Mon. Sep 27th, 2021

A couple of weeks ago I wrote about the University of Houston College of Medicine and their plans for a DPC clinic. I thought about their ambitious goals and realized that I really wanted them to succeed. In fact, it’s bad press for all DPC if they don’t do well. Therefore I wrote to Stephen J. Spann, M.D., their Dean of Medicine, this weekend and to his credit he got right back to me. Here are some of the things he said in the email:

  • Thank you for your kind note and for sharing your blog and the piece about our upcoming DPC clinic! 
  • I have been following the DPC model for a long time, every since my friend and colleague Dr. Erika Bliss started what I believe was the first DPC practice, in Seattle Washington over 10 years ago!  I have known her since she was a Family Medicine resident, and had numerous conversations with her about the model during the time she was designing it an after she started it. 
  • We have talked to a number of folks around the country and in our area who have a lot of experience with the model as well, including Jay Keese, the executive director of the DPC Coalition our to Washington, D.C., and Tom Banning, who is the CEO of the Texas Academy of Family Physicians and serves on the board of the DPC Coalition; also Dr. Chris Larsen, who runs a DPC practice in Austin. 
  • Dr. Omar Matuk-Villazon who is our Chief Medical Officer has visited a lot of local DPC practices; I met on Friday with Dr. Rebecca Behrens, one of my former medical students at Baylor College of Medicine, who has started a solo DPC practice in the Heights area here in Houston. 
  • We definitely do NOT want to create a DINO (DPC clinic  in name only)!  This will not be a charity practice; the gift from the Cullen Trust for Health was to provide us with operational start-up capital to allow us to develop a pilot to test the concept in our target market, which is the working poor in Houston who do not have health insurance coverage and often choose not to go to safety net clinics (many of them are undocumented immigrants who worry that they will be reported and deported), and end up waiting to get care late in the stream of illness in emergency rooms and require hospitalization, leading to poor outcomes and high costs. 
  • Our model has to be sustainable, so patients will need to pay a monthly subscription to receive the broad range of primary care services offered. 
  • And we are recruiting a fulltime family physician to staff this; we need someone bilingual in Spanish as we anticipate that there will be a significant number of patients who only speak Spanish, given the target market and geographic location of our first clinic. 
  • We do hope to have some of our medical students learning in these clinics; our students spend one half-day a week throughout the 4 year curriculum in a primary care clinical setting, as our goal is that at least 50% of our graduates will choose to practice in primary care specialties; I believe the DPC is a viable and attractive model that our students should get to see up close. 
  • Your point about the doctors having “skin in the game” is a good one; we will need to find a way to do this even though our model will be an employed physician model and our docs will be on our faculty, but practicing fulltime in the DPC clinic. 

I found Dr. Spann’s responses on the money. I still think this is an uphill battle, however. Therefore, I have agreed to meet with him and Dr. Matuk-Villazon and offer my services to help in any way. I have the time being retired from clinical medicine. I hope to keep you all updated on their story and may need to pick your brains on things in the future.

If anyone is interested in working at this clinic then get back to me. You would be a pioneer in this field as no medical school has tried this before. The job description is here. They really needs someone who can speak Spanish.

To be continued….

20600cookie-checkI Have Communicated With the University Of Houston College of Medicine About Their DPC Clinic and They Do NOT Want It To Be a DINO!

By Doug Farrago

Douglas Farrago MD is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Douglas Farrago, MD received his Bachelor of Science from the University of Virginia in 1987, his Masters of Education degree in the area of Exercise Science from the University of Houston in 1990, and his Medical Degree from the University of Texas at Houston in 1994. His residency training occurred way up north at the Eastern Maine Medical Center in Bangor, Maine. In his final year, he was elected Chief Resident by his peers. Dr. Farrago has practiced family medicine for twenty-three years, first in Auburn, Maine and now in Forest, Virginia. He founded Forest Direct Primary Care in 2014, which quickly filled in 18 months. Dr. Farrago still blogs every day on his website Authenticmedicine.com and lectures worldwide about the present crisis in our healthcare system and the effect it has on the doctor-patient relationship. Dr. Farrago’s has written three books on direct primary care: The Official Guide to Starting Your Own Direct Primary Care Practice, The Direct Primary Care Doctor’s Daily Motivational Journal and Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity) are all best sellers in this genre. He is a leading expert in direct primary care model and lectures medical students, residents, and doctors on how to start their own DPC practice. He retired from clinical medicine in October, 2020.

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