I fully agree there are for sure pros and cons of the direct primary care model (DPC) I own two practices in Florida as an autonomous nurse practitioner. I am also doing my DNP program evaluation project to do some deep diving into this model. It has been a fit for me and given me a renewed sense of purpose despite burnout which I'm sure you can empathize with! The usual max cost per month is $99 monthly. Happy to be a resource.
Once upon a time, I did secretarial work for a Home Healthcare Company that specialized in PT/OT/etc. for homebound patients, not PCP or anything though. It was- overall- a great experience and I was left wondering why couldn't we, as a society, do more home health care things since it could reduce overhead costs, etc. It would be great to see that as a norm
Exactly. I used to have to work with patients with severe disabilities and the elderly, who could not get healthcare, as they could not leave the home. They basically rotted at home and waited to die. Every once and awhile, I could find a PCP, who would make house calls, but they were few.
I am in NP school and am planning on being on primary care. If given the opportunity, I most definitely would do house calls. Rural communities are terribly underserved.
I don’t think it’s backwards. I think it’s an understanding that we are missing important components of healthcare that existed with the older model. As a hospice nurse, I often say that I’m kind of like that doctor with the little black bag that used to make house calls… it helps families realize that I’m now managing (with the help of a NP and a Dr) their primary care. There is simply something about getting to know someone at that level (I’m in their home at least twice a week) that makes a huge difference in how health care is provided. I’ve always joked that everyone deserves a hospice nurse managing all of their care… Direct Primary Care seems to fill that need. Also, not all DPC is home care and not all is super expensive. There is one in Detroit (can’t think of the name) that works to provide DPC care to lower income clientele. I think there is a place for this.
Front and back of the house talk. As a disabled RN that worked in the ER and then also hospice I find myself always feeling like a drug seeker if I ever which is rare have to go to the ER. It is a nightmare. I suffer from lupus and I once had to go to my local ER because my husband was at work and transportation was an issue so my daughter 17 at the time took me because I had lost sight Due to optic neuritis secondary to my lupus. Luckily we found out later. My daughter took me to my local ER which I was a great nurse at before becoming disabled. I loved my colleagues and thought we all got along. Well right away my nurse and ex colleague made a comment about the number of medication‘s I was on this was after I had been in an induced coma for nearly a month and left with a trach and a number of complications. Also said this in front of my child. Then I hear this woman outside the door telling the doctor she’s on a lot of meds. I got no Neuro exam or anything shot of Toradol and sent for the door I was throwing up along the way and I still was blind. I felt like trash. And had to wait for my husband to get home from work to go to a larger hospital. I was in severe pain and blind and terrified and the funny thing is they sent me home after an MRI and didn’t find it until the resident looked again and found it the next morning and called me and told me to come back.
As a person in medical my goal is to keep people out of clinics and hospitals and never have to get on the managing illness wheel. We need trauma care ... Everything else is for profit.
I am a nurse starting a new job and it is difficult as someone who has health issues to constantly repeat to nre doctors all what has been done. I am currently trying to get all my medical records sent to me. I have 4 different specialists I work with to control my Lupus/Fibromyalgia. I work as a staff nurse and want to continue being as active as I can. I work hard to keep health in check. I feel those with complicated health history won't get the care they need. I am fortunate that I could probably do any of these modules but alot of people won't be. Good discussion and very informative. Definitely going to do more research in this. Now I know more about the job Amazon was offering me lol. I am learning ICU drips in my new job but down the road when I have more experience and education this is something to look into.
In my experience with dpc, they tend to have a more holistic way of caring for their patients. That is not something I've experienced with my PCP. And I don't know what it costs in other areas of the country but in rural Missouri it's about 100/month for an individual and 150ish for a family of four. That's unlimited visits, discounted prescriptions, unlimited lab draws and I'm sure other things I can't think of at the moment. Through my work, insurance would cost around 200/month for just myself. Dpc is great because they aren't bound by the rules of insurance. Anyway, I think it's fabulous.
I heard about this, probably great for primary, personal care. BUT the problem is...if you need something involving extensive tests and hospitalization (emergency care, strokes, MI's, etc....) this type of bill can easily run up over $100,000/week. So still need to pay for health insurance UHG! Great ethical discussion. Thank-you!
I want to be a health nurse because I cured a lot of my issues of asthma chronic infections and arthritis by changing my diet. I don't have my BA so decided not to go for my NP because of that. I am extremely knowledgeable about holisticn ways of helping chronic illnesses. I have not taken antibiotics in over ten years or steroids. No more asthma symptoms. My hashimotos is controlled with diet. I take no meds. I am working on the mental health component that effects all diseases. I have CPTSD.
This conversation misses alot of what has to happen to change the paradigm. You may not know this but health co ops are the wave of the future and are already pretty robust. These co ops are owned by the people who invest in them. No insurance rules. They do not work through insurance so they do not have to try to " screen" them for other profitable illnesses. It's kind of painful to realize that you all are not aware that there is already a change happening. Imaging places around me are already doing walk in. I do not have to have a rx to get an image. I can go in and just pay for one and walk out with the image. There are places around here that have walk in labs. No doctor needed. I can just walk in and order a full panel. No insurance needed. This is becoming more and more common.
My husband and I are on the health exchange. We order our own labs on Direct Labs (and take the results to our PCP) because they are WAY cheaper than having them drawn through our provider. The only reason this works is because we don't have chronic conditions and I know which labs to order.
I would never allow a male to do a prostate exam. No exceptions unless it's done in the OR. I was a bit offended by the "man up" speech about that. Not part of the topic and we'd never say something like that to women.
You don't have to be an NP to do nursing concierge. As long as you do not dx. You can consult and recommend and help people take control of their own health it's basically health coach with an RN the patient is freer and the nurse is freer to explore. This will be how we transition . People do not trust higher medical people anymore. It will be nurses working in nursing theory that will create the new health care paradigm. If you do the math it's cheaper to learn to be healthy with someone at your side for awhile , then to be a chronic patient in an industry that makes money on your illness. It's actually cheaper to hire someone per hour in their home than to drain the resources in these huge conglomerates. It's already becoming common place. Not in big cities. You don't need a doctor in your back pocket when your not working in illness management and you are actually helping people get off the medications. It does come through that this is mostly around prescribing. People want their health back and they want off the medications. They realize this system has been keeping this sick and getting sicker, on this perpetual wheel. If you want to get back to helping the person , you need to take some time learning what holism is , which will require integrating nursing theory , or at least revisit the tenets. Otherwise you will not be desired by the person seeking health at home. Because people who are trained in the hospital model have no bedside manner. That's the difference. When you are working in that paradigm it will just be the same mess only out of the hospital, instead of inside. It's funny that you totally ridiculed nursing theory the other day but are talking about the environment as being important. The irony. Also as a health provider it is alarming that we can not say " vagina "
I don’t understand the diss on nursing theory. I’m quite a bit older than Nurse Liz but I truly value the viewpoint that nursing theory provides. I think a lot of schools did not teach it in a way that connected the dots for students, unfortunately.
You really are unaware of how many people are healing themselves with these alternative things that you are laughing at. You need a detox and a deprogram.
Oh foods ... You mean like the hospital makes. If you hate it ... Then you will NEVER teach a patient to love it. You cannot teach what you don't believe. I'm sorry this is so painful. The gal in the lower left corner may be having some early synaptic awareness... It is good this conversation is happening. But you have to deprogram the medical programming you have.
I fully agree there are for sure pros and cons of the direct primary care model (DPC) I own two practices in Florida as an autonomous nurse practitioner. I am also doing my DNP program evaluation project to do some deep diving into this model. It has been a fit for me and given me a renewed sense of purpose despite burnout which I'm sure you can empathize with! The usual max cost per month is $99 monthly. Happy to be a resource.
Once upon a time, I did secretarial work for a Home Healthcare Company that specialized in PT/OT/etc. for homebound patients, not PCP or anything though. It was- overall- a great experience and I was left wondering why couldn't we, as a society, do more home health care things since it could reduce overhead costs, etc. It would be great to see that as a norm
Exactly. I used to have to work with patients with severe disabilities and the elderly, who could not get healthcare, as they could not leave the home. They basically rotted at home and waited to die.
Every once and awhile, I could find a PCP, who would make house calls, but they were few.
Nurses tend to have an overwhelming caseload and/or responsibilities, so nurses tend not stay long. Simply put high turnovers
I am in NP school and am planning on being on primary care. If given the opportunity, I most definitely would do house calls. Rural communities are terribly underserved.
I don’t think it’s backwards. I think it’s an understanding that we are missing important components of healthcare that existed with the older model.
As a hospice nurse, I often say that I’m kind of like that doctor with the little black bag that used to make house calls… it helps families realize that I’m now managing (with the help of a NP and a Dr) their primary care.
There is simply something about getting to know someone at that level (I’m in their home at least twice a week) that makes a huge difference in how health care is provided.
I’ve always joked that everyone deserves a hospice nurse managing all of their care… Direct Primary Care seems to fill that need.
Also, not all DPC is home care and not all is super expensive. There is one in Detroit (can’t think of the name) that works to provide DPC care to lower income clientele.
I think there is a place for this.
Front and back of the house talk. As a disabled RN that worked in the ER and then also hospice I find myself always feeling like a drug seeker if I ever which is rare have to go to the ER. It is a nightmare. I suffer from lupus and I once had to go to my local ER because my husband was at work and transportation was an issue so my daughter 17 at the time took me because I had lost sight Due to optic neuritis secondary to my lupus. Luckily we found out later. My daughter took me to my local ER which I was a great nurse at before becoming disabled. I loved my colleagues and thought we all got along. Well right away my nurse and ex colleague made a comment about the number of medication‘s I was on this was after I had been in an induced coma for nearly a month and left with a trach and a number of complications. Also said this in front of my child. Then I hear this woman outside the door telling the doctor she’s on a lot of meds. I got no Neuro exam or anything shot of Toradol and sent for the door I was throwing up along the way and I still was blind. I felt like trash. And had to wait for my husband to get home from work to go to a larger hospital. I was in severe pain and blind and terrified and the funny thing is they sent me home after an MRI and didn’t find it until the resident looked again and found it the next morning and called me and told me to come back.
As a person in medical my goal is to keep people out of clinics and hospitals and never have to get on the managing illness wheel.
We need trauma care ... Everything else is for profit.
I am a nurse starting a new job and it is difficult as someone who has health issues to constantly repeat to nre doctors all what has been done. I am currently trying to get all my medical records sent to me. I have 4 different specialists I work with to control my Lupus/Fibromyalgia. I work as a staff nurse and want to continue being as active as I can. I work hard to keep health in check. I feel those with complicated health history won't get the care they need. I am fortunate that I could probably do any of these modules but alot of people won't be. Good discussion and very informative. Definitely going to do more research in this. Now I know more about the job Amazon was offering me lol. I am learning ICU drips in my new job but down the road when I have more experience and education this is something to look into.
In my experience with dpc, they tend to have a more holistic way of caring for their patients. That is not something I've experienced with my PCP. And I don't know what it costs in other areas of the country but in rural Missouri it's about 100/month for an individual and 150ish for a family of four. That's unlimited visits, discounted prescriptions, unlimited lab draws and I'm sure other things I can't think of at the moment. Through my work, insurance would cost around 200/month for just myself. Dpc is great because they aren't bound by the rules of insurance. Anyway, I think it's fabulous.
Yes totally agree here! I own two clinics and it has really helped me beat burnout and feel better about what I do in healthcare!
I heard about this, probably great for primary, personal care. BUT the problem is...if you need something involving extensive tests and hospitalization (emergency care, strokes, MI's, etc....) this type of bill can easily run up over $100,000/week. So still need to pay for health insurance UHG!
Great ethical discussion. Thank-you!
I want to be a health nurse because I cured a lot of my issues of asthma chronic infections and arthritis by changing my diet. I don't have my BA so decided not to go for my NP because of that. I am extremely knowledgeable about holisticn ways of helping chronic illnesses. I have not taken antibiotics in over ten years or steroids. No more asthma symptoms. My hashimotos is controlled with diet. I take no meds. I am working on the mental health component that effects all diseases. I have CPTSD.
This conversation misses alot of what has to happen to change the paradigm.
You may not know this but health co ops are the wave of the future and are already pretty robust. These co ops are owned by the people who invest in them. No insurance rules. They do not work through insurance so they do not have to try to " screen" them for other profitable illnesses.
It's kind of painful to realize that you all are not aware that there is already a change happening.
Imaging places around me are already doing walk in. I do not have to have a rx to get an image. I can go in and just pay for one and walk out with the image.
There are places around here that have walk in labs. No doctor needed. I can just walk in and order a full panel. No insurance needed.
This is becoming more and more common.
My husband and I are on the health exchange. We order our own labs on Direct Labs (and take the results to our PCP) because they are WAY cheaper than having them drawn through our provider. The only reason this works is because we don't have chronic conditions and I know which labs to order.
Very true!! Doctors I have worked with actually recommended getting imaging sans a referral or order.
Can you post some links to these exchanges ? Where are you located?
What is the cost and what is covered?
I would never allow a male to do a prostate exam. No exceptions unless it's done in the OR. I was a bit offended by the "man up" speech about that. Not part of the topic and we'd never say something like that to women.
wow Mr midwife's headset mic is VERY sensitive lol it picks up every breath he takes especially when he takes a deep breath and exhales 😂
He is very refreshing. He tells it like it is!! 🤣
How can nurse Adrian be "so smart" yet not be an analyst on CNN?
You don't have to be an NP to do nursing concierge. As long as you do not dx. You can consult and recommend and help people take control of their own health it's basically health coach with an RN the patient is freer and the nurse is freer to explore. This will be how we transition . People do not trust higher medical people anymore. It will be nurses working in nursing theory that will create the new health care paradigm.
If you do the math it's cheaper to learn to be healthy with someone at your side for awhile , then to be a chronic patient in an industry that makes money on your illness. It's actually cheaper to hire someone per hour in their home than to drain the
resources in these huge conglomerates.
It's already becoming common place. Not in big cities.
You don't need a doctor in your back pocket when your not working in illness management and you are actually helping people get off the medications. It does come through that this is mostly around prescribing.
People want their health back and they want off the medications. They realize this system has been keeping this sick and getting sicker, on this perpetual wheel.
If you want to get back to helping the person , you need to take some time learning what holism is , which will require integrating nursing theory , or at least revisit the tenets.
Otherwise you will not be desired by the person seeking health at home.
Because people who are trained in the hospital model have no bedside manner.
That's the difference. When you are working in that paradigm it will just be the same mess only out of the hospital, instead of inside.
It's funny that you totally ridiculed nursing theory the other day but are talking about the environment as being important. The irony.
Also as a health provider it is alarming that we can not say
" vagina "
I don’t understand the diss on nursing theory. I’m quite a bit older than Nurse Liz but I truly value the viewpoint that nursing theory provides. I think a lot of schools did not teach it in a way that connected the dots for students, unfortunately.
Something like a care navigator, I have a nurse friend who is doing that as well and she loves it!
Need nurse or doctor to mine home be case am home bound how does work
You really are unaware of how many people are healing themselves with these alternative things that you are laughing at.
You need a detox and a deprogram.
Hi Tanya - where can we see your content on these ideas you are speaking of,
Oh foods ... You mean like the hospital makes.
If you hate it ... Then you will NEVER teach a patient to love it. You cannot teach what you don't believe.
I'm sorry this is so painful.
The gal in the lower left corner may be having some early synaptic awareness...
It is good this conversation is happening. But you have to deprogram the medical programming you have.
Right. Hospitals are creating their own patients by serving their employees carbs, sugar and fat.