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
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.
Associates: The link to Dr. Nikhila Schroeder's allergy
practice specializing in sublingual immunotherapy.
Twitter link for Dr.
Episode 004: The
nuts and bolts of how to set up a direct primary care clinic with
Dr. Chad Savage.
Dr.Amat describes the reasons why she left the traditional model of
practicing insurance based medicine and opened her own direct care
YouTube for Paradocs:
Here you can watch the video of my late son singing his solo on the
Paradocs YouTube page.
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