Christopher Ewin, MD discusses a revolution in the business model of primary care.
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Host: What makes your practice so unique? Dr. Christopher Ewin: Well, first of all, there is a big revolution and evolution of a change in the business model of primary care. What we're realizing is that primary care physicians have been working for the wrong employer for too long; instead of working for the government and the insurance companies, we'd rather work for you, the patient. We find that the costs go down tremendously, if we do that. There are about three different models that are out there where doctors are changing. One is going back to the regular fee-for-service kind of model where it's transparent. Your sore throat will charge you certain fee. In the old days, what they did was charge according to a stamp. If it's four cents, they charge you $4. Now that's 41 cents, maybe $41. The second model is the kind that I have. I started a business called "One to One MD", about four or five years ago. It is a retainer model. We call that a Fee-for-Care model. I charge one annual fee once a year for unlimited access to care 24x7: text messaging, email, same-day service, you get in and out, no waiting. By keeping a smaller practice and staying within my hula-hoop, I can only take care of so many people. I can give people service like other industries. The third model is a fee for non-covered services model. That's like the MDVIP model. What they do is, physicians have a smaller panel, about 600 patients, and they still charge a fee of like $1500 for non-covered services that Medicare and the insurance companies don't pay. But when the patients come in to see them, they still charge the insurance company and they still charge the Medicare fees. Host: What needs to happen to make Direct-Practices more common? Dr. Christopher Ewin: Some people call this concierge or boutique medicine and the new, new term is Direct-Practices. What that means is that we have a direct financial relationship with our patients. To make this happen in healthcare, it's the physicians that have to change. The insurers, the politicians, the employers, the HR people, they have no clue how to run my business. It's amazing how many people inflict rules and regulations that really inhibit my ability to take care of the patient. So to make this happen, doctors have to change. What we're doing now with SIMPD is, we are sharing our knowledge, our experiences as a 501(c)(6) trade organization to say, let me show you all the different models and physicians. What works in Fort Worth, Texas, doesn't necessarily work in New York City. If you're in the back country, you have to figure out what works for you and your patients because of their cultural differences, etcetera. You figure out which model you want to do. So in order to expand these models, we need to educate other people. Host: What are you hoping to learn from this Congress? Dr. Christopher Ewin: This Congress is especially important for me. I learned something from every individual here. I've learned a lot from medial tourism that the average doctor has no clue. There are medical errors that they're reporting and it's such a big thing including the IOM report that 100,000 people die. I personally think, that's because they don't have a personal physician and they can't call them and take care of things in the very beginning stages, not only prevention of heart disease and stroke and control of diabetes, but also if you're a little old lady, and that's your mother, and she gets a little bit of bronchitis, if I treat it early, first day when it's coming down, the sooner I take care of her, the sooner she's going to get better. In terms of this World Congress, it's very, very interesting for me to learn from so many different aspects of the industry, the insurers, and the Medicare people. But it's nice for me to share my knowledge of what's happening on the front lines of medicine, because it's affecting our practices. Host: What is the future of Primary Care Physicians? Dr. Christopher Ewin: One of the