Memes and Accusations About DINOs
Written by Garrison Bliss, MD
With all of this anger about “DINO” medicine, do you think it would be interesting to know whether these are DPC companies or not? In a related article, there is actually a list of the companies that form the bulk of this “DPC” growth. They are:
Paladina Health
Plum Health
Nextera Healthcare
PeakMed
Crossover Health
One Medical
Boston Direct Health
Forward Health
Oak Street Health
EverMed
Anything surprising that jumps out at you? I don’t know all of these companies, but I know most of them (and I have spoken with many of their founders over the years). Before you ASSUME that they do not actually participate in the our culture, it would be a great idea to know something about them. Are their patients less happy, as happy or more happy than your patients? Are their medical outcomes the same, better or worse than ours? Are their doctors as happy, less happy or more happy than ours? Are they in DPC, dangerous for DPC or ahead of DPC as we define it? Are we competitors, enemies or simply engaged in this revolution in different arenas? Is it POSSIBLE that DPC can function in many arenas at a time without damaging its culture and accomplishments?
I think it is time to begin studying this openly and honestly. Enough with the memes and accusations. The point of DPC was NEVER to assume eternal superiority of the first model, but to create a playing field built on the goal of optimizing Primary Healthcare and access to that care. I personally sought to the existing underfunctioning model to a far better model in the USA, to a path leading to better more accessable care throughout this country (and eventually internationally – nothing wrong with aspiration!!). Wouldn’t it be nice if we could start measuring our success at all levels and seeing how it fares as DPC seeks scientific verification of its amazing accomplishments and portential contribution to the welfare of our country and world?
Doug and I have talked about this before and I am happy to open this up to many others. None of us knows what is actually happening, but it may not be as bad as you think.
I could not agree more, Dr Bliss. Well voiced. DPC is not superior to all other healthcare service models if it does not fit all target markets and segments. If the original goals and vision for DPC are achieved via alternate business models, then mission accomplished.
I feel it would be important to know the amount of private equity investment in these models. Private equity will want a certain return on investment and may act similar to insurance companies and systems.
I’d love to see the data for each of these companies. I feel pretty certain Plum health and Nextera meet the DPC philosophies. Some of these listed still deal with insurance and for me would not be DPC. Some have been bought out by massive companies seeking profit for sure. How will they change. There are signs they are changing. I know there are some questions about patient care, physician and provider satisfaction, visit durations and other major changes from corporate take over. I also know there is research on this in the works, undercover, hard hitting true tales form the inside. Are they just as good? Do they meet the quadruple aim? These big DINO groups are going to do as they please and make big waves. Us peons in rural America trying to help our communities just doing our best to save primary care. Many of these giant corporates plans are failing in primary care and closing office (Village MD, One Medical, and now Walmart). Ever time this happens, I die a little as primary care seems to fail. Primary care is not money making venture except for the massive downstream markups it can generate. Not sure why corporate America can’t see that. There is not 10-15X profit here. Sorry. So if the “data” says all these huge companies are good for care; great. Let me see it. But the ultimate question for me is who does YOUR doctor work for, you or some administrator?
Great point Dr. Bliss. We need boots on the ground. Over the last couple months I’ve had 2 meetings, interviewing an employed medical provider from 2 of the companies listed above, who’s still working there. This provider reached out TO ME, to blow the whistle on the corruption of DPC in those clinics. I have an “update” interview scheduled next week. I’ll be publishing the story here on DPCN. I still have this follow-up interview before I have all the questions answered, but I can assure our readers with 100% certainty that these 2 companies are abusing their doctors and mid-levels and practicing ANYTHING BUT authentic medicine. One of them STARTED as DPC and then got traded around like a baseball card until it was unrecognizable as DPC, and looks just like the cartel-sponsored machine we all escaped, treating patients and medical professionals as commodities, in the name of profit for big companies. From what I can tell, as these companies grow, administrators enter the equation, the overhead grows, and the model devolves.