Second anniversary!

Well, the experiment continues and there’s really no reason for us to pull the plug at this point. For any docs considering a jump to our model, be forewarned that Pre-R isn’t a cash cow. However, it’s more enjoyable medicine than any I’ve practiced.

We now have patients who know us and our system pretty well, and even a few “superusers.” These are folks who call us fairly often when they’re at home, at work or on vacation, and with questions regarding their whole families. They’re awesome. These sorts of relationships and follow up are what I’ve missed for 20ish years of emergency medicine.

Here are some other Pre-R topics that may be of interest:

  1. Insurance
    We are die hard direct pay folks now. We don’t even talk about super-bills any more. They’re just a waste of everyone’s time. In the early days we provided super-bills for patients who requested them, but we learned that their reimbursements were typically minimal. So why bother? Overhead and patient costs drop precipitously when insurance is chopped from the equation.
  2. Our target demographic
    Folks with high deductibles or no insurance use our service the most. Rarely do we get calls from anyone with Medicare or other kinds of full coverage. When we do, they are either desperate for immediate care, or they don’t know that we don’t take insurance. When they find out we don’t, they sometimes opt instead for Medstop or the ER, which is fair enough. Those places have admin and enough patience to process insurance.
  3. IT
    Vanessa continues to fine tune our website and has learned so much these past couple years she’s now teaching Computer Information Systems 201 at Cuesta College. She’s also getting close to launching our Pre-R app as well. Stay tuned. Hopefully some time before baby #2!:)
  4. Can Pre-R be a full time gig?
    I suspect no. For the past year I’ve been working occasional 24 hour shifts in hospitals out of town, and there’s really no way Pre-R could ever compete with such reliable revenue. For Pre-R to compete we would need a call center to help field overlapping calls all day long, and frankly, we just don’t want that. We had a taste of call overload on January 2nd when all the urgent cares in SLO County were closed. Vanessa and I learned that day to be careful what we wish for.
    For me, Pre-R is like driving for Uber on days off. It’s nice supplemental income. It helps me and Vanessa to feel creative. Plus, it’s been an incredible way to get out to meet the community.
    I often wonder what would happen to healthcare if every doc opened their own version of Pre-R. I’m certain there’d be less burnout at least. I suspect fewer docs would retire. Maybe the looming doctor shortage would no longer be a thing. Hard to know.
  5. Products
    Our pediatric doser is available online at Amazon. Get yours through them or come visit our Farmers’ Market booth on January 27th.
    The STS (for femur fractures) has been adopted by Dallas, Boston and New York Fire Departments among others. And our rescue harness continues to be a crowd pleaser at parties.
    Stay tuned for new products on the horizon for 2017!
  6. As for the Affordable Care Act?
    For patients, we’re in for a ride.
    For Pre-R, however, no worries. That’s the beauty of direct pay.
Pre-R – Making Healthcare Healthier!
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