Discover and read the best of Twitter Threads about #Directprimarycare
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Sadly, #MedicareForAll will not help #healthcare costs until the underlying problem with MEDICARE and the ENTIRE HEALTH SYSTEM is FIXED, a LONG 🧵 1 of 24 #Medtwitter @somedocs @AmerMedicalAssn @WCMSSM @MichStateMedSoc References: bit.ly/3rBcvGP bit.ly/3lE3nxf 
2/ b/c @SenateFloor @HouseFloor & @CMSGov are yet again not fixing the true problem & instead are again targeting #Physicians by decreasing payments by another 9.75% on top of the fact that reimbursements to providers has already been decreased by 22% over the past 2 decades
3/ On average only 40% of the what your #insurance , including #Medicare , pays your doctor actually goes to the doctor as #income . The overhead costs to be a doctor takes at least 60% of the payment a doctor gets from Medicare or Insurance equivalent. bit.ly/3ptDX6B
1/ If y'all want to know why health care costs are high in America, pull up a chair & pour a stiff drink...
My patient is 67 yo lady (call her Sue) w/ newly diagnosed COPD. She is very reluctant to take meds but I convinced her to at least try an inhaler for relief of symptoms.
My patient is 67 yo lady (call her Sue) w/ newly diagnosed COPD. She is very reluctant to take meds but I convinced her to at least try an inhaler for relief of symptoms.
2/ In addition to general stubbornness, Sue is also understandably concerned about the cost of the med. I had some Dulera samples so gave her 2 months of that.
Follow-up visit: Sue reports it's working well so wants to continue.
Great! (wish that was the end of the story)
Follow-up visit: Sue reports it's working well so wants to continue.
Great! (wish that was the end of the story)
3/ I don't have unlimited samples, so suggested she get could get a similar med from the pharmacy. (Sue didn't even know she had a Part D med plan.) So, being a cost-conscientious doctor, I prescribe her an AirDuo inhaler to Walgreens.
1/ It’s been a week.
It’s well into Friday evening & I just got off the phone with a patient who had urgent radiology results. This was after spending > 40 min on the phone w another patient discussing the same this afternoon.
(18 more to come; stick with me.)
It’s well into Friday evening & I just got off the phone with a patient who had urgent radiology results. This was after spending > 40 min on the phone w another patient discussing the same this afternoon.
(18 more to come; stick with me.)
2/ I only got 2 items on today’s long “to do” list done — but that’s on me. I was finally able to sit down for a couple hours uninterrupted and dig deep into a few patient cases from the week.
(And I “don’t work” on Fridays.)
(And I “don’t work” on Fridays.)
3/ As I hung up the phone, I reflected on how #directprimarycare has enabled me to get to the heart of medicine & the doctor-patient relationship.
During that call, my patient’s spouse broke down and — through sobs — simply said: “Thanks for being so kind.”
During that call, my patient’s spouse broke down and — through sobs — simply said: “Thanks for being so kind.”
Another true #DPC for the win story... Friday morning I saw a @MMMedCare patient at a school event. “I’m so glad to see you as I need to talk to you about my 5yo. For a month he has been complaining of increased thirst, so I checked his blood sugar an hour ago & it was 289!” 1/?
Child has no history of #diabetes & generally is in good health. Only other sxs -increased hunger & bed wetting. No vomiting, no confusion. Mom had checked own BS & a siblings & both were normal so it was unlikely machine error. Normally new, random BS of 289 =trip to ER
#DPC 2/?
#DPC 2/?
We were at school to watch our children in a performance & her son appeared well. Still with a blood sugar of 289 after fasting all night, I knew he needed immediate follow-up so I said I should see him right after. As we left school his only complaint was “I’m hungry” #DPC 3/?
