Why health insurance doesn’t help you
Have you ever wondered why, out of all the different areas in the service industry, health insurance is both the most expensive and has the worst customer service?

The answer is fairly obvious. Health insurance companies provide you with lousy customer service because you are not their real customer. In fact, you’re a liability. Your medical bills eat into their profits, increase their risk, and take money out of the pocket of their true customer.

So who is the insurance company’s true customer? Currently, and historically, it’s the investor—followed by your employer, although the last several years have seen employers asking their employees to pitch in more and more as insurance premiums escalate. And even if you pay for the premiums entirely on your own, you’re still last in terms of leverage and coverage.

Investors are the real customers
Health insurance isn’t really a service at all; at least, not for you. Investors fund insurance companies with the hope that money collected from premiums will exceed money paid in medical claims. The difference between revenues and expenses is the investor’s net profit margin.

So when an insurance company denies your medical claim, it’s because they’re trying to serve their real customer (the investor) by lowering expenses (claims paid) to keep more revenue (premiums). If they paid your claims quickly and completely when you submitted them, they would have less net profits to give to their investors, their true and only customer.

Employers are in a bind
The health insurance company’s relationship with investors also explains why premiums continue to increase (increased premiums equal greater revenues). Even though employers pay for much of the cost of health insurance premiums, they’re usually unwilling customers with little to no leverage for price negotiation.

So when premium costs rise, employers have no choice but to share the cost with their employees, even while they continue to bear a large financial burden for an insurance product that is shrinking in every way except price.

Health insurance ≠ health care
In sum, insurance companies have 1) a captive payer base among employers with more than 50 employees, 2) no regulatory or monetary incentive to minimize revenue generation by lowering premiums or paying out more claims, and 3) no cap on the amount of profit they can pay to their true customer, the investor.

For example, the following are the 2019 returns-on-investment for three health insurance companies among the top 10 in the S&P 500 for the health care industry—Humana: 33.2%, Aetna: 43.4%, Cigna: 57.4%.

Is it any wonder you dread calling your insurance company to get a claim paid or reimbursed? So what can you do, knowing you are not and never will be the insurance company’s true customer? And how do you get good customer service and medical care without spending a fortune?

Once you realize that the insurance company is not designed to serve your interests, you should look for a model that is. This is the space in which direct primary care is innovating.

Direct primary care = real health care
Direct primary care (DPC) is broad-scope, insurance-free medical care. When you join a DPC, you pay an affordable monthly fee for unlimited, 24/7 access to your doctor by phone, text and email, same-day office and virtual visits, simple surgical procedures, at-cost pricing on blood tests, and discount cash prices on x-rays, MRIs, and CT scans.

With DPC, your doctor partners with you for most of your healthcare needs (at no extra charge), drastically decreasing your chances of hospitalization or specialty care and saving you money. You can also choose cheaper medical insurance plans or health shares that complement DPC services and save more money. And because you’re the true customer, you get the best customer service imaginable.

It’s clear that health insurance is not truly a service industry—not for policy holders, at any rate. This explains why health insurance does not equal health care. At Voyage Direct Primary Care, you’ll get top-shelf customer service and superior health care at lower cost.

The post Why health insurance ≠ health care appeared first on Voyage Clinics.

“The health care system needs to be restructured to reflect the realities of patient care. From 1975 to 2010, the number of health care administrators increased 3,200 percent. There are now roughly 10 administrators for every doctor. If we converted even half of those salary lines to additional nurses and doctors, we might have enough clinical staff members to handle the work. Health care is about taking care of patients, not paperwork.”

The quotes above come from an article in the New York Time. It’s worth reading all the way through. I find it highly insightful and brings to light something I’ve been saying for years.

One morning in Moab, after being up all night delivering a baby, I was on my way to the office for a 9:00 a.m. start at the clinic. In my disheveled state, I passed one of the hospital administrators and told her I had been up all night with a baby and mama. She didn’t respond with, “thank you,” or “is there anything I can do for you?” She simply said, “You signed up for this.” I felt cold and unappreciated.

This kind of attitude, and the administrative burdens accompanying it, are burning out physicians and nurses in record numbers. I’ve spent countless hours clicking bureaucratic boxes, documenting for billers and coders, being on call, and staying up all night—all for free, all because it’s what the system needs, but most of all for my patients.

I actually don’t mind going the extra mile for my patients; it’s interfacing with the complex system they’ve handed me in the name of data collection that diminishes my ability to adequately care for people. I’m squeezed for time and energy, documenting complicated algorithms into computers, knowing that this documentation has no bearing on the improvement of healthcare.

Bureaucrats and administrators implemented these systems so they could crunch numbers, document patient care patterns (justifying lower physician pay if they don’t comply), and, frankly, create a need for their own jobs. I’ve gone round and round with administrators; their imposed burdens leave me less time to spend with and care for my patients. Their reply: “It’s just the way it is. The government mandates these changes, and if we don’t comply, they will dock our reimbursement by xx% per year for the next 4 years.”

So I went sadly back to work. During the six years I spent working in a rural hospital, it made no difference whether I worked in the ER, the hospital, the clinic, labor and delivery, or OR the system was always bogged down and broken. To alleviate some of this burden, we hire people (scribes and staff members) to help us click boxes the way “they” want us to; sacrificing, working, working…

I’ve seen countless examples of patients who needed just 10 more minutes during an office visit to really get to the bottom of their problems. Or 15 more minutes to discuss weight loss and real options for keeping it off. “Sorry, the system does not allow for this.” It’s bogged down with administrators and bureaucrats and their efforts to squeeze us for cash (physicians, nurses, and patients).

I stepped off that broken system after I saw a family suffer major complications from a simple strep throat that should have been diagnosed easily in the office. There was a lack of availability, access points, and affordability. There has to be a way to prevent a 10-year-old American from becoming permanently disabled by a silly (and easily treatable) strep infection.

I created Voyage Direct Primary Care to get rid of these pain points and deliver the exceptional care that families deserve. I no longer click boxes or scramble through loads of administrative silliness. Ditching bureaucrats and their silliness gives me more time to listen to and care for my patients.

I went into medicine for one reason only: to care for patients. That reason will remain my “why” until the day I die. But I couldn’t care for my patients the way I wanted to until I started my own clinic; when somebody else owned it, their why (money) trumped mine (care). This is why physicians need to own and operate their own clinics. This is the type of care Americans deserve.

I believe that if physicians and nurses work together with the American citizens, we can provide a fresh new way of delivering meaningful healthcare; we can revolutionize healthcare and improve wellness nationwide!

The post The Corporate Model of Healthcare Exploits the Kindness of Doctors and Nurses appeared first on Voyage Clinics.

This picture was taken during John’s third year of residency. Our family was living in Jacksonville, FL, and during that year—not too long before this picture was taken, actually—I contracted appendicitis and had to have my appendix out. Elijah was 10 months old. If it hadn’t been for John’s help, I don’t know what I would have done.

I feel incredibly lucky to have a doctor in my family. He’s stitched up three of our four children on multiple occasions, saving us the hassle and cost of an emergency room visit every time. He set my son’s broken wrist, prescribed antibiotics for my daughter who contracted strep throat, and adjusted my neck and back when I woke up the morning of my first law school final in excruciating pain from incorrect studying posture.

In addition to his medical training, however, he’s always been a great team player and consultant concerning alternative and complementary treatments. So when I wanted to give my babies echinacea with elderberry syrup to help build their immune systems, he agreed. He suggested I use melatonin instead of Tylenol PM to help reset my kids’ sleep cycles when they were jet lagged. And he recommended increased vitamin D to help with my sagging energy levels instead of caffeine.

I don’t share these stories to boast that because I’m married to a doctor, I get special treatment. Every one of his patients gets special treatment. And I know because I’m married to the doctor. John started Voyage Direct Primary Care because the subscription model allows him to be the kind of doctor he wants to be–one who cares for his patients like he cares for his own family.

It’s beautiful care, and I’m proud to support him in this journey. So come join us. We’d love to make you part of our extended family.

-Shaunna Sanders, a.k.a. “the doctor’s wife”

The post Add a Doctor to Your Family appeared first on Voyage Clinics.

Several years, I found myself stranded in the middle of a 480-foot, exposed slickrock “trail” with my wife, four young kids and only a flashlight and a headlamp between the six of us. Oh, did I mention it was midnight? Well, it was. And there we were, stuck on the trail because we’d lost sight of the cairns.

We wanted to hike to Delicate Arch by moonlight. After a short rest about halfway up the slickrock, however, I scanned ahead for the next cairn, as usual, but it wasn’t there! Somehow, a critical stack of rocks had been accidentally or maliciously disassembled, leaving us stranded in the dark on the edge of a slippery and possibly nasty drop if we went the wrong way.

Forging Ahead in the Dark

After a few moments of fruitless searching, I handed the headlamp to my wife and instructed our children to wait with her while I went ahead to scout the way. I found the next cairn more than seventy-five feet ahead.

“It’s here,” I hollered into the darkness. “Come on. Follow my light.”

I watched their quavering headlamp rise, move slowly toward me, then stop again half the distance away.

I waited, wondering if I should leave the cairn to find out what the trouble was, but they soon resumed their trek. When they reached me, I asked, “What were you doing back there?”

“When it seemed like we were halfway,” my wife explained, “we stopped, gathered some rocks, and made a new cairn. That way, we won’t have this problem on the way down, and the other hikers won’t have a problem on the way up!”

It’s easy to see why I wanted to marry her; she’s always thinking ahead.

Cairns are a Cooperative Movement

Cairns are a great example of the power of a cooperative movement. Anybody can create them. They’re an easy way to crowdsource trailblazing, and everybody benefits.

There’s a sense of belonging when you hike a trail marked by cairns. In those stacks of rocks, you can sense the presence of those who have come before and those who will come after. You feel connected by a common objective (finish the hike; enjoy the scene), and you’re impressed with a deep sense of purpose. By hiking that trail and by adding a rock or two when needed, you are enriching your own life and the lives of others.

Direct Primary Care is a Cooperative Movement

Direct primary care is also a cooperative movement. There’s a sense of belonging when you join the team of doctors and patients working together to fix things that are broken or knocked down in the healthcare system. You are enriching your own life and the lives of the providers working with you. You join your efforts with those who have come before and those who will come after.

So what about you? If you’ve joined Voyage Direct Primary Care, what do you like about being part of this cooperative movement? If you haven’t joined, what benefits can you see from connecting? What cairn could you add to the trail?

The post The Power of Cooperative Movements appeared first on Voyage Clinics.

Several years back, the government rolled out a plan designed to incentivize physicians to get electronic health records (EHR). They offered to subsidize the cost of an EHR if the physician purchased a “compliant” electronic health record. (Carrot) They called this their “meaningful use” initiative.

According to the definition of “meaningful use,” an EHR is compliant if the physician using it makes his/her data back-door accessible to the government. In common parlance, however, making meaningful use of an electronic tool has nothing to do with allowing third-party access to the data collected in that tool.

I didn’t feel right about sharing that kind of private information, but I worked for a hospital at that time, and they needed the money to purchase the new, expensive EHR (which decreased efficiency by at least 20-30% and contributed to physician and nurse burn out by 100%) so they could take advantage of the carrot instead of the stick (see below). I asked what the hospital/the government was going to do with this data. They could not tell me. I said it was wrong. They didn’t care.

Since then, the government has continued to inundate the healthcare industry with collectible data-points, creating more useless burden on the physicians who often end up hiring additional staff to click boxes and put in data. Meanwhile, there is a mass exodus of physicians. (see this NPR article)

Once the government had lured as many providers as possible with the carrot, they implemented policy saying “if you do not purchase a compliant health record, we will lower your reimbursement by x percent per year for so many years.” (See the stick?) Furthermore, regulators tell us that if we do not put in the data points they require, they will consider us a poorly performing physician and further lower our reimbursement. (Another stick that they call their “pay for performance” initiative.) As a result, even more physicians leave healthcare.

Still no word on what they’re planning on doing with your data.

Voyage Direct Primary Care uses an EHR that does not comply with “meaningful use” protocols. Heather and I are not compliant with governmental “Pay for performance” initiatives. Our patients’ data has never been more secure, however, and I’ve never been happier. But most importantly, I’m able to deliver way better care now, and I’ve fallen back in love with my profession.

-Dr. John

The post Physician burnout and what to do about it appeared first on Voyage Clinics.

Transcription
Dr. Sanders: Hi, Dr. Sanders of Voyage Direct Primary Care. Today I’m discussing, what is membership medicine? Voyage Direct Primary Care offers a subscription family medical service, it’s kind of like the Netflix of medicine. It’s a reasonable, affordable family medicine fee, and you get an all-access pass to a good, board-certified family doctor, like myself, Dr. Sanders.

The post What is Membership Medicine? appeared first on Voyage Clinics.

Transcription
Dr. Sanders: Dr. Sanders of Voyage Direct Primary Care here to talk about today how Voyage Direct Primary Care can be utilized with your insurance to provide comprehensive coverage for your family. When you engage with Voyage Direct Primary Care, now you gain unprecedented access to a doctor via text, video chat, phone call, office visit, with no copays or deductibles, so we don’t utilize your insurance at all in the office. We do like to have on the back end just in case there’s a catastrophe, an ER visit or a hospital visit that we’d need to utilize it with. Again, Voyage Direct Primary Care, Dr. Sanders.

The post Voyage DPC with Insurance. How it works? appeared first on Voyage Clinics.

Transcription
Dr. Sanders: Hey Dr. Sanders of Voyage Direct Primary Care. Today I was going to speak to you a little bit about the benefit of Voyage Direct Primary Care to your employees. Whether you’re a small business or self-employed, Voyage Direct Primary Care can offer an enhancement to your benefit package. 

If maybe you can’t afford health insurance, through Voyage Direct Primary Care you now have very reasonable cost for a health plan that covers all of family medicine care to your employees. Dr. Sanders with Voyage Direct Primary Care.

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