An Interview With Dr. Josh Umbehr, Real Life Medical Concierge Service Provider

In my quest to educate my readers about the future of our nations Health Care and the ways in which we as citizens (not politicians) can make it better, I am exploring concierge medical care.  I believe that the best Health Care in the world should be a private, consumer based model which is entirely what concierge medical care is.  In my previous post about Medical Conceirge Service, I referenced Atlas MD and since that post I have had the good fortune of befriending Dr. Josh Umbehr, one of the providers at Atlas MD.  Dr. Josh took time out of his busy schedule for a brief interview and I thought I would pass it along. Here is hope that you will see the benefits of a consumer based healthcare model and join me in my desire to maintain the World’s Best Healthcare.

interview

Without further a due, here is my interview with Dr. Josh a Concierge Choice Physician.

 

  (CF)  What inspired you to take the route of a concierge choice physician rather than a traditional medical service provider?

 (Dr Josh)  Frustration. Frustration with third parties telling me what to do. Frustrations with patients not being able to afford medications. Frustrations with an inefficient system.

 (CF)  I certainly feel your frustrations!! How does the cost of your service really work, and how do you make money at $50 per month?

 (Dr. Josh)  How does the phrase go when flipping homes? You making money on the buy, not the sell. The average practice has between seven and ten employees per physician in order to play the insurance game. We have one staff/RN for three physicians. It’s a very efficient system. The membership model allows for a consistent revenue stream.  Simple math: average of $50 per patient per month x 600 patients equals 30,000 per month at 12 months equals $360,000 per year, minus 30% for overhead, equals $240,000, minus $40,000 for employment taxes and benefits, equals a physician bringing home an approximate $200,000.  When doctors locally in a traditional healthcare delivery system are making $140,000, this is a significant improvement.

(CF)  How do you generate a 95% cost savings on medicines?  Where do the meds come from?

(Dr. Josh)  Honduras :-) we use the third-largest wholesale distributor in the country, but the first to solely work with hospital pharmacists. We get our medications from the same suppliers that pharmacies and hospitals do. However our business model is sustainable off the memberships costs alone. Because our goal is to save our patients as much money each month, any additional fee (such as markups on medicines or labs) is competing with our stated goal.  Just today I saved a woman $75 a month on one medicine and her membership cost is only cost $50. She is also on a medicine called Zofran for nausea, and the insurance company will only give her 12 pills a month. Our wholesale price on Zofran, generic, is $3.75 for 30 pills and she can have as many as she would like.

(CF)  That sounds like patients are the direct beneficiaries of the cost savings, rather that the insurance company making the profits!  How will the individual mandate affect your service starting in 2014?

(Dr. Josh)  Politics aside, reform will cause the price of health insurance to go through the roof.  Furthermore, the increased bureaucracy will continue to drive good physicians out of the profession because of high burnout rates. Decreasing access and increasing cost will be strong motivators for individuals and companies to look for affordable solutions. I believe this will launch direct primary care practices into the mainstream market very quickly.

(CF)  It sounds like your service is great for the patient and great for the doctor, just not so for the middle man.  :-)  Is there any need to have insurance if you can be seen for $50 per month?

(Dr. Josh)  Yes, We  will always need an insurance product to prevent against catastrophic illness or loss. This is the same principle behind car insurance, home insurance, and life insurance. However all those products are rarely used, and as a result are more affordable.  You don’t have car insurance to pay for gasoline, tires, and oil changes.  We do not need health insurance for primary care. We can carve this service out of the traditional plans, and it will make them more affordable.

(CF)  Affordability  is the key, I think that the Affordable Care Act will be anything but affordable!  Is there an association where I can find a concierge service that is close to where I live?

(Dr. Josh)  The aapsonline.comhttp://aapsonline.org/index.php/articles/category/patient_tools/ is an excellent resource for direct primary care practices, for patients and physicians alike.

(CF)  Where do you see the future of medical concierge, if the federal government is expanding medicaid and other federally run programs.

(Dr. Josh)  Similar to the system in Massachusetts, having insurance does not equate to having care. The government can expand their insurance products as much as they would like, but they cannot directly provide care. Most physicians break even on Medicare reimbursements and lose money on Medicaid reimbursements. I imagine this trend will continue to worsen under reform. As reimbursements go down, physicians will refuse to accept certain patients insurance, so inevitably, it will cause patients to have less access.

If you want to contact Dr. Josh directly feel free to call (316) 260-6454, or if you are in the Wichita, Kansas area, stop by their office located at:  10500 E Berkeley Square #200  

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10 Comments

  1. Great interview you guys. The whole system is already so flawed and it’s just getting so much worse with the affordable care nonsense.

    The other issue with medicine today is the fact that pharm companies own the docs. They run the controlled trials and tell them what to prescribe. Functional medicine with a holistic approach is the way of the future. Not 15 little blue pills each morning that cause more problems than they fix.

    • Jacob, I have to respectfully disagree. pharmaceutical companies do not tell me, or any other doctor, have practice.

      • The true problem is transparency. Doctors’ offices and hospitals need to publish price-lists, so we can see the true costs. Insurance companies need to do the same. If insurance companies cover $xy for cpt code yz, flat-rate, published in simple english, we wouldn’t need “in-/out-“of-networks, and could comparison shop, and know where we’re getting ripped off.

        We would know where we stand.

        Especially if there was a central resource for “standard prices” for every service, obviously adjusted for location etc. We could then go the medical concierge route or, even better, a pay-for-service route, and just have “catastrophic” medical coverage. This would work out better for society as a whole, though not vested interests…

        After all, why don’t I pay $50 to see a PCP when I need to. Then pay $75 for an xyz specialist when I need them. Why not clear pricing if there’s nothing to hide?… Every other profession in the world works like this. Why not medicine?

        • Jim says:

          Well said! I agree healthcare needs to be run more like a profitable business, it would make it abundantly cheaper. Price Transparency would be part of it, but there are so many areas where providers need to make up for cost deficiencies. They lose money, or are simply not reimbursed for many different diagnoses, so they are forced to make up for it in test ordering and modifiers added to CPT codes.

  2. Jim says:

    For sure Jacob, doctors are “encourgaged” to prescribe meds as the fix of all ailments. Problem is if you have to take a certain med, then another med must be associated with it to offset the side-effects. Its a vicious cycle, and people just end up having to live the rest of there lives taking pills, sad way to go!!

  3. LOVE this, Jim. Our chiro operates similarly, and because he is now our primary doc, we spend very little on healthcare for our family of six. We use a high deductible program for our insurance for emergencies, and use lots of natural health care preventative methods to avoid the traditional docs.

  4. Jim says:

    Laurie, that is totally the way to go! I think this medical concierge service will take off in the next few years when people really realize how much the govt screwed up healthcare delivery. They can’t do it efficiently! Just billing claims, and managing denials a hospital has to have a full staff, which is payroll, insurance, retirement, for each employee and a hospital just cannot afford it! Glad to see you can spend little on healthcare, that is likely because you lead an active lifestyle and eat well, which is 90% of what you need to stay healthy. Kudos!!

  5. Matt Becker says:

    I love the concept of an HSA with a high-deductible plan. I’ve heard of these kinds of services before and it sounds like they fit right in with that kind of set-up. It just feels like such a more efficient way to spend your money. And true insurance is really supposed to only be for big events anyways, not things like routine check-ups and meds. Very cool interview.

    • Jim says:

      For Sure Matt, the HSA also gives you the freedom to make the decisions that are in your best interests, not the insurance company or anyone else’s! You are so right about the insurance plans not covering routine maintenance. Like Dr. Josh says, car insurance doesnt cover tires, gas, and tune-ups, that is all routine!

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