[INTRODUCTION]
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[EPISODE]
Christopher Habig
Hello everyone and welcome to another episode of Healthcare Americana. I am your host Christopher Habig, CEO and co-founder of Freedom Healthworks. Today we have the pleasure of speaking with Dr. William Steelman, the physician and founder of Steelman Medical Group in Houston, Texas, a true pioneer in the concierge direct primary care model. Dr. Steelman has made significant strides in really transforming how primary healthcare is delivered, even though he might confess to using paper and pencil, every once in a while, focusing on patient-centered care and transparency. Dr. Steelman, welcome to the show. Welcome to Healthcare Americana.
Dr. William Steelman
Thank you for having me. Yeah, we recently had a hurricane blow through and then a cloud strike shut our electronics down. So all the power to the pen.
Christopher Habig
You know, at one point in time, human beings considered paper and pencil to be a form of technology. And I just don't want to lose sight of that when everybody's like, we have this healthcare technology. It's great. This thing will make you waffles and it'll enter in your scribe and then it'll do all this kind of stuff. And then you come marching in with a pen and sit in there taking handwritten notes. I mean, I'm sure the patient had to be just completely mind blown. Like, what are you doing? Is this back to the stone age?
Dr. William Steelman
Yeah. Well, I mean, you know, I, I always kind of personally despise that, that doctor's office where you walk in and they're staring at the laptop up against the wall and just asking you questions, not looking at you. And, you know, like some of my patients used to kid about how many times the doctor actually looked me in the eye, you know, you know, as to how disconnected the, the old fee for service world was.
Christopher Habig
And then you're like, you know what, I see the stuff about AI. You're like, okay, in that world, that is a robot. That's why assembly lines are getting replaced by fast food workers are getting replaced by robots. Assembly lines are already there. And it's like, well, if we just put robots in the exam room, then it'd be a lot easier. And I feel like you're about to say, well, there's a big but, that's not the way medicine should be practiced.
Dr. William Steelman
Right. Well, I, you know, I do see, I do see some, you know, some synergy there because I do use some of the, AI services can do things for us. use AI to generate photos for, advertisements. It'll take a text to a picture. I use AI for, for taking, you know, conversations and just converting them straight into soap notes or referrals or anything like that.
You can use AI in a lot of different ways that really does make the overall tedious work go away. And I see that being a big part of this, but at the same time, if you don't have the interpersonal skills and you spent your whole undergrad career learning how to be perfect and epic, then your toast assumes the power's out.
Christopher Habig
Absolutely. You're a very, very well paid data clerk at that point in time, let alone why even go to medical school when you're just sit there and should be working on your keyboard speed. Dr. Stillman, in my introduction, you know, stumbled upon this this phrase that really I found on your website. And I know that that you give credit to some other people there, you know, friends of the show of this concept of concierge direct primary care. And what really caught my eye about this, and our listeners will understand that, there's so many times where DPC physicians, they waste so much time and energy into establishing themselves as DPC and not concierge. And it confuses the hell out of staff. It confuses the hell out of patients. And in my mind, it makes marketability that much more difficult because you're introducing a new concept, new industry where concierge is kind of familiar. You said, screw it. I'm just going to combine these two terms. How has that worked out for you when you talk to patients about what you're doing in your practice?
Dr. William Steelman
So originally, like I said, we saw this idea pop up in the wild and we said, well, we really initially thought that we were gonna open a traditional fee for service office. And we said, well, we wanna be able to offer more services to people who wanna pay for house calls or aesthetic work. We have our own skincare line. We wanted to do our comp bougie services. So we had all these things that we, we wanted to be able to add that didn't make sense as like a traditional, like, you all encompassing primary care service. And then, and then what we found was that when we tried to describe, we, when we made the switch to go, unfortunately late, switching to, to direct primary care, we found that people were just utterly confused.
The mind virus of insurance-based care really has a grip on people and it's hard for them to get out of that. But if you say to them you're a concierge doc and you do house calls and you do all these other services, then they understand that immediately. And in my area, that's what they understood.
Christopher Habig
Right, in Dallas there's been some very early high-end concierge practices. Houston's, they're bringing that up in that area too, just from our standpoint at Freedom Health Works. But it's like this mindset in the physician world, because we get more and more docs now that we talk to, to say, well, Freedom, I know you guys do DPC, but what I really want to do is concierge. And I say, give me your definition of what that term means, because everybody has a different definition. And in my mind, there's like no really right or wrong answer, regardless of how you work with insurance.
But by and large, most of those docs who say, hey, I want to start a concierge practice are just looking at a higher level, higher cost, really higher price point. Same DPC model, same pure membership, no insurance, but just a higher price point. And I thought that was just fascinating. So again, I'd to get your take on it. But that seems to be the most prevalent shift, you know, a DPC membership is anywhere from $0 to $100, $115. And then everything over that, docs are saying, oh, this is now a concierge practice. No insurance on either side of it. Have you run any of that kind of mindset in the broader physician community when you're talking to colleagues?
Dr. William Steelman
Yeah, so we initially went on, when we were doing our initial setup, we made the huge mistake of trying to hire a traditional consulting group that was a fee for service consultant that sets up traditional fee for service specialists, right? And they didn't understand a thing about what we were trying to set up.
We had tell them again. No, we don't charge for procedures in the office No, we don't we're not charging copay. It was like they couldn't get over this thing. We had to keep telling them it was it was kind of weird but that was that so not using you know DPC centric Setup was was actually a big waste of money for us ended up being a problem.
But once we took the reins ourselves and set up, what we found was that people knew the services that they wanted and they just told us. And so we started setting up things to meet people where they wanted the service. So it was for the market we were in, you know, and it turned out to be a very good value altogether. And we tried to lower the price down to the open market where we thought most of the GPCs were managing. then also, you know, that it met our particular goals because our real estate was a little bit more expensive.
Christopher Habig
Sure, it's amazing what happens when you listen to the market, right? It's like when patients will tell you what they want because I think everybody has some type of horrific healthcare experience where they wanted to do something and they couldn't do it, whether it was get a sick kid in or take a look at something that might be infected or a weird looking mole and they're like, yeah, I just didn't. A lot of times they want to talk to you.
And we kind of joke, because we hear this question a lot when we work with docs of, well, if I start my own practice, don't I have to be on call all the time? It's like, well, not if you don't want to. There's ways around it. This is your practice, right? If you want to be 24-7, we'll put a 24-7 up on there. most of the time, patients just want to hear, hey, this is normal, or this is OK, or, yeah, let's go ahead and have that looked at coming at the office.
Is that like the three most popular answers in what your model is doing right now when people call in? Is it a lot of it just peace of mind?
Dr. William Steelman
Okay, so my area is particularly blessed, I would say, with a lot of resources and they have a lot of specialty care. But in terms of primary care, they may have a primary physician. They may have only seen the PA or NP. Most of them did not know their PCP's name. And these are people who have everything. So to come on board and solve problems for people who have traditionally been bounced around in the healthcare system. It's just like the South Park episodes. This is a mind-blowing thing for some people. And I would say, yeah, what they say to me is, is this the future? Is this the way doctors are gonna be? That I can just get what I need? And I'm like, yeah, pretty much. Like this is no one's going in 10 years if you don't have a DPC doctor, I don't know what you're doing.
Christopher Habig
Yeah, and especially in a world of instant gratification, people want to see that. That's why we, know, I don't see WebMD as much. think Google's kind of consumed a lot of those medical searches, but it's like people need an answer right now and whenever you search anything, you're going to get the worst news ever rather than just giving you a call because you do house calls.
Dr. William Steelman
Yeah, I did one the other day and saved an ER visit. So we were, we were chatting earlier about some of the, price estimates for these, for these ER visits and, and, and urgent care visits and, know, you know, end of the evening on a holiday, you know, Friday coming in and being able to prevent somebody who just needed basic reassurance and help, you know, it took me 15 minutes on site to diagnose and be able to start the treatment with one phone call follow-up, you know, it's like, come on. And this stuff would have ended up when this would have ended up in the urgent care for plus the mandatory CYA CT scan, plus contrast, just an unbelievable call. We’re talking 2,500 for CT, at a hospital ER, plus the professional fees. Most of the urgent care I suspect still have hospital affiliations and facility fees that they're charging on top of that.
So I put that down on a little notebook how much I'm saving each patient, as I go, just for personal gratification. I want to have a little ticker like the national debt clock.
Christopher Habig
I hope you're having as much savings as our national debt is right now. That would be a heck of a story. I'm looking at one of those things, like fundraising thermometers that climbs up to a certain goal here.
Dr. William Steelman
Exactly. Maybe that's a good idea actually.
Christopher Habig
I'm kind of laughing. I'm like, do you ever get hate mail from your local ER that says, stop saving people from coming into our facility?
Dr. William Steelman
No, I'm small potatoes. I'm serving particularly informed people in my area who are interested in a traditional primary care doc that, you know, I don't know if this is something common anymore, but my hospital, when I started training, we were on pen and paper still. We didn't switch to EMR until about halfway through my residency. I think I'm the last generation. But that's how we operate.
Christopher Habig
Absolutely. Absolutely. We were talking just before we hit record button about kind of throwing around. Well, when we continue that story that you're talking about and you save an ER visit, there's some great industry videos and studies out there that, you know, I believe put the price tag about 250K that lost revenue to hospital when a concierge or DPC physician saves an ER visit or keeps somebody out of the hospital. And both of our reactions were, ooh, that feels low. That feels really, really low.
But I know you say you're small potatoes right now, but if you're saving 20, 30 patients each year from going into your local hospital, put that at a million bucks each. I mean, you're going to start impacting local hospitals big time, big time. At what point do you think kind of looking at your crystal ball, at what point do you think the hospitals wake up to this and say, ooh, maybe this isn't in our best interest or maybe we should start paying more attention to these concierge docs?
Dr. William Steelman
Well, you know, there's two things with that. One is September 4th is when the FTC rule is set to drop and that officially ends the non-competes for the docs. Meaning that you've got an entire nation full of doctors who now can reevaluate the contract, which makes independent direct specialty care and direct primary care a very viable thing. So that's one that I'm looking for.
Christopher Habig
If non if the nonprofits fall into that one though, there's a lot of nonprofit hospitals that aren't regulated by the FTC and I believe it's in the courts right now.
Dr. William Steelman
So they did go back, the US Chamber of Commerce sued and there's others, but they haven't put a stay on it yet. So it's not officially stopped. So drop date is September 4th. We're going to wait until the last minute. But I'm optimistic for this because they did have a carve out for not-for-profits that specifically have a for-profit arm, which is how most positions are contracted out. So this is something I'm looking forward to because I would really like to see the hospitals take advantage of this because, believe it or not, something that I say frequently is that we actually improve their profitability. Yes, we take away from inappropriate ER visits, which is excess healthcare spending, but if I can go to someone's house and I can scan their liver with a quick screening ultrasound abdomen that we don't charge for, I'm also identifying something quickly, and I'm able to send that person in for an earlier specialty visit, and get a follow-up confirmatory study, something like that. So good healthcare should drive good referrals to the hospital. And the hospital systems that are the first to grab onto the DPC movement are gonna benefit from this.
Christopher Habig
I tend to agree with you, but again, everything, all the incentives in healthcare from the insurance and from the hospital side are built to do the opposite of what you just described. don't want efficient referrals. They don't want somebody coming in and just doing this referral over here because the insurance companies, they want to build the maximum that they possibly can to get their medical loss ratios in balance. And I don't really blame them. They got regulated into profitability and into a set profit margin, which I wouldn't necessarily be on that one, but no one has any love law for the insurance companies. So they're incentivized to bill as much as possible. And then hospitals are too.
So, you know, I hear what you're saying, but there's a fundamental problem in the way the traditional healthcare industry functions, where what you just described is still considered an outlier. So they might look at that and say, well, that is taking revenue off, but it's all funny money anyways.
Dr. William Steelman
Right. Yeah, and the other half of that is, you know, that it also gives a bigger opportunity for self-funded employer programs to dump the BUCAs and come back to the hospitals directly with their own programs, which would close the circle, make it local. And healthcare is local. I'm absolutely convinced of this.
Christopher Habig
I love that you said that. tell every single politician that. Every time I sit down with politician I say, do you agree politics is local? They're like, yeah, absolutely. That's number one. I go, I'm going to blow your mind here again. All healthcare is local. They're like, what? What do you mean? A fifth of our economy is based off the interaction between Dr. Steelman and a patient. And every single doctor out there is doctor and a patient. Fifth of the economy. It's an unreal, very House of Cards feel, when you get down to it, of just that one interaction.
I want to go back to the FTC, say that it goes through and that the nonprofit hospitals are included in that. Do you think you see a mass exodus of physicians running for the exits or do you think you see more of a Stockholm syndrome where they just kind of hunker down because they don't know what to do?
Dr. William Steelman
I see something along the lines of, try on medical care out of North Carolina. that was one example where the docs, left the hospital, and then renegotiated a contract with the hospital to provide the care, just like it used to be a private group. You would have three private groups in town and they would have their own patients and then they were referred to specialty care to the hospital and the hospital didn't have to worry about followup and staffing primary care clinics because it was all taken care of.
But that I think that what that is the base of the pyramid that we depend on in the hospital system. Because when I discharge people from the hospital, I write, follow up with your primary care physician in seven to 10 days. And guess how many of those people even have met a primary care physician?
Christopher Habig
Not many. Zero.
Dr. William Steelman
Yeah. Right. But guess how, guess how involved I am with my patients when, when they're sick, they go to the ER, they go to the hospital, they come out of the hospital. I'm on them immediately. I'm on them through the whole visit. And you know, my plan is to, I'm not gonna go back into the hospital again, because that's just, it's too much, right? But I can navigate for them. I can, I can coordinate with them. I basically take over all of the headaches that the case managers in the hospital have to deal with. So, readmissions, I mean, forget about it. It's a win.
Christopher Habig
Absolutely. Let's I want to talk about that because I love this concept that you know your physician is the quarterback of your care and your primary excuse me be specific your primary care physician is a quarterback of your care. Walk us through kind of that customer journey or patient journey when you say all right Mr. Doe you need to go see a specialist in the hospital or yeah you do need to be admitted. What do you tell them about the involvement that you're going to have? How involved are you? What do you tell them what to do, instructions, all that kind of stuff for quite literally surviving a hospital admission?
Dr. William Steelman
Sure. I mean, you know, my background was internal medicine. and I, I, I came out, trained traditional in the office, where we would see people in the office, send them to the hospital, see them in the hospital, discharge them, go see them in the office again. Sometimes, you know, in and out within the same week. But, like I said, that was the last dinosaur place on earth that, did that, you know? and we gave out our cell phones, you know, that's the way it was in a small town.
But DPC is just what I see as an extension of that in a more formal sense. My intention my when I set this practice up I wanted to be you know, I wanted to help people with navigation I wanted to help them with cost savings. I want to help them with prevention So if they get sick and need to be hospitalized I want to help them navigate that system because I know all too well how confusing it can be because you have specialists that walk in and are just not very personable. And will say two words they didn't understand and you know that used to be my job was to walk in and say he meant to tell you all this stuff. And you know you do a lot of side talk to try to help them understand what the surgeon just did and what they're gonna do next. Because continuity of care is something we all assume happens. But I can I can promise you it doesn't happen even at the nicest hospitals. I've worked at I think 10 different hospital systems total. None of them can say we nailed down follow-ups. It just doesn't happen if you don't have a 100% dedicated primary.
Christopher Habig
How important is it to have specialist partners that are operating outside of the hospital world that understand your model, understand the level of care that you want to produce for your patients, and then be able to communicate both ways with you for a patient's care?
Dr. William Steelman
So it's extremely efficient when I've gotten it to work so far because I know all the players in my hometown and who's involved. And I just text them. I said, hey, I got this guy. I'm going to send him for an MRI. And then I'm going to refer him off to your office. I'll make sure you get a copy of the CD. I'll get you a full H&P from me that's updated with all the meds and everything's right.
So I'm basically handing it to them on a golden platter. I mean, I don't know why they don't love it. But for the most part, they're under so much pressure from the insurance world that they don't know which way is up in the general sense. But in practice, it should be, this is the way that we all trained for the medical system to work anyways. So it's flawless integration when it works.
Christopher Habig
I like that when it works. think there's a lot of people who saying, yes, this is everything is amazing when it works from using a credit card machine to pay for gas or for coffee all the way through. you know, medicine is so it's so it's so personally like you got to rely on people. I don't know how else to put that. And when they're so hurried and so rushed and struggling to meet quotas of how many patients they have to see in the office, things fall through the crack. And unfortunately, those things are human beings. And that's what has always been very, very scary from my standpoint, learning more and more about how that side of the coin works and how it operates on that side.
Dr. William Steelman
What I imagine is that as DPC grows, as DPC becomes primary care, which is absolutely how I see it, and then direct specialty care will become a thing too, as I see it as well, especially for the screening stuff. We were talking about green imaging just announcing they were opening up colonoscopies, is groundbreaking stuff. You know, this is exactly where I see it going.
Imagine how much better specialty care you could get through a hospital system if you weren't constantly being driven all these bogus consults from, you know, urgent care box number one that was just too busy to interpret the EKG or to work up, you know, a syncope spell. Or they're too worried about all the possibilities of malpractice and all this kind of stuff. And so they just refer away, refer away, become this referral machine. Sure, that drives up overall spend, but it also wastes the specialist's time so that they're just worn out and they're not able to catch the real stuff. So imagine if they get everything on a golden platter, all lined up and all handed to them for this just a straight, right to diagnosis, right to treatment, how much better their lives would be. That's just my thought.
Christopher Habig
I've been a firm believer that primary care, like we mentioned, it's the entrance for a lot of people into the world of getting better treatment from the healthcare side of it. And it's going to be building out a strong foundation. Kind of like a pyramid. Where right now we have an inverted pyramid because we, the least amount of money and time at primary care and it's top heavy because the surgeons are the rock stars and that's where all the money goes and the time goes. We flip that over and we have that base feeding up into less specialists. And maybe I'm a pie in the sky guy, but I truly believe that hospitals would self-correct. They would understand this and lean down and kind of skinny down their operations in order to serve those primary care, kind of like a normal pyramid-based function going in there. I don't know if that's going to be true, though. There might be a lot of hospitals who say, gosh, we can't skinny down or change our model at all. We're just going to go ahead and close and relocate to urban population centers and leave the vast majority of the United States unable to seek anything beyond family medicine or primary care, which it all works together. So that that's where it…kind of a pie in the sky, tell me I'm nuts thinking that. But we’re already seeing the consolidation in urban centers right now.
Dr. William Steelman
Yeah, you're seeing consolidation in suburban centers. you know, there's no question that these hospitals are just mega, mega corporate machines now. you, it's partially funded, you like you're seeing that Medicare cut coming up in 2025. There's, I don't know anybody who can continue to take hits like that in the fee for service world and stay open, not without being subsidized or owned by venture capital or major hospital systems. So that's why I jumped ship when I when I did. And why I said this is the future this is what I think. Plus I wanted it to be.
Christopher Habig
Well, that's a good motivation right there. This is what you want to do, right? You seem to be a pretty happy doctor. You're smiling, you got good stories. You don't see that a lot. I was at a conference recently and it was a lot of CME heavy and we're there kind of educating about the concierge and DPC side of it. And I tell you, our table was full compared to some of the local hospitals out there that nobody talked to, but the docs in this conference just seemed like zombies. And all of a sudden they’d talk to us and be like, wait a minute, what is this? This is unbelievable. So even though we kind of live in this echo chamber in our industry, like you've still got to make these outroads into the broader physician base because there's still tons and tons of physicians out there, the vast majority of them that don't even know that this is a reality, don't even know your kind of practice is real and it's viable. It's almost mind blowing. We've been doing this for a while and just like, man. There's got to be more momentum than what we see, but that's okay. One doc at a time, we can fix this thing. We can turn it around.
Dr. William Steelman
Yeah, I am enjoying growing slowly as it is because we perfect our processes one step at a time. Every time we find some inefficiency, we rewrite it. And so we're creating this as we go with all of our process. But you can't just cookie cut or make this happen.
I have had people approach me and talk about joining larger practices that are, don't know, I'm sure you've heard the DPC and name only idea here where you become a virtual processing agent, and it's like, it's so disconnected from what we're talking about, what my practice is really set up as in terms of like traditional Marcus Welby-type physician. This old old old school, you know, I gotta get my leisure suit out and do the Halloween thing. But no it's interesting to see this grow up and people try to go well this particular service is really good in DPC we can break that off and just sell that as a service this little piece of the pie. I'm like it doesn't work guys. I mean like sure that'll be effective, but you get this synergy when you complete the circle and you have an entire ecosystem for patients to start and finish in. Selling this off piecemeal for somebody to do electronically, remotely, it's not everything. It doesn't work if you don't have the rest of it.
Christopher Habig
Oh absolutely. I'm relating it to this idea that, you know, when people, go to the dentist every six months, right, that's ingrained in us since we were little kids. But people do everything they can to avoid going to the doctor. And I'm thinking, think of all the different systems in your body that have to be functioning together in near perfect harmony for us to even get out of bed or drive a car, go to work or think or do anything. Yet, we don't want to go to the doctor.
So what you just said of, you need that PCP, you need that relationship with your doctor, because there are so many things that are working together in perfect harmony that's absolutely amazing. Why wouldn't you want somebody who has that general knowledge to be able to spot problems on speed dial and bring all of that together in one house so that there's not leakage and there's not waste and there's not compliance issues when you gotta run all over town to try to do a specialist for every single thing. And I think a lot of Americans have fallen into that mindset that, I just go to my family doc as a quick triage so that can get a referral. I just need that referral, whether it's a, I said like a funny looking mole, like I gotta go see a dermatologist. Well, no, you don't. We have amazing citizens in your communities that can do almost everything that these specialists can and satisfy most care needs of any American pretty much any given day, which is really remarkable. So what you're saying resonates very, very well.
Last question for you here, Dr. Steelman, you mentioned earlier on in this episode that the concierge side of it and the membership side was kind of an afterthought is the wrong word to use there, but you kind of built it after you had certain things like your own skincare line going and you had all these kinds of things going. I'm going to assume, based on what I know and what I've talked about, that that's kind of the different direction, I guess, to build practices than what most physicians do.
So walk us through, give us a quick summary of what that journey was into more of the aesthetic side of it and then why you went, you know what, we need to put a membership on here as well.
Dr. William Steelman
So initially we looked at, well, whole journey started, and I've gone through this on other, another podcast and things. But in general, what happened was, I kept having patients in the hospital who were getting readmitted because they would leave, get sick, didn't have anybody to call. They just come back to the ER. And that costs them an unbelievable amount of money. It actually hurts the hospitals because they get readmission rates that they don't want. And they actually turn some of that stress on the doctors who were told, you you're a bad doctor, you got a readmission. And you know, it's just this unnecessary thing. And everyone kept asking me, like, when are gonna open your own office? When are you gonna open it? And so I said, okay, fine, I'm gonna open an office, I'm gonna look into this, I'm gonna see what it says. And then what I did was I looked around the fee for service world and I saw what kind of contracts they were giving and it was horrendous. Like I would have to have 2500 to 3500 people. I would have to cram them in. I'd have to hire this humongous staff. I would have to take in an SBA loan and a huge, you know, building to have enough rooms to make this, you know, know, economically viable. It just wasn't a viable process.
So I said, okay, fine. I'm going to offer all these services that people are asking me for. The aesthetics. The travel medicine. The advanced diagnostics. So I used Peter Attia's book, “Outlive” as a reference to try to set my healthcare 3.0 goals. Like, what am gonna do that's gonna really transform how I think a doctor should be in 2024? And I said, okay, so let's start from scratch. What are all the services I'm gonna offer? How much is that gonna cost? What is it gonna actually come down to? And what I found was there was no way to subsidize this without a membership.
And so the only way, I didn't know about DPC until about six months into this journey, I had never even heard of it. So that's how good the message is getting across to the world, you know, just for reference. But we were pretty set that we were going to be Concierge and we were going to be, you know, a couple hundred bucks a month and do all these things. And then I said, well then we'll throw in all these labs. And I said, I said, why do that? Let's just go to a lower price. That's about the same time I discovered DPC. And I said, this is a no brainer because it sets your, it sets your ability to maintain the business, paid for entirely. The house is entirely paid for by your memberships. Pays for your docs, pays for your services, pays for everything on the sun. And then you're free to do whatever you want to do that you can maintain, good health among your patients.
And so I said, okay. I'll get certified in aesthetics. I did filler, hyaluronic acid fillers and Botox. Super easy. Some scary stuff to discover that along the way. You know, like, what kind of wild west these med spas are doing, compared to how absolutely risk-averse you are in the medical world compared to the med spas. It's pretty amazing.
Once you step into that world, you realize, if I could do this, why can't I do this other stuff? So we came up with this skincare line because we said, okay, well, I'm going to capture people making them beautiful on the outside in order to grab them and make them go get their colonoscopy.
And then I'm going to convince them, hey, why don't you get these lab tests done? Let's find out if you're pre-diabetic. And you would not believe how many pre-diabetic people I've picked up. How many fatty livers I've picked up. In people that had no idea, right? And it's all these little things that trigger people's interest in engaging the healthcare system in general that allow me to reach out and actually do the internal medicine side.
So I found that that setting the low price where DPCs tend to be that that 75 to 100 usually cap out about 150, which is what the ACA limit for DPC designation was. And I don't know why that is, but you know, that's a separate talk. But that's where we said it. We said ninety nine dollars. We'll start there and we'll give it a shot. And it turned that not a single patient ever asked us about the cost. None. Like we had a couple of patients that were like, you want me to pay you like a membership? Like, I don't understand. But they, they were stuck in the insurance mindset. And so you have to constantly educate people. And what I found is that I have to basically chase them down to get them to engage me, to call me back. And what was helpful was my wife is very personable, so she actually gave them her cell phone too. And they would text her at 10 o'clock at night rather than text me. And then you kind of like begin the training of like how to DPC as a patient. And it actually becomes very convenient. For me, I actually really enjoy doing the work now. I'm not the same person that I was when I was working full-time in the hospital anymore.
You said I was happy. People that know me would know that I was a pretty miserable soul under the fee-for-service world. And I was not prospering. So doing this and getting joy out of medicine again is just life-changing.
Christopher Habig
It's very inspirational and there's an old joke you'll hear on different conferences is that when you walk into a physician conference and you look around at everybody, how do you know how to spot all the DPC or concierge physicians? They're the ones smiling, just like you are right there behind camera right there.
So Dr. William Steelman with the Steelman Medical Group out of beautiful Houston. Dr. Steelman, thanks for joining us here on Healthcare Americana.
Dr. William Steelman
Thank you for having me.
Christopher Habig
And to our listeners, thank you for joining us on this episode of Healthcare Americana. We hope you found today's discussion insightful and inspiring. If you enjoy the show, leave us a rating and review on your favorite podcast platform. For more episodes and latest updates. Visit our website at healthcareamericana.com.
I'm Christopher Habig, once again, reminding you to stay informed, stay healthy and stay empowered. Until next time, take care.
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