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The Paradocs Podcast

The Paradocs is a fun and lively discussion with a couple of docs on the practice of medicine. Occasionally serious, usually lighthearted, and accidentally informative. A show for physicians to learn more about what is going on and a great place for them to direct their friends and family to better understand the challenges they face.

Aug 20, 2019

One of the most frequently asked questions I get from people when I describe direct primary care is whether a direct care model would work for specialists in medicine. For instance, I didn't know how to answer because it seems like it would be too hard to have doctors who specialize to charge patients cash without an established relationship. Health insurance dominates how most pay for care.  Therefore,  would either patients or docs ever move towards cash?
My guest is Dr. Nikhila Schroeder, a pediatric allergist/immunologist who began her own private practice a little over a year ago decided to make the move to cash. She does not take any third party payers and has a 100% direct care model.
Dr. Schroeder specializes in sublingual immunotherapy (SLIT). SLIT is a proven way of treating patients with allergies using their gut rather than the traditional method of allergy shots. Therefore, she doesn't practice in a traditional clinic where revenue is based on the number of patients seen. Instead, she can spend more time with her patients sometimes over 2 hours.
Her story one year out from the launch of the clinic is an interesting one where she describes the sort of things that many starting a small business face: trouble raising capital, a long time until the break even point, and uncertainty of success. She describes the process as both challenging and rewarding but one worth doing.
There is one bit of advice she has for someone deciding to embark on a practice model like this - secure a business loan while you are still employed. This means you will have an income stream to show the bank.
Above all, the decision to practice medicine at the pace you want and establishing the type of patient relationships you want is worth more than what can be measured on a balance sheet. Dr. Nikhila Schroeder is an allergist and the owner of Allergenuity Health Associates. She specializes in the treating allergies using sublingual therapy instead of the traditional allergy shots.


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show notes

Allergenuity Health Associates: The link to Dr. Nikhila Schroeder's allergy practice specializing in sublingual immunotherapy.

Twitter link for Dr. Schroeder: @DrNikhilaMEng

Episode 004: The nuts and bolts of how to set up a direct primary care clinic with Dr. Chad Savage.

Episode 002: Dr.Amat describes the reasons why she left the traditional model of practicing insurance based medicine and opened her own direct care clinic.

YouTube for Paradocs: Here you can watch the video of my late son singing his solo on the Paradocs YouTube page.

Patreon - Become a show supporter today and visit my Patreon page for extra bonus material. Every dollar raised goes towards the production and promotion of the show.

Listen to The Paradocs on RadioPublic