Why Your Health Insurance Is Broken by Design: Direct Primary Care with Brandon Alleman | Ep 40

What's up guys? Sam here with Kill What's up guys? Sam here with Kill Growth Podcast. Today I have Brandon Growth Podcast. Today I have Brandon Growth Podcast. Today I have Brandon Alman with Antioch Direct Primary Care. Alman with Antioch Direct Primary Care. Alman with Antioch Direct Primary Care. » Y » Y » Y » but just Antioch Med. » but just Antioch Med. » but just Antioch Med. » Antioch Med. » Antioch Med. » Antioch Med. » That's easy to say. I like saying » That's easy to say. I like saying » That's easy to say. I like saying Antioch Med. Antioch Med. Antioch Med. » Yeah. » Yeah. » Yeah. » Um but thanks for being here. » Um but thanks for being here. » Um but thanks for being here. » Yeah, I'm excited. » Yeah, I'm excited. » Yeah, I'm excited. » Made the big journey from Witchaw. » Made the big journey from Witchaw. » Made the big journey from Witchaw. » It's a it's a great drive. » It's a it's a great drive. » It's a it's a great drive. » Yeah. » Yeah. » Yeah. » I always joke when you have four kids at » I always joke when you have four kids at » I always joke when you have four kids at home, a 30-minute drive alone is, you home, a 30-minute drive alone is, you home, a 30-minute drive alone is, you know, great. know, great. know, great. » I go to Waw a couple days a week and I'm » I go to Waw a couple days a week and I'm » I go to Waw a couple days a week and I'm not going to lie, I enjoy the ride there not going to lie, I enjoy the ride there not going to lie, I enjoy the ride there and the ride home. Um, you can get and the ride home. Um, you can get and the ride home. Um, you can get worked up on podcasts. Catch up on my worked up on podcasts. Catch up on my worked up on podcasts. Catch up on my podcast. I'm still behind on our podcast. I'm still behind on our podcast. I'm still behind on our podcasts. podcasts. podcasts. » Uh, but great. Uh, so you've not » Uh, but great. Uh, so you've not » Uh, but great. Uh, so you've not listened to an episode, so we start with listened to an episode, so we start with listened to an episode, so we start with a nice No, don't don't apologize. You're a nice No, don't don't apologize. You're a nice No, don't don't apologize. You're going to listen to this one. I hope. going to listen to this one. I hope. going to listen to this one. I hope. » Uh, actually, I don't think I've ever » Uh, actually, I don't think I've ever » Uh, actually, I don't think I've ever listened to myself on a podcast listened to myself on a podcast listened to myself on a podcast afterwards. afterwards. afterwards. » Maybe I'll listen to the other ones. » Maybe I'll listen to the other ones. » Maybe I'll listen to the other ones. » There you go. There you go. Perfect. Um, » There you go. There you go. Perfect. Um, » There you go. There you go. Perfect. Um, so we just start out with an easy uh so we just start out with an easy uh so we just start out with an easy uh we'd love to know your story of like how we'd love to know your story of like how we'd love to know your story of like how did you when did you become a doctor and did you when did you become a doctor and did you when did you become a doctor and then what led you into Antioch? Sure. then what led you into Antioch? Sure. then what led you into Antioch? Sure. Um, yeah, stop me if I go too far back, Um, yeah, stop me if I go too far back, Um, yeah, stop me if I go too far back, but » I'm good at interrupting. » I'm good at interrupting. » I'm good at interrupting. » No, in college I actually majored in » No, in college I actually majored in » No, in college I actually majored in math and physics and so, um, I finished math and physics and so, um, I finished math and physics and so, um, I finished those degrees in three years and then those degrees in three years and then those degrees in three years and then took a kind of took a kind of took a kind of semmedical mission trip to Africa semmedical mission trip to Africa semmedical mission trip to Africa between my junior and senior year. between my junior and senior year. between my junior and senior year. » Wait, so you got two degrees in three » Wait, so you got two degrees in three » Wait, so you got two degrees in three years? years? years? » Um, yes. Finished those course » Um, yes. Finished those course » Um, yes. Finished those course work in three years. And so between work in three years. And so between work in three years. And so between junior and senior year, took this trip junior and senior year, took this trip junior and senior year, took this trip to Africa. Um we were doing kind of AIDS to Africa. Um we were doing kind of AIDS to Africa. Um we were doing kind of AIDS education. And so I came back from that education. And so I came back from that education. And so I came back from that trip and had a summer job working at the trip and had a summer job working at the trip and had a summer job working at the particle accelerator at Michigan State. particle accelerator at Michigan State. particle accelerator at Michigan State. And it was like it was fun. I got to And it was like it was fun. I got to And it was like it was fun. I got to program. I got to learn C++. It was fun program. I got to learn C++. It was fun program. I got to learn C++. It was fun stuff. But I was like nobody cares about stuff. But I was like nobody cares about stuff. But I was like nobody cares about this. I mean a very small this. I mean a very small this. I mean a very small » Did you not care about it either? » Did you not care about it either? » Did you not care about it either? » I cared about it, but a very small » I cared about it, but a very small » I cared about it, but a very small subset of the people in the world subset of the people in the world subset of the people in the world understood or cared about this. Uh my understood or cared about this. Uh my understood or cared about this. Uh my brother now works at the particle brother now works at the particle brother now works at the particle accelerator at Michigan State. So it's accelerator at Michigan State. So it's accelerator at Michigan State. So it's nothing nothing wrong with that nothing nothing wrong with that nothing nothing wrong with that work, work, work, » but it was just um the juxtaposition of » but it was just um the juxtaposition of » but it was just um the juxtaposition of those things are like I like science. those things are like I like science. those things are like I like science. I'm I'm good at these things. Is is I'm I'm good at these things. Is is I'm I'm good at these things. Is is there a way to use that in a different there a way to use that in a different there a way to use that in a different role? So decided to go to med school my role? So decided to go to med school my role? So decided to go to med school my senior year. So took all my prerexs my senior year. So took all my prerexs my senior year. So took all my prerexs my senior year. Um actually had a year in senior year. Um actually had a year in senior year. Um actually had a year in between undergrad and med school. Did a between undergrad and med school. Did a between undergrad and med school. Did a fullbrite scholarship in fullbrite scholarship in fullbrite scholarship in Eastern Europe. And then Eastern Europe. And then Eastern Europe. And then » you said fullbrite scholarship. » you said fullbrite scholarship. » you said fullbrite scholarship. » Fullbrite scholarship. Yeah. So it's a » Fullbrite scholarship. Yeah. So it's a » Fullbrite scholarship. Yeah. So it's a it's a exchange program. So either it's a exchange program. So either it's a exchange program. So either teachers or scholars can do a year teachers or scholars can do a year teachers or scholars can do a year abroad and then countries send people to abroad and then countries send people to abroad and then countries send people to the United States as well. the United States as well. the United States as well. » So then applied for med school while I » So then applied for med school while I » So then applied for med school while I was there. Didn't know if I would like was there. Didn't know if I would like was there. Didn't know if I would like clinical care or not. Um so wound up clinical care or not. Um so wound up clinical care or not. Um so wound up doing the MD PhD program. So combines doing the MD PhD program. So combines doing the MD PhD program. So combines getting MD with getting your PhD. getting MD with getting your PhD. getting MD with getting your PhD. » So did two years of med school, three » So did two years of med school, three » So did two years of med school, three years of PhD work, two years of med years of PhD work, two years of med years of PhD work, two years of med school. and then made the decision kind school. and then made the decision kind school. and then made the decision kind of as I went through I liked clinical of as I went through I liked clinical of as I went through I liked clinical work more and more and took some classes work more and more and took some classes work more and more and took some classes just on health care systems and just on health care systems and just on health care systems and healthcare quality and I was like I'm healthcare quality and I was like I'm healthcare quality and I was like I'm actually going to go into primary care actually going to go into primary care actually going to go into primary care which is kind of unheard of going which is kind of unheard of going which is kind of unheard of going through the MDPh program I think I was through the MDPh program I think I was through the MDPh program I think I was the only one the only one the only one » what was your draw why » what was your draw why » what was your draw why » I I heard about the type of practice we » I I heard about the type of practice we » I I heard about the type of practice we do in medical school and knew probably do in medical school and knew probably do in medical school and knew probably if I was going to practice clinically uh if I was going to practice clinically uh if I was going to practice clinically uh it would probably be in something like it would probably be in something like it would probably be in something like that » okay I'm not great at having bosses and » okay I'm not great at having bosses and » okay I'm not great at having bosses and so uh I knew I'd probably wanna um do so uh I knew I'd probably wanna um do so uh I knew I'd probably wanna um do something that uh I had a little bit something that uh I had a little bit something that uh I had a little bit more control in and knew more control in and knew more control in and knew that yeah are we are we doing a good job that yeah are we are we doing a good job that yeah are we are we doing a good job in taking care of medicine. I think lots in taking care of medicine. I think lots in taking care of medicine. I think lots of medicine now is of medicine now is of medicine now is easy to feel like you're a cog and a and easy to feel like you're a cog and a and easy to feel like you're a cog and a and a machine and I didn't want that's the a machine and I didn't want that's the a machine and I didn't want that's the truck I got. truck I got. truck I got. » So yeah that's been my journey to » So yeah that's been my journey to » So yeah that's been my journey to medicine. So um m or chose to go into medicine. So um m or chose to go into medicine. So um m or chose to go into family medicine. Yeah. I think I was the family medicine. Yeah. I think I was the family medicine. Yeah. I think I was the only MD PhD student to match into family only MD PhD student to match into family only MD PhD student to match into family medicine in the country that year. medicine in the country that year. medicine in the country that year. » Came to Witchaw for residency training » Came to Witchaw for residency training » Came to Witchaw for residency training and then opened our practice um right and then opened our practice um right and then opened our practice um right after coming or actually while we were after coming or actually while we were after coming or actually while we were while I was in residency. So while I was in residency. So while I was in residency. So » and was the practice direct primary » and was the practice direct primary » and was the practice direct primary care immediately? care immediately? care immediately? » Yes, » Yes, » Yes, » it was. You went right in. So let's talk » it was. You went right in. So let's talk » it was. You went right in. So let's talk about that like why direct primary care? about that like why direct primary care? about that like why direct primary care? Yeah. I um Yeah. I um Yeah. I um » because like what it it was happening » because like what it it was happening » because like what it it was happening like I I Atlas MD was already there. I like I I Atlas MD was already there. I like I I Atlas MD was already there. I remember because I remember when you remember because I remember when you remember because I remember when you guys opened. guys opened. guys opened. » Yeah. We were not the first um there » Yeah. We were not the first um there » Yeah. We were not the first um there were probably a couple hundred other were probably a couple hundred other were probably a couple hundred other practices in the country. So we didn't practices in the country. So we didn't practices in the country. So we didn't » which is still not a lot. » which is still not a lot. » which is still not a lot. » Yeah. We didn't come up with the idea » Yeah. We didn't come up with the idea » Yeah. We didn't come up with the idea for sure but um I started medical school for sure but um I started medical school for sure but um I started medical school with my co-founder Nick Thompson. And so with my co-founder Nick Thompson. And so with my co-founder Nick Thompson. And so we met at Iowa. He came to this program. we met at Iowa. He came to this program. we met at Iowa. He came to this program. He got three years ahead of me because I He got three years ahead of me because I He got three years ahead of me because I did the PhD work. So he was kind of did the PhD work. So he was kind of did the PhD work. So he was kind of exiting residency as I was entering. He exiting residency as I was entering. He exiting residency as I was entering. He did some international work kind of did some international work kind of did some international work kind of moonlit for a while and then together we moonlit for a while and then together we moonlit for a while and then together we just like we decided like yeah this is just like we decided like yeah this is just like we decided like yeah this is the type of practice that um if we're the type of practice that um if we're the type of practice that um if we're going to take care of people this aligns going to take care of people this aligns going to take care of people this aligns our incentives best with our patients if our incentives best with our patients if our incentives best with our patients if that makes sense. that makes sense. that makes sense. » Yeah. » Yeah. » Yeah. » So that's something we talk about a lot » So that's something we talk about a lot » So that's something we talk about a lot is why direct primary care. Lots of is why direct primary care. Lots of is why direct primary care. Lots of people do it for lots of reasons. To me people do it for lots of reasons. To me people do it for lots of reasons. To me it's um it best aligns our incentives it's um it best aligns our incentives it's um it best aligns our incentives with taking care of patients. And so with taking care of patients. And so with taking care of patients. And so that's our main focus and it's just led that's our main focus and it's just led that's our main focus and it's just led to some other uh uh areas to affect to some other uh uh areas to affect to some other uh uh areas to affect medicine as a whole. So medicine as a whole. So medicine as a whole. So » yeah. What take me through that moment » yeah. What take me through that moment » yeah. What take me through that moment or your decision-m were you familiar or your decision-m were you familiar or your decision-m were you familiar with DPC the whole time you were like in with DPC the whole time you were like in with DPC the whole time you were like in residency? Did residency? Did residency? Did » So in medical school I our family » So in medical school I our family » So in medical school I our family medicine textbook had this blurb at the medicine textbook had this blurb at the medicine textbook had this blurb at the back and it was about a doctor in North back and it was about a doctor in North back and it was about a doctor in North Carolina that did this thing Carolina that did this thing Carolina that did this thing like did this different practice and like did this different practice and like did this different practice and that just really resonated with me. I that just really resonated with me. I that just really resonated with me. I don't know how much you know about don't know how much you know about don't know how much you know about medicine, but a traditional medicine, but a traditional medicine, but a traditional » I I know the appropriate amount of » I I know the appropriate amount of » I I know the appropriate amount of ibuprofen to take ibuprofen to take ibuprofen to take » That's good. That's a great place to » That's good. That's a great place to » That's good. That's a great place to start. But a traditional outpatient start. But a traditional outpatient start. But a traditional outpatient physician or traditional any physician, physician or traditional any physician, physician or traditional any physician, they're what's called fee for service. they're what's called fee for service. they're what's called fee for service. So, somebody has to come see them. They So, somebody has to come see them. They So, somebody has to come see them. They have to code the visit according to this have to code the visit according to this have to code the visit according to this coding thing and then usually a third coding thing and then usually a third coding thing and then usually a third party determines how much that code is party determines how much that code is party determines how much that code is worth. worth. worth. » Gotcha. Insurance. » Gotcha. Insurance. » Gotcha. Insurance. » Uh, yes. Yeah. Usually an insurer of » Uh, yes. Yeah. Usually an insurer of » Uh, yes. Yeah. Usually an insurer of some kind. some kind. some kind. um um um that leads to some perverse incentives. that leads to some perverse incentives. that leads to some perverse incentives. So sure So sure So sure » if somebody So the most common » if somebody So the most common » if somebody So the most common outpatient codes for a family med doctor outpatient codes for a family med doctor outpatient codes for a family med doctor a 992 and3 and a 92 and4 so moderately a 992 and3 and a 92 and4 so moderately a 992 and3 and a 92 and4 so moderately complex visit 992 and3 slightly more complex visit 992 and3 slightly more complex visit 992 and3 slightly more complex visit 992 and4 and I've assigned complex visit 992 and4 and I've assigned complex visit 992 and4 and I've assigned how much those are worth that's not how much those are worth that's not how much those are worth that's not really what patients need. Patients really what patients need. Patients really what patients need. Patients don't come in and say, "I'm a 992 and4." don't come in and say, "I'm a 992 and4." don't come in and say, "I'm a 992 and4." They say, "I have these problems that I They say, "I have these problems that I They say, "I have these problems that I want solved, and I want to work out with want solved, and I want to work out with want solved, and I want to work out with somebody to solve them." somebody to solve them." somebody to solve them." If I can only make so much on a 92 and4, If I can only make so much on a 92 and4, If I can only make so much on a 92 and4, I have to put that 92 and4 in a certain I have to put that 92 and4 in a certain I have to put that 92 and4 in a certain time spot, and I see that many 992 and4s time spot, and I see that many 992 and4s time spot, and I see that many 992 and4s or 9923s a day, well, I got to see 25 of or 9923s a day, well, I got to see 25 of or 9923s a day, well, I got to see 25 of those a day or more to meet my overhead those a day or more to meet my overhead those a day or more to meet my overhead and pay myself a salary. So, I care as a and pay myself a salary. So, I care as a and pay myself a salary. So, I care as a physician in the FIFA service system of physician in the FIFA service system of physician in the FIFA service system of getting people in and out. That's not getting people in and out. That's not getting people in and out. That's not what people want when they uh interact what people want when they uh interact what people want when they uh interact with the healthcare provider. So, this with the healthcare provider. So, this with the healthcare provider. So, this was a way for us to say, hey, we can if was a way for us to say, hey, we can if was a way for us to say, hey, we can if we change the payment model, it changes we change the payment model, it changes we change the payment model, it changes how we can do how we can deliver care. how we can do how we can deliver care. how we can do how we can deliver care. » What's the ratio? I mean, 25 a day. That » What's the ratio? I mean, 25 a day. That » What's the ratio? I mean, 25 a day. That seems like a lot of people. seems like a lot of people. seems like a lot of people. » That's that's on the low end. So, um » That's that's on the low end. So, um » That's that's on the low end. So, um » what's the high end? » what's the high end? » what's the high end? » The high end is probably 40 40 a day. » The high end is probably 40 40 a day. » The high end is probably 40 40 a day. » But they're Yeah, they're the average » But they're Yeah, they're the average » But they're Yeah, they're the average facetime you get with a primary care facetime you get with a primary care facetime you get with a primary care physician at a normal fee for service physician at a normal fee for service physician at a normal fee for service visit is about 8 minutes. You may visit is about 8 minutes. You may visit is about 8 minutes. You may interact with MA, you may interact with interact with MA, you may interact with interact with MA, you may interact with a nurse, but the time I get to spend my a nurse, but the time I get to spend my a nurse, but the time I get to spend my doctor is tell me your one problem and doctor is tell me your one problem and doctor is tell me your one problem and » you spend more time with the nurse. » you spend more time with the nurse. » you spend more time with the nurse. Yeah. In that model, I would agree. Yeah. In that model, I would agree. Yeah. In that model, I would agree. » And yeah, tell me that one problem. » And yeah, tell me that one problem. » And yeah, tell me that one problem. We'll address that. Don't say anything We'll address that. Don't say anything We'll address that. Don't say anything else because I don't have time for it. else because I don't have time for it. else because I don't have time for it. Um, make another visit because then I Um, make another visit because then I Um, make another visit because then I can then I can bill you again, right, if can then I can bill you again, right, if can then I can bill you again, right, if you come back. So again, I I don't think you come back. So again, I I don't think you come back. So again, I I don't think doctors are doing that malevolently. doctors are doing that malevolently. doctors are doing that malevolently. » Sure. » Sure. » Sure. » That's just the system they're given and » That's just the system they're given and » That's just the system they're given and that's the system they have to they have that's the system they have to they have that's the system they have to they have to work within. And I think that's why to work within. And I think that's why to work within. And I think that's why you see not many people going into you see not many people going into you see not many people going into primary care and why you see burnout primary care and why you see burnout primary care and why you see burnout very high in the profession as very high in the profession as very high in the profession as well. So well. So well. So » interesting burnout. So you don't see a » interesting burnout. So you don't see a » interesting burnout. So you don't see a lot of people going into direct primary lot of people going into direct primary lot of people going into direct primary care or you see more people going into care or you see more people going into care or you see more people going into » Yeah. So from a couple hundred clinics » Yeah. So from a couple hundred clinics » Yeah. So from a couple hundred clinics when we started now there's over 3,000. when we started now there's over 3,000. when we started now there's over 3,000. So direct primary care certainly over So direct primary care certainly over So direct primary care certainly over the last 10 years has become much the last 10 years has become much the last 10 years has become much more popular and new clinics are opening more popular and new clinics are opening more popular and new clinics are opening all the time. So I think that's somewhat all the time. So I think that's somewhat all the time. So I think that's somewhat revitalizing interest in primary care. revitalizing interest in primary care. revitalizing interest in primary care. Everybody's incentives are different for Everybody's incentives are different for Everybody's incentives are different for choosing DPC and we can talk about that choosing DPC and we can talk about that choosing DPC and we can talk about that a little bit a little bit a little bit » but yes I think that's a little bit » but yes I think that's a little bit » but yes I think that's a little bit revitalizing this is a new way to revitalizing this is a new way to revitalizing this is a new way to practice medicine practice medicine practice medicine » but the vast majority of physicians and » but the vast majority of physicians and » but the vast majority of physicians and patients are still seen in a fee for patients are still seen in a fee for patients are still seen in a fee for service setting and still getting kind service setting and still getting kind service setting and still getting kind of the lowest common denominator care. of the lowest common denominator care. of the lowest common denominator care. Yeah. Yeah. Yeah. » So t take me through the business model » So t take me through the business model » So t take me through the business model a little bit if you're good with that. a little bit if you're good with that. a little bit if you're good with that. So, it's a subscriptionbased um I think So, it's a subscriptionbased um I think So, it's a subscriptionbased um I think that's what a lot of people see and when that's what a lot of people see and when that's what a lot of people see and when I've talked to people about it because I've talked to people about it because I've talked to people about it because we've done it for probably eight years we've done it for probably eight years we've done it for probably eight years now with you guys. now with you guys. now with you guys. » Um » Um » Um » you can say that I can't say that. » you can say that I can't say that. » you can say that I can't say that. » Right. Yeah. Yeah. Yeah. You're like, » Right. Yeah. Yeah. Yeah. You're like, » Right. Yeah. Yeah. Yeah. You're like, "Yes, you said it first. "Yes, you said it first. "Yes, you said it first. » Don't tell them everything." Okay. » Don't tell them everything." Okay. » Don't tell them everything." Okay. » Um in that model, I think a lot of » Um in that model, I think a lot of » Um in that model, I think a lot of people go, "Oh, it's just another people go, "Oh, it's just another people go, "Oh, it's just another monthly fee once I understand what it monthly fee once I understand what it monthly fee once I understand what it is." But that model in my mind day is." But that model in my mind day is." But that model in my mind day one like how do you fund how does how do one like how do you fund how does how do one like how do you fund how does how do you make that work because what you make that work because what you make that work because what were you charging 10 years ago per adult were you charging 10 years ago per adult were you charging 10 years ago per adult and per kid and per kid and per kid » cuz it was pretty low. » cuz it was pretty low. » cuz it was pretty low. » Yeah, we were uh I think we started out » Yeah, we were uh I think we started out » Yeah, we were uh I think we started out at $40 an adult and $10 a child. at $40 an adult and $10 a child. at $40 an adult and $10 a child. » Yeah, it was » Yeah, it was » Yeah, it was » um we were not very good business people » um we were not very good business people » um we were not very good business people back then. Uh back then. Uh back then. Uh » sure. » sure. » sure. » And I think the business model you » And I think the business model you » And I think the business model you referenced another clinic, so I'll referenced another clinic, so I'll referenced another clinic, so I'll reference another podcast if that's reference another podcast if that's reference another podcast if that's okay. Great. Uh most people have okay. Great. Uh most people have okay. Great. Uh most people have probably heard of the acquired podcast. probably heard of the acquired podcast. probably heard of the acquired podcast. Y Y Y » but if you've listened to the Costco » but if you've listened to the Costco » but if you've listened to the Costco episode of the acquired podcast, episode of the acquired podcast, episode of the acquired podcast, » we functionally have the exact same » we functionally have the exact same » we functionally have the exact same business model, right? business model, right? business model, right? » So Costco doesn't lose money on anything » So Costco doesn't lose money on anything » So Costco doesn't lose money on anything they sell, right? But their margins on they sell, right? But their margins on they sell, right? But their margins on what they sell are much lower than what they sell are much lower than what they sell are much lower than what Dylan sells, right? So they sell you a Dylan sells, right? So they sell you a Dylan sells, right? So they sell you a huge thing of almonds. It's it's very huge thing of almonds. It's it's very huge thing of almonds. It's it's very inexpensive, but you have to have a inexpensive, but you have to have a inexpensive, but you have to have a membership to get in the door. membership to get in the door. membership to get in the door. » But I pay 150 bucks a year or whatever » But I pay 150 bucks a year or whatever » But I pay 150 bucks a year or whatever it is. So we have the same thing. So it is. So we have the same thing. So it is. So we have the same thing. So your membership gets you in the door. It your membership gets you in the door. It your membership gets you in the door. It gets you access to your physician and gets you access to your physician and gets you access to your physician and then as many problems as we can solve then as many problems as we can solve then as many problems as we can solve within our walls for our patients, we within our walls for our patients, we within our walls for our patients, we try to solve within our walls for our try to solve within our walls for our try to solve within our walls for our patients. patients. patients. » Yeah. » Yeah. » Yeah. » So along with the membership, you get » So along with the membership, you get » So along with the membership, you get you get the physician. You get the you get the physician. You get the you get the physician. You get the physician that you can call after hours. physician that you can call after hours. physician that you can call after hours. You get the physician that you can text You get the physician that you can text You get the physician that you can text during hours. You get the physician during hours. You get the physician during hours. You get the physician that's going to see you that day if that's going to see you that day if that's going to see you that day if that's what you need. You get the that's what you need. You get the that's what you need. You get the physician that's going to stitch your physician that's going to stitch your physician that's going to stitch your kid up if that's what they need. But kid up if that's what they need. But kid up if that's what they need. But along with that, we solve other problems along with that, we solve other problems along with that, we solve other problems in healthcare as well. So that's kind of in healthcare as well. So that's kind of in healthcare as well. So that's kind of the business model, if that makes sense. the business model, if that makes sense. the business model, if that makes sense. Yeah, it does. Uh talk about the start Yeah, it does. Uh talk about the start Yeah, it does. Uh talk about the start of it though, like how long did it take of it though, like how long did it take of it though, like how long did it take to I mean were you guys moonlighting? to I mean were you guys moonlighting? to I mean were you guys moonlighting? Did you just Did you just Did you just » So so our startup cost um uh so so kind » So so our startup cost um uh so so kind » So so our startup cost um uh so so kind of the history. I was beginning my third of the history. I was beginning my third of the history. I was beginning my third year or in my second year residence. I year or in my second year residence. I year or in my second year residence. I went to Nick Thompson, Dr. Nick, and went to Nick Thompson, Dr. Nick, and went to Nick Thompson, Dr. Nick, and said like, "Hey, this is a we should do said like, "Hey, this is a we should do said like, "Hey, this is a we should do this type of clinic. You could ask him this type of clinic. You could ask him this type of clinic. You could ask him about this." He had originally thought about this." He had originally thought about this." He had originally thought like that's a really dumb idea, but he like that's a really dumb idea, but he like that's a really dumb idea, but he kind of did his own research and he's kind of did his own research and he's kind of did his own research and he's like, "No, actually I think this will like, "No, actually I think this will like, "No, actually I think this will work." Yeah. work." Yeah. work." Yeah. » So, we started um and yes, didn't pay » So, we started um and yes, didn't pay » So, we started um and yes, didn't pay ourselves anything from the business for ourselves anything from the business for ourselves anything from the business for at least two years. So, we were at least two years. So, we were at least two years. So, we were moonlighting, but we put only about moonlighting, but we put only about moonlighting, but we put only about $30,000 of capital and then never any $30,000 of capital and then never any $30,000 of capital and then never any debt in the business. debt in the business. debt in the business. » Gotcha. » Gotcha. » Gotcha. » So, » So, » So, moonlight on the side at rurals and moonlight on the side at rurals and moonlight on the side at rurals and residency and things like that to kind residency and things like that to kind residency and things like that to kind of fund ourselves while the of fund ourselves while the of fund ourselves while the business grew. business grew. business grew. » Okay. And so, Nick took all the patients » Okay. And so, Nick took all the patients » Okay. And so, Nick took all the patients year one um because I was still in year one um because I was still in year one um because I was still in residency. I did a lot of the payroll residency. I did a lot of the payroll residency. I did a lot of the payroll and backend accounting and things like and backend accounting and things like and backend accounting and things like that and then I joined clinically right that and then I joined clinically right that and then I joined clinically right after residency. So after residency. So after residency. So » yeah, » yeah, » yeah, » overall that model like building a » overall that model like building a » overall that model like building a business like that is so different than business like that is so different than business like that is so different than setting up because if you were to set up setting up because if you were to set up setting up because if you were to set up a residency um or a practice in a a residency um or a practice in a a residency um or a practice in a hospital, hospital, hospital, » how does that model work like doctor » how does that model work like doctor » how does that model work like doctor says because I know like you can lease a says because I know like you can lease a says because I know like you can lease a space at a hospital or you do like a space at a hospital or you do like a space at a hospital or you do like a profit sharing or you work for the profit sharing or you work for the profit sharing or you work for the hospital. break. hospital. break. hospital. break. » Almost no new independent primary care » Almost no new independent primary care » Almost no new independent primary care practices are starting. So if a primary practices are starting. So if a primary practices are starting. So if a primary care physician is going to be working in care physician is going to be working in care physician is going to be working in the traditional system, they're either the traditional system, they're either the traditional system, they're either joining an existing practice or they're joining an existing practice or they're joining an existing practice or they're joining a hospital system that's joining a hospital system that's joining a hospital system that's functionally existing practice. Got it. functionally existing practice. Got it. functionally existing practice. Got it. I I don't know of another I know of I I don't know of another I know of I I don't know of another I know of several primary care offices in the several primary care offices in the several primary care offices in the Kansas area that have been assumed by Kansas area that have been assumed by Kansas area that have been assumed by hospital systems, but no one is starting hospital systems, but no one is starting hospital systems, but no one is starting their own business and choosing to be their own business and choosing to be their own business and choosing to be fee for service. So yeah, all of the new fee for service. So yeah, all of the new fee for service. So yeah, all of the new independent practices are more clinics independent practices are more clinics independent practices are more clinics like ours than anything. So like ours than anything. So like ours than anything. So » is there other versions of DPC out » is there other versions of DPC out » is there other versions of DPC out there? Like the your models or different there? Like the your models or different there? Like the your models or different variations of it? variations of it? variations of it? » There's a little bit some people are » There's a little bit some people are » There's a little bit some people are hybrid. Some people will still bill hybrid. Some people will still bill hybrid. Some people will still bill Medicare a little bit and um do DPC for Medicare a little bit and um do DPC for Medicare a little bit and um do DPC for non-medicare patients. I think one often non-medicare patients. I think one often non-medicare patients. I think one often times we get um assumed we're concierge times we get um assumed we're concierge times we get um assumed we're concierge medicine and the history of that might medicine and the history of that might medicine and the history of that might be a little bit useful. be a little bit useful. be a little bit useful. » Yeah, » Yeah, » Yeah, » we push back against that term. You you » we push back against that term. You you » we push back against that term. You you certainly we certainly think you get certainly we certainly think you get certainly we certainly think you get concierge service at our office. concierge service at our office. concierge service at our office. Concier medicine from the 80s and 90s Concier medicine from the 80s and 90s Concier medicine from the 80s and 90s was kind of double dipping. So I would was kind of double dipping. So I would was kind of double dipping. So I would still bill you fee for service for all still bill you fee for service for all still bill you fee for service for all the medical things, but I wanted a lower the medical things, but I wanted a lower the medical things, but I wanted a lower patient panel. So I just charge a patient panel. So I just charge a patient panel. So I just charge a retainer to get access to me. retainer to get access to me. retainer to get access to me. » Oh. » Oh. » Oh. » So So that's the biggest difference » So So that's the biggest difference » So So that's the biggest difference between concierge and direct primary between concierge and direct primary between concierge and direct primary care. So we are not concierge. We are we care. So we are not concierge. We are we care. So we are not concierge. We are we are not contracted with any insurance are not contracted with any insurance are not contracted with any insurance company to deliver care. All of our company to deliver care. All of our company to deliver care. All of our things is are based on based on things is are based on based on things is are based on based on membership. So I don't know if I membership. So I don't know if I membership. So I don't know if I answered your question, but we can. answered your question, but we can. answered your question, but we can. » No, no, no. It's great. Actually, that's » No, no, no. It's great. Actually, that's » No, no, no. It's great. Actually, that's really interesting. So like back in the really interesting. So like back in the really interesting. So like back in the day then was that just this doctor's day then was that just this doctor's day then was that just this doctor's that good. Here's my retainer if you that good. Here's my retainer if you that good. Here's my retainer if you want access and I do insurance and I want access and I do insurance and I want access and I do insurance and I don't want to see as many people. don't want to see as many people. don't want to see as many people. » Right. So I had a fancier office. I got » Right. So I had a fancier office. I got » Right. So I had a fancier office. I got a cup of coffee when I walked in. Right. a cup of coffee when I walked in. Right. a cup of coffee when I walked in. Right. The concierge was the experience and I The concierge was the experience and I The concierge was the experience and I » I wish Tyler handed me a cup of coffee » I wish Tyler handed me a cup of coffee » I wish Tyler handed me a cup of coffee when I walked in. when I walked in. when I walked in. » And the um Yeah, it's a way to add extra » And the um Yeah, it's a way to add extra » And the um Yeah, it's a way to add extra revenue that isn't the medical side. revenue that isn't the medical side. revenue that isn't the medical side. » Got it. We we don't Yeah. That that » Got it. We we don't Yeah. That that » Got it. We we don't Yeah. That that double dipping double dipping double dipping just isn't kind of what we're going just isn't kind of what we're going just isn't kind of what we're going for in our model. We get to take care of for in our model. We get to take care of for in our model. We get to take care of a broad range of people. So we take care a broad range of people. So we take care a broad range of people. So we take care of individuals. We take care of people of individuals. We take care of people of individuals. We take care of people from businesses. We we do a lot of from businesses. We we do a lot of from businesses. We we do a lot of different things. So So we're not different things. So So we're not different things. So So we're not concierge medicine. Most of DPC is is concierge medicine. Most of DPC is is concierge medicine. Most of DPC is is that some people will still some people that some people will still some people that some people will still some people try to try to do a hybrid practice, bill try to try to do a hybrid practice, bill try to try to do a hybrid practice, bill some insurance, don't there are very few some insurance, don't there are very few some insurance, don't there are very few like that. Those are just confusing to like that. Those are just confusing to like that. Those are just confusing to run and it's easy to get yourself in run and it's easy to get yourself in run and it's easy to get yourself in trouble uh doing the wrong thing or trouble uh doing the wrong thing or trouble uh doing the wrong thing or billing patient the wrong thing. So billing patient the wrong thing. So billing patient the wrong thing. So » conflict. » conflict. » conflict. » So we've been pure DPCs from the » So we've been pure DPCs from the » So we've been pure DPCs from the beginning. beginning. beginning. » Okay. » Okay. » Okay. » Um so you said there's 3,000 of them » Um so you said there's 3,000 of them » Um so you said there's 3,000 of them now. So I feel like the majority of now. So I feel like the majority of now. So I feel like the majority of people I talked to aren't in DPC or they people I talked to aren't in DPC or they people I talked to aren't in DPC or they have no and then I like try and explain have no and then I like try and explain have no and then I like try and explain it. it. it. » But if you're saying those aren't » But if you're saying those aren't » But if you're saying those aren't opening so they're still existing. So is opening so they're still existing. So is opening so they're still existing. So is there an is it is the education like there an is it is the education like there an is it is the education like when people are going through residency when people are going through residency when people are going through residency is it biased towards pushing them is it biased towards pushing them is it biased towards pushing them towards a hospital and an existing towards a hospital and an existing towards a hospital and an existing practice? So I think uh Nick and I were practice? So I think uh Nick and I were practice? So I think uh Nick and I were a little bit unique in that me going a little bit unique in that me going a little bit unique in that me going through the MD PhD program I didn't have through the MD PhD program I didn't have through the MD PhD program I didn't have any debt coming out of medical school any debt coming out of medical school any debt coming out of medical school » and Nick with kind of moonlighting and » and Nick with kind of moonlighting and » and Nick with kind of moonlighting and things was able to pay down debt very things was able to pay down debt very things was able to pay down debt very quickly. I think most people coming out quickly. I think most people coming out quickly. I think most people coming out of school are looking at $200 to of school are looking at $200 to of school are looking at $200 to $300,000 worth of debt and saying $300,000 worth of debt and saying $300,000 worth of debt and saying » I need I need a job that's going to pay » I need I need a job that's going to pay » I need I need a job that's going to pay me a salary so I can do this. And me a salary so I can do this. And me a salary so I can do this. And » and a lot of hospitals they'll they'll » and a lot of hospitals they'll they'll » and a lot of hospitals they'll they'll negotiate contracts with debt on the negotiate contracts with debt on the negotiate contracts with debt on the school. Is that school. Is that school. Is that » so sometimes will be a signing bonus, » so sometimes will be a signing bonus, » so sometimes will be a signing bonus, sometimes be loan repayment, sometimes be loan repayment, sometimes be loan repayment, sometimes will be things like that. Um but yeah, will be things like that. Um but yeah, will be things like that. Um but yeah, while people may start medical school while people may start medical school while people may start medical school very um idealistic, that gets beat out very um idealistic, that gets beat out very um idealistic, that gets beat out of you in these seven years of training. of you in these seven years of training. of you in these seven years of training. And so you come out of residency, you're And so you come out of residency, you're And so you come out of residency, you're tired, and you're like, well, I just tired, and you're like, well, I just tired, and you're like, well, I just want somebody to want somebody to want somebody to » So I our goal in growing is we want to » So I our goal in growing is we want to » So I our goal in growing is we want to provide a better place for physicians to provide a better place for physicians to provide a better place for physicians to practice and then allow people to get practice and then allow people to get practice and then allow people to get better primary care as well. Do you are better primary care as well. Do you are better primary care as well. Do you are you looking because obviously finding you looking because obviously finding you looking because obviously finding doctors is a big part of this that fit doctors is a big part of this that fit doctors is a big part of this that fit your model. Yeah. Um your model. Yeah. Um your model. Yeah. Um » Oh, we're hiring. Yes. All the time. » Oh, we're hiring. Yes. All the time. » Oh, we're hiring. Yes. All the time. Send them our way. Send them our way. Send them our way. » Uh are you are you around students quite » Uh are you are you around students quite » Uh are you are you around students quite a bit? Like are you looking for people a bit? Like are you looking for people a bit? Like are you looking for people coming out of residency or are you coming out of residency or are you coming out of residency or are you looking for people that are already have looking for people that are already have looking for people that are already have some experience that have been at a some experience that have been at a some experience that have been at a practice? practice? practice? » Both can work. Okay. We've done both. Um » Both can work. Okay. We've done both. Um » Both can work. Okay. We've done both. Um we three of our physicians practiced a we three of our physicians practiced a we three of our physicians practiced a little while in feif for service and little while in feif for service and little while in feif for service and then kind of joined direct then kind of joined direct then kind of joined direct primary care after that experience. primary care after that experience. primary care after that experience. three of our physicians um came right three of our physicians um came right three of our physicians um came right out of our residency doing that. So, out of our residency doing that. So, out of our residency doing that. So, it's both. But I don't I think that's on it's both. But I don't I think that's on it's both. But I don't I think that's on the physician side. I think you were the physician side. I think you were the physician side. I think you were asking a little patient side as well. asking a little patient side as well. asking a little patient side as well. » So, yeah, I'm just curious if it's » So, yeah, I'm just curious if it's » So, yeah, I'm just curious if it's exploding and there's 3,000 clinics now exploding and there's 3,000 clinics now exploding and there's 3,000 clinics now and there's only 200 10 years ago, and there's only 200 10 years ago, and there's only 200 10 years ago, right? Where it's over 10x, right? Where it's over 10x, right? Where it's over 10x, » but when you look at the number of » but when you look at the number of » but when you look at the number of providers total, that's still not a providers total, that's still not a providers total, that's still not a large number. large number. large number. » Got it. » Got it. » Got it. » If that makes sense. That does make » If that makes sense. That does make » If that makes sense. That does make sense. sense. sense. » It's a large it's a large increase over » It's a large it's a large increase over » It's a large it's a large increase over what used to exist. The vast majority of what used to exist. The vast majority of what used to exist. The vast majority of care is still delivered in the old care is still delivered in the old care is still delivered in the old system. So, system. So, system. So, » so let's talk about because you love to » so let's talk about because you love to » so let's talk about because you love to talk about insurance. Let's talk about talk about insurance. Let's talk about talk about insurance. Let's talk about health insurance comp. health insurance comp. health insurance comp. Yeah. Like everyone loves talking about Yeah. Like everyone loves talking about Yeah. Like everyone loves talking about health insurance. health insurance. health insurance. » Um, so like break that down for me » Um, so like break that down for me » Um, so like break that down for me because that was the model as a because that was the model as a because that was the model as a self-employed person that self-employed person that self-employed person that » was just a no-brainer with kids, right? » was just a no-brainer with kids, right? » was just a no-brainer with kids, right? Okay, I'm going to pay I don't know what Okay, I'm going to pay I don't know what Okay, I'm going to pay I don't know what we pay now. Is it 25? we pay now. Is it 25? we pay now. Is it 25? » What how much are kids now? » What how much are kids now? » What how much are kids now? » Um, an individual child membership is » Um, an individual child membership is » Um, an individual child membership is $39 a month. $39 a month. $39 a month. » $39. So, I pay 39 a month and I get » $39. So, I pay 39 a month and I get » $39. So, I pay 39 a month and I get unlimited primary care to my kid, right? unlimited primary care to my kid, right? unlimited primary care to my kid, right? And » as in we can text Dr. Nick and email Dr. » as in we can text Dr. Nick and email Dr. » as in we can text Dr. Nick and email Dr. Nick and show up when we need to and get Nick and show up when we need to and get Nick and show up when we need to and get the proper care. So, like with kids, the proper care. So, like with kids, the proper care. So, like with kids, life-changing, right? Like that's what I life-changing, right? Like that's what I life-changing, right? Like that's what I tell anybody. Like, if you have young tell anybody. Like, if you have young tell anybody. Like, if you have young kids, I mean, the amount of emergency kids, I mean, the amount of emergency kids, I mean, the amount of emergency room visits room visits room visits » we've been saved by Dr. Nick, like it's » we've been saved by Dr. Nick, like it's » we've been saved by Dr. Nick, like it's I I don't I should have counted that. I I don't I should have counted that. I I don't I should have counted that. That would have been a good case study. That would have been a good case study. That would have been a good case study. Yeah. Yeah. Yeah. » How many times would have I gone, which » How many times would have I gone, which » How many times would have I gone, which we did go before to like we probably we did go before to like we probably we did go before to like we probably have gone once. have gone once. have gone once. » And we we track that a little bit. The » And we we track that a little bit. The » And we we track that a little bit. The number of after hours calls we get if number of after hours calls we get if number of after hours calls we get if you assume a certain percentage of those you assume a certain percentage of those you assume a certain percentage of those would have been urgent care ER visits, would have been urgent care ER visits, would have been urgent care ER visits, » we are saving the saving the system a » we are saving the saving the system a » we are saving the saving the system a lot of unnecessary care for those. lot of unnecessary care for those. lot of unnecessary care for those. » Exactly. So that allowed us to think » Exactly. So that allowed us to think » Exactly. So that allowed us to think more strategic about our health more strategic about our health more strategic about our health insurance. Knowing we had access to insurance. Knowing we had access to insurance. Knowing we had access to that, we weren't as worried about our that, we weren't as worried about our that, we weren't as worried about our deductible. Yep. Um, so what is the deductible. Yep. Um, so what is the deductible. Yep. Um, so what is the And I feel like anytime I've talked to And I feel like anytime I've talked to And I feel like anytime I've talked to you, you're always like it's like this you, you're always like it's like this you, you're always like it's like this unicorn. You're trying to you're you're unicorn. You're trying to you're you're unicorn. You're trying to you're you're packaging it together. You're always packaging it together. You're always packaging it together. You're always thinking through what is the perfect thinking through what is the perfect thinking through what is the perfect » combination. Um » combination. Um » combination. Um » I think um » I think um » I think um » I think people don't understand health » I think people don't understand health » I think people don't understand health insurance and health insurance doesn't insurance and health insurance doesn't insurance and health insurance doesn't work like work like work like any other insurance you're used to. And any other insurance you're used to. And any other insurance you're used to. And so I I can't I can't remember if I've so I I can't I can't remember if I've so I I can't I can't remember if I've said this to you before, but I haven't said this to you before, but I haven't said this to you before, but I haven't said this to you on camera before. So said this to you on camera before. So said this to you on camera before. So » yeah, » yeah, » yeah, » uh I I do a little thought experiment » uh I I do a little thought experiment » uh I I do a little thought experiment and so um and so um and so um you have homeowners insurance, right? you have homeowners insurance, right? you have homeowners insurance, right? You you own a home. You you own a home. You you own a home. » When do you expect to use your » When do you expect to use your » When do you expect to use your homeowners insurance? homeowners insurance? homeowners insurance? » In a disaster, » In a disaster, » In a disaster, » right? Right. You you really never want » right? Right. You you really never want » right? Right. You you really never want to use your homeowner insurance. to use your homeowner insurance. to use your homeowner insurance. » We've somehow equated health insurance » We've somehow equated health insurance » We've somehow equated health insurance instead of like, hey, I should use this instead of like, hey, I should use this instead of like, hey, I should use this when something really bad happens to I when something really bad happens to I when something really bad happens to I have to have this thing in order to have to have this thing in order to have to have this thing in order to access any care. And so we would never access any care. And so we would never access any care. And so we would never think about that with our car either. think about that with our car either. think about that with our car either. So, car insurance. I'm only planning to So, car insurance. I'm only planning to So, car insurance. I'm only planning to use this if my car is like totaled. If use this if my car is like totaled. If use this if my car is like totaled. If my car has to be towed away, I'm my car has to be towed away, I'm my car has to be towed away, I'm planning to use my car insurance. If you planning to use my car insurance. If you planning to use my car insurance. If you get a chip on your windshield, are you get a chip on your windshield, are you get a chip on your windshield, are you taking that? Are you're running that taking that? Are you're running that taking that? Are you're running that through your auto insurance? Almost through your auto insurance? Almost through your auto insurance? Almost never, right? never, right? never, right? » Yeah. » Yeah. » Yeah. » So, so we've we've trained people the » So, so we've we've trained people the » So, so we've we've trained people the wrong way with health insurance to think wrong way with health insurance to think wrong way with health insurance to think like, I have to have this in order to like, I have to have this in order to like, I have to have this in order to access care and the system is then is access care and the system is then is access care and the system is then is then built around that. then built around that. then built around that. Really, for something to be an insurable Really, for something to be an insurable Really, for something to be an insurable event, it has to meet two criteria. has event, it has to meet two criteria. has event, it has to meet two criteria. has to be rare and it has to be like to be rare and it has to be like to be rare and it has to be like financially catastrophic. financially catastrophic. financially catastrophic. » Yeah. » Yeah. » Yeah. » When your kid gets a cough, is that » When your kid gets a cough, is that » When your kid gets a cough, is that rare? rare? rare? » No. » No. » No. » Is it financially catastrophic? » Is it financially catastrophic? » Is it financially catastrophic? » Right. No. » Right. No. » Right. No. » No. So, it shouldn't be insured, right? » No. So, it shouldn't be insured, right? » No. So, it shouldn't be insured, right? » So, I think that's what people need to » So, I think that's what people need to » So, I think that's what people need to start with is like, I should really only start with is like, I should really only start with is like, I should really only be using insurance when it's an be using insurance when it's an be using insurance when it's an unexpected event that is really unexpected event that is really unexpected event that is really expensive. expensive. expensive. » Yeah. » Yeah. » Yeah. » Even something like getting an ACL » Even something like getting an ACL » Even something like getting an ACL repair. The cost of an ACL repair is repair. The cost of an ACL repair is repair. The cost of an ACL repair is like $8,000. that is less than mo most like $8,000. that is less than mo most like $8,000. that is less than mo most people's car. Mo most people don't use people's car. Mo most people don't use people's car. Mo most people don't use their auto insurance to purchase a new their auto insurance to purchase a new their auto insurance to purchase a new car, right? They plan for this and they car, right? They plan for this and they car, right? They plan for this and they fund it. And an ACL repair is not fund it. And an ACL repair is not fund it. And an ACL repair is not something that has to be done like something that has to be done like something that has to be done like tomorrow you'll die. Something that's tomorrow you'll die. Something that's tomorrow you'll die. Something that's done over weeks. done over weeks. done over weeks. » So I I think just the way we've » So I I think just the way we've » So I I think just the way we've approached insurance has led to well now approached insurance has led to well now approached insurance has led to well now care has to fit in this box and care has to fit in this box and care has to fit in this box and care then is the lowest common denominator then is the lowest common denominator then is the lowest common denominator care. So if you fix the way we deliver care. So if you fix the way we deliver care. So if you fix the way we deliver care, insurance can then be over here on care, insurance can then be over here on care, insurance can then be over here on the side. I should have accessible the side. I should have accessible the side. I should have accessible um care for lots of the accessible um care for lots of the accessible um care for lots of the things I need. I should be able to pay a things I need. I should be able to pay a things I need. I should be able to pay a little to protect myself against the little to protect myself against the little to protect myself against the unknowns. I think the other thing is unknowns. I think the other thing is unknowns. I think the other thing is that most of that most of that most of most bankruptcies have a healthcare most bankruptcies have a healthcare most bankruptcies have a healthcare component to them. And so even people component to them. And so even people component to them. And so even people who are insured, it's not even who are insured, it's not even who are insured, it's not even protecting them from the thing that it's protecting them from the thing that it's protecting them from the thing that it's supposed to be protecting them. It's not supposed to be protecting them. It's not supposed to be protecting them. It's not protecting them financially. So yeah, protecting them financially. So yeah, protecting them financially. So yeah, the whole space of how we've chosen to the whole space of how we've chosen to the whole space of how we've chosen to ensure health in our in our country has ensure health in our in our country has ensure health in our in our country has is just like it's perversely is just like it's perversely is just like it's perversely incentivized. So incentivized. So incentivized. So » yeah, that's a really good take. No, » yeah, that's a really good take. No, » yeah, that's a really good take. No, you've not said that before. That's a you've not said that before. That's a you've not said that before. That's a really good really good really good » good. » good. » good. » So there are ways there are ways to fix » So there are ways there are ways to fix » So there are ways there are ways to fix that. that. that. » Yeah. » Yeah. » Yeah. » But » But » But » so break that down for me. What today? » so break that down for me. What today? » so break that down for me. What today? Um Um Um so let's just talk about somebody has a so let's just talk about somebody has a so let's just talk about somebody has a job, right? Um so for example, and you job, right? Um so for example, and you job, right? Um so for example, and you and I talked about this. My wife just and I talked about this. My wife just and I talked about this. My wife just started working at the nursing program started working at the nursing program started working at the nursing program at Butler, right? and she got at Butler, right? and she got at Butler, right? and she got insurance and I and I said I verbat him insurance and I and I said I verbat him insurance and I and I said I verbat him I don't know if you remember this I said I don't know if you remember this I said I don't know if you remember this I said yeah she got great insurance you go well yeah she got great insurance you go well yeah she got great insurance you go well I don't know if it's great um but break I don't know if it's great um but break I don't know if it's great um but break that down someone's working somewhere that down someone's working somewhere that down someone's working somewhere and they think they have great and they think they have great and they think they have great insurance » why go DPC yeah if they feel like » why go DPC yeah if they feel like » why go DPC yeah if they feel like they've already got right a great setup they've already got right a great setup they've already got right a great setup » I think what people don't see is what's » I think what people don't see is what's » I think what people don't see is what's taken out of their paycheck so taken out of their paycheck so taken out of their paycheck so » sure » sure » sure » if you work at a let's say you work at a » if you work at a let's say you work at a » if you work at a let's say you work at a 100 person company. What do you think 100 person company. What do you think 100 person company. What do you think the average premium cost for an the average premium cost for an the average premium cost for an insurance plan is for a somebody who's insurance plan is for a somebody who's insurance plan is for a somebody who's fully insured at a 100% company? For a fully insured at a 100% company? For a fully insured at a 100% company? For a family » for a whole family? » for a whole family? » for a whole family? » Yeah. For the year? » Yeah. For the year? » Yeah. For the year? » Like Oh, for the year. Yeah. 25 35 » Like Oh, for the year. Yeah. 25 35 » Like Oh, for the year. Yeah. 25 35 grand. grand. grand. » Yeah. So, like $27,000. » Yeah. So, like $27,000. » Yeah. So, like $27,000. » So, would you rather have that money in » So, would you rather have that money in » So, would you rather have that money in cash and you figure out your own cash and you figure out your own cash and you figure out your own insurance or would you rather pay for a insurance or would you rather pay for a insurance or would you rather pay for a Blue Cross card in your pocket? Right. Blue Cross card in your pocket? Right. Blue Cross card in your pocket? Right. » Which they don't normally do, right? » Which they don't normally do, right? » Which they don't normally do, right? » They Yeah. So the tax structures don't » They Yeah. So the tax structures don't » They Yeah. So the tax structures don't often allow them to often allow them to often allow them to » because if they give it to you as if » because if they give it to you as if » because if they give it to you as if they give it to you as cash, you have to they give it to you as cash, you have to they give it to you as cash, you have to pay taxes on it. If they give it to an pay taxes on it. If they give it to an pay taxes on it. If they give it to an insurance company, it's a it's a tax insurance company, it's a it's a tax insurance company, it's a it's a taxfree » Yeah. I I mean it makes sense if if if I » Yeah. I I mean it makes sense if if if I » Yeah. I I mean it makes sense if if if I knew there was an option or I knew where knew there was an option or I knew where knew there was an option or I knew where to go or I knew where to start. That'd to go or I knew where to start. That'd to go or I knew where to start. That'd be one thing. It's like even knowing be one thing. It's like even knowing be one thing. It's like even knowing that I could find something better or that I could find something better or that I could find something better or even just the headache of nobody wants even just the headache of nobody wants even just the headache of nobody wants to go figure that out you. But I think to go figure that out you. But I think to go figure that out you. But I think what's really happening is B because what's really happening is B because what's really happening is B because we've tied that's another thing that we've tied that's another thing that we've tied that's another thing that doesn't have to be this way but doesn't have to be this way but doesn't have to be this way but currently is that way the tax incentive currently is that way the tax incentive currently is that way the tax incentive for a business to provide the healthcare for a business to provide the healthcare for a business to provide the healthcare for its employees means that's a lets us for its employees means that's a lets us for its employees means that's a lets us you know that has to happen you know that has to happen you know that has to happen » what's really happening is those hundred » what's really happening is those hundred » what's really happening is those hundred people are taking functionally $300,000 people are taking functionally $300,000 people are taking functionally $300,000 a year and handing it to an HR person a year and handing it to an HR person a year and handing it to an HR person and saying spend this money well and saying spend this money well and saying spend this money well » does that HR person is that person » does that HR person is that person » does that HR person is that person expert in healthcare Probably not. expert in healthcare Probably not. expert in healthcare Probably not. » No, not at all. And so we we've » No, not at all. And so we we've » No, not at all. And so we we've there's this term in a book they there's this term in a book they there's this term in a book they call this proxy buyers, right? So call this proxy buyers, right? So call this proxy buyers, right? So employees have turned their employers employees have turned their employers employees have turned their employers into proxy buyers for their healthcare into proxy buyers for their healthcare into proxy buyers for their healthcare when that is not their expertise. when that is not their expertise. when that is not their expertise. » If you want to f further follow the » If you want to f further follow the » If you want to f further follow the incentives, so I'm a CFO or and then the incentives, so I'm a CFO or and then the incentives, so I'm a CFO or and then the HR person and I have to pick healthcare. HR person and I have to pick healthcare. HR person and I have to pick healthcare. Well, if you don't know what you're Well, if you don't know what you're Well, if you don't know what you're doing, what do you do next? Like if your doing, what do you do next? Like if your doing, what do you do next? Like if your car breaks down, who you go to? car breaks down, who you go to? car breaks down, who you go to? » Yeah. Mechanic. » Yeah. Mechanic. » Yeah. Mechanic. » You go to a mechanic. So you go to next » You go to a mechanic. So you go to next » You go to a mechanic. So you go to next insurance broker. Yeah. So, an insurance broker. Yeah. So, an insurance broker. Yeah. So, an insurance broker and some of them are great. broker and some of them are great. broker and some of them are great. Um, a lot of them uh they are oftentimes Um, a lot of them uh they are oftentimes Um, a lot of them uh they are oftentimes paid on a commission if they're selling paid on a commission if they're selling paid on a commission if they're selling you blue cross. So, if your insurance you blue cross. So, if your insurance you blue cross. So, if your insurance gets more expensive, does the broker gets more expensive, does the broker gets more expensive, does the broker make more or less money? make more or less money? make more or less money? » I'd assume more » I'd assume more » I'd assume more » makes more money percentage. » makes more money percentage. » makes more money percentage. » So, a lot of the incentives are even » So, a lot of the incentives are even » So, a lot of the incentives are even this expert who's helping them, this expert who's helping them, this expert who's helping them, » there's not a ton of incentives to drive » there's not a ton of incentives to drive » there's not a ton of incentives to drive you to the right cost. It's drive you to you to the right cost. It's drive you to you to the right cost. It's drive you to what's easy, renewable, and I get I get what's easy, renewable, and I get I get what's easy, renewable, and I get I get paid. And when $27,000 a year is going paid. And when $27,000 a year is going paid. And when $27,000 a year is going towards just the premium, well then I towards just the premium, well then I towards just the premium, well then I don't want to get any care because I've don't want to get any care because I've don't want to get any care because I've already spent all this money, right? I'm already spent all this money, right? I'm already spent all this money, right? I'm not going to do DPC because I'm already not going to do DPC because I'm already not going to do DPC because I'm already spending this money. My money's already spending this money. My money's already spending this money. My money's already been spent on something that's low been spent on something that's low been spent on something that's low quality. There's this there's this quality. There's this there's this quality. There's this there's this shift. So what we've done and we're shift. So what we've done and we're shift. So what we've done and we're probably as deep as anyone into this of probably as deep as anyone into this of probably as deep as anyone into this of partnering with businesses to say, hey, partnering with businesses to say, hey, partnering with businesses to say, hey, when you when you have like all of this when you when you have like all of this when you when you have like all of this easy care accessible, build a plan easy care accessible, build a plan easy care accessible, build a plan around this. If all of this care is around this. If all of this care is around this. If all of this care is accessible, you can pay a lot less for accessible, you can pay a lot less for accessible, you can pay a lot less for the insurance side when we can do when the insurance side when we can do when the insurance side when we can do when we can solve all these problems on the we can solve all these problems on the we can solve all these problems on the primary care side. So, we've partnered primary care side. So, we've partnered primary care side. So, we've partnered with several medium to large size with several medium to large size with several medium to large size companies to to kind of redo their companies to to kind of redo their companies to to kind of redo their health plan around this type of primary health plan around this type of primary health plan around this type of primary care and that makes all the other care and that makes all the other care and that makes all the other downstream decisions easier if that downstream decisions easier if that downstream decisions easier if that makes sense. makes sense. makes sense. » Yeah. No, it does. Um, so walk me » Yeah. No, it does. Um, so walk me » Yeah. No, it does. Um, so walk me through that. I'm curious because if through that. I'm curious because if through that. I'm curious because if you're that's almost like a lead funnel you're that's almost like a lead funnel you're that's almost like a lead funnel for you on the direct primary care side, for you on the direct primary care side, for you on the direct primary care side, but then you're also helping them with but then you're also helping them with but then you're also helping them with the insurance side. So, do you have a the insurance side. So, do you have a the insurance side. So, do you have a brokerage or a brokerage you prefer or brokerage or a brokerage you prefer or brokerage or a brokerage you prefer or refer when you're putting these things refer when you're putting these things refer when you're putting these things together? together? together? » We've done some in the past, we've done » We've done some in the past, we've done » We've done some in the past, we've done some of it ourselves. We are working now some of it ourselves. We are working now some of it ourselves. We are working now more and partnering with people who as more and partnering with people who as more and partnering with people who as they see costs going up and up and up. they see costs going up and up and up. they see costs going up and up and up. Employers are coming to them and say, Employers are coming to them and say, Employers are coming to them and say, "Hey, we need better solutions than "Hey, we need better solutions than "Hey, we need better solutions than this. We we can't just keep paying 10% this. We we can't just keep paying 10% this. We we can't just keep paying 10% more a year." 2026 has been the some of more a year." 2026 has been the some of more a year." 2026 has been the some of the highest healthcare increases ever. the highest healthcare increases ever. the highest healthcare increases ever. So, people are now looking to solutions. So, people are now looking to solutions. So, people are now looking to solutions. Well, now if I get this bundle of care Well, now if I get this bundle of care Well, now if I get this bundle of care for a fixed price at a much at a much for a fixed price at a much at a much for a fixed price at a much at a much lower cost, it allows me to be creative lower cost, it allows me to be creative lower cost, it allows me to be creative with the other things I do. You're with the other things I do. You're with the other things I do. You're starting to see specialists do this as starting to see specialists do this as starting to see specialists do this as well and being transparent in their well and being transparent in their well and being transparent in their prices. So, what this allows, you know, prices. So, what this allows, you know, prices. So, what this allows, you know, you take that um you take that um you take that um um um um I guess maybe going back to this a I guess maybe going back to this a I guess maybe going back to this a little bit. So, that 100% company on little bit. So, that 100% company on little bit. So, that 100% company on average a business is going to spend average a business is going to spend average a business is going to spend about $10,000 per employee per year. um about $10,000 per employee per year. um about $10,000 per employee per year. um on their care. So that's a million on their care. So that's a million on their care. So that's a million dollars, right? dollars, right? dollars, right? » So it allows them to take that million » So it allows them to take that million » So it allows them to take that million dollars and buy healthcare at the right dollars and buy healthcare at the right dollars and buy healthcare at the right price for the common things. So your price for the common things. So your price for the common things. So your colonoscopies, your MRIs, your primary colonoscopies, your MRIs, your primary colonoscopies, your MRIs, your primary care, your sutures, even up things care, your sutures, even up things care, your sutures, even up things up to a knee replacement, right? Those up to a knee replacement, right? Those up to a knee replacement, right? Those are all steerable known cost things. If are all steerable known cost things. If are all steerable known cost things. If if I'm doing all that at the right if I'm doing all that at the right if I'm doing all that at the right price, not going through insurance for price, not going through insurance for price, not going through insurance for those things, I can spend much less on those things, I can spend much less on those things, I can spend much less on just the rare things on the cancers and just the rare things on the cancers and just the rare things on the cancers and the car accidents and the things like the car accidents and the things like the car accidents and the things like that. So, you get people way better care that. So, you get people way better care that. So, you get people way better care um by picking this type of primary care, um by picking this type of primary care, um by picking this type of primary care, right? Because right? Because right? Because » most of the people, they're so scared of » most of the people, they're so scared of » most of the people, they're so scared of their deductible and their copay, I'm their deductible and their copay, I'm their deductible and their copay, I'm just going to avoid care until I have to just going to avoid care until I have to just going to avoid care until I have to go to the ER, right? go to the ER, right? go to the ER, right? » I think that's very real. » I think that's very real. » I think that's very real. » So, you're getting So, yeah, as the » So, you're getting So, yeah, as the » So, you're getting So, yeah, as the business, if I make a different business, if I make a different business, if I make a different decision, I can get my people way more decision, I can get my people way more decision, I can get my people way more for less money is the goal. So, for less money is the goal. So, for less money is the goal. So, » yeah. Yeah. » yeah. Yeah. » yeah. Yeah. » So value. So, so savings, but then also » So value. So, so savings, but then also » So value. So, so savings, but then also better care is the ultimate goal. better care is the ultimate goal. better care is the ultimate goal. » Value is the right term. Yeah. » Value is the right term. Yeah. » Value is the right term. Yeah. » Value because Yeah. You're not saying » Value because Yeah. You're not saying » Value because Yeah. You're not saying like, "Hey, this is also this is cheaper like, "Hey, this is also this is cheaper like, "Hey, this is also this is cheaper and I promise it's better." and I promise it's better." and I promise it's better." » You lead with cheap. It's » You lead with cheap. It's » You lead with cheap. It's » the And it is this it is this strange » the And it is this it is this strange » the And it is this it is this strange thing. It's like you're telling me I'm thing. It's like you're telling me I'm thing. It's like you're telling me I'm going to save money and I'm going to get going to save money and I'm going to get going to save money and I'm going to get something that's a way better something that's a way better something that's a way better experience. And the answer is yes. And experience. And the answer is yes. And experience. And the answer is yes. And people just don't believe you when you people just don't believe you when you people just don't believe you when you tell them that. But the people who have tell them that. But the people who have tell them that. But the people who have experienced it, experienced it, experienced it, » they usually don't go back. if that » they usually don't go back. if that » they usually don't go back. if that makes sense. makes sense. makes sense. » So, I I'm curious on uh when you have » So, I I'm curious on uh when you have » So, I I'm curious on uh when you have kids and Haley and I have talked about kids and Haley and I have talked about kids and Haley and I have talked about this, like if if you just got two this, like if if you just got two this, like if if you just got two adults, they have no kids adults, they have no kids adults, they have no kids » and they, you know, they never or they » and they, you know, they never or they » and they, you know, they never or they go once a year to the doctor. go once a year to the doctor. go once a year to the doctor. » Um what your DPC percentage I'm curious » Um what your DPC percentage I'm curious » Um what your DPC percentage I'm curious how much of it's like family versus just how much of it's like family versus just how much of it's like family versus just single adults or couples. Um single adults or couples. Um single adults or couples. Um » we we're a little bit weird in that » we we're a little bit weird in that » we we're a little bit weird in that sense. So, um because we do some extra sense. So, um because we do some extra sense. So, um because we do some extra things. So, things. So, things. So, Dr. Elson does a lot of women's health. Dr. Elson does a lot of women's health. Dr. Elson does a lot of women's health. I still do obstetrics. Dr. Nick used to I still do obstetrics. Dr. Nick used to I still do obstetrics. Dr. Nick used to do obstetrics. Uh, deliver babies. do obstetrics. Uh, deliver babies. do obstetrics. Uh, deliver babies. » Oh, gotcha. » Oh, gotcha. » Oh, gotcha. » Um, uh, we most DPCs are around 10 to » Um, uh, we most DPCs are around 10 to » Um, uh, we most DPCs are around 10 to 15% pediatrics. We are much higher. 15% pediatrics. We are much higher. 15% pediatrics. We are much higher. We're like 30% pediatrics. Okay. We're like 30% pediatrics. Okay. We're like 30% pediatrics. Okay. » So, our families and, um, peds are » So, our families and, um, peds are » So, our families and, um, peds are higher than most, but we're about Yeah. higher than most, but we're about Yeah. higher than most, but we're about Yeah. 70% adult, 30% pediatrics. 70% adult, 30% pediatrics. 70% adult, 30% pediatrics. » So, so I was wrong in my assumption. My » So, so I was wrong in my assumption. My » So, so I was wrong in my assumption. My assumption was the majority of your uh assumption was the majority of your uh assumption was the majority of your uh uh members would be kids like uh members would be kids like uh members would be kids like pediatrics. pediatrics. pediatrics. » Interesting. » Interesting. » Interesting. » Most of them most of them are adults and » Most of them most of them are adults and » Most of them most of them are adults and so that comes from individuals. So I I so that comes from individuals. So I I so that comes from individuals. So I I think of us as taking care of kind of think of us as taking care of kind of think of us as taking care of kind of three buckets of people. Some are three buckets of people. Some are three buckets of people. Some are uninsured, right? They for whatever uninsured, right? They for whatever uninsured, right? They for whatever reason they own their own business. They reason they own their own business. They reason they own their own business. They they're they're uninsured in the eyes of they're they're uninsured in the eyes of they're they're uninsured in the eyes of the traditional healthare system. But the traditional healthare system. But the traditional healthare system. But they see us as like well I'm I'm late they see us as like well I'm I'm late they see us as like well I'm I'm late 40s early 50s. I know I have healthcare 40s early 50s. I know I have healthcare 40s early 50s. I know I have healthcare problems. I know I'm going to need problems. I know I'm going to need problems. I know I'm going to need medications. I know I'm going to leave medications. I know I'm going to leave medications. I know I'm going to leave labs. labs. labs. » Hey, I can get all this through Antioch » Hey, I can get all this through Antioch » Hey, I can get all this through Antioch uh through for a known cost. I didn't go uh through for a known cost. I didn't go uh through for a known cost. I didn't go into this, but into this, but into this, but » everybody is usually aware of like cost » everybody is usually aware of like cost » everybody is usually aware of like cost plus drugs now. And I think that's a plus drugs now. And I think that's a plus drugs now. And I think that's a great resource. great resource. great resource. » We have 200 drugs that are all cheaper » We have 200 drugs that are all cheaper » We have 200 drugs that are all cheaper than his, if that makes sense. So, when than his, if that makes sense. So, when than his, if that makes sense. So, when you become a member, you have access to you become a member, you have access to you become a member, you have access to those medications that are less. If you those medications that are less. If you those medications that are less. If you go and get a lab test through your go and get a lab test through your go and get a lab test through your insurance, um the most five most common insurance, um the most five most common insurance, um the most five most common labs are a a CMP, an A1C, a thyroid labs are a a CMP, an A1C, a thyroid labs are a a CMP, an A1C, a thyroid test, a blood count, um and a lipid test, a blood count, um and a lipid test, a blood count, um and a lipid panel. Often times people go get that panel. Often times people go get that panel. Often times people go get that done their insurance and what they're done their insurance and what they're done their insurance and what they're paying out of pocket is a couple paying out of pocket is a couple paying out of pocket is a couple hundred, right? Just even towards their hundred, right? Just even towards their hundred, right? Just even towards their deductible. Antioch that those five deductible. Antioch that those five deductible. Antioch that those five tests are like $40. tests are like $40. tests are like $40. » Yeah. » Yeah. » Yeah. » So, we're building other things in that » So, we're building other things in that » So, we're building other things in that the membership is more valuable for that the membership is more valuable for that the membership is more valuable for that as well. So we get a lot of people in as well. So we get a lot of people in as well. So we get a lot of people in that bucket of uninsured, but I know the that bucket of uninsured, but I know the that bucket of uninsured, but I know the cost of everything. We then have the cost of everything. We then have the cost of everything. We then have the business bucket. So we take care of business bucket. So we take care of business bucket. So we take care of about 70 businesses in Witchah or in the about 70 businesses in Witchah or in the about 70 businesses in Witchah or in the Witchaw and the surrounding areas. We Witchaw and the surrounding areas. We Witchaw and the surrounding areas. We take care of school districts, take care take care of school districts, take care take care of school districts, take care of and you know um oil and gas of and you know um oil and gas of and you know um oil and gas companies. They send all their people to companies. They send all their people to companies. They send all their people to us to get their primary care. And then us to get their primary care. And then us to get their primary care. And then we have people that are insured but they we have people that are insured but they we have people that are insured but they don't want to go wait an hour to see don't want to go wait an hour to see don't want to go wait an hour to see their doctor. And so they come because their doctor. And so they come because their doctor. And so they come because of the experience we give them, too. So of the experience we give them, too. So of the experience we give them, too. So those are kind of the buckets of people those are kind of the buckets of people those are kind of the buckets of people we take care of. And and that's the we take care of. And and that's the we take care of. And and that's the hardest part to probably sell, I'm hardest part to probably sell, I'm hardest part to probably sell, I'm assuming. Um because we're in that assuming. Um because we're in that assuming. Um because we're in that category, like do we we're a member category, like do we we're a member category, like do we we're a member because of the experience and the level because of the experience and the level because of the experience and the level of care, right? Like we're we're of care, right? Like we're we're of care, right? Like we're we're insured. We have a low deductible. Yeah. insured. We have a low deductible. Yeah. insured. We have a low deductible. Yeah. » But we want better care, right? Like and » But we want better care, right? Like and » But we want better care, right? Like and we're willing to spend for better care. we're willing to spend for better care. we're willing to spend for better care. What what is the most common What what is the most common What what is the most common misconception uh about your practice or misconception uh about your practice or misconception uh about your practice or DPCs in general? DPCs in general? DPCs in general? » Yeah, I think that is concierge » Yeah, I think that is concierge » Yeah, I think that is concierge medicine. medicine. medicine. » The concierge. Yeah. And I think the » The concierge. Yeah. And I think the » The concierge. Yeah. And I think the misconception of double paying, like I misconception of double paying, like I misconception of double paying, like I have insurance, why would I do this? have insurance, why would I do this? have insurance, why would I do this? It's like, It's like, It's like, » and that's what everyone always says to » and that's what everyone always says to » and that's what everyone always says to me when I refer bring it up. They're me when I refer bring it up. They're me when I refer bring it up. They're always like, "Oh, why would I?" And they always like, "Oh, why would I?" And they always like, "Oh, why would I?" And they start doing the math, right? They start doing the math, right? They start doing the math, right? They start doing the math like, "Well, doing the math like, "Well, doing the math like, "Well, » I only went to the doctor like once last » I only went to the doctor like once last » I only went to the doctor like once last four months." And I'm like, "Well, maybe four months." And I'm like, "Well, maybe four months." And I'm like, "Well, maybe you should have gone." you should have gone." you should have gone." » Yeah. And I think that's um a lot of » Yeah. And I think that's um a lot of » Yeah. And I think that's um a lot of what we do in primary care is what we do in primary care is what we do in primary care is preventative health as well. And so, and preventative health as well. And so, and preventative health as well. And so, and we are moving the I hate the term we are moving the I hate the term we are moving the I hate the term wellness. It's like the worst term of wellness. It's like the worst term of wellness. It's like the worst term of all cuz most of it's most of it snake. all cuz most of it's most of it snake. all cuz most of it's most of it snake. Why do you hate wellness? You're a Why do you hate wellness? You're a Why do you hate wellness? You're a doctor for curing a lot. doctor for curing a lot. doctor for curing a lot. » I hate the term wellness. Uh most of » I hate the term wellness. Uh most of » I hate the term wellness. Uh most of it's snake oil is why I hate it. it's snake oil is why I hate it. it's snake oil is why I hate it. » Um but I think there is an evidence base » Um but I think there is an evidence base » Um but I think there is an evidence base that even if I'm even if I'm late 30s, that even if I'm even if I'm late 30s, that even if I'm even if I'm late 30s, early 40s, there are things you should early 40s, there are things you should early 40s, there are things you should be doing to prepare for your 50s and be doing to prepare for your 50s and be doing to prepare for your 50s and 60s. 60s. 60s. » And a medical clinic should help you do » And a medical clinic should help you do » And a medical clinic should help you do that. It shouldn't just say, "Ah, you're that. It shouldn't just say, "Ah, you're that. It shouldn't just say, "Ah, you're mostly healthy, CIA." It's like, well, mostly healthy, CIA." It's like, well, mostly healthy, CIA." It's like, well, » how can we help you be healthy when » how can we help you be healthy when » how can we help you be healthy when you're 60 even though you're 38 now? So you're 60 even though you're 38 now? So you're 60 even though you're 38 now? So » So preventative, you prefer preventative » So preventative, you prefer preventative » So preventative, you prefer preventative the term over wellness. I like the term over wellness. I like the term over wellness. I like evidence-based wellness. That's evidence-based wellness. That's evidence-based wellness. That's » evidence based term I'm trying to » evidence based term I'm trying to » evidence based term I'm trying to promote. I don't I I don't know if I promote. I don't I I don't know if I promote. I don't I I don't know if I came up with it. I don't know if I've came up with it. I don't know if I've came up with it. I don't know if I've seen it anywhere else. seen it anywhere else. seen it anywhere else. » So, just evidence-based wellness to » So, just evidence-based wellness to » So, just evidence-based wellness to avoid snake oils. Is that the avoid snake oils. Is that the avoid snake oils. Is that the » Yeah. So, I mean, like people come and » Yeah. So, I mean, like people come and » Yeah. So, I mean, like people come and they're on like seven different they're on like seven different they're on like seven different supplements and all these supplements and all these supplements and all these supplements have 20 ingredients and I'm just like I have 20 ingredients and I'm just like I have 20 ingredients and I'm just like I don't know what these are doing for you. don't know what these are doing for you. don't know what these are doing for you. I think there's probably five good I think there's probably five good I think there's probably five good supplements you can take and if you supplements you can take and if you supplements you can take and if you bought them at Amazon, they were going bought them at Amazon, they were going bought them at Amazon, they were going to be this price. We can get you them to be this price. We can get you them to be this price. We can get you them for 30% less. for 30% less. for 30% less. » Can you source creatine? Yeah. » Can you source creatine? Yeah. » Can you source creatine? Yeah. » What do you think of creatine? » What do you think of creatine? » What do you think of creatine? » Um, there's pretty good evidence for » Um, there's pretty good evidence for » Um, there's pretty good evidence for that. It that's one of those things that. It that's one of those things that. It that's one of those things where it's not like life-changing, but where it's not like life-changing, but where it's not like life-changing, but it's a little bit of a no-brainer, if it's a little bit of a no-brainer, if it's a little bit of a no-brainer, if that makes sense. It's not going to It's that makes sense. It's not going to It's that makes sense. It's not going to It's That is a very low risk. That is a very low risk. That is a very low risk. » It's not going to cure cancer, but » It's not going to cure cancer, but » It's not going to cure cancer, but » it's a very low risk of hurting anybody, » it's a very low risk of hurting anybody, » it's a very low risk of hurting anybody, but as far as like preserving muscle but as far as like preserving muscle but as far as like preserving muscle mass as people get older. There may be mass as people get older. There may be mass as people get older. There may be some cognitive benefits to it. So, I some cognitive benefits to it. So, I some cognitive benefits to it. So, I mean, I take that each day. So, mean, I take that each day. So, mean, I take that each day. So, » yeah. So, but » yeah. So, but » yeah. So, but » and you can get it if you want it, you » and you can get it if you want it, you » and you can get it if you want it, you can get it cheaper at our office. See, can get it cheaper at our office. See, can get it cheaper at our office. See, you're even a member and you don't you're even a member and you don't you're even a member and you don't you don't even know what you don't even know don't even know what you don't even know don't even know what you don't even know what we do. So, I would say that's the what we do. So, I would say that's the what we do. So, I would say that's the misconception too is like people don't misconception too is like people don't misconception too is like people don't even realize the number of things we can even realize the number of things we can even realize the number of things we can do even when they've been even when do even when they've been even when do even when they've been even when they've been they've been they've been » Dr. Nick right now. » Dr. Nick right now. » Dr. Nick right now. » I need creatine. » I need creatine. » I need creatine. So yeah, th those are the types of So yeah, th those are the types of So yeah, th those are the types of things of just like yeah being Costco of things of just like yeah being Costco of things of just like yeah being Costco of once you're in here anything related to once you're in here anything related to once you're in here anything related to your health and wellness anything your health and wellness anything your health and wellness anything you see on TV that's a online advertisement see on TV that's a online advertisement see on TV that's a online advertisement Antioch does better and cheaper and Antioch does better and cheaper and Antioch does better and cheaper and people just don't know about it. So all people just don't know about it. So all people just don't know about it. So all the stupid kings skincare that's being the stupid kings skincare that's being the stupid kings skincare that's being sold we have all of those things better sold we have all of those things better sold we have all of those things better and cheaper at our office. and cheaper at our office. and cheaper at our office. » Maybe that should be your advertising. » Maybe that should be your advertising. » Maybe that should be your advertising. » All the weight loss drugs we have those » All the weight loss drugs we have those » All the weight loss drugs we have those better and cheaper at our office. better and cheaper at our office. better and cheaper at our office. All all the anything. So that should be All all the anything. So that should be All all the anything. So that should be advertising as other people's advertising as other people's advertising as other people's commercials and then just end with like commercials and then just end with like commercials and then just end with like we got you better. We do better and we got you better. We do better and we got you better. We do better and cheaper every time. cheaper every time. cheaper every time. » So » So » So » that's awesome. Uh growth model » that's awesome. Uh growth model » that's awesome. Uh growth model for you guys and your limitations of for you guys and your limitations of for you guys and your limitations of growth um practically like so you have growth um practically like so you have growth um practically like so you have space you need doctors you how many space you need doctors you how many space you need doctors you how many patients to a doctor do you allow at patients to a doctor do you allow at patients to a doctor do you allow at Antioch? Antioch? Antioch? » We we'd like to get full-time physicians » We we'd like to get full-time physicians » We we'd like to get full-time physicians up to 600 patients. up to 600 patients. up to 600 patients. » Okay. traditional fee for service, they » Okay. traditional fee for service, they » Okay. traditional fee for service, they would have 2400 on their panel, but they would have 2400 on their panel, but they would have 2400 on their panel, but they define that as anybody they've seen in define that as anybody they've seen in define that as anybody they've seen in the last three years. So, it's not the last three years. So, it's not the last three years. So, it's not always, it's not like they're seeing always, it's not like they're seeing always, it's not like they're seeing those people four times every year. We those people four times every year. We those people four times every year. We see our we interact with our patients see our we interact with our patients see our we interact with our patients much more often by text, email, call um much more often by text, email, call um much more often by text, email, call um than a traditional office would. Though than a traditional office would. Though than a traditional office would. Though I I kind of say a fever service doctor I I kind of say a fever service doctor I I kind of say a fever service doctor may have 2400 patients, but maybe doing may have 2400 patients, but maybe doing may have 2400 patients, but maybe doing 25% of the medical care. We try to do 25% of the medical care. We try to do 25% of the medical care. We try to do 90% of the medical care on those at 90% of the medical care on those at 90% of the medical care on those at least 600 patients. least 600 patients. least 600 patients. » 800 would probably be the max for an » 800 would probably be the max for an » 800 would probably be the max for an individual physician with a nurse to individual physician with a nurse to individual physician with a nurse to take care of. So we have some physicians take care of. So we have some physicians take care of. So we have some physicians that are kind of approaching 700 and that are kind of approaching 700 and that are kind of approaching 700 and that's kind of a sweet spot. So that's kind of a sweet spot. So that's kind of a sweet spot. So » when is a physician ready for that » when is a physician ready for that » when is a physician ready for that model? How often can a physician come model? How often can a physician come model? How often can a physician come in, you hire a physician, right? you in, you hire a physician, right? you in, you hire a physician, right? you need another physician, you have you need another physician, you have you need another physician, you have you have too much influx. Like, have too much influx. Like, have too much influx. Like, » are they on their own day one? How long » are they on their own day one? How long » are they on their own day one? How long does it take for them to learn your does it take for them to learn your does it take for them to learn your systems and because it's a little systems and because it's a little systems and because it's a little different, but it's still just primary different, but it's still just primary different, but it's still just primary care? care? care? » Yeah, it doesn't I I would say some of » Yeah, it doesn't I I would say some of » Yeah, it doesn't I I would say some of the things are a little bit different, the things are a little bit different, the things are a little bit different, but it's still documenting, ordering but it's still documenting, ordering but it's still documenting, ordering meds, ordering labs, ordering imaging. meds, ordering labs, ordering imaging. meds, ordering labs, ordering imaging. Like, it's you're pushing different Like, it's you're pushing different Like, it's you're pushing different buttons in a different system, buttons in a different system, buttons in a different system, but » learning that system is pretty quick. » learning that system is pretty quick. » learning that system is pretty quick. So, we had a physician start in January So, we had a physician start in January So, we had a physician start in January and I just met with him yesterday and I just met with him yesterday and I just met with him yesterday and he's like, I think I got it after two he's like, I think I got it after two he's like, I think I got it after two months. So, months. So, months. So, » especially people that have practiced » especially people that have practiced » especially people that have practiced outside of residency before, they pick outside of residency before, they pick outside of residency before, they pick it up much faster. They're they're used it up much faster. They're they're used it up much faster. They're they're used to being busy and can pick it up. to being busy and can pick it up. to being busy and can pick it up. » Um, we'd love to be able to fill » Um, we'd love to be able to fill » Um, we'd love to be able to fill physicians quickly. So, we'd love to be physicians quickly. So, we'd love to be physicians quickly. So, we'd love to be able to fill kind of in six months, if able to fill kind of in six months, if able to fill kind of in six months, if that makes sense. So, shooting get that makes sense. So, shooting get that makes sense. So, shooting get somebody to a full panel our current or somebody to a full panel our current or somebody to a full panel our current or current newest hires on track for that. current newest hires on track for that. current newest hires on track for that. » Awesome. » Awesome. » Awesome. » Um, but it is a little bit of a » Um, but it is a little bit of a » Um, but it is a little bit of a two-sided market. You don't want to go two-sided market. You don't want to go two-sided market. You don't want to go chase a bunch of patients unless you chase a bunch of patients unless you chase a bunch of patients unless you have a doctor lined up and you don't have a doctor lined up and you don't have a doctor lined up and you don't want to hire a doctor unless you have want to hire a doctor unless you have want to hire a doctor unless you have patients lined up. So, it is kind of patients lined up. So, it is kind of patients lined up. So, it is kind of matching those things. matching those things. matching those things. » Yeah. » Yeah. » Yeah. » Yeah. That'd be » Yeah. That'd be » Yeah. That'd be » as we as we grow, it allows us to be to » as we as we grow, it allows us to be to » as we as we grow, it allows us to be to compete on the physician side with compete on the physician side with compete on the physician side with hospital systems because we can hospital systems because we can hospital systems because we can guarantee them a salary. We have guarantee them a salary. We have guarantee them a salary. We have benefits. We have a 401k. We've kind of benefits. We have a 401k. We've kind of benefits. We have a 401k. We've kind of grown as grown as grown as » we got cash flow now. So, you can kind » we got cash flow now. So, you can kind » we got cash flow now. So, you can kind of hire early, of hire early, of hire early, » right? Yeah, that makes sense. That's » right? Yeah, that makes sense. That's » right? Yeah, that makes sense. That's probably your best investment. probably your best investment. probably your best investment. » Yeah. » Yeah. » Yeah. » Um, from the business perspective, » Um, from the business perspective, » Um, from the business perspective, » finding the right Yes. finding the right » finding the right Yes. finding the right » finding the right Yes. finding the right and our staff is great. So we, you know, and our staff is great. So we, you know, and our staff is great. So we, you know, Google reviews is probably the main Google reviews is probably the main Google reviews is probably the main feedback we get and people always feedback we get and people always feedback we get and people always reference our staff like reference our staff like reference our staff like » instead of coming and sitting in a » instead of coming and sitting in a » instead of coming and sitting in a waiting room, you have somebody that you waiting room, you have somebody that you waiting room, you have somebody that you know who says hi, like knows your name, know who says hi, like knows your name, know who says hi, like knows your name, get ushers, yeah, ushers you back and get ushers, yeah, ushers you back and get ushers, yeah, ushers you back and like takes care of you, right? So yeah. like takes care of you, right? So yeah. like takes care of you, right? So yeah. » Yeah, that's great. Um breakdown. So is » Yeah, that's great. Um breakdown. So is » Yeah, that's great. Um breakdown. So is universal healthcare a good idea? universal healthcare a good idea? universal healthcare a good idea? Um, Um, Um, the words are a good idea. Like, the words are a good idea. Like, the words are a good idea. Like, everyone having healthcare is a good everyone having healthcare is a good everyone having healthcare is a good idea. idea. idea. » It's all such a mess. It's so » It's all such a mess. It's so » It's all such a mess. It's so complicated. complicated. complicated. » Everyone having healthcare is a good » Everyone having healthcare is a good » Everyone having healthcare is a good idea, idea, idea, » right? » right? » right? » Uh, I mean, I would say, » Uh, I mean, I would say, » Uh, I mean, I would say, well, define more what you mean. well, define more what you mean. well, define more what you mean. » What is it a human right to have health » What is it a human right to have health » What is it a human right to have health insurance? I think it's kind of the best insurance? I think it's kind of the best insurance? I think it's kind of the best way to start that conversation. Oh, I way to start that conversation. Oh, I way to start that conversation. Oh, I mean, you don't have to say anything. mean, you don't have to say anything. mean, you don't have to say anything. » This is totally my personal opinion. So, » This is totally my personal opinion. So, » This is totally my personal opinion. So, this does not this does not reflect uh this does not this does not reflect uh this does not this does not reflect uh necessarily everyone in Antioch's necessarily everyone in Antioch's necessarily everyone in Antioch's beliefs. beliefs. beliefs. » If you're If we're going all the way » If you're If we're going all the way » If you're If we're going all the way back to like what are rights, I tend to back to like what are rights, I tend to back to like what are rights, I tend to ascribe to the view that uh most of our ascribe to the view that uh most of our ascribe to the view that uh most of our inherent rights are negative rights. inherent rights are negative rights. inherent rights are negative rights. So people can't do these things to you. So people can't do these things to you. So people can't do these things to you. Does that make sense? Does that make sense? Does that make sense? » Sure. » Sure. » Sure. » So people can't stop you from doing » So people can't stop you from doing » So people can't stop you from doing this. People can't stop you from doing this. People can't stop you from doing this. People can't stop you from doing this. this. this. » It's hard for me to say that it's a » It's hard for me to say that it's a » It's hard for me to say that it's a right for somebody to provide something right for somebody to provide something right for somebody to provide something to you, if that makes sense. So there to you, if that makes sense. So there to you, if that makes sense. So there are certainly systems that can make it are certainly systems that can make it are certainly systems that can make it easier for people to get what they need, easier for people to get what they need, easier for people to get what they need, but I I don't I it tends not to be a a but I I don't I it tends not to be a a but I I don't I it tends not to be a a right for somebody to provide anything right for somebody to provide anything right for somebody to provide anything specific to you. specific to you. specific to you. » Yeah, » Yeah, » Yeah, » that's kind of how I approach that. Now, » that's kind of how I approach that. Now, » that's kind of how I approach that. Now, » could we make decisions as individuals » could we make decisions as individuals » could we make decisions as individuals and donors and politicians that would and donors and politicians that would and donors and politicians that would make » universal healthcare possible? Yes. Is » universal healthcare possible? Yes. Is » universal healthcare possible? Yes. Is it the decisions we're currently making? it the decisions we're currently making? it the decisions we're currently making? No. No. No. » Uh what's your take on that? if » Uh what's your take on that? if » Uh what's your take on that? if that were to work. And and the reason I that were to work. And and the reason I that were to work. And and the reason I bring this up, it was the most bring this up, it was the most bring this up, it was the most fascinating conversation I've had about fascinating conversation I've had about fascinating conversation I've had about the topic was a gentleman I know uh the topic was a gentleman I know uh the topic was a gentleman I know uh moved to Witchaw from the UK, been there moved to Witchaw from the UK, been there moved to Witchaw from the UK, been there his whole life. And I was like, "Well, his whole life. And I was like, "Well, his whole life. And I was like, "Well, how's it going? You've been here for how's it going? You've been here for how's it going? You've been here for like a year." He's like, "Good." He's like a year." He's like, "Good." He's like a year." He's like, "Good." He's like, "Yeah." He's like, "Health like, "Yeah." He's like, "Health like, "Yeah." He's like, "Health insurance is really weird here." That insurance is really weird here." That insurance is really weird here." That was his first He's like, "I can't quite was his first He's like, "I can't quite was his first He's like, "I can't quite figure it out. I He" He said, "It's and figure it out. I He" He said, "It's and figure it out. I He" He said, "It's and I don't think anyone really knows." I don't think anyone really knows." I don't think anyone really knows." Yeah. Uh, and he did like a lot of due Yeah. Uh, and he did like a lot of due Yeah. Uh, and he did like a lot of due diligence, was like trying to figure out diligence, was like trying to figure out diligence, was like trying to figure out what to do for his family and he just what to do for his family and he just what to do for his family and he just had never had to think about it for 42 had never had to think about it for 42 had never had to think about it for 42 years. years. years. » Right. Right. » Right. Right. » Right. Right. » Never crosses his brain. » Never crosses his brain. » Never crosses his brain. » Yeah. So, I don't » Yeah. So, I don't » Yeah. So, I don't » What question do you want me to answer? » What question do you want me to answer? » What question do you want me to answer? » Yeah. No, I'm just curious like » Yeah. No, I'm just curious like » Yeah. No, I'm just curious like does it actually work anywhere else is does it actually work anywhere else is does it actually work anywhere else is probably the question. probably the question. probably the question. » There are lots of things that could » There are lots of things that could » There are lots of things that could work. Yeah. So I think I think the work. Yeah. So I think I think the work. Yeah. So I think I think the question you're asking is like could question you're asking is like could question you're asking is like could universal like I think you're saying universal like I think you're saying universal like I think you're saying could » and still have good care and like what » and still have good care and like what » and still have good care and like what are the consequences or are the consequences or are the consequences or » government funded universal care work? » government funded universal care work? » government funded universal care work? Sure it could work. Sure it could work. Sure it could work. » Is it the best possible system? I I » Is it the best possible system? I I » Is it the best possible system? I I don't think so. don't think so. don't think so. » Yeah. » Yeah. » Yeah. » I think it tends to work in very » I think it tends to work in very » I think it tends to work in very homogeneous populations. So most of the homogeneous populations. So most of the homogeneous populations. So most of the countries where you see it working well, countries where you see it working well, countries where you see it working well, the Finlands, the Denmarks, the Swedes, the Finlands, the Denmarks, the Swedes, the Finlands, the Denmarks, the Swedes, 97% of people in those countries are 97% of people in those countries are 97% of people in those countries are Finnish and Danish and Swedish, right? Finnish and Danish and Swedish, right? Finnish and Danish and Swedish, right? So in very small homogeneous populations So in very small homogeneous populations So in very small homogeneous populations where everyone looks like each other. where everyone looks like each other. where everyone looks like each other. » Interesting. » Interesting. » Interesting. » People are fine funding universal » People are fine funding universal » People are fine funding universal things. Our country does not look like things. Our country does not look like things. Our country does not look like that. And so it's much harder with 50 that. And so it's much harder with 50 that. And so it's much harder with 50 states and uh 50 different law sets and states and uh 50 different law sets and states and uh 50 different law sets and things to do something on that wide a things to do something on that wide a things to do something on that wide a scale. So could it work? Yes. But it's scale. So could it work? Yes. But it's scale. So could it work? Yes. But it's very hard to implement something like very hard to implement something like very hard to implement something like that. that. that. » Yeah. » Yeah. » Yeah. » I don't That's a good take. » I don't That's a good take. » I don't That's a good take. » I'm trying to I'm kind of being a little » I'm trying to I'm kind of being a little » I'm trying to I'm kind of being a little broad. I'm just saying like broad. I'm just saying like broad. I'm just saying like » also » also » also » I want you I want you to offend someone. » I want you I want you to offend someone. » I want you I want you to offend someone. My goal here is for you to say something My goal here is for you to say something My goal here is for you to say something that makes someone mad. that makes someone mad. that makes someone mad. » But I think so Medicare or Medicaid » But I think so Medicare or Medicaid » But I think so Medicare or Medicaid right now. So we think of Medicaid as a right now. So we think of Medicaid as a right now. So we think of Medicaid as a government program, but what happens is government program, but what happens is government program, but what happens is the federal government funds the state. the federal government funds the state. the federal government funds the state. The state administers the program. The state administers the program. The state administers the program. The state has no idea on how to run a health state has no idea on how to run a health state has no idea on how to run a health run a run an insurance company. So who run a run an insurance company. So who run a run an insurance company. So who do they go to? do they go to? do they go to? » Do you know who runs Medicaid in Kansas? » Do you know who runs Medicaid in Kansas? » Do you know who runs Medicaid in Kansas? No. So Blue Cross United and Centine are No. So Blue Cross United and Centine are No. So Blue Cross United and Centine are the three people that sponsor Medicaid the three people that sponsor Medicaid the three people that sponsor Medicaid programs. programs. programs. » Sentine is like the 24th largest company » Sentine is like the 24th largest company » Sentine is like the 24th largest company in the United States. You ever heard of in the United States. You ever heard of in the United States. You ever heard of them? them? them? » No. » No. » No. » So they made like hundred billion » So they made like hundred billion » So they made like hundred billion dollars in revenue. I think dollars in revenue. I think dollars in revenue. I think » that's it. » that's it. » that's it. » Uh running Medicaid programs. » Uh running Medicaid programs. » Uh running Medicaid programs. » Wow. » Wow. » Wow. » So when people find that out and » So when people find that out and » So when people find that out and that is not to say like Centine is evil that is not to say like Centine is evil that is not to say like Centine is evil or bad. they make some decisions. I or bad. they make some decisions. I or bad. they make some decisions. I certainly wouldn't, but I don't think I certainly wouldn't, but I don't think I certainly wouldn't, but I don't think I don't think people when people think of don't think people when people think of don't think people when people think of that, they think of like, oh, we're all that, they think of like, oh, we're all that, they think of like, oh, we're all taking care of each other, and that's a taking care of each other, and that's a taking care of each other, and that's a great idea, but what practically happens great idea, but what practically happens great idea, but what practically happens is you fun you fund a system that is is you fun you fund a system that is is you fun you fund a system that is interested in extracting money from the interested in extracting money from the interested in extracting money from the system when you have those things. system when you have those things. system when you have those things. » Yeah. » Yeah. » Yeah. » And so it's it's it uh I don't think » And so it's it's it uh I don't think » And so it's it's it uh I don't think people would like the outcome if that people would like the outcome if that people would like the outcome if that were done tomorrow. So, so I and you were done tomorrow. So, so I and you were done tomorrow. So, so I and you kind of answered my next question, which kind of answered my next question, which kind of answered my next question, which is if is the system broken by design or is if is the system broken by design or is if is the system broken by design or is the system just broken because of is the system just broken because of is the system just broken because of those who benefit, right? And is it those who benefit, right? And is it those who benefit, right? And is it designed to be broken for a specific designed to be broken for a specific designed to be broken for a specific group of people that are benefiting? group of people that are benefiting? group of people that are benefiting? » I would I would change it a little bit » I would I would change it a little bit » I would I would change it a little bit and one of my favorite things to say is and one of my favorite things to say is and one of my favorite things to say is no system's broken. The system is no system's broken. The system is no system's broken. The system is working perfectly. Right? working perfectly. Right? working perfectly. Right? » There you go. the system just » There you go. the system just » There you go. the system just designed in a way that doesn't really designed in a way that doesn't really designed in a way that doesn't really help physicians or patients is who we help physicians or patients is who we help physicians or patients is who we think the system's for. But the system's think the system's for. But the system's think the system's for. But the system's really for the people who currently are really for the people who currently are really for the people who currently are extracting money out of the system. So extracting money out of the system. So extracting money out of the system. So for them it's working great. Right. for them it's working great. Right. for them it's working great. Right. » Right. » Right. » Right. » Um I think the people that have the most » Um I think the people that have the most » Um I think the people that have the most leverage to change that are the CFOs and leverage to change that are the CFOs and leverage to change that are the CFOs and HR people who are making the decisions. HR people who are making the decisions. HR people who are making the decisions. So most of So most of So most of » of like what entity? Insurance » of like what entity? Insurance » of like what entity? Insurance companies? companies? companies? » No of businesses. The businesses of » No of businesses. The businesses of » No of businesses. The businesses of businesses, right? Oh, so no insurance businesses, right? Oh, so no insurance businesses, right? Oh, so no insurance company is paying any healthcare funds. company is paying any healthcare funds. company is paying any healthcare funds. So people need to like So people need to like So people need to like » not think about that. » not think about that. » not think about that. » All the insurance company is is the HR » All the insurance company is is the HR » All the insurance company is is the HR and the SCFO has picked that person. and the SCFO has picked that person. and the SCFO has picked that person. That person takes their money and pays That person takes their money and pays That person takes their money and pays health care costs and charges a premium health care costs and charges a premium health care costs and charges a premium for doing it. for doing it. for doing it. » So all of the care is funded by » So all of the care is funded by » So all of the care is funded by individuals. It's either funded by individuals. It's either funded by individuals. It's either funded by taxpayers or it's either funded by taxpayers or it's either funded by taxpayers or it's either funded by employees. It's one of the employees. It's one of the employees. It's one of the » So you're saying we need to start a » So you're saying we need to start a » So you're saying we need to start a movement. movement. movement. » It is. It is the easiest movement to do » It is. It is the easiest movement to do » It is. It is the easiest movement to do because you could decide tomorrow. It's because you could decide tomorrow. It's because you could decide tomorrow. It's the scariest to do cuz no one wants to the scariest to do cuz no one wants to the scariest to do cuz no one wants to mess up healthare, right? mess up healthare, right? mess up healthare, right? » But the people that have done it are the » But the people that have done it are the » But the people that have done it are the ones that are going to like change the ones that are going to like change the ones that are going to like change the healthare in a community. healthare in a community. healthare in a community. » But as soon as the buyers start saying, » But as soon as the buyers start saying, » But as soon as the buyers start saying, "Hey, we want something different." The "Hey, we want something different." The "Hey, we want something different." The suppliers say, "Okay, we're ready." suppliers say, "Okay, we're ready." suppliers say, "Okay, we're ready." Right? And no one will move without the Right? And no one will move without the Right? And no one will move without the other. If everyone keeps picking other. If everyone keeps picking other. If everyone keeps picking » the standard insurance, you're going to » the standard insurance, you're going to » the standard insurance, you're going to keep getting the same standard problems. keep getting the same standard problems. keep getting the same standard problems. » So, so DPC, direct primary care is an » So, so DPC, direct primary care is an » So, so DPC, direct primary care is an example of that, right? That's a that's example of that, right? That's a that's example of that, right? That's a that's a small disruption that's changed how a small disruption that's changed how a small disruption that's changed how people view health insurance. people view health insurance. people view health insurance. » Yes. And it's happened because you can, » Yes. And it's happened because you can, » Yes. And it's happened because you can, you know, a solo doc can find 600 people you know, a solo doc can find 600 people you know, a solo doc can find 600 people to make it work. And I I would argue the to make it work. And I I would argue the to make it work. And I I would argue the vast majority of DPCs are people have vast majority of DPCs are people have vast majority of DPCs are people have just been fed up with the system and I'm just been fed up with the system and I'm just been fed up with the system and I'm leaving. I think Antioch is trying to leaving. I think Antioch is trying to leaving. I think Antioch is trying to be, hey, we never were in within the be, hey, we never were in within the be, hey, we never were in within the system. We are not trying to like system. We are not trying to like system. We are not trying to like conform to the system. We're trying to conform to the system. We're trying to conform to the system. We're trying to make a new one that makes the old system make a new one that makes the old system make a new one that makes the old system obsolete, if that makes sense. So obsolete, if that makes sense. So obsolete, if that makes sense. So » yeah. » yeah. » yeah. Uh, so expansion DPC, can a DPC get too Uh, so expansion DPC, can a DPC get too Uh, so expansion DPC, can a DPC get too big? Like if your DPC blows up, is there big? Like if your DPC blows up, is there big? Like if your DPC blows up, is there a point where it just doesn't make sense a point where it just doesn't make sense a point where it just doesn't make sense to not like have another location? to not like have another location? to not like have another location? » Oh, we would we we have started kind of » Oh, we would we we have started kind of » Oh, we would we we have started kind of taking care of some bigger groups that taking care of some bigger groups that taking care of some bigger groups that are outside of Witchaw. And so through are outside of Witchaw. And so through are outside of Witchaw. And so through tele medicine right now, we can extend tele medicine right now, we can extend tele medicine right now, we can extend ourselves. ourselves. ourselves. » Sure. » Sure. » Sure. » But yes, eventually we're going to need » But yes, eventually we're going to need » But yes, eventually we're going to need locations. My my aspirations currently locations. My my aspirations currently locations. My my aspirations currently do not go beyond the borders of Kansas. do not go beyond the borders of Kansas. do not go beyond the borders of Kansas. » Sure. We actually are um participating » Sure. We actually are um participating » Sure. We actually are um participating in a grant to try to um provide tele in a grant to try to um provide tele in a grant to try to um provide tele medicine or DPC services to rural medicine or DPC services to rural medicine or DPC services to rural uninsured patients right now. So we are uninsured patients right now. So we are uninsured patients right now. So we are we are trying to yes as as many people we are trying to yes as as many people we are trying to yes as as many people as we can reach with higher quality as we can reach with higher quality as we can reach with higher quality primary care in Kansas. That's that's primary care in Kansas. That's that's primary care in Kansas. That's that's Antioch's reach. So we will eventually Antioch's reach. So we will eventually Antioch's reach. So we will eventually have more locations than we do now. have more locations than we do now. have more locations than we do now. » Instead of like just making one location » Instead of like just making one location » Instead of like just making one location bigger makes sense to set up like bigger makes sense to set up like bigger makes sense to set up like » there are some benefits to having a hub. » there are some benefits to having a hub. » there are some benefits to having a hub. So we do procedures in our office. We So we do procedures in our office. We So we do procedures in our office. We have imaging that comes to our office have imaging that comes to our office have imaging that comes to our office equipment. So um it's nice to be in one equipment. So um it's nice to be in one equipment. So um it's nice to be in one sense and me being next to the hospital sense and me being next to the hospital sense and me being next to the hospital deliver babies is nice but no we don't deliver babies is nice but no we don't deliver babies is nice but no we don't want to we don't want a mother ship. Uh want to we don't want a mother ship. Uh want to we don't want a mother ship. Uh we would we would like a hub and spoke we would we would like a hub and spoke we would we would like a hub and spoke if that makes sense. if that makes sense. if that makes sense. » Yeah. Why are rural hospitals uh failing » Yeah. Why are rural hospitals uh failing » Yeah. Why are rural hospitals uh failing and suffering? Uh and I'm going to bring and suffering? Uh and I'm going to bring and suffering? Uh and I'm going to bring up a specific example and you can you up a specific example and you can you up a specific example and you can you know answer how you want. know answer how you want. know answer how you want. » Uh Eldredo our hospital Susan B. » Uh Eldredo our hospital Susan B. » Uh Eldredo our hospital Susan B. town's been on the struggle bus for a town's been on the struggle bus for a town's been on the struggle bus for a while now. while now. while now. » Yeah. » Yeah. » Yeah. » Uh what's your take on why » Uh what's your take on why » Uh what's your take on why hospitals like that and small hospitals like that and small hospitals like that and small communities are struggling? communities are struggling? communities are struggling? » I I mean hospitals wind up again totally » I I mean hospitals wind up again totally » I I mean hospitals wind up again totally my opinion and I am not an expert in my opinion and I am not an expert in my opinion and I am not an expert in hospital finance but hospitals hospital finance but hospitals hospital finance but hospitals wind up being price takers right so I wind up being price takers right so I wind up being price takers right so I have to keep my insurance contracts and have to keep my insurance contracts and have to keep my insurance contracts and hospitals are paid on a DRG. So somebody hospitals are paid on a DRG. So somebody hospitals are paid on a DRG. So somebody enters the hospital doors, they're enters the hospital doors, they're enters the hospital doors, they're admitted and they have what's DRG stand admitted and they have what's DRG stand admitted and they have what's DRG stand for? for? for? » Yeah. Uh it's a a diagnosis related » Yeah. Uh it's a a diagnosis related » Yeah. Uh it's a a diagnosis related group. group. group. » Okay. » Okay. » Okay. » So somebody's admitted to the hospital » So somebody's admitted to the hospital » So somebody's admitted to the hospital and they have this problem, right? And and they have this problem, right? And and they have this problem, right? And that problem determines what the that problem determines what the that problem determines what the hospital gets paid. hospital gets paid. hospital gets paid. Um Um Um if that is Medicare, Medicaid, private if that is Medicare, Medicaid, private if that is Medicare, Medicaid, private insurance, it's all different rates, insurance, it's all different rates, insurance, it's all different rates, right? Well, if I'm either not super right? Well, if I'm either not super right? Well, if I'm either not super efficient in the hospital or I can't get efficient in the hospital or I can't get efficient in the hospital or I can't get people out of the hospital and I am I people out of the hospital and I am I people out of the hospital and I am I have this care that I'm providing that have this care that I'm providing that have this care that I'm providing that I'm not fully reimbursed for, I'm not fully reimbursed for, I'm not fully reimbursed for, well, my my margins are going to go well, my my margins are going to go well, my my margins are going to go down, right? And so, I think hospitals down, right? And so, I think hospitals down, right? And so, I think hospitals are stuck in that system of everybody are stuck in that system of everybody are stuck in that system of everybody thinks uh healthcare costs too much. thinks uh healthcare costs too much. thinks uh healthcare costs too much. Okay, we're going to lower the prices we Okay, we're going to lower the prices we Okay, we're going to lower the prices we pay to providers. Well, you're you're pay to providers. Well, you're you're pay to providers. Well, you're you're like cutting off the people who are like cutting off the people who are like cutting off the people who are providing the care in that sense providing the care in that sense providing the care in that sense » when a lot of the increases going to » when a lot of the increases going to » when a lot of the increases going to pharmacy benefit managers, you know, pharmacy benefit managers, you know, pharmacy benefit managers, you know, traditional carriers, things like that. traditional carriers, things like that. traditional carriers, things like that. So, I think a lot of hospitals are just So, I think a lot of hospitals are just So, I think a lot of hospitals are just being continually squeezed uh in that I being continually squeezed uh in that I being continually squeezed uh in that I can't I can't charge any more for my can't I can't charge any more for my can't I can't charge any more for my services because those things are set. services because those things are set. services because those things are set. My cost of employing nurses is going way My cost of employing nurses is going way My cost of employing nurses is going way up. My cost of employing physicians is up. My cost of employing physicians is up. My cost of employing physicians is going a little bit up. my fixed costs going a little bit up. my fixed costs going a little bit up. my fixed costs are rising and my reimbursements are rising and my reimbursements are rising and my reimbursements are declining and so like and they don't declining and so like and they don't declining and so like and they don't have any options to price differently. have any options to price differently. have any options to price differently. Well, that's not true. They don't think Well, that's not true. They don't think Well, that's not true. They don't think they have any options to price they have any options to price they have any options to price differently. differently. differently. » How could they price differently? » How could they price differently? » How could they price differently? » I think there is a certainly an » I think there is a certainly an » I think there is a certainly an opportunity for a hospital to go to the opportunity for a hospital to go to the opportunity for a hospital to go to the CFOs and HR people who are deciding on CFOs and HR people who are deciding on CFOs and HR people who are deciding on their insurance and say, "Hey, we could their insurance and say, "Hey, we could their insurance and say, "Hey, we could lower your cost if you pay us lower your cost if you pay us lower your cost if you pay us differently." Right? So that is a you differently." Right? So that is a you differently." Right? So that is a you see that happening in some places like see that happening in some places like see that happening in some places like surgery centers that aren't full service surgery centers that aren't full service surgery centers that aren't full service hospitals take no insurance flat prices hospitals take no insurance flat prices hospitals take no insurance flat prices contract with large groups to say send contract with large groups to say send contract with large groups to say send your surgeries to us we're going to do a your surgeries to us we're going to do a your surgeries to us we're going to do a high quality job we're going to charge high quality job we're going to charge high quality job we're going to charge you this price there's no surprises so you this price there's no surprises so you this price there's no surprises so surgery center of Oklahoma um opened surgery center of Oklahoma um opened surgery center of Oklahoma um opened around 2009 they kind of pioneered that around 2009 they kind of pioneered that around 2009 they kind of pioneered that » and who's paying them I guess I I lost » and who's paying them I guess I I lost » and who's paying them I guess I I lost who was in between who was in between who was in between » the health plan's paying them » the health plan's paying them » the health plan's paying them » okay right » okay right » okay right » but it's a negotiated flat Yeah, they're » but it's a negotiated flat Yeah, they're » but it's a negotiated flat Yeah, they're just skipping the insurance part of just skipping the insurance part of just skipping the insurance part of paying them. So, they're sending them a paying them. So, they're sending them a paying them. So, they're sending them a bill for the total cost of the surgery, bill for the total cost of the surgery, bill for the total cost of the surgery, they're paying it. they're paying it. they're paying it. » Gotcha. If you get a knee replacement at » Gotcha. If you get a knee replacement at » Gotcha. If you get a knee replacement at a surgery center in Witto, it may cost a surgery center in Witto, it may cost a surgery center in Witto, it may cost $28,000. If you go to the one major $28,000. If you go to the one major $28,000. If you go to the one major hospital, major hospital systems, it hospital, major hospital systems, it hospital, major hospital systems, it might cost $72,000. might cost $72,000. might cost $72,000. » Gotcha. » Gotcha. » Gotcha. » The quality is better at the surgery » The quality is better at the surgery » The quality is better at the surgery center. So, if you're the patient and center. So, if you're the patient and center. So, if you're the patient and you're the payer, where would you want you're the payer, where would you want you're the payer, where would you want to go there? to go there? to go there? » The one thing I guess I feel like I'm » The one thing I guess I feel like I'm » The one thing I guess I feel like I'm jumping all around, but you're doing jumping all around, but you're doing jumping all around, but you're doing great. um great. um great. um the insurance company doesn't have any the insurance company doesn't have any the insurance company doesn't have any incentive for price to go down either incentive for price to go down either incentive for price to go down either and that doesn't make sense to people and that doesn't make sense to people and that doesn't make sense to people because you would think that's would be because you would think that's would be because you would think that's would be the insurance company's incentive. So the insurance company's incentive. So the insurance company's incentive. So I'll ask you a question. So uh I'll ask you a question. So uh I'll ask you a question. So uh » doesn't make any sense. I can't wait. » doesn't make any sense. I can't wait. » doesn't make any sense. I can't wait. » So imagine you're Geico, right? Okay. » So imagine you're Geico, right? Okay. » So imagine you're Geico, right? Okay. and your actuaries come to you and say, and your actuaries come to you and say, and your actuaries come to you and say, "Hey, we we think there are going to be "Hey, we we think there are going to be "Hey, we we think there are going to be a billion or uh uh we think there are a billion or uh uh we think there are a billion or uh uh we think there are going to be $850 million in claims that going to be $850 million in claims that going to be $850 million in claims that are going to happen in the state of are going to happen in the state of are going to happen in the state of Kansas, Kansas, Kansas, and we think you should charge a billion and we think you should charge a billion and we think you should charge a billion dollars in premium so that you can pay dollars in premium so that you can pay dollars in premium so that you can pay all the claims, and then there's this all the claims, and then there's this all the claims, and then there's this margin to have over, margin to have over, margin to have over, » right? » right? » right? » Imagine I came up with an innovation » Imagine I came up with an innovation » Imagine I came up with an innovation that made all the drivers safer and that made all the drivers safer and that made all the drivers safer and there were only $750 million in claims. there were only $750 million in claims. there were only $750 million in claims. What would happen to Geico's profits What would happen to Geico's profits What would happen to Geico's profits that year?" that year?" that year?" » They'd go up. » They'd go up. » They'd go up. » They'd go up. What would happen to the » They'd go up. What would happen to the » They'd go up. What would happen to the amount they could charge the next year amount they could charge the next year amount they could charge the next year though? though? though? » They could charge the same. » They could charge the same. » They could charge the same. » Well, they would probably be competed » Well, they would probably be competed » Well, they would probably be competed against, right? against, right? against, right? » So, somebody else would offer a lower » So, somebody else would offer a lower » So, somebody else would offer a lower price. The price of insurance would go price. The price of insurance would go price. The price of insurance would go down » across the board in everybody. » across the board in everybody. » across the board in everybody. » Yeah. Okay. » Yeah. Okay. » Yeah. Okay. » So, imagine the same thing in the » So, imagine the same thing in the » So, imagine the same thing in the healthcare space though. healthcare space though. healthcare space though. » So, in fully insured businesses. » So, in fully insured businesses. » So, in fully insured businesses. So, uh um there's a term called the So, uh um there's a term called the So, uh um there's a term called the Buas. So, Blue Cross United, Sigma, Buas. So, Blue Cross United, Sigma, Buas. So, Blue Cross United, Sigma, Humana, Etna. Uh I'm going to use that. Humana, Etna. Uh I'm going to use that. Humana, Etna. Uh I'm going to use that. So, I'm not picking one. So, uh, a a a So, I'm not picking one. So, uh, a a a So, I'm not picking one. So, uh, a a a Buoua actuary goes and says, "Well, we Buoua actuary goes and says, "Well, we Buoua actuary goes and says, "Well, we think there going to be $850 million in think there going to be $850 million in think there going to be $850 million in medical claims in Kansas this year. So, medical claims in Kansas this year. So, medical claims in Kansas this year. So, we think you should charge a billion we think you should charge a billion we think you should charge a billion dollars in premium so that you're going dollars in premium so that you're going dollars in premium so that you're going to pay all your costs and then there's to pay all your costs and then there's to pay all your costs and then there's this, you know, premium to have so we this, you know, premium to have so we this, you know, premium to have so we can keep functioning in company." Makes can keep functioning in company." Makes can keep functioning in company." Makes total sense. Well, what if I, as the total sense. Well, what if I, as the total sense. Well, what if I, as the most awesome primary care doctor ever, most awesome primary care doctor ever, most awesome primary care doctor ever, make everybody in Kansas healthier and make everybody in Kansas healthier and make everybody in Kansas healthier and they're only $750 million in claims? they're only $750 million in claims? they're only $750 million in claims? What happens to the profits of that What happens to the profits of that What happens to the profits of that insurance company that year? This is the insurance company that year? This is the insurance company that year? This is the trick question. trick question. trick question. » It's still up, isn't it? » It's still up, isn't it? » It's still up, isn't it? » So, the law actually says that if that » So, the law actually says that if that » So, the law actually says that if that happens, they have to give money back. happens, they have to give money back. happens, they have to give money back. » Oh, it's regulated. » Oh, it's regulated. » Oh, it's regulated. » So, it's regulated that there's a a » So, it's regulated that there's a a » So, it's regulated that there's a a medical loss ratio. So, they can only medical loss ratio. So, they can only medical loss ratio. So, they can only make 15%. make 15%. make 15%. » So, if I want to make more money next » So, if I want to make more money next » So, if I want to make more money next year as one of the bukas, what do I have year as one of the bukas, what do I have year as one of the bukas, what do I have to do to healthcare costs? They have to to do to healthcare costs? They have to to do to healthcare costs? They have to go up. Yes. go up. Yes. go up. Yes. » The premiums have to go up. So, so this » The premiums have to go up. So, so this » The premiums have to go up. So, so this is not like a when people understand is not like a when people understand is not like a when people understand this, it's not a surprise that this is this, it's not a surprise that this is this, it's not a surprise that this is happening. It's a it's a fun it's a happening. It's a it's a fun it's a happening. It's a it's a fun it's a function of the system. function of the system. function of the system. » No, it's the realization's shocking, but » No, it's the realization's shocking, but » No, it's the realization's shocking, but it's not like the fact that's real it's not like the fact that's real it's not like the fact that's real is not shocking. is not shocking. is not shocking. » And this came in it didn't used to » And this came in it didn't used to » And this came in it didn't used to be like this. This came in with the ACA be like this. This came in with the ACA be like this. This came in with the ACA and I think it was well-intentioned, and I think it was well-intentioned, and I think it was well-intentioned, right? We're we're trying to like right? We're we're trying to like right? We're we're trying to like » Right. It we don't want people to » Right. It we don't want people to » Right. It we don't want people to profiteeer off healthcare, right? But profiteeer off healthcare, right? But profiteeer off healthcare, right? But what they unknowingly did is created a what they unknowingly did is created a what they unknowingly did is created a system where costs have to go up, right? system where costs have to go up, right? system where costs have to go up, right? If my if me as the insurance company If my if me as the insurance company If my if me as the insurance company wants to make more the next year and I wants to make more the next year and I wants to make more the next year and I can capt this 15% so that the total can capt this 15% so that the total can capt this 15% so that the total price has to go up price has to go up price has to go up » and that makes so much sense why there's » and that makes so much sense why there's » and that makes so much sense why there's fees that make no like give me an fees that make no like give me an fees that make no like give me an example of one of the things you guys do example of one of the things you guys do example of one of the things you guys do that's outrageous at a fee service for that's outrageous at a fee service for that's outrageous at a fee service for fee model like is it x-rays or you have fee model like is it x-rays or you have fee model like is it x-rays or you have you have some services there where it's you have some services there where it's you have some services there where it's like a multiple like if I get a if it like a multiple like if I get a if it like a multiple like if I get a if it goes through insurance goes through insurance goes through insurance » the CBC is one of those so that you » the CBC is one of those so that you » the CBC is one of those so that you might get charged $90 for a CBC uh going might get charged $90 for a CBC uh going might get charged $90 for a CBC uh going through insurance. You may pay $50 if through insurance. You may pay $50 if through insurance. You may pay $50 if you go to or $25 if you go to like a a you go to or $25 if you go to like a a you go to or $25 if you go to like a a local just cash pay. We do a CBC at our local just cash pay. We do a CBC at our local just cash pay. We do a CBC at our office for $3.50, right? office for $3.50, right? office for $3.50, right? » Yeah. » Yeah. » Yeah. » And and that is not losing money on » And and that is not losing money on » And and that is not losing money on that. That's just we are that. That's just we are that. That's just we are » we are contracted with the lab. The lab » we are contracted with the lab. The lab » we are contracted with the lab. The lab charges us this. We charge a little bit charges us this. We charge a little bit charges us this. We charge a little bit extra for our nurs's time and the tubes extra for our nurs's time and the tubes extra for our nurs's time and the tubes and all these things. So, we don't lose and all these things. So, we don't lose and all these things. So, we don't lose money on the CBC, money on the CBC, money on the CBC, but we are solving a problem for our but we are solving a problem for our but we are solving a problem for our patients to make our membership patients to make our membership patients to make our membership valuable. valuable. valuable. » Right. We do. And the nice thing is as » Right. We do. And the nice thing is as » Right. We do. And the nice thing is as we get bigger, we can add more of these we get bigger, we can add more of these we get bigger, we can add more of these types of services. So we we got liquid types of services. So we we got liquid types of services. So we we got liquid nitrogen in our office. I think we nitrogen in our office. I think we nitrogen in our office. I think we charge seven5 $10 an application. It's charge seven5 $10 an application. It's charge seven5 $10 an application. It's probably a couple hundred to do at a probably a couple hundred to do at a probably a couple hundred to do at a dermatologist office. Well, we only fill dermatologist office. Well, we only fill dermatologist office. Well, we only fill the tank twice a year. We're just the tank twice a year. We're just the tank twice a year. We're just charging to cover our costs and a little charging to cover our costs and a little charging to cover our costs and a little bit of margin. So bit of margin. So bit of margin. So » yeah, » yeah, » yeah, » medicines are the same way. It » medicines are the same way. It » medicines are the same way. It » It's funny because like everything » It's funny because like everything » It's funny because like everything you're saying about DPC almost sounds you're saying about DPC almost sounds you're saying about DPC almost sounds like a version of universal healthcare like a version of universal healthcare like a version of universal healthcare that would work, right? cuz you know that would work, right? cuz you know that would work, right? cuz you know like if you work your way backwards it's like if you work your way backwards it's like if you work your way backwards it's kind of like this full circle of like kind of like this full circle of like kind of like this full circle of like everything you're saying is like yeah everything you're saying is like yeah everything you're saying is like yeah it'd be great if I could just pay it'd be great if I could just pay it'd be great if I could just pay » a fair amount every month and then pay » a fair amount every month and then pay » a fair amount every month and then pay just a little cash for everything. just a little cash for everything. just a little cash for everything. » Right. Right. » Right. Right. » Right. Right. » You know and then make it all work. » You know and then make it all work. » You know and then make it all work. » So it's it certainly would work. The » So it's it certainly would work. The » So it's it certainly would work. The people to make those decisions the people to make those decisions the people to make those decisions the people that can most easily make it CFOs people that can most easily make it CFOs people that can most easily make it CFOs HR people on the business side. HR people on the business side. HR people on the business side. » You then have to have legislators change » You then have to have legislators change » You then have to have legislators change Medicaid and Medicare. But there's no Medicaid and Medicare. But there's no Medicaid and Medicare. But there's no reason that those things can't happen in reason that those things can't happen in reason that those things can't happen in Medicaid and Medicare. You can use the Medicaid and Medicare. You can use the Medicaid and Medicare. You can use the same concepts we use of kind of the cost same concepts we use of kind of the cost same concepts we use of kind of the cost plus model in in those things. It's just plus model in in those things. It's just plus model in in those things. It's just going to take longer in those systems. going to take longer in those systems. going to take longer in those systems. » Co cost plus drugs. Um the play on » Co cost plus drugs. Um the play on » Co cost plus drugs. Um the play on words there, right? So it's cost plus words there, right? So it's cost plus words there, right? So it's cost plus what » um they if you uh they're very » um they if you uh they're very » um they if you uh they're very transparent about this. So they have transparent about this. So they have transparent about this. So they have acquisition cost of the medicine, they acquisition cost of the medicine, they acquisition cost of the medicine, they have phil fee from the pharmacist, they have phil fee from the pharmacist, they have phil fee from the pharmacist, they have the 15% they charge, and they have the 15% they charge, and they have the 15% they charge, and they have shipping. Right. shipping. Right. shipping. Right. » Okay. So they have a » Okay. So they have a » Okay. So they have a » our just margins are lower than theirs. » our just margins are lower than theirs. » our just margins are lower than theirs. So all it is and but this was a great So all it is and but this was a great So all it is and but this was a great example. We we we worked with a small example. We we we worked with a small example. We we we worked with a small company to change their insurance and we company to change their insurance and we company to change their insurance and we got insurance companies often for got insurance companies often for got insurance companies often for smaller companies will not give you any smaller companies will not give you any smaller companies will not give you any reporting. reporting. reporting. » Like they won't even tell you what » Like they won't even tell you what » Like they won't even tell you what you're spending your money on. They'll you're spending your money on. They'll you're spending your money on. They'll just tell you the price is increasing. just tell you the price is increasing. just tell you the price is increasing. That would be a great legislative change That would be a great legislative change That would be a great legislative change to mandate that they had to give you to mandate that they had to give you to mandate that they had to give you full claims data to see what's going on. full claims data to see what's going on. full claims data to see what's going on. But we had two highcost medicines. And But we had two highcost medicines. And But we had two highcost medicines. And one of the medications, the plan was one of the medications, the plan was one of the medications, the plan was being charged $1,500 every month for being charged $1,500 every month for being charged $1,500 every month for this person to fill their medication. this person to fill their medication. this person to fill their medication. And I looked into it and this is a And I looked into it and this is a And I looked into it and this is a generic medication. It's a chronic generic medication. It's a chronic generic medication. It's a chronic medication. It is for a chronically medication. It is for a chronically medication. It is for a chronically managed condition. And it was a and it managed condition. And it was a and it managed condition. And it was a and it like I said, it wasn't a name brand. It like I said, it wasn't a name brand. It like I said, it wasn't a name brand. It was a generic. So I just looked up how was a generic. So I just looked up how was a generic. So I just looked up how much can we just order this medicine much can we just order this medicine much can we just order this medicine into our office for? What do you think into our office for? What do you think into our office for? What do you think the price was that they were charging the price was that they were charging the price was that they were charging $1,500 a month for $1,500 a month for $1,500 a month for » that? You got it for? » that? You got it for? » that? You got it for? » Yeah. What price did I get it for? » Yeah. What price did I get it for? » Yeah. What price did I get it for? » $20 a month. » $20 a month. » $20 a month. » It was like 100. So we save the company » It was like 100. So we save the company » It was like 100. So we save the company $1,400 on one medication for one person. $1,400 on one medication for one person. $1,400 on one medication for one person. » One person » One person » One person » per month, right? And these are just the » per month, right? And these are just the » per month, right? And these are just the games that are being played. games that are being played. games that are being played. » No one knows the price of anything. Even » No one knows the price of anything. Even » No one knows the price of anything. Even though the CFO and the HR person are though the CFO and the HR person are though the CFO and the HR person are buying insurance, they're they're buying insurance, they're they're buying insurance, they're they're they're price blind. They don't know they're price blind. They don't know they're price blind. They don't know the price of anything. So somebody tells me price of anything. So somebody tells me price of anything. So somebody tells me drugs $1,300, they're like, "Okay, I drugs $1,300, they're like, "Okay, I drugs $1,300, they're like, "Okay, I guess it is, right?" guess it is, right?" guess it is, right?" » Yeah. You have no idea. And that's I » Yeah. You have no idea. And that's I » Yeah. You have no idea. And that's I never really thought about that. An never really thought about that. An never really thought about that. An employer has no idea. Yeah. employer has no idea. Yeah. employer has no idea. Yeah. » How much money? » How much money? » How much money? » And they wouldn't accept that in any » And they wouldn't accept that in any » And they wouldn't accept that in any other acquisition like in any other acquisition like in any other acquisition like in any business. You would never accept like business. You would never accept like business. You would never accept like that lack of lack of knowledge and that lack of lack of knowledge and that lack of lack of knowledge and transparency. transparency. transparency. » People just haven't asked that question » People just haven't asked that question » People just haven't asked that question in healthcare because we assume like in healthcare because we assume like in healthcare because we assume like well I don't know this worked. well I don't know this worked. well I don't know this worked. » One of the book plans worked last year. » One of the book plans worked last year. » One of the book plans worked last year. I assume it'll work this year. I guess I assume it'll work this year. I guess I assume it'll work this year. I guess we're going to renew, right? we're going to renew, right? we're going to renew, right? » Yeah. » Yeah. » Yeah. » But the only way it's going to change if » But the only way it's going to change if » But the only way it's going to change if people make different decisions than people make different decisions than people make different decisions than they're currently making. So they're currently making. So they're currently making. So » what are you most proud of at Antioch » what are you most proud of at Antioch » what are you most proud of at Antioch and your DPC model you've built? Oh man, and your DPC model you've built? Oh man, and your DPC model you've built? Oh man, I'm I'm a person that tends to be more I'm I'm a person that tends to be more I'm I'm a person that tends to be more dissatisfied than proud. dissatisfied than proud. dissatisfied than proud. » Yeah. Uh, no. I I think I think the fact » Yeah. Uh, no. I I think I think the fact » Yeah. Uh, no. I I think I think the fact that people walk in and that people walk in and that people walk in and just realize this is totally different just realize this is totally different just realize this is totally different than any other healthcare experience. than any other healthcare experience. than any other healthcare experience. That they're there and cared for and That they're there and cared for and That they're there and cared for and that people care about them. Um, that is that people care about them. Um, that is that people care about them. Um, that is that is the culture of our practice. And that is the culture of our practice. And that is the culture of our practice. And so, so, so, yeah, we're we're just way different yeah, we're we're just way different yeah, we're we're just way different than any other experience where, oh, you than any other experience where, oh, you than any other experience where, oh, you come check in. Okay, sit down, fill out come check in. Okay, sit down, fill out come check in. Okay, sit down, fill out this paperwork, we'll call you in 45 this paperwork, we'll call you in 45 this paperwork, we'll call you in 45 minutes. You're you're you're you're minutes. You're you're you're you're minutes. You're you're you're you're treated like a like a human at our treated like a like a human at our treated like a like a human at our office. And I think that's that's what I office. And I think that's that's what I office. And I think that's that's what I always say to people. I I hate to say always say to people. I I hate to say always say to people. I I hate to say that out loud in front of that out loud in front of that out loud in front of » fee model, service fee model people that » fee model, service fee model people that » fee model, service fee model people that I know, but it's like it I know, but it's like it I know, but it's like it » I I you know, I've said things about » I I you know, I've said things about » I I you know, I've said things about brokers. I've said things about brokers. I've said things about brokers. I've said things about insurance companies. I've said things insurance companies. I've said things insurance companies. I've said things about hospitals. They're just all about hospitals. They're just all about hospitals. They're just all playing the game. Right. playing the game. Right. playing the game. Right. » Right. They're they're not » Right. They're they're not » Right. They're they're not » they might not even like this game, but » they might not even like this game, but » they might not even like this game, but they're playing it to the best of their they're playing it to the best of their they're playing it to the best of their abilities. abilities. abilities. » I've just been always like, why don't we » I've just been always like, why don't we » I've just been always like, why don't we just play a different game than that? just play a different game than that? just play a different game than that? And yeah, And yeah, And yeah, » and people can choose to do that. It it » and people can choose to do that. It it » and people can choose to do that. It it just um just um just um » yeah, they have to think a little bit » yeah, they have to think a little bit » yeah, they have to think a little bit more deeply. And we're getting to the more deeply. And we're getting to the more deeply. And we're getting to the point where it's costing so much that point where it's costing so much that point where it's costing so much that we're seeing this happen. People are we're seeing this happen. People are we're seeing this happen. People are saying like we got to do something saying like we got to do something saying like we got to do something different. different. different. » Yep. » Yep. » Yep. » Yeah. It'll be interesting. What do you » Yeah. It'll be interesting. What do you » Yeah. It'll be interesting. What do you think this will all look like in five? think this will all look like in five? think this will all look like in five? Do you think in five years there's going Do you think in five years there's going Do you think in five years there's going to be another big change? 10 years? to be another big change? 10 years? to be another big change? 10 years? » Uh we'll either have universal » Uh we'll either have universal » Uh we'll either have universal healthcare or we'll we'll find a healthcare or we'll we'll find a healthcare or we'll we'll find a solution that works better than what we solution that works better than what we solution that works better than what we currently have. currently have. currently have. » What time frame do you think? » What time frame do you think? » What time frame do you think? » Uh yeah, five to 10 years. One of those » Uh yeah, five to 10 years. One of those » Uh yeah, five to 10 years. One of those two things will happen. Yeah. two things will happen. Yeah. two things will happen. Yeah. » There'll either be a revolution and » There'll either be a revolution and » There'll either be a revolution and people will decide like we're not people will decide like we're not people will decide like we're not putting up with this anymore and we're putting up with this anymore and we're putting up with this anymore and we're going to do this ourselves going to do this ourselves going to do this ourselves » or there will be some version of » or there will be some version of » or there will be some version of universal healthcare. universal healthcare. universal healthcare. » What how's technology and maybe » What how's technology and maybe » What how's technology and maybe specifically AI is what I'd like to ask specifically AI is what I'd like to ask specifically AI is what I'd like to ask in the medical field like what are you in the medical field like what are you in the medical field like what are you seeing? It's been a great tool. Um, we seeing? It's been a great tool. Um, we seeing? It's been a great tool. Um, we use a HIPPA compliant AI called open use a HIPPA compliant AI called open use a HIPPA compliant AI called open evidence for our practice that evidence for our practice that evidence for our practice that » and it it it is like having a consult in » and it it it is like having a consult in » and it it it is like having a consult in every patient. So, it doesn't just help every patient. So, it doesn't just help every patient. So, it doesn't just help us write our notes. It actually goes in us write our notes. It actually goes in us write our notes. It actually goes in and says like you should think about and says like you should think about and says like you should think about this and here's a test you could this and here's a test you could this and here's a test you could consider ordering. It is like an adjunct consider ordering. It is like an adjunct consider ordering. It is like an adjunct to the thinking. So, it is not replacing to the thinking. So, it is not replacing to the thinking. So, it is not replacing our thinking. It's like having a couple our thinking. It's like having a couple our thinking. It's like having a couple of other doctors looking over your of other doctors looking over your of other doctors looking over your shoulder and saying don't forget about shoulder and saying don't forget about shoulder and saying don't forget about this and make sure they get the this and make sure they get the this and make sure they get the screening and do these things. So that's screening and do these things. So that's screening and do these things. So that's been we've implemented that in the last been we've implemented that in the last been we've implemented that in the last year and it's extremely helpful. It's year and it's extremely helpful. It's year and it's extremely helpful. It's making our doctors more efficient and making our doctors more efficient and making our doctors more efficient and we're we're we're » you know we don't because we have time » you know we don't because we have time » you know we don't because we have time we miss a lot less than normal people we miss a lot less than normal people we miss a lot less than normal people but now we're now we're missing even but now we're now we're missing even but now we're now we're missing even less. less. less. » Sure. Uh are you recording? How does it » Sure. Uh are you recording? How does it » Sure. Uh are you recording? How does it take notes on actions? It's audio. take notes on actions? It's audio. take notes on actions? It's audio. » Gotcha. recording goes into the HIPPA » Gotcha. recording goes into the HIPPA » Gotcha. recording goes into the HIPPA compliant platform, generates the notes compliant platform, generates the notes compliant platform, generates the notes to document and then um and then it it to document and then um and then it it to document and then um and then it it is not yet integrated enough to like do is not yet integrated enough to like do is not yet integrated enough to like do the tasks, but it's creating the tasks, but it's creating the tasks, but it's creating the summary. Yeah. summary. Yeah. summary. Yeah. » So, it creates summary, creates » So, it creates summary, creates » So, it creates summary, creates recommendations, but it doesn't go past recommendations, but it doesn't go past recommendations, but it doesn't go past that point. that point. that point. » Not currently. » Not currently. » Not currently. » Do you see it's going to go past that » Do you see it's going to go past that » Do you see it's going to go past that point? point? point? » Yeah, it would have to be more right » Yeah, it would have to be more right » Yeah, it would have to be more right now. this is a separate tool that we're now. this is a separate tool that we're now. this is a separate tool that we're using and then connecting back to our using and then connecting back to our using and then connecting back to our EMR um EMR um EMR um » integrated AI tools into the EMR can » integrated AI tools into the EMR can » integrated AI tools into the EMR can start doing some of the things while start doing some of the things while start doing some of the things while we're talking. Oh, we're going to get we're talking. Oh, we're going to get we're talking. Oh, we're going to get this lab on you and go to the lab's this lab on you and go to the lab's this lab on you and go to the lab's order, right? That will eventually be order, right? That will eventually be order, right? That will eventually be happening. So, happening. So, happening. So, » Oh, yeah. Yeah, that makes sense. That'd » Oh, yeah. Yeah, that makes sense. That'd » Oh, yeah. Yeah, that makes sense. That'd be that's wild. Yeah. I'm going to be that's wild. Yeah. I'm going to be that's wild. Yeah. I'm going to prescribe you this. Um do you want to prescribe you this. Um do you want to prescribe you this. Um do you want to pick it up here or there? And then by pick it up here or there? And then by pick it up here or there? And then by the time the doctor walks out of the time the doctor walks out of the time the doctor walks out of the office, it's already done. office, it's already done. office, it's already done. » Done. Yep. » Done. Yep. » Done. Yep. » Yeah, I believe that. Dude, » Yeah, I believe that. Dude, » Yeah, I believe that. Dude, » it's all moving fast. Um dude, you're » it's all moving fast. Um dude, you're » it's all moving fast. Um dude, you're awesome. Thank you. This was fun. I've awesome. Thank you. This was fun. I've awesome. Thank you. This was fun. I've learned a ton. Um my my brain's learned a ton. Um my my brain's learned a ton. Um my my brain's exploding about their 15% and they exploding about their 15% and they exploding about their 15% and they benefit by everything going benefit by everything going benefit by everything going » I give this talk to residents and I I » I give this talk to residents and I I » I give this talk to residents and I I try to emphasize like I don't really try to emphasize like I don't really try to emphasize like I don't really think there are any villains. Like no think there are any villains. Like no think there are any villains. Like no one's sure no one's trying to be evil. one's sure no one's trying to be evil. one's sure no one's trying to be evil. It's just the outcomes are seem evil It's just the outcomes are seem evil It's just the outcomes are seem evil at the end of the day. So at the end of the day. So at the end of the day. So » yeah. And I mean that's just the nature » yeah. And I mean that's just the nature » yeah. And I mean that's just the nature of capitalism too. like when it of capitalism too. like when it of capitalism too. like when it infiltrates all these other like there's infiltrates all these other like there's infiltrates all these other like there's somebody leveraging something to make a somebody leveraging something to make a somebody leveraging something to make a lot of money in every industry. lot of money in every industry. lot of money in every industry. » You just got to set up the rules of the » You just got to set up the rules of the » You just got to set up the rules of the game better. So that's what we're trying game better. So that's what we're trying game better. So that's what we're trying to do. So I think to do. So I think to do. So I think » capitalism is not in of itself bad. It's » capitalism is not in of itself bad. It's » capitalism is not in of itself bad. It's like you can't give a crappy set of like you can't give a crappy set of like you can't give a crappy set of rules to capitalism because then you get rules to capitalism because then you get rules to capitalism because then you get really crappy outcomes. So really crappy outcomes. So really crappy outcomes. So » yeah. No. » yeah. No. » yeah. No. » Yeah. That's good. Well, we've been at » Yeah. That's good. Well, we've been at » Yeah. That's good. Well, we've been at Antioch for eight years and uh the Antioch for eight years and uh the Antioch for eight years and uh the culture and the treatment and everything culture and the treatment and everything culture and the treatment and everything keeps us coming back and that's the keeps us coming back and that's the keeps us coming back and that's the thing that I want to stress for anybody thing that I want to stress for anybody thing that I want to stress for anybody listening DPC listening DPC listening DPC uh as a model like you do have to uh as a model like you do have to uh as a model like you do have to experience it to fully understand it. I experience it to fully understand it. I experience it to fully understand it. I don't think there'll ever be a perfect don't think there'll ever be a perfect don't think there'll ever be a perfect message or you know for a while I think message or you know for a while I think message or you know for a while I think over time it's just like anything you over time it's just like anything you over time it's just like anything you know bad news travels faster than good know bad news travels faster than good know bad news travels faster than good news. So the more the system breaks, the news. So the more the system breaks, the news. So the more the system breaks, the more you're going to and DPC models are more you're going to and DPC models are more you're going to and DPC models are going to be talked about. But I do think going to be talked about. But I do think going to be talked about. But I do think I encourage everybody to look into it. I encourage everybody to look into it. I encourage everybody to look into it. Visit a DPC clinic. Uh if you're in the Visit a DPC clinic. Uh if you're in the Visit a DPC clinic. Uh if you're in the area, obviously check out Antioch. Yeah. area, obviously check out Antioch. Yeah. area, obviously check out Antioch. Yeah. » And uh you know, anything you see on TV, » And uh you know, anything you see on TV, » And uh you know, anything you see on TV, we can do better. We'll get your we can do better. We'll get your we can do better. We'll get your creatine. So creatine. So creatine. So » I like it. No, I'm I'm on it. So thanks, » I like it. No, I'm I'm on it. So thanks, » I like it. No, I'm I'm on it. So thanks, dude. Appreciate you. dude. Appreciate you. dude. Appreciate you. » Thanks. ---