:05:12,560 Speaker 2: they say, well you're going to need a referral. That 103 00:05:12,640 --> 00:05:17,280 Speaker 2: drives me bananas. So I feel like many of us. 104 00:05:17,600 --> 00:05:20,240 Speaker 2: I'll speak to two examples. One is the referral. You 105 00:05:20,240 --> 00:05:23,400 Speaker 2: need a referral to go see this doctor. Yes, I know. 106 00:05:23,480 --> 00:05:25,159 Speaker 2: That's why I'm here seeing you because I don't know 107 00:05:25,160 --> 00:05:27,520 Speaker 2: where to go. I think we're I think we're doing 108 00:05:27,520 --> 00:05:30,800 Speaker 2: that right now, right, That to me is such talk 109 00:05:30,839 --> 00:05:34,440 Speaker 2: about bullshit, right, talk about just billing to bill. And 110 00:05:34,480 --> 00:05:36,800 Speaker 2: then the other thing, to your point is the accessibility. 111 00:05:36,880 --> 00:05:38,600 Speaker 2: Like you're like, you can text me, you can call me, 112 00:05:38,720 --> 00:05:41,640 Speaker 2: you can email me. That's why I'm your doctor, That's 113 00:05:41,640 --> 00:05:43,520 Speaker 2: why I'm here. Being a doctor is not a nine 114 00:05:43,560 --> 00:05:46,440 Speaker 2: to five job. You know, people don't get sick within 115 00:05:46,480 --> 00:05:48,800 Speaker 2: the you know, normal business hours exactly. 116 00:05:48,960 --> 00:05:52,360 Speaker 3: Yeah, they don't schedule it, no, yeah, No. It takes 117 00:05:52,400 --> 00:05:55,440 Speaker 3: a lot of patience to be a patient, or it 118 00:05:55,520 --> 00:05:58,520 Speaker 3: kind of sucks to be a patient, right, yeah, it's 119 00:05:58,560 --> 00:05:59,680 Speaker 3: not a virtue, it's a bit. 120 00:06:00,640 --> 00:06:00,839 Speaker 2: Yeah. 121 00:06:01,080 --> 00:06:04,760 Speaker 3: So yeah, And I think that you would never redesign 122 00:06:04,839 --> 00:06:06,880 Speaker 3: this model if you put the patient first and like 123 00:06:06,960 --> 00:06:09,880 Speaker 3: put all these roadblocks in. And if I went to 124 00:06:09,960 --> 00:06:12,080 Speaker 3: a hotel while traveling and I said, oh, well, you 125 00:06:12,120 --> 00:06:13,600 Speaker 3: need a pillow, you know, you need to go to 126 00:06:13,640 --> 00:06:15,680 Speaker 3: the pillow store. Of course I need a pillow. That's 127 00:06:15,680 --> 00:06:18,159 Speaker 3: why I'm at a hotel. I need all the hotels things, 128 00:06:19,000 --> 00:06:22,560 Speaker 3: you know, and then somehow that's my responsibility or nobody knows, 129 00:06:22,839 --> 00:06:25,640 Speaker 3: you know how or what. But it's broken. For like 130 00:06:26,720 --> 00:06:30,960 Speaker 3: if it's the system is working even though it's broken. Right, 131 00:06:31,080 --> 00:06:33,839 Speaker 3: the Affordable Care Act and the way that it's set 132 00:06:33,920 --> 00:06:37,680 Speaker 3: up is the systems get paid for volume, and they 133 00:06:37,960 --> 00:06:40,479 Speaker 3: if they got paid one price for all your care, 134 00:06:40,480 --> 00:06:44,359 Speaker 3: they would streamline that and not create as many visits. 135 00:06:44,600 --> 00:06:47,920 Speaker 3: But they're like a lawyer being paid by the word. Right, 136 00:06:48,040 --> 00:06:51,039 Speaker 3: So oh yeah, now we get another co pay. Yeah, 137 00:06:51,080 --> 00:06:53,880 Speaker 3: the family doctor could take care of your psoriasis, but 138 00:06:54,000 --> 00:06:57,200 Speaker 3: if we refer you on to dermatology, then we get 139 00:06:57,279 --> 00:07:00,240 Speaker 3: another doctor visit and we get to build dermatology. It's 140 00:07:00,279 --> 00:07:03,880 Speaker 3: not family doctor price, and we you know, squeeze money 141 00:07:03,880 --> 00:07:06,120 Speaker 3: out of the system. And you know, so you have 142 00:07:06,160 --> 00:07:12,000 Speaker 3: this very competitive care system against the insurance system, and 143 00:07:12,040 --> 00:07:13,680 Speaker 3: they're trying to get as much money from each other 144 00:07:13,720 --> 00:07:17,840 Speaker 3: as they can and the patient gets stuck in the middle. 145 00:07:18,240 --> 00:07:21,120 Speaker 3: So when you say, look, I'm paid one price for 146 00:07:21,160 --> 00:07:23,720 Speaker 3: the month, I might as well be as efficient as possible, 147 00:07:24,000 --> 00:07:25,960 Speaker 3: make it as easy. I don't need to schedule you 148 00:07:26,080 --> 00:07:29,440 Speaker 3: unnecessarily if you can text me, and that's faster and 149 00:07:29,480 --> 00:07:32,200 Speaker 3: better for you, it's faster and better for us. And 150 00:07:32,920 --> 00:07:36,280 Speaker 3: I heard something recently. You know, if you flip it 151 00:07:36,320 --> 00:07:37,960 Speaker 3: on its head, you would never see a fee for 152 00:07:38,040 --> 00:07:40,600 Speaker 3: service gym, right, you would where you have to pay 153 00:07:40,640 --> 00:07:43,160 Speaker 3: every time you go in, because that's not the psychology 154 00:07:43,200 --> 00:07:45,280 Speaker 3: of people don't want to go to the gym, or 155 00:07:45,320 --> 00:07:48,160 Speaker 3: at least most people don't, and most people don't want 156 00:07:48,200 --> 00:07:50,560 Speaker 3: to go to the doctor. So you build a system 157 00:07:50,600 --> 00:07:54,440 Speaker 3: with fewer barriers, not more. And like, Okay, I'm at work, 158 00:07:54,520 --> 00:07:56,679 Speaker 3: the kids sick, they just send a picture of a rash. 159 00:07:56,760 --> 00:07:58,640 Speaker 3: I don't want to add all this to my day. 160 00:07:58,920 --> 00:08:01,440 Speaker 3: But I can order anything I want from Amazon, but 161 00:08:01,480 --> 00:08:04,320 Speaker 3: I still have to drive across town to see my doctorate. 162 00:08:04,800 --> 00:08:07,880 Speaker 3: It's it doesn't make any sense of outdated and there's 163 00:08:07,920 --> 00:08:08,600 Speaker 3: better ways. 164 00:08:08,760 --> 00:08:10,840 Speaker 2: Yeah, and I think to that point. Right, So you've 165 00:08:10,880 --> 00:08:13,720 Speaker 2: been practicing medicine for two decades, if not more, right, 166 00:08:13,720 --> 00:08:15,920 Speaker 2: because you're not we're not including school and residency and 167 00:08:15,960 --> 00:08:19,920 Speaker 2: all the things. So you're talking upwards of two decades, 168 00:08:20,040 --> 00:08:23,600 Speaker 2: and you've probably seen a lot of the same things 169 00:08:23,680 --> 00:08:25,720 Speaker 2: as I would hope you would as a professional in 170 00:08:25,760 --> 00:08:28,720 Speaker 2: your business. I think part of what we're trying to 171 00:08:28,760 --> 00:08:31,520 Speaker 2: achieve here is I can do telemed for some of 172 00:08:31,520 --> 00:08:34,160 Speaker 2: the basic things because of the fact that I have 173 00:08:34,280 --> 00:08:37,600 Speaker 2: seen this on thirteen or fifteen other patients, maybe just 174 00:08:37,640 --> 00:08:39,600 Speaker 2: in the last two days because there's something going around 175 00:08:39,679 --> 00:08:42,640 Speaker 2: or whatever. So I don't need that in office visit. 176 00:08:43,280 --> 00:08:47,440 Speaker 3: Yeah, the reason for the office visit was never for 177 00:08:47,559 --> 00:08:50,000 Speaker 3: the quality of the care, is just for the building aspect. 178 00:08:50,480 --> 00:08:53,080 Speaker 3: And I think you know, you take something like depression 179 00:08:53,120 --> 00:08:56,400 Speaker 3: or anxiety. I feel the care is better when they're 180 00:08:56,400 --> 00:08:58,480 Speaker 3: not in the office, right, And it's always nice to 181 00:08:58,480 --> 00:09:00,720 Speaker 3: have a good crise session and the eye to eye 182 00:09:00,720 --> 00:09:05,840 Speaker 3: and talk to people, you know. But if you're really anxious, 183 00:09:05,840 --> 00:09:08,360 Speaker 3: you're anxious about coming to the doctor's office, you're anxious 184 00:09:08,360 --> 00:09:12,040 Speaker 3: about having that phone call and juggling work and everything else. 185 00:09:12,320 --> 00:09:13,960 Speaker 3: So if you just wake up at two am and 186 00:09:14,040 --> 00:09:16,760 Speaker 3: type out an hour long email to your doctor and 187 00:09:16,800 --> 00:09:19,600 Speaker 3: go to bed feeling better, that's care, right, And I 188 00:09:19,600 --> 00:09:21,640 Speaker 3: don't have to answer it at two am. But I 189 00:09:21,720 --> 00:09:25,080 Speaker 3: can take that, you know, read it through it later, 190 00:09:25,280 --> 00:09:29,280 Speaker 3: build a response, you give you links, right. I think 191 00:09:29,320 --> 00:09:32,719 Speaker 3: it's we've always felt the care was what was documented 192 00:09:32,720 --> 00:09:37,920 Speaker 3: and build insurance. But really that's the least caring part 193 00:09:38,000 --> 00:09:39,960 Speaker 3: of all of this. So to be able to take 194 00:09:40,000 --> 00:09:41,920 Speaker 3: my time and give you a great answer and not 195 00:09:41,960 --> 00:09:44,960 Speaker 3: feel rushed, but also provide more resources that then you 196 00:09:45,040 --> 00:09:47,960 Speaker 3: can remember, oh yeah, find that email, save that link, 197 00:09:48,080 --> 00:09:52,199 Speaker 3: go to that resource. It's just a much richer experience 198 00:09:52,280 --> 00:09:54,840 Speaker 3: and it's cheaper, right, Like that's the it should feel 199 00:09:54,840 --> 00:09:58,280 Speaker 3: too good to be true aspect of it, but also 200 00:09:58,400 --> 00:09:59,960 Speaker 3: costco is too good to be true, and this is 201 00:10:00,000 --> 00:10:01,600 Speaker 3: that's really just a costco model. 202 00:10:01,440 --> 00:10:05,120 Speaker 2: That actually dovetails perfectly into my next question. So you're 203 00:10:05,120 --> 00:10:08,360 Speaker 2: doing something that everybody should be doing, right, because it 204 00:10:08,400 --> 00:10:11,440 Speaker 2: makes sense. It makes more time for the patient, it 205 00:10:11,480 --> 00:10:13,520 Speaker 2: makes more time for the doctor, so you don't feel 206 00:10:13,559 --> 00:10:16,800 Speaker 2: rushed because typically, whether you're billed fifty dollars or eight 207 00:10:16,840 --> 00:10:20,840 Speaker 2: hundred dollars, you're getting ten minutes and so which also 208 00:10:21,120 --> 00:10:24,000 Speaker 2: really stinks because sometimes it does take more than ten minutes. 209 00:10:24,320 --> 00:10:26,440 Speaker 2: I mean, you know, full disclosure, everybody. I am a 210 00:10:26,440 --> 00:10:29,480 Speaker 2: patient of doctor Josh's, as are my kids, and there 211 00:10:29,480 --> 00:10:30,920 Speaker 2: are times when I'm on the phone with him for 212 00:10:30,920 --> 00:10:33,360 Speaker 2: an hour and he is on the phone where I'm like, well, wait, 213 00:10:33,360 --> 00:10:35,520 Speaker 2: I don't understand this. I don't understand that. What should 214 00:10:35,559 --> 00:10:37,360 Speaker 2: I take for this? And he's like, you don't need 215 00:10:37,400 --> 00:10:40,679 Speaker 2: an antibiotic, you need a sionus thing. You don't need this, 216 00:10:40,800 --> 00:10:42,920 Speaker 2: you know, because I'm not a doctor, but he takes 217 00:10:42,960 --> 00:10:45,120 Speaker 2: the time to talk to me. I think one of 218 00:10:45,120 --> 00:10:48,880 Speaker 2: the things that is I'm trying to understand is why 219 00:10:49,200 --> 00:10:52,880 Speaker 2: everybody's not doing this. It seems like a more efficient model, 220 00:10:52,960 --> 00:10:55,000 Speaker 2: both economically and time wise. 221 00:10:55,920 --> 00:10:59,000 Speaker 3: Yeah, I mean, if I had an answer to that, 222 00:10:59,040 --> 00:11:01,520 Speaker 3: then everybody would be doing I'm glad or not. 223 00:11:01,559 --> 00:11:03,360 Speaker 2: I'm glad that you're the one, and trust me, I'm 224 00:11:03,360 --> 00:11:03,920 Speaker 2: happy for you. 225 00:11:05,440 --> 00:11:08,240 Speaker 3: Well, but I think it's doctors are very risk adverse 226 00:11:08,280 --> 00:11:10,840 Speaker 3: and the system is so big, I mean, twenty percent 227 00:11:10,840 --> 00:11:14,760 Speaker 3: of our GDP. It just moves really slow. And there's 228 00:11:14,800 --> 00:11:17,480 Speaker 3: a lot of people who are frustrated with the high 229 00:11:17,480 --> 00:11:19,920 Speaker 3: insurance premiums but don't need a lot of care. And 230 00:11:19,960 --> 00:11:22,120 Speaker 3: so it's one of those like doing your taxes, you 231 00:11:22,160 --> 00:11:25,840 Speaker 3: hate it every time, but the frustration wasn't to the 232 00:11:25,840 --> 00:11:28,960 Speaker 3: boiling point. And when we started this in twenty ten, 233 00:11:29,080 --> 00:11:32,200 Speaker 3: there were, you know, a handful of doctors doing this model, 234 00:11:32,559 --> 00:11:35,920 Speaker 3: and now there's almost three thousand clinics doing this model. 235 00:11:36,240 --> 00:11:39,319 Speaker 3: So I think we are seeing a huge increase because 236 00:11:39,360 --> 00:11:42,800 Speaker 3: in perspective, it took Starbucks sixteen years to get their 237 00:11:42,800 --> 00:11:47,520 Speaker 3: first seventeen stores, and they're selling coffee right then. As 238 00:11:47,640 --> 00:11:50,319 Speaker 3: we compete against our system that gets worse every year, 239 00:11:50,720 --> 00:11:53,120 Speaker 3: and we always try to keep our prices low, I 240 00:11:53,120 --> 00:11:57,520 Speaker 3: think it makes the change for the direction of change 241 00:11:57,559 --> 00:12:00,440 Speaker 3: easier every year. And so far in twenty twenty six, 242 00:12:00,520 --> 00:12:02,839 Speaker 3: we're seeing that this is the most expensive year in 243 00:12:02,880 --> 00:12:05,600 Speaker 3: the history of healthcare, and people are saying that they're 244 00:12:05,640 --> 00:12:09,199 Speaker 3: kind of just tapping out. Yes, I understand, I want insurance. 245 00:12:09,200 --> 00:12:12,520 Speaker 3: I needed I've moved heaven and Earth to be able 246 00:12:12,559 --> 00:12:14,679 Speaker 3: to afford it, and now I just can't anymore. We 247 00:12:14,800 --> 00:12:17,360 Speaker 3: played all the games of deductibles and out of pockets 248 00:12:17,360 --> 00:12:20,280 Speaker 3: and whatnot, and so but now when they drop an 249 00:12:20,280 --> 00:12:24,439 Speaker 3: eight hundred dollars per month insurance plan per person, yes 250 00:12:24,520 --> 00:12:26,840 Speaker 3: they actually have more money. Right now they can find 251 00:12:26,840 --> 00:12:30,199 Speaker 3: an affordable insurance plan, pair it with direct care and 252 00:12:30,480 --> 00:12:34,240 Speaker 3: actually maybe save extra. So I think we'll see this 253 00:12:34,400 --> 00:12:36,880 Speaker 3: really start to take off in the coming months and years. 254 00:12:37,120 --> 00:12:39,559 Speaker 3: Is it just a better product, and that's what patients 255 00:12:39,559 --> 00:12:41,040 Speaker 3: want so to. 256 00:12:40,880 --> 00:12:44,440 Speaker 2: That point, I know that you do telemed, you do 257 00:12:44,559 --> 00:12:47,760 Speaker 2: an office when necessary, you'll go to somebody's house if necessary. 258 00:12:48,600 --> 00:12:51,839 Speaker 2: You're able to prescribe prescriptions, You're able to send those 259 00:12:51,880 --> 00:12:56,120 Speaker 2: prescriptions from your in house pharmacy. What about things like 260 00:12:56,200 --> 00:12:58,360 Speaker 2: you know, if somebody needs a lab or somebody needs 261 00:12:58,400 --> 00:13:00,640 Speaker 2: an MRI or things like that. How does that work? 262 00:13:01,960 --> 00:13:05,000 Speaker 3: Pretty well? Right? The doctors doing this model have access 263 00:13:05,040 --> 00:13:07,959 Speaker 3: to wholesale meds, but we haven't basically behind that wall. 264 00:13:08,320 --> 00:13:10,440 Speaker 3: And when you cut out the middleman, now you know 265 00:13:10,480 --> 00:13:14,200 Speaker 3: Walmart has a four dollars a month prescription plan. We 266 00:13:14,280 --> 00:13:17,079 Speaker 3: have a four dollars a year prescription plan, a lot 267 00:13:17,120 --> 00:13:19,800 Speaker 3: of meds that are a penny of pill. So you 268 00:13:19,960 --> 00:13:23,319 Speaker 3: remove that hassle, that insurance bureaucracy, that wait at the pharmacy. 269 00:13:23,520 --> 00:13:26,400 Speaker 3: But you kind of apply that same concept to other pieces. 270 00:13:26,679 --> 00:13:31,040 Speaker 3: We have Client Bill, which is basically just doctor pricing 271 00:13:31,400 --> 00:13:35,600 Speaker 3: with national labs like Quester lab Core, which patients can 272 00:13:35,600 --> 00:13:38,000 Speaker 3: get anywhere across the country through a direct care doc. 273 00:13:38,360 --> 00:13:40,560 Speaker 3: So a standard blood test to see if you have 274 00:13:40,600 --> 00:13:43,240 Speaker 3: diabetes A one c's it's going to be around you know, 275 00:13:43,960 --> 00:13:47,360 Speaker 3: fifty two dollars and fifty cents, check your thyroid for 276 00:13:47,400 --> 00:13:50,280 Speaker 3: two dollars and seventy five cents check your cholesterol for 277 00:13:50,480 --> 00:13:54,200 Speaker 3: three dollars. Now, when you make the care so cheap, 278 00:13:54,240 --> 00:13:57,040 Speaker 3: it's too cheap to ensure you save thirty or forty 279 00:13:57,040 --> 00:14:01,439 Speaker 3: percent off your insurance premiums among other changes. And a 280 00:14:01,520 --> 00:14:04,640 Speaker 3: cache MRI in Kansas might be three fifty, but in 281 00:14:04,679 --> 00:14:09,360 Speaker 3: Florida it's two fifty. Again, yeah, since most people aren't 282 00:14:09,360 --> 00:14:12,040 Speaker 3: getting an MRI too often, just the savings for more 283 00:14:12,040 --> 00:14:15,600 Speaker 3: affordable insurance helps to cover those things. But when it's 284 00:14:15,600 --> 00:14:20,160 Speaker 3: built through insurance three right, So to. 285 00:14:20,000 --> 00:14:23,440 Speaker 2: That point as well, if I look at for example, 286 00:14:24,240 --> 00:14:26,200 Speaker 2: I have had to have you know, all my kids 287 00:14:26,240 --> 00:14:31,680 Speaker 2: or athletes. Something is always broken inevitably, And even though 288 00:14:32,840 --> 00:14:34,960 Speaker 2: you can have insurance and it's supposed to be a 289 00:14:35,000 --> 00:14:38,440 Speaker 2: cope at the hospital, I can't get the appointment through 290 00:14:38,440 --> 00:14:42,160 Speaker 2: the insurance. So I can't get the appointment for the surgery. 291 00:14:42,240 --> 00:14:44,240 Speaker 2: I can't get the appointment for the MRI. I can't 292 00:14:44,240 --> 00:14:46,840 Speaker 2: get that. I mean it is like these are not 293 00:14:46,880 --> 00:14:48,880 Speaker 2: things like if you're going in for a cat scan, 294 00:14:49,040 --> 00:14:53,200 Speaker 2: an MRI and an ultrasound, a sonograt whatever these things are, 295 00:14:53,840 --> 00:14:58,760 Speaker 2: it's because something is potentially more serious and requires a 296 00:14:58,800 --> 00:15:02,520 Speaker 2: deeper look. And yet we can't get you in for 297 00:15:02,560 --> 00:15:05,360 Speaker 2: a month, right. But if I turn around and say 298 00:15:05,400 --> 00:15:07,720 Speaker 2: I'll pay cash, you don't have to run it through 299 00:15:07,720 --> 00:15:10,120 Speaker 2: my insurance. I can get you in right now. We 300 00:15:10,160 --> 00:15:13,160 Speaker 2: have an appointment in an hour. I'm like, oh my god, 301 00:15:14,320 --> 00:15:14,560 Speaker 2: you know. 302 00:15:14,760 --> 00:15:17,240 Speaker 3: And I guess it's shocking, not shocking, right in the 303 00:15:17,280 --> 00:15:21,360 Speaker 3: sense of if Amazon was waiting for my check, my 304 00:15:21,400 --> 00:15:24,200 Speaker 3: paper check to be mailed, then yeah, they're not shipping 305 00:15:24,200 --> 00:15:26,880 Speaker 3: anything until they get the money. And whoever pays the 306 00:15:26,920 --> 00:15:29,880 Speaker 3: piper picks the tune. I think that's how good it 307 00:15:29,920 --> 00:15:33,880 Speaker 3: can be with consumer driven healthcare. Of the consumer has 308 00:15:33,880 --> 00:15:36,600 Speaker 3: the money, then suddenly everybody finds a way to make 309 00:15:36,640 --> 00:15:39,880 Speaker 3: this work. Right. I find this sort of infinitely hilarious 310 00:15:39,920 --> 00:15:42,880 Speaker 3: that Walgreens can tell you exactly what everything in their 311 00:15:42,920 --> 00:15:45,840 Speaker 3: store costs. You can see the inventory, you say, you know, 312 00:15:45,880 --> 00:15:48,120 Speaker 3: miniboxes of cereal are there, and what the price is, 313 00:15:48,160 --> 00:15:51,000 Speaker 3: and they'll run a coupon and they just make that 314 00:15:51,040 --> 00:15:53,160 Speaker 3: as easy as possible because they have to to compete 315 00:15:53,160 --> 00:15:55,720 Speaker 3: against other stores. But then you get to the meds 316 00:15:55,840 --> 00:15:58,400 Speaker 3: and oh, we have no idea what these things cost 317 00:15:58,480 --> 00:16:01,000 Speaker 3: and we have to run your insurance and it's bloated. 318 00:16:01,320 --> 00:16:04,040 Speaker 3: It's just such a huge profit center for most places. 319 00:16:04,080 --> 00:16:06,600 Speaker 3: They don't want to compete. They don't you know, there's 320 00:16:06,640 --> 00:16:09,360 Speaker 3: companies that sell pills online that we get for five 321 00:16:09,440 --> 00:16:13,160 Speaker 3: cents that they sell for ten cents, right because they can't. 322 00:16:13,800 --> 00:16:17,400 Speaker 3: And that's the issue is my dad would joke, you know, 323 00:16:17,480 --> 00:16:19,440 Speaker 3: rule number one of the rat races. Everybody's got to 324 00:16:19,480 --> 00:16:22,960 Speaker 3: keep being a rat. And you know we're in some ways. 325 00:16:22,960 --> 00:16:24,720 Speaker 3: You could argue we're giving up a lot of profit 326 00:16:24,880 --> 00:16:28,000 Speaker 3: by doing the meds. Basically it costs plus ten percent. 327 00:16:29,560 --> 00:16:32,120 Speaker 3: But also then we don't need a marketing budget, right, 328 00:16:32,160 --> 00:16:34,960 Speaker 3: we don't have a problem recruiting and retaining patients. But 329 00:16:35,040 --> 00:16:38,120 Speaker 3: also we're I think we're building trust with the patient 330 00:16:38,120 --> 00:16:41,680 Speaker 3: because they can see how transparent that is. There's a 331 00:16:41,760 --> 00:16:45,840 Speaker 3: trust issue in medicine, like you're just treating my recommending 332 00:16:45,920 --> 00:16:49,040 Speaker 3: high cholesterol medicine because you make money off that. And 333 00:16:49,080 --> 00:16:51,240 Speaker 3: then you get the bill and it's thirty four cents 334 00:16:51,240 --> 00:16:53,800 Speaker 3: a month for your your centostat and you're like, well, 335 00:16:53,920 --> 00:16:55,800 Speaker 3: if he is making money on it, it's not enough. 336 00:16:56,400 --> 00:16:59,200 Speaker 2: Yeah, right, right. 337 00:16:59,120 --> 00:17:02,760 Speaker 3: Right, Because I think you need it, and they're like, Okay, 338 00:17:02,960 --> 00:17:07,359 Speaker 3: now I can trust you because you're transparent when others aren't, 339 00:17:07,520 --> 00:17:09,840 Speaker 3: or there's no reason to lie for thirty four cents, 340 00:17:10,480 --> 00:17:12,920 Speaker 3: or now you kind of feel like the mister Rogers thing. Right, 341 00:17:12,960 --> 00:17:15,720 Speaker 3: look for the helpers. Now the doctor who will tell 342 00:17:15,720 --> 00:17:17,639 Speaker 3: you what that is, or go the extra mile. Or 343 00:17:18,200 --> 00:17:21,600 Speaker 3: yesterday you had a ninety visit, ninety minute visit with 344 00:17:22,240 --> 00:17:26,240 Speaker 3: the whole family and somewhere joining by zoom and speakerphone, 345 00:17:26,320 --> 00:17:31,560 Speaker 3: and because everybody needed to hear this, and we wanted 346 00:17:31,560 --> 00:17:33,720 Speaker 3: to just be very efficient and take the time it takes. 347 00:17:34,080 --> 00:17:37,560 Speaker 3: And no insurance should pay for that, right. That's it's 348 00:17:37,600 --> 00:17:40,399 Speaker 3: not what insurance is for. It's for taking care of 349 00:17:40,560 --> 00:17:45,000 Speaker 3: rare and expensive events, not for what the doctor's supposed 350 00:17:45,040 --> 00:17:49,000 Speaker 3: to be doing right, high touch care. And I think 351 00:17:49,040 --> 00:17:52,560 Speaker 3: that's it too, is separating insurance is a great tool 352 00:17:53,280 --> 00:17:56,560 Speaker 3: for the right thing. A wrench can make a decent hammer, 353 00:17:56,600 --> 00:17:58,920 Speaker 3: but a hammer makes a horrible wrench. We keep trying 354 00:17:58,920 --> 00:18:02,800 Speaker 3: to force doctors into, you know, doing something through the 355 00:18:02,880 --> 00:18:06,320 Speaker 3: lens of insurance when really you just it's designed by subtraction. 356 00:18:06,440 --> 00:18:08,640 Speaker 3: Cut all that out and what's left ends up being 357 00:18:08,760 --> 00:18:09,600 Speaker 3: very effective. 358 00:18:11,480 --> 00:18:15,840 Speaker 2: You know, I'm interested in how you work with hospitals 359 00:18:16,000 --> 00:18:18,560 Speaker 2: and if they so, I'm assuming that you would tell 360 00:18:18,600 --> 00:18:21,640 Speaker 2: your patients you have US for fifty dollars a month, 361 00:18:21,760 --> 00:18:24,919 Speaker 2: ten bucks for your kids, and that covers you, you know, 362 00:18:25,000 --> 00:18:29,520 Speaker 2: for everything, and then catastrophic insurance for things like outside 363 00:18:29,560 --> 00:18:31,760 Speaker 2: of the boundaries. Like what do you recommend to people 364 00:18:31,800 --> 00:18:32,719 Speaker 2: who have that question? 365 00:18:33,640 --> 00:18:35,959 Speaker 3: Yeah, in the same way that you kind of have 366 00:18:36,600 --> 00:18:41,439 Speaker 3: cash for gasoline, savings for tires, and insurance for car accidents, 367 00:18:41,760 --> 00:18:44,600 Speaker 3: we would make the similar analogy that you use, you know, 368 00:18:44,840 --> 00:18:47,520 Speaker 3: general cash for the direct Care fifty dollars a month 369 00:18:47,560 --> 00:18:51,399 Speaker 3: membership as for two or three dollars a month, et cetera. 370 00:18:51,880 --> 00:18:54,159 Speaker 3: And then your savings for the bigger stuff, maybe that 371 00:18:54,320 --> 00:18:57,879 Speaker 3: MRI for three fifty, that's CT for two fifty, and 372 00:18:57,920 --> 00:19:02,800 Speaker 3: then some form of health insurance. It sounds a little vague, 373 00:19:02,880 --> 00:19:05,880 Speaker 3: but it makes sense. I say, we recommend the most 374 00:19:05,880 --> 00:19:09,560 Speaker 3: affordable insurance you're comfortable with, because insurance is really not 375 00:19:09,680 --> 00:19:13,840 Speaker 3: health insurance. It's financial insurance. And if you're young and healthy, 376 00:19:14,040 --> 00:19:18,960 Speaker 3: it's easy to say I'll roll the dice and hope 377 00:19:19,000 --> 00:19:22,360 Speaker 3: for the best, because statistically that's what happens. But I've 378 00:19:22,359 --> 00:19:25,040 Speaker 3: got car insurance, usually have home insurance or you know 379 00:19:25,080 --> 00:19:27,160 Speaker 3: those kind of things. Or if I follow in my parents' house, 380 00:19:27,240 --> 00:19:31,560 Speaker 3: they have home insurance, so you're never completely abandoned. But 381 00:19:31,720 --> 00:19:37,120 Speaker 3: then there's the cost sharing programs that were an interesting 382 00:19:37,160 --> 00:19:40,120 Speaker 3: aspect out of the Affordable Care Act. Then you have 383 00:19:41,720 --> 00:19:45,080 Speaker 3: the ACA plans if you can afford the deductible, or 384 00:19:45,240 --> 00:19:49,479 Speaker 3: we work with employers to decrease their insurance premiums so 385 00:19:49,520 --> 00:19:52,400 Speaker 3: that they can pay for the membership and the insurance. 386 00:19:53,560 --> 00:19:56,000 Speaker 3: So there's a range of options, and of course we 387 00:19:56,080 --> 00:20:00,239 Speaker 3: have one ourselves, and we built an insurance program much 388 00:20:00,280 --> 00:20:03,760 Speaker 3: harder than it sounds now we know, but to build 389 00:20:03,800 --> 00:20:06,720 Speaker 3: an insurance plan that fits directly with direct care so 390 00:20:06,760 --> 00:20:09,720 Speaker 3: that a family of four under forty should be under 391 00:20:09,720 --> 00:20:10,760 Speaker 3: four hundred and fifty. 392 00:20:10,560 --> 00:20:13,920 Speaker 2: Dollars a month, because people need to hear that. 393 00:20:14,600 --> 00:20:17,400 Speaker 3: Yeah, a family of four under forty, two adults, two 394 00:20:17,480 --> 00:20:20,200 Speaker 3: kids would be under four to fifty a month. And 395 00:20:21,960 --> 00:20:24,000 Speaker 3: you know that the national average is getting close to 396 00:20:24,040 --> 00:20:27,320 Speaker 3: twenty five hundred a month, and you can do a 397 00:20:27,320 --> 00:20:30,480 Speaker 3: lot of good I there's this perception that the best 398 00:20:30,520 --> 00:20:33,119 Speaker 3: way to spend the money is on the health insurance premium, 399 00:20:33,280 --> 00:20:36,320 Speaker 3: and I think what families are realizing is that's no 400 00:20:36,400 --> 00:20:40,400 Speaker 3: longer true and they'd rather just have their own and say, well, 401 00:20:40,440 --> 00:20:42,199 Speaker 3: you know, how much less anxiety would I have if 402 00:20:42,200 --> 00:20:44,400 Speaker 3: I had a thousand extra bucks a month to either 403 00:20:44,440 --> 00:20:47,879 Speaker 3: pay off my bills or buy a doctor, or you know, 404 00:20:48,000 --> 00:20:51,120 Speaker 3: help my kid's college fund. And those are the things 405 00:20:51,119 --> 00:20:53,439 Speaker 3: that I think really matter. And I talk with my 406 00:20:53,440 --> 00:20:55,760 Speaker 3: med students all the time. If we take her home 407 00:20:55,800 --> 00:20:58,639 Speaker 3: seriously of do no harm, that should also include do 408 00:20:58,680 --> 00:21:01,639 Speaker 3: no financial harm. Doctor should be finding a way to 409 00:21:01,960 --> 00:21:05,200 Speaker 3: help patients kind of throughout the whole system, from family 410 00:21:05,240 --> 00:21:09,440 Speaker 3: medicine to meds, to labs, to imaging, to specialists to pathology, 411 00:21:09,560 --> 00:21:11,800 Speaker 3: to hospital bills and whatnot. 412 00:21:12,400 --> 00:21:13,800 Speaker 2: So I want you to speak to and you did 413 00:21:13,840 --> 00:21:16,960 Speaker 2: just a little bit there about your health insurance. So 414 00:21:17,119 --> 00:21:20,480 Speaker 2: at list dot MD for those of you listening, is 415 00:21:20,480 --> 00:21:22,160 Speaker 2: where you can go to find out more about Josh 416 00:21:22,240 --> 00:21:25,560 Speaker 2: and his partnering you know, physicians and their clinics all 417 00:21:25,600 --> 00:21:30,320 Speaker 2: across the country. And then atlass Insurance is brand new. 418 00:21:30,359 --> 00:21:33,000 Speaker 2: I will tell you as a friend of Josh talking 419 00:21:33,000 --> 00:21:35,200 Speaker 2: to him over the past four years, he has been 420 00:21:35,280 --> 00:21:37,720 Speaker 2: through it trying to make this a reality. So God 421 00:21:37,760 --> 00:21:40,919 Speaker 2: bless you for sticking with it. Tell us what it 422 00:21:40,960 --> 00:21:43,399 Speaker 2: costs for that and how that works and how people 423 00:21:43,400 --> 00:21:45,960 Speaker 2: can find out more and get involved and get that insurance. 424 00:21:46,600 --> 00:21:49,960 Speaker 3: Yeah, the insurance website is Atlas dot direct. We're in 425 00:21:50,000 --> 00:21:56,760 Speaker 3: twenty states. The goal is that it's a plan that's 426 00:21:56,760 --> 00:22:00,399 Speaker 3: closer to something like affleck, where we want the payments 427 00:22:00,400 --> 00:22:02,919 Speaker 3: to go to the patient, not to this broken system. 428 00:22:03,160 --> 00:22:07,399 Speaker 3: So it's the prices are based on age, gender, and 429 00:22:07,480 --> 00:22:11,639 Speaker 3: state only. So we don't make this as a complicated 430 00:22:11,720 --> 00:22:16,120 Speaker 3: sign up process because other insurances might see you as 431 00:22:16,280 --> 00:22:18,639 Speaker 3: a high risk if you have high blood pressure. We 432 00:22:18,680 --> 00:22:20,800 Speaker 3: don't because we know blood pressure meds are a pinny 433 00:22:20,840 --> 00:22:23,879 Speaker 3: of pill and that just kind of really changes the 434 00:22:23,920 --> 00:22:27,080 Speaker 3: math on this. And you have to be a member 435 00:22:27,080 --> 00:22:29,520 Speaker 3: of a direct care practice. That was part of our goal, 436 00:22:29,880 --> 00:22:32,919 Speaker 3: but that it still fits with the car insurance analogy 437 00:22:33,000 --> 00:22:36,840 Speaker 3: of if you try to ensure family medicine, then that's 438 00:22:36,840 --> 00:22:40,320 Speaker 3: when the price explodes. Everyone thinks the expensive part is hospitals, 439 00:22:40,400 --> 00:22:47,080 Speaker 3: cancer surgeries. That's actually not bad. It's the daily stuff 440 00:22:47,560 --> 00:22:51,120 Speaker 3: that nickels and dimes you to death. But the insurance 441 00:22:51,359 --> 00:22:55,720 Speaker 3: is no deductible, no copay, no network. You're welcome to 442 00:22:55,800 --> 00:22:58,360 Speaker 3: use it anywhere, and then you can enroll all year 443 00:22:58,400 --> 00:23:01,520 Speaker 3: long and that covers one hundred thousand dollars in care 444 00:23:02,040 --> 00:23:04,560 Speaker 3: and end up everyone. The most common question is is 445 00:23:04,600 --> 00:23:07,879 Speaker 3: that enough? And by our math, it is most people 446 00:23:08,280 --> 00:23:11,560 Speaker 3: they hear these giant inflated bills, but no one pays 447 00:23:11,600 --> 00:23:14,959 Speaker 3: that bill. To that point, we partner with a great company, 448 00:23:15,080 --> 00:23:18,560 Speaker 3: good bill dot com, and they're a hospital negotiation service 449 00:23:18,920 --> 00:23:22,879 Speaker 3: that we offer their services for free for both our 450 00:23:22,920 --> 00:23:25,920 Speaker 3: clinic patients and our insured patients, so that we can 451 00:23:25,960 --> 00:23:28,119 Speaker 3: try to help you on the front end, in the 452 00:23:28,160 --> 00:23:32,040 Speaker 3: middle and on the back end, because hospitals don't give 453 00:23:32,040 --> 00:23:34,480 Speaker 3: out all the required discounts that they need to to 454 00:23:34,520 --> 00:23:38,840 Speaker 3: maintain their nown. Surprise right, yeah, they will if you ask, 455 00:23:39,359 --> 00:23:41,399 Speaker 3: just most people don't know to ask, or most people 456 00:23:41,440 --> 00:23:44,960 Speaker 3: try to pay through insurance. And the really frustrating thing 457 00:23:45,080 --> 00:23:51,520 Speaker 3: is the hospitals incentivized to inflate these prices because eventually 458 00:23:51,560 --> 00:23:54,320 Speaker 3: they sell this debt on the debt auctions, so you 459 00:23:54,359 --> 00:23:56,520 Speaker 3: can buy one hundred to two hundred dollars in medical 460 00:23:56,520 --> 00:24:01,159 Speaker 3: debt for a dollar. What right, It's insane, It's absolutely insane. 461 00:24:01,560 --> 00:24:03,560 Speaker 3: So a lot of times the direct care community to 462 00:24:03,720 --> 00:24:06,200 Speaker 3: you know, do a good deed or help a charity 463 00:24:06,280 --> 00:24:08,600 Speaker 3: or something. We'll get together ten thousand dollars to buy 464 00:24:08,920 --> 00:24:11,680 Speaker 3: you know, you know, one hundred plus thousand dollars of 465 00:24:13,400 --> 00:24:15,400 Speaker 3: medical debt and just give it away. And there's great 466 00:24:15,400 --> 00:24:19,360 Speaker 3: services that do that. Undo medical debt is one we've 467 00:24:19,359 --> 00:24:22,439 Speaker 3: partnered with a lot and we did that once. We 468 00:24:22,440 --> 00:24:26,600 Speaker 3: did a reverse copey where we paid patients. You know, 469 00:24:26,640 --> 00:24:28,680 Speaker 3: we did a raffle. I saw that bar did that 470 00:24:28,680 --> 00:24:30,640 Speaker 3: that gave everybody walked it through the door of five 471 00:24:30,680 --> 00:24:34,160 Speaker 3: dollars as a reverse cover charge. I thought, that's brilliant, right, 472 00:24:35,119 --> 00:24:37,600 Speaker 3: And I saw, duncan this is in your necklace dunk 473 00:24:37,600 --> 00:24:42,440 Speaker 3: a Donuts today, somebody had a medical problem whatever, they 474 00:24:42,480 --> 00:24:45,760 Speaker 3: covered the bill, gave them coffee for a year and 475 00:24:45,800 --> 00:24:49,560 Speaker 3: then bottom, you know, tickets to the baseball season. Like 476 00:24:49,600 --> 00:24:52,119 Speaker 3: you know what, That's like brilliant marketing, right because it 477 00:24:52,240 --> 00:24:55,359 Speaker 3: has nothing, but it makes you feel good and uh. 478 00:24:56,080 --> 00:24:59,720 Speaker 3: And so when healthcare is transparent, that's that's really easy 479 00:24:59,760 --> 00:25:02,119 Speaker 3: to do. And I feel feel like that's real caring 480 00:25:02,200 --> 00:25:06,320 Speaker 3: and companies want to feel cared for and cared about, 481 00:25:06,480 --> 00:25:09,879 Speaker 3: and that's where direct care comes in. So there's just 482 00:25:09,920 --> 00:25:14,000 Speaker 3: all these great ways to look at the system and 483 00:25:14,040 --> 00:25:18,000 Speaker 3: find solutions wherever they're at. Meds for ninety five percent less, 484 00:25:18,040 --> 00:25:21,639 Speaker 3: laws for ninety five percent less, but hospital discounts and 485 00:25:21,680 --> 00:25:25,080 Speaker 3: no copays. So it's really easy to get down on 486 00:25:25,119 --> 00:25:27,920 Speaker 3: the healthcare system right now. No one it doesn't feel 487 00:25:27,960 --> 00:25:30,119 Speaker 3: if you're a patient someone's looking out for you. But 488 00:25:30,480 --> 00:25:33,240 Speaker 3: I think it's it's brivous before the dawn. 489 00:25:33,600 --> 00:25:37,239 Speaker 2: No, I think artith. I hope that everybody listening to this, 490 00:25:37,359 --> 00:25:40,480 Speaker 2: I strongly advise you to check out to check out 491 00:25:40,520 --> 00:25:43,280 Speaker 2: doctor Josh. He's not, just as you can hear, the 492 00:25:43,320 --> 00:25:46,760 Speaker 2: most normal, relatable person. He's not trying to overtalk you 493 00:25:46,800 --> 00:25:49,480 Speaker 2: with fancy schmancy words and make you feel like you 494 00:25:49,520 --> 00:25:51,680 Speaker 2: are a waste of his time. I don't think there 495 00:25:51,720 --> 00:25:55,359 Speaker 2: is anything more infuriating than trying to get to your 496 00:25:55,400 --> 00:25:57,960 Speaker 2: doctor to ask a question. If I didn't think it 497 00:25:58,000 --> 00:26:00,159 Speaker 2: was important, I wouldn't bother you. That doesn't I mean, 498 00:26:00,200 --> 00:26:02,000 Speaker 2: there aren't people out there who are like out of 499 00:26:02,000 --> 00:26:05,080 Speaker 2: their minds and just you know, they're like hypochondriacs, right, 500 00:26:05,119 --> 00:26:07,200 Speaker 2: They're just constantly calling about things. That's a real thing. 501 00:26:07,520 --> 00:26:10,119 Speaker 2: But your average Joe is like, I just what do 502 00:26:10,119 --> 00:26:11,800 Speaker 2: you think? Just like take some time and all like 503 00:26:11,840 --> 00:26:13,399 Speaker 2: where am I? You know, like they just have a 504 00:26:13,440 --> 00:26:15,880 Speaker 2: simple question. I am one of those people. I am 505 00:26:15,920 --> 00:26:19,400 Speaker 2: not doctor Google. I'll look at doctor Google and then 506 00:26:19,480 --> 00:26:20,679 Speaker 2: send it to you and be like, yeah, is this 507 00:26:20,760 --> 00:26:23,040 Speaker 2: for real? Because I don't think that's not my thing. 508 00:26:23,200 --> 00:26:25,919 Speaker 2: Like people are experts in their field for a reason. 509 00:26:26,600 --> 00:26:29,119 Speaker 2: And part of the problem with medicine right now is 510 00:26:29,200 --> 00:26:31,199 Speaker 2: while you may be an expert, I can't get to you. 511 00:26:31,800 --> 00:26:34,960 Speaker 2: I can't talk to you. And your nurse or your 512 00:26:35,119 --> 00:26:38,480 Speaker 2: assistant or your secretary at the front desk is an asshole. 513 00:26:39,040 --> 00:26:42,480 Speaker 2: So when I call and she's mean to me, I 514 00:26:42,520 --> 00:26:44,760 Speaker 2: don't want to come to your office anymore, you know. 515 00:26:44,880 --> 00:26:48,040 Speaker 2: I mean, so much of the patient care has been lost, 516 00:26:48,720 --> 00:26:51,920 Speaker 2: and I feel like you are like this shining light 517 00:26:52,080 --> 00:26:53,760 Speaker 2: on the hill, right I'm like, oh my god, there's 518 00:26:53,800 --> 00:26:54,760 Speaker 2: one guy doing. 519 00:26:54,600 --> 00:26:58,239 Speaker 3: It right well in thousands of doctors you work in 520 00:26:58,280 --> 00:27:01,679 Speaker 3: with suspect, I know, yes, and that's but you're right. 521 00:27:01,720 --> 00:27:04,600 Speaker 3: We lost the hospitality side and this Disney does a 522 00:27:04,640 --> 00:27:08,080 Speaker 3: better job of that. And you know, there is that 523 00:27:08,280 --> 00:27:10,280 Speaker 3: aspect of I left the office, but I still have 524 00:27:10,320 --> 00:27:15,679 Speaker 3: a question and I yes, and I think half the 525 00:27:15,680 --> 00:27:18,919 Speaker 3: time I'll tease patients at their hypocontracts. But the system 526 00:27:18,960 --> 00:27:21,280 Speaker 3: made them that way because they have all these questions 527 00:27:21,280 --> 00:27:24,240 Speaker 3: and no answers, and like great, keep emailing. Eventually you 528 00:27:24,320 --> 00:27:27,000 Speaker 3: kind of run out of questions, right, Like that's the 529 00:27:27,119 --> 00:27:29,560 Speaker 3: any membership model. Netflix knows you're going to watch a 530 00:27:29,560 --> 00:27:32,199 Speaker 3: lot of videos at times, but then come down at 531 00:27:32,240 --> 00:27:35,720 Speaker 3: times and and you know, hey, that's our business problem 532 00:27:35,760 --> 00:27:37,480 Speaker 3: to solve. But the fact we've been doing it for 533 00:27:37,680 --> 00:27:41,520 Speaker 3: fifteen years across the house as a doctor, so it works. Yes, sure, 534 00:27:41,640 --> 00:27:43,919 Speaker 3: and that gives those patients now, you know, if you 535 00:27:43,960 --> 00:27:47,200 Speaker 3: pay a lower price, now everybody gets you know, access 536 00:27:47,240 --> 00:27:50,480 Speaker 3: to everything in the gym and rather than you know, 537 00:27:50,520 --> 00:27:54,280 Speaker 3: at a price that's ridiculous essentially, And this is that 538 00:27:54,400 --> 00:27:56,280 Speaker 3: same way. Now if you need more, you don't have 539 00:27:56,280 --> 00:27:59,399 Speaker 3: to worry about paying more. You're good. A gentleman had 540 00:27:59,440 --> 00:28:01,520 Speaker 3: a weird skin infection. I saw him every day for 541 00:28:01,600 --> 00:28:05,080 Speaker 3: a month by either in the office or text or email, picture, 542 00:28:05,280 --> 00:28:07,760 Speaker 3: video call, just and it took you know, a couple 543 00:28:07,760 --> 00:28:10,240 Speaker 3: of minutes each time, so probably wasn't an hour over 544 00:28:10,280 --> 00:28:13,040 Speaker 3: the whole month. But we made sure with just the meds, 545 00:28:13,240 --> 00:28:16,760 Speaker 3: you know, change dressings, do whatever, keep it good. And 546 00:28:16,960 --> 00:28:19,719 Speaker 3: and to think that, you know, for fifty dollars that 547 00:28:19,760 --> 00:28:22,480 Speaker 3: could have been medical. You know, I don't want to 548 00:28:22,480 --> 00:28:26,040 Speaker 3: say bankruptcy, but just stress and debt and hassle and 549 00:28:26,080 --> 00:28:26,720 Speaker 3: no one's. 550 00:28:28,680 --> 00:28:30,600 Speaker 2: Get in, and then worrying that you can't. 551 00:28:31,200 --> 00:28:33,200 Speaker 3: He was an early riser, so usually my five point 552 00:28:33,160 --> 00:28:38,160 Speaker 3: thirty text was him, you know, but every mark great, Hey, wonderful. 553 00:28:38,160 --> 00:28:40,280 Speaker 3: I love it. I'm a dada guys, give me data, 554 00:28:40,400 --> 00:28:42,560 Speaker 3: Tell me how that fingers. You know, most patients won't 555 00:28:42,560 --> 00:28:45,600 Speaker 3: communicate enough. You know, you get pink eye. Text me 556 00:28:45,640 --> 00:28:48,760 Speaker 3: a picture, Text me a picture every hour. You know, 557 00:28:49,000 --> 00:28:51,440 Speaker 3: let's let's not worry about this because that continuity of 558 00:28:51,480 --> 00:28:53,560 Speaker 3: care is great. You're paying for that. And so when 559 00:28:53,600 --> 00:28:54,960 Speaker 3: I go to Costco, I have no need to go 560 00:28:55,000 --> 00:28:57,880 Speaker 3: to other grocery stores, right because I know my best 561 00:28:57,960 --> 00:29:01,280 Speaker 3: value is there. And and and I love the idea 562 00:29:01,400 --> 00:29:03,920 Speaker 3: you know, behind the Costco hot dog, right, like I 563 00:29:04,040 --> 00:29:06,160 Speaker 3: f and murder you if you change the price of 564 00:29:06,160 --> 00:29:09,560 Speaker 3: the time. Right, that CEO was committed to it, And 565 00:29:09,960 --> 00:29:12,120 Speaker 3: I feel like doctors should have some aspect of that 566 00:29:12,160 --> 00:29:15,120 Speaker 3: of like, no, we are committed to no copaste. Yes, 567 00:29:15,200 --> 00:29:17,800 Speaker 3: you know there's inflation and other stuff, but some things 568 00:29:17,840 --> 00:29:22,360 Speaker 3: we just you know, patient comes first and uh, you 569 00:29:22,360 --> 00:29:24,960 Speaker 3: know if you need you know, some dressing or you 570 00:29:25,000 --> 00:29:27,600 Speaker 3: know some wrap or band aids in the office, like 571 00:29:28,000 --> 00:29:30,840 Speaker 3: you know, the courtesy of those things that we've we've 572 00:29:30,880 --> 00:29:33,640 Speaker 3: lost that because we squeezed the profitability of clinics to 573 00:29:33,680 --> 00:29:36,520 Speaker 3: the breaking point. Patients feel that, doctors feel it. 574 00:29:37,200 --> 00:29:39,240 Speaker 2: Yeah, and the patient feels like a number and the 575 00:29:39,280 --> 00:29:42,760 Speaker 2: doctor feels annoyed because we're all working under the same burdens. 576 00:29:42,880 --> 00:29:45,320 Speaker 2: You remove the burden and you return to what Woods 577 00:29:45,560 --> 00:29:46,800 Speaker 2: was patient care. 578 00:29:47,640 --> 00:29:50,120 Speaker 3: Oh what's so amazing is it's so bad for everybody. 579 00:29:50,160 --> 00:29:54,320 Speaker 3: But then that we're still hesitant to change, right, Yeah, nobody's. 580 00:29:53,920 --> 00:29:56,480 Speaker 2: Happy with I have to say though, but there are 581 00:29:57,680 --> 00:30:00,200 Speaker 2: It's to your point, right, like there are people who 582 00:30:00,200 --> 00:30:02,800 Speaker 2: forge a path. I EU right, you forge a path, 583 00:30:02,840 --> 00:30:05,280 Speaker 2: you try something new. Your dad is a perfect example 584 00:30:05,320 --> 00:30:08,440 Speaker 2: of that, right, working in sanitation, being a trash man 585 00:30:08,520 --> 00:30:10,360 Speaker 2: his whole life, and then going back to school and 586 00:30:10,360 --> 00:30:13,760 Speaker 2: becoming an attorney. You know, there's something amazing to that. 587 00:30:14,600 --> 00:30:16,280 Speaker 3: It is, And he had this great he had a 588 00:30:16,320 --> 00:30:18,640 Speaker 3: First Amendment case that actually went to the Supreme Court 589 00:30:19,160 --> 00:30:22,040 Speaker 3: was critical of the local government and became a huge case. 590 00:30:22,160 --> 00:30:24,440 Speaker 3: And you know, I think we learned that it's like, 591 00:30:24,480 --> 00:30:28,240 Speaker 3: if there's something wrong, you just fix it right, consequences 592 00:30:28,280 --> 00:30:30,560 Speaker 3: be damned. But at the same time then you sort 593 00:30:30,560 --> 00:30:33,080 Speaker 3: of realize that just because it is doesn't mean it 594 00:30:33,080 --> 00:30:35,240 Speaker 3: has to stay that way. So if it's broke, go fix. 595 00:30:35,040 --> 00:30:37,080 Speaker 2: Itsh I'll tell you. 596 00:30:37,200 --> 00:30:41,400 Speaker 3: I hope I tell you. I me too. 597 00:30:43,040 --> 00:30:47,200 Speaker 2: Yeah, we're at it, man. Thank you for listening. This 598 00:30:47,360 --> 00:30:49,680 Speaker 2: is the Rogue Recap. I've been here with doctor Josh. 599 00:30:49,720 --> 00:30:52,600 Speaker 2: If you haven't heard the websites at list dot m D, 600 00:30:52,960 --> 00:30:56,160 Speaker 2: at list dot direct, please go, please find out more. 601 00:30:56,200 --> 00:30:59,080 Speaker 2: He's wonderful. It can only help you and your family. 602 00:30:59,080 --> 00:31:00,680 Speaker 2: I promise you I already do it. 603 00:31:00,960 --> 00:31:01,200 Speaker 3: Josh. 604 00:31:01,280 --> 00:31:03,080 Speaker 2: Thanks for being with us today. You're the best. 605 00:31:03,640 --> 00:31:04,120 Speaker 3: Thank you. 606 00:31:04,760 --> 00:31:07,080 Speaker 2: I am Linda McLaughlin. This is the Roague Recap. You 607 00:31:07,120 --> 00:31:09,440 Speaker 2: know what to do. Roague Recap dot com at Lindamick 608 00:31:09,560 --> 00:31:12,719 Speaker 2: at Roague Recap. Be careful out there, Pray for our troops. 609 00:31:12,840 --> 00:31:21,680 Speaker 2: Have a good night, everybody.