On this episode of the show, I am interviewing Dr. Jeffrey Davis. Dr. Davis is the founder of Link Primary Care, the premier concierge direct primary care company in St. Louis.
Dr. Davis completed undergraduate his studies at Northwestern University, medical school at Vanderbilt University, and residency training at the University of California in San Diego. He then completed his MBA at Washington University in St. Louis and started Link Primary Care in an effort to provide affordable, personalized, and convenient primary medical care. At Link Primary Care you get quick and easy access to your own personal doctor for a low monthly fee. They offer complete general medical care, urgent visits, and wellness care with no co-pays or deductibles. At Link Primary Care they offer a free month with any new one-year membership. They also have weekly meet and greet sessions at the clinic - call to schedule a time to visit!
Phone: (314) 798-7422
This episode has been transcribed by Otter. ai Terminology and grammar may not be accurate.
Hello, and welcome to STL Active St Louis's premier health and wellness podcast. STL active aims to give listeners in the St. Louis area the information they need to succeed and progress with their health and fitness. This podcast is brought to you by St. Louis PT.com and hosted by Doctor of Physical Therapy, Greg Judice.
Hey everyone, it's Dr. Greg, owner, and physical therapist at Judice Sports & Rehab. On this episode of the show, I'm interviewing Dr. Jeffrey Davis. Dr. Davis is a Board Certified emergency medicine physician and the founder of Lync primary care. He has decades of experience as a practicing emergency room physician and healthcare administrator. He completed Undergraduate Studies at Northwestern University Medical School at Vanderbilt University and residency training at the University of California in San Diego. Last but not least, he completed his MBA at Washington University here in St. Louis. Without further ado, let's get into the interview with Dr. Jeffrey Davis. Welcome to the show. We've got Dr. Jeffrey Davis, thank you for being here.
Thanks for having me. It's great to be here.
Awesome. I appreciate you being here. Dr. Davis is from Link Direct Primary Care. Tell us about your background.
So yeah, so I've been in healthcare for my whole career. I'm an emergency room physician by training. I've been in practice for a little over 20 years, doing direct clinical care. And then I've been doing administrative work for more than 15 years. And the beginning of that was, you know, largely in health systems. So I was working out on the West Coast as the chief of Emergency Medicine at Kaiser Permanente facility, and then here in the St. Louis region as chief of Emergency Medicine at Missouri Baptist for years, and started thinking about primary care over the course of that time. Which led me to open Link Primary Care back in 2020. And it was really based on observations about a variety of factors in the healthcare system. One is just the really appalling lack of access that people have to good primary care. And there's really good outcomes data that having good primary care lowers the cost of care and populations, and improves health outcomes in groups of people. And ever since I was a medical school, people haven't really had an interest in primary care, largely because of the economics. It's a really hard specialty to go into. And it's really because fee for service medicine doesn't work well for primary care. And direct primary care is this different version of a payment model, which allows you to change the operations model. And I think it's really a fascinating opportunity. So that's what sort of brought me to this point. Awesome.
Because I'm thinking of primary care for my generation. Right? It doesn't really get utilized. A lot of my peers will say that it's outdated, right, direct, you're not direct, but primary care in general, like, why would you go to one, you can just go to the urgent care or, you know, go to the pharmacy or whatever, like, maybe comment on that a little bit?
Well, you know, primary care has evolved over time. And I think, you know, we see that, because access has been so difficult for so long, these other businesses have cropped up to sort of taking over that position. Urgent Care is a perfect example. Because people don't have fast and easy access to a doctor, they know when they trust, if they have a problem, their knee jerk reflex is to go to urgent care, because they can get good access, they can walk in anytime they need it. And primary care has really dropped the ball on access. You're the problem is that you're getting a couple of things you probably don't need. Number one, you're not talking to a doctor that you know and trust. And having a relationship with someone who understands your values and your medical problems and your needs. Really can tailor therapy to what you need. You get better decision-making in those kind of circumstances also. So, you know, you we see that utilization of labs and imaging and specialty referrals are much, much less with a good primary care relationship. Because you have time to say what are we doing and why what are they what are our needs? What kind of medical problems are we approaching? And how are we going to get to solutions. And so a good primary care doctor really is a health care system navigator. So that role doesn't exist in the emergency department or an urgent cares. Their job is to provide services based on a snapshot of wanting to get you out the door and get you out the door. But I understand why people have have moved to that sort of perspective on primary care, because access has been terrible for a generation.
So what is the problem with access these days?
So again, I think really, it's a, it's an economic problem of payment. And then it creates problems operationally. So fee for service doesn't work well, for primary care, really, because a visit isn't paid much. So in order for doctors to try and have a viable clinic, they see 1000s of patients in their panel. So they have really big panels they're responsible for, and they have to do a lot of visits every day. So their visit length is 10 minutes or 15 minutes per patient. And they just crank through people, and you really don't have any time to get to know your patients or to talk about what's going on or to manage problems in a collaborative way. And because of that system, access is really bad. You know, the average time to get an appointment in this country is between two and three months for primary care. And a lot of doctors are closed. And sometimes, you know, it can be a year before you can get a visit.
And when you say they're closed their panels, they're full, they're not accepting any patients. And so as part of that, because there aren't enough primary care physicians, yes. And part of that is because they don't get paid enough.
Yes, well, those are the same problem. As rightly, yeah, it's the same problem. Because there are a lot of primary care physicians that aren't in the workforce right now. They're on the sidelines. It's a really challenging specialty, the way it's been set up, you have, you know, huge volumes of patients take care of you have very little time to see them, you generally don't get paid for a lot of the work that you do, like charting or callbacks, those sorts of things. And, and you've seen over the course of the last generation that primary care practices have been purchased and aggregated in the health systems or they're purchased by private equity groups, hospital system hospital systems. Yeah, exactly. And, and it's not. For altruistic reasons. It's because primary care is an engine to generate profitable referrals, for labs for specialist visits, and for imaging and the other tests that hospitals and health systems participate in. So it's in their best interest to have primary care doctors seeing as many patients as possible and then sending them on to use all these other services, which are very profitable. Now, that's great for profit for health systems, but it's terrible from a patient perspective. And so that's what we're trying to change with link primary care. And the purpose of the model is because we don't do any third party insurance billing, we have a really simple, direct contracting relationship with our patients. All of the economic drivers of operations go out the window, so we can afford to cut our panel size by 80%. So, you know, a full time handle for our doc would be 600 patients. And you know, our normal intake visits are an hour and a half to two hours long. And our follow up visits are 30 to 60 minutes long.
So you do have the opportunity to build that relationship with your patients, which is what the problem was initially is that people don't see value in primary care if they're only there. 10 minutes? Yeah, absolutely. The doctor took two months to see them and then sees him for 10 minutes. And then you really think about
it's a joke. Yeah, it's a joke. So we try and put that operations model on its head and say, we're here for you 24. Seven, we give direct access to the physician by phone by text message by email by video chat. So if you're at work, and you have a, you know, one line question for your doctor, you can get a one line answer in 10 seconds, it's really fast and easy via text to be a phone call. If you need to be seen in the clinic, we you know, we measure access at like primary care in hours, not in weeks or months. So if you need to be seen the same day for a problem, we can see you the same day. So and all of that capability comes from this different payment model, essentially,
to go into that payment model for me.
So it's really straightforward. We do direct contracting with individuals and with companies for services. So they pay a membership fee, which is generally monthly, some people do longer contracts. And it's basically a global fee for our services. So that means unlimited visits, unlimited access to your doctor, regardless of the problem. And it allows us to form and maintain those relationships. We do a lot of procedures in the clinic as well, a lot of which are only done in urgent care or specialty circumstances. So for example, if you hurt yourself, you have laceration you need stitches. We can take care of that. You don't have to go to the ER to get that done. Yeah, we do. cryotherapy We do skin biopsies, full service, primary care actually is a really broad spectrum of work we can accomplish. And our global membership fee covers all of those things. So you're not paying for each one of those visits, you're not paying for the procedure. There are no co pays no deductibles, it's just a simple fee once a month.
So let's backtrack just a little bit. So we talked about the problem with access in the primary care world. Why does that problem exist? Is it strictly economic driven? Is it an insurance problem? Is it a legislation problem? Is it all the above, we can go big here, I want to get to the bottom of it myself. Because there's always multiple ways to fix the problem. You can either go through all the proper channels and talk to your legislator and hope that they take you seriously and want to help you. Or you can fix it yourself, which is obviously kind of what you're going for. Right? Kind of what I'm going for is the DIY version of fixing this problem. Is there another way to fix this problem?
So yeah, I mean, I think, fundamentally, you have to go really deep and broad to say, how does healthcare work in the United States? And why? Look at the history and the development of the markets? You know, how do employers provide health care services and why? And that's a really interesting topic, I think. It's it's extremely complex. And I'm not an expert on all things in terms of healthcare payment. But a couple of bright lines are that the way that insurance companies handle payment is not in the best interests of patients who purchase services. There's clearly a problem with transparency and pricing. And that's, I think, been relatively big news in the last few years. And, again, fee for service models work well, for doing things. It's a it's a relatively clean and easy system that we use to say, if you're going to do a specific kind of a procedure, we can put a price on it. And I think the problem is in the development of that we focused a lot on procedural specialties, but not a lot on thinking and talking specialties essentially, and, and those are a lot of the primary care specialties, obviously, internal medicine, Family Medicine, pediatrics, etc. But that's the foundation of the healthcare system is thinking and talking and collaboration, education, shared decision making. That's where you get really good quality care.
It's just less tangible, right? If I go to the grocery store, and I buy whatever, I'm buying chicken, I'm paying $6 for x chicken, right. And I can see it, and I can weigh it, and it's the same thing. Right. But what's the difference in value in a 10? minute visit a two hour visit? I mean, depends on the quality? Well, it depends on you know, there's a lot that goes into it. Yeah, it's much more complex. And so what we have to do then is look at outcomes data and say, Well, what does it look like when people have great Primary Care Access, and when they have terrible Primary Care Access, and you know, what's good is that we have tons of information about that we have great outcomes data. And over and over again, the literature is crystal clear, which is, an ounce of prevention is worth a pound of cure for primary care, having good access to a primary care doctor improves composite health outcomes. So you have lower risks of stroke, heart disease, better management of diabetes, and high blood pressure, all the things that you would look at to say how healthy is a population of people, and the costs are lower. And so the secret sauce is is that doing? Have this relationship, it's an is having a person you trust having the time to have conversations. And I think not having paradoxical financial incentives to do tests that maybe you don't need or maybe don't make any sense. So it is harder to nail down what good primary care is and isn't. But clearly we know that people who have it do better systems that focus on it do better, not just to the United States, but also internationally. There's really good outcomes data on that. That's awesome. Yeah.
So going back to link How did you how did you decide this is what I want to do? This is what I want to start coming from the ER world coming from the administrative world how'd you get to starting like
so it's a good story is sort of by fits and starts and you know, I was doing a lot of research on different kinds of health care companies and direct primary Here's a really interesting model, it's the fastest growing model of primary care in the United States. And I think it because it's probably it hits, what we would consider in the healthcare world to be a triple aim or a quadruple aim. And that's what I find to be most compelling and sort of exciting about it. So number one, it's fantastic for patients, they get great access, they get what they expect, and what they would want, which is a, you know, a great relationship with a personal trusted physician partner, that they can call at any time and get the answers that they need. So they have this great relationship. And it's affordable. So a lot of people can use it. And what the more I did research on it, the what I found is, it's as good for physicians, and for clinics as it is for patients. So physicians, as I'm sure you know, are super burned out, particularly in primary care, they're overworked, like we were talking earlier, they have to care for 1000s and 1000s of patients, they get 10 minute visits, they're really frustrated with their work. And physicians who switch and do direct primary care, completely transform their career, they're extremely happy with the work life balance, they have a lot more in the tank to give to their patients, they really like having deep personal relationships with their patients, then it feels like going back to a simpler time in medicine, where you had a family doctor who knew you. And it's easier. Because we don't do any third party billing, there's no insurance, billing and direct primary care, a lot of what makes medicine difficult goes out the window. So documentation requirements that are ridiculous and arbitrary to fulfill the needs of one contract or a different insurance company, those go out the window, right, the only thing you document is what you need to take good care of the patient. So it's really good for patients, it's really good for physicians, which is great. And then remarkably, it saves people money. And I which was shocking, because you would think that giving people amazing access, and lots of time with their doctor would be more expensive, but it's the opposite. So people who use direct primary care, they save money, they save money, number one, because we're less expensive than going through traditional systems. But they also don't do things they don't need to do, there's a much lower rate of specialist referrals, probably 15% lower because a good primary care doctor can manage a lot of problems. That specialist take care of there's, you know, nearly 10%, lower rates of hospitalization when you have good primary care. And I see this in my clinical practice in the emergency department every day, you know, half of the patients I see on any given day, have problems that could be managed by a good primary care doctor, their blood pressure is out of control, or they're having a heart attack or a stroke, because they haven't been taking care of themselves. Their cholesterol is out of control and they don't have access to a doctor. They're emergencies in
that moment. But they didn't have
they don't need to be right, absolutely. Or they have an injury or an illness that a good primary care doctor could take care of in the office or, or by phone or with a with a snapshot like a picture. So it's it's a really unique model that I think brings the best of physician practices, and it offers it to people in a way that's really compelling.
So it sounds like this is the obvious choice. And I use a direct primary care doctor and someone I met before I met you, but how is this not more widely known? Is it? You know? Because that's what the three letter acronym companies don't want you to know? Is it one of those things? Or? Or how do we? How do we spread the word for this and spread the word for the the more value based medicine versus fee for service medicine? Yeah, so
it's new, you know, direct primary care has only been around in earnest of the last 20 years, let's say nationally, and it really grew out of individual doctors who said, I'm fed up with doing corporate medicine, I'm going to start a practice and I'm not going to take insurance and I'm going to have a tiny practice to get to know my patients again, and and sort of rediscover what's good about medicine. So that's how it began. And that's basically what we still do. But in the context of massive for profit institutions, that are the incumbents in the market. And so I think when we educate people about what direct primary care is, people pretty quickly say, Yeah, that makes complete sense. And I love the model and, and where do we sign up? But it's really small, you know, in comparison to large health systems, or like I said, equity owned primary care groups, and you know, as healthcare has become, really a terrifyingly large industry. The United States, everyone wants a piece of it, there's a lot of money to be made. And so there's a lot of competition in the marketplace, from hospitals and health systems and insurance companies, but pharmacy benefit companies and Walmart and CVS, there are a lot of people who are trying to understand how to play in this space. So it's a very competitive marketplace. But I think fundamentally, the value of direct primary care shines in comparison to a lot of the offerings in the market.
Gotcha. So I've asked this question on this show before. Is there a difference between direct primary care and concierge medicine? And what is it if there is? Yeah,
no, it's a great question. I get that a lot. So there's a lot of overlap. So it's confusing. And I describe like primary care as a concierge direct primary care company. And and that's more confusing. Exactly.
Because there's overlap. And
now there's a lot of overlap. So here's how I would say, so concierge medicine basically does two things you pay for access to your primary care doctor. Number one, and they continue to charge your insurance, they continue to build insurance. We don't do that.
So people get super bills, or is it totally No, no billing
with direct primary care? So there's only one bill? Yeah, there's no outside billing, there's no other professional fees that are billed for those things. So concierge, doctors will will bill you a fee directly. And they also charge your insurance for services. So in a sense, they double bill. And the fees for concierge medicine are generally three to 10 times what we charge. So those tend to be much more expensive practices. And what they're selling is access, which is essentially part of what we sell as well. So there is overlap for sure. You know, I say that we're a concierge direct primary care company. And the concierge means fast and easy access to a full service personal physician that knows which is what they're selling, which is what essentially okay selling. But they continue to you know, they bill insurance as well for the services they provide.
Got it. Okay, that makes sense. So what is it about? link that sets you guys apart from other DPC practices?
That's a good question. So we do a couple things that are different, we try to have a global fee that covers like we were describing earlier, pretty much all the services that we perform. And so we you know, we have our standard global fee. And if you need procedures, you're not paying for those. There's no additional per visit fees, there aren't additional fees for the other things that we do. And that's not true of all DPC is. We haven't talked much about some of the other services, we provide sort sort of an opportunity now Go for it, we have a pharmacy on site as an example. And so one of the things we do is purchase medications at wholesale price, and stock them and then we dispense them to our members at wholesale price. And so a lot of our members find that they might save, you know, hundreds or even 1000s of dollars a month just on our pharmacy benefit. And that's
even if they do have insurance,
even if they do have insurance. And we do contracting with local lab and imaging providers. And the purpose is for value for our members, we don't have a financial incentive to drive people to one specific company or another. But for example, if you you know, needed a chest X ray, you might pay, you know, $150 for it to a normal health system. And we can get the same chest X Ray for $30. Well, that's great, particularly if you have a $5,000 deductible in your out of pocket for your chest X ray, even if you have insurance. And if you're out of pocket and you don't have insurance, well, it makes a huge difference. And again, that's not a source of revenue for us, per se, it's a way that we drive value to our members. And so in a sense, we're sort of like Costco, and we have a membership that gets you in the door, but the value of the goods and services that we provide is worth more than the cost that you're paying for them. Got it. I love it. Yeah,
that's a good way to put it. So I wanted to put this in there. I've got a patient. He's, he works for an insurance company. Right. He's He's in the big, the big mill. He goes to a concierge physician and comes to see me and out of network provider. Yeah. If that doesn't show Yeah.
Well, no, I mean, you know, yeah, it's it's a really good point. And, you know, I talked to a lot of business owners and professionals who already know the problem with the markets and understand what the issues are. And they seek out these sorts of businesses like Lync primary care, because they know that the value is really important for their own health and for access to be able to have a trusted provider. And so yeah, we see that a lot. And we know what we're trying to do is bring concierge medicine from being an elitist, you know, only CEOs of companies can afford it. And we're trying to bring it to the broad market, because it's the kind of health care that everyone needs. And it's the kind of health care everyone deserves. And so that's the purpose of, of our company.
I like it. So tell me, why did you start a company in 2020?
I didn't mean to. It was accident, you know, 2020. I meant to, but COVID was an interesting year. So it's been a fascinating year for everyone. And it's been really brutal for a lot of companies. So certainly, you know, in hindsight, it wasn't, I wouldn't recommend it. Because, you know, the wheels came off in a lot of areas of industry. That being said, you know, it's the spring. And I feel like the world is thawing in a lot of ways. And I think, you know, people need what we offer more than ever, I think, even before COVID, there were a lot of people who couldn't afford to access care. Even if they had insurance, they were functionally uninsured, because they couldn't afford the co-payments or coinsurance is, or they couldn't afford their medicines. And so a lot of people would ration their own care, either they wouldn't go to their doctor, or they wouldn't buy their medicines, and then they end up having a really bigger problem, more expensive problem later on. And I think the COVID epidemic has actually made that 100 times worse, because of the economic impacts and the problems with access that we've seen. Well, that
are the fear of going and getting care. Absolutely. Now, if someone was dealing with some chest pain in April of last year, you think they got it dealt with? I mean, no, everything was so unknown and scary that, you know, they waited until it became a bigger deal or a chronic problem. Yep. And that is one of the most frustrating things for me. Healthcare in general, is that minor things become major things, because people either can't afford it don't know that they need it. or a combination there. It's it's very frustrating.
Well, no, you're absolutely right. So we see a lot of people now who are coming back and saying, hey, I've been basically neglecting my health over the last year, which is completely understandable, because it's been a terrifying experience for all of us. And a lot of people lost their jobs and they lost their insurance coverage. A lot of companies that used to offer insurance packages don't anymore because it's too expensive. And so, yeah, people have a lot of needs that we're trying to meet now, this year.
I love that term functionally uninsured?
Well, it's a mess. And, and, you know, there are again, good data on this over, you know, over a 15 roughly year period, leading up to like 2017 when the data, you know, probably a little over 7 million Americans lost their health insurance where they used to have it and access to care. And individual family spending on health insurance and health related expenses went up 25%. And spending on everything else like food and shelter and clothing went down over the same time. So Americans are paying more for health care than they ever have in the past. The average deductible now for people who even can have insurance is $5,000. And 70% of American households don't have over $1,000 in savings in the bank. And so it takes one episode of care to bankrupt a family. So when we look back over 70% of bankruptcies related to medical expenses, were in families that have insurance, which is crazy. Cuz again, you know, ostensibly, that's the whole point of having insurance is to prove is to be able to pay for your care. And so I think it's it's a it's a window to see that the system in its current state is really failing people. Health insurance has a place in the market and that place is to deal with catastrophic injury or illness. So if you have a heart attack, you have to have emergency surgery if you have cancer, those things it those are 100,000 500,000 million dollar claims. That's the purpose of health insurance. But the market gets really perverted when those things are used for really simple problems like like the $4 person, like your primary care doctor or the $4 prescriptions at Walmart, right? And so there's a lot of talk about consumerism in healthcare, and it's a great idea. The problem is that purchasers of Health Care Services, so normal men and women in the United States have no chance of understanding how to purchase healthcare services. It's an impossible. It's not like going to Walmart and buying, you know, a Diet Coke, you have no idea what the prices are for what you're going to buy, different people will buy the same product, and they're charged completely different prices for it. And you also have no way to tell what the quality is of the product. And the options are not great either. And yeah, and you don't get a man. I mean, and I made a great, I mean, there's not a lot of them. No, no, two options there you have, yeah, you have a very limited number of options. And these are frequently really emotionally charged decisions. Also, because these are health decisions there. They can be life and death decisions. It's just really hard to make good, good purchasing decisions about health care. And, you know, one of the things that we do, again, we were talking earlier, like what's the value of having time to talk to your doctor? So one of the things we do is we help people navigate the healthcare system. Like that's one of our primary roles is saying, well, what's out there? And what services do you actually need? What do you not need? Who does? You know, the thing that you need in the market? How much does it cost? Who does a good job who does a bad job? What data can we actually look at quality and, and have an informed conversation? And you know, a lot of our job as physicians primary care, especially is just to present the information, and then have a collaborative conversation to say, here are the options, here's what we could do. Here's what I think the best option, or what do you want to do? How does this feel to you? What are your priorities? And that's where the sort of the meat of this collaboration really is powerful?
So just to interject a little bit. I've noticed that healthcare literacy is awful. Yeah. Because the most likely because there is no primary care. Yeah. And so they hurt, they go to urgent care, Urgent Care refers them to a specialist, because that's they have back pain. So they go to a surgeon first, right? Yeah. Well, they don't know anything about what's going on. They don't know what their options were in the meantime. And now their first interaction with someone that can provide them help. Is the surgeon. Yeah, scary to me? Well, they didn't go through primary care. They didn't go through physical therapy, they didn't go through like, right, there's, there's channels missed there that have people that could have helped them along the way.
Oh, absolutely. And at much lower cost, right. And now people assume they need the specialists every single time. Well, you know, we talked about access a while ago, and it's the same problem all over again, is that if people don't have access to a trusted resource that can lead them through these conversations, explain what the treatment options are, and why you would choose one or another or what the natural history of their illness is, and the cadence, we're going to do this, first, we're going to do this other thing second, and really come up with a plan together, then people self refer to specialists exactly like you're talking about, they have a knee problem. They say I need to go see an orthopedic surgeon, maybe I need a knee replacement. And unfortunately, again, people are paid to do things. And so if you go to someone, they're probably going to do something which you may not need. And so you know, there's a lot of talk about, for example, waste in the medical system in the United States, and the numbers are just incredible. People quote, you know, 25%, or 33, a third of all healthcare spending, the United States is waste. hundreds of billions. Oh, yeah. Like, yeah, like $900 billion. I think it was a lot of incredible numbers. And part of the problem is people getting services that they just don't need, which is incredible, but it's, it's actually a really important problem. And, you know, it's really, it's been described in a lot of different circumstances, a tool Gawande and a lot of others have talked about, you know, if you go to places where there are a lot of doctors offering certain kinds of services, you're much more likely to get those services. And if you compare populations in different parts of the country, their rates of getting certain kinds of procedures are dramatically different, even though they had the same health problems. And again, that's an that's a markets problem. That's an economics question.
That's marketing works.
Fantastic. But it's not about the health of the patients that we're trying to, we're trying to serve. Okay.
So when it comes to navigating that healthcare system, I would consider that to be a specialty of a primary care physician because they need to be able to quarterback the situation to an extent right they need to be able to know am I referring to cardiovascular? am I referring to orthopedic? am I referring to whatever? What do I know that other thing is? How How do you know when it's within your scope? ...versus when it's time to refer? Is there like a checklist? Is it just based off of clinical reasoning? Is it combination? Like how does how do you know, as a provider, when it's something we can help with at Link? ...versus something we need to send them out?
That's a great question. So you're exactly right. Our job is to be the quarterback for patients. And so I think the question of when to refer is pretty easy. Because the scope of practice for primary care is pretty straightforward. We kind of know, okay, if we're going to manage your diabetes, let's say, Here, the medicines we use, here are the targets for your hemoglobin A1 C, or whatever, we're gonna look at your daily blood sugar journal. How are, you know, how is that working? Is it working? Well, are we getting control Are we not? There's second line, third line. And if you have certain kinds of cases, you say, this is much more complex, or your diabetes, blood glucose problem is so fragile that we really have to bring in a specialist and that's why they exist. People who have insulin pumps or type one diabetics who are very brittle, have had long term problems, many of those people need to be managed by an endocrinologist. And it's the same thing with a lot of problems. If you have very complex gastrointestinal problems, having a GI doctor is a really good idea. If you have specific heart problems, having a cardiologist is a really good idea. That being said, again, one of the fundamental differences of having high quality, personalized primary care is that there's never a question about who the quarterback is. There's never a question about who your actual doctor is, you have a team of consultants, right? The primary care doctors job is to get information from all those people, make it into a sensible plan, and then be the point person to explain to the patient what's going on. Why is the cardiologist think you need to get a stress test? Why are you on a blood thinner medicine for atrial fibrillation? How does that met, you know, deal with your Crohn's disease? How are those things related, and that's where some time and knowledge and relationship make all the difference in the world, because then you can have important conversations about managing multiple problems simultaneously. And it becomes pretty easy and obvious to say, we really need to bring in outside help for this problem, or now, this is something we can manage today in the office. And it's and it's pretty straightforward. And having trust with a patient and the doctor makes all the difference in the world, because patient knows that you don't have any incentive, other than trying to give them the best care that that you can get for them.
So one of the things that I was asking you before was how do you how do you get to be as successful as you've been, and one of the things you said was building those personal relationships. And obviously, you do that with your patients. But there's more to it than that you have to build those relationships with the specialists, you have to build those relationships with other providers, I'm sure. What is your philosophy, your strategy when it comes to starting and then maintaining those relationships?
So I think, number one, is maintaining the perspective that true north is what's best for the patient. And I think that's really helpful in these conversations. You know, our interest is in finding groups of providers or institutions that provide really high quality care. First, and they understand why they do it. And that they're not overly focused on profitability, let's say, for example, and so it doesn't take long when you're having conversations with providers or businesses that we're going to partner with to say, Why Why do you do this work? You know, what's your philosophy on patient care? You know, what, what kind of patients come here and see you. And I think there's a lot again, being open and honest about what our model looks like how it's different than the sort of mainstream model. The nature of our fiduciary responsibility, I'd say to our patients is really important to put at the front. Like I said, we do direct contracting with, with specialists and other companies here in town. And the purpose is to get value for our customer, excuse me, for our members, for our patients that we're taking care of. And I think it's really important that these other companies know that, that these aren't profit generating procedures or referrals or services. The purpose is to get them the best care at the best value, which is, you know, some version of quality divided by price, right? That's what we're looking for. And so I think just clarity and transparency about what our business model is like and the kind of people we're looking for, it goes a long way
at shifting gears a little bit. What is your Either favorite or craziest er story. I got to change it up a little bit. Oh, that's
a good. That's a good. I haven't had that question a long time. I'll tell you I had a great story. This just happened. And this is sort of an ER story. And it's sort of not but it's very topical. So. So we've been affected our family, obviously, by COVID, like everyone else. And so we circle the wagons. We haven't traveled in a long time. Happily, we've had the opportunity to get vaccinated now in our family, because we're healthcare worker family, and so we've gotten vaccinated. So we took a we took a vacation a few weeks ago for the first time in a year, which was wonderful. And we went to San Diego and you know, we spent some time living on the west coast, we had a great time. So we were out there on a Friday, we went whale watching. And we were out with my wife, and we have three kids. And so we were out, bobbing around looking for whales, we had a great time. And we were coming back to the harbor. It's 230 in the afternoon, they're going to take the next group of people out whale watching. And we come across this boat floating in the harbor and San Diego Harbor, sort of by the year, the airbase there, and there are three people in the water. They look like they're their kids. They're probably 19 years old, 20 years old. And so we slow down and we today you guys need some help. And they said yes. And which is surprising them, right? We figured they were you know, house were a nice day. Yeah, they're floating around or swimming. And so we pull up alongside them. And the fruit you know, there are three, three people on it. The first one sort of clambers out the second one claimers out and the third one tries to get up and their friends, they lift him up to the side of the boat, and they'll his legs come out of the water and one of them is hanging on by a thread. I couldn't believe it. I'm with my wife and kids were on vacation. They lift them out of the way. It looks like a shark movie. Like Jaws, there's a big pool of blood in the water. I couldn't believe it.
And you want it
Well, you know, you do what you can do. Right? So So and there's no one on the boat who can help. And there, I think there are six kids on the boat. So you know, I kind of go into action. So I jumped onto their boat and I pull my belt off and, and put a tourniquet around this kid's leg who's bleeding to death on their boat in front of the five other kids. And then everything was okay. Shockingly, so the harbor police came and we got them back to shore. And you know paramedics came and they whisked him away and I lost my belt. I haven't gotten my I haven't seen that belt again.
Don't expect it. I
don't think I'm going to get that back. But I did. I talked to the to the police subsequently. And unfortunately, this this boy lost his leg. It was I think mangled. Probably was hit by the propeller of their own boat when he fell off the boat. But we saved his life. So that's a pretty good story that happened two weeks ago, was not what I was expecting.
Well, I know that is recent and is I don't know, that was beautiful.
That just happened. And so you don't necessarily get all your days off. I you know, I joke with people. I hate working on the weekends. But you know, it was an amazing operator. Look, we were in the right place at the right moment. I'm pretty sure if we would have been a minute later, he probably, you know, incredibly would have bled to death in the water or in the boat. So we just got so lucky. But what you know, that's, that's a unique. Yeah, it's a unique story to sort of say, Hey, this is what I do for a living to my kids on vacation. So yeah,
that's one. That is pretty neat. I mean, not for him. But yeah, it's it's good that you were there. It's good that we were there. Yeah.
And he's doing fine, apparently, which is good.
Good. So what is with the name? Why Link?
So Link was intended to convey as this sense of having a relationship that was kind of the point is that you would have a Link between your doctor and the patient, that you would know who who was in your court. Just like if you had a tax question, you have a tax person. If you had, if you had a legal question, maybe you have a lawyer, you have a personal friend who's a doctor or a doctor in the family, that's the person you would call. And so for us, it was like, Oh, we would be that person for you. There would never be any question about who is in your court who the quarterback is, you know, who's going to, you know, answer your question, who's going to help you out when you need it. So that was the point of link.
Again, like, that's what I thought I just wanted to make sure. What is your vision for Link short term long term? Where are you in five years?
So, you know, we're a St. Louis company. And my interest is in being a St. Louis company. So I want to be the best direct primary care company in the St. Louis market. So when people are looking for, you know, a great, fast, easy, trusting physician really lationship full service care at a moment's notice that they would come to us. And, and I think our communities need that, here in St. Louis. You know, there's we, you know, we have a lot of individuals who use our business, for their, you know, families or their own personal healthcare needs, and other also companies who use our services for their employees. We haven't talked a lot about that. But I think there's a huge opportunity in our business communities, to give better care to employees, but also save money for the businesses, which this year especially, you know, coming out of 2020 has never been a more important question. And there are, again, great case studies of companies all over the country who find ways to use direct primary care to provide services to employees.
So how does that typically set up within the companies?
Well, there, there are a lot of ways to skin a cat. So some places it depends on the company, some places will say, we don't offer any health care benefits, and we're going to offer direct primary care to our employees. And that's it
on by employee basis.
No, no, yeah, on a by employee basis. And that might be their standalone health benefit. And let me tell you, when you go from nothing to direct primary care, that's a huge jump for value. And then a lot of companies will offer direct primary care, like Link Primary Care within the context of a health plan, just like it would look, you know, with a PPO, etc. Sometimes there'll be a menu of choices for employees, they'll say, well, you can use a, you know, a high deductible health plan plus a PPO model, you can use a high deductible health plan and plus link primary care. And you can choose, you know, what's what's good about that is that enlightened insurance companies and enlightened tpas, and businesses know that direct primary care saves money. And so the costs for health plans that include direct primary care are invariably cheaper. On the premium side, and also on the claim side, what
are the insurance companies doing to battle that? Well,
I mean, it depends. So some insurance companies think that it's a great opportunity to service their customers better. And so they're on board. And I think those are the enlightened ones, those I think we have great partners on the on the TPA side insurance company side. But we're small, again, by comparison to two really huge insurance companies. And, you know, it's a competitive market. And that's, that's fine. I think, ultimately, the the most important question, from a business perspective is, you know, who's in your court? And I can, you know, sort of, like we were talking about earlier, I get paid in a very clean, clear way, it's very easy for me to describe how much we get paid for our services. And what we're providing, I would think from the business
standpoint, it's got to make sense because it's a set fee, right? They know what their costs are before the year starts. Yes, to an extent, I mean, obviously, there's going to be specialty referrals. But if you can cut down on 70% of those, that's pretty big.
Yeah, it is. And so I think having transparency is really important. And having a sense of what the fees are going to be is really important. I think, also, just again, having a partner who has your economic interest in mind is really important. Because if, you know, employees of a company need services that we can take care of that's perfect. We again, have no economic incentive to, to, you know, create downstream services to, to refer to patient, you know, patients to specialists. There's no kickbacks, there's no other, you know, economic incentive for us to do things that aren't in their best interest. And I think again, that's sort of about the level of trust with, with these companies we work with to say, yeah, we're stewards of, of their health care dollars in a way that other places aren't.
That is an interesting model. And as you know, I've been toying with that myself. So we'll have to talk more about that. Absolutely. Once we make it happen. Yeah, absolutely. I agree. Awesome. Anything that you would like to offer the listeners of the show?
Well, number one, I want to say thanks for having me on. It's been great to talk about what we do. Yeah, so I'd love to offer a discount to anyone who hears about Link Primary Care, through your podcast, your show. You know, our normal fees are on our website. For an adult, it's $99 for spouse, or partner at $79. And then for children is $49. And we'll offer a 20% discount of our normal fees to anyone who wants to, to sign up and join and has heard about us through this broadcast.
Awesome. That is awesome. Thank you very much. Of course, no happy Thank you for being on anything else you want to share before we hang up here.
Well, no, I number one, thanks again for having us. I think it's you know, There are one thing that I would say is is really important, I think is people are struggling to find trusted providers and value and, and one thing I would say is that we're out here, there are people worth talking to you that are out here. That's why I started this show. Which is great. And you know, I appreciate what you're trying to accomplish with it. There are good options in the market, and it doesn't require fancy technology. Sometimes all it requires is is knowing a person who wants to take care of you the right way.
Thank you again for being here. And this has been STL Active. Thank you.
Thank you for listening to the STL Active podcast from St. Louis PT.com If you enjoyed the show, please spread the word. Thanks again and see you next time.