My vision for DPC: grow without sacrificing culture and community
DPC thrives at the local level. We all want to grow DPC so more clinicians and more patients can benefit. The risk with growing DPC, as I saw when I consulted private equity firms, is scaling too quickly and with the wrong partner can lead to reduced quality of care. The investment firm or chain operates top-down and the practice loses its culture and connection to the community it serves. That is why I designed Timshel Health to respect the autonomy and uniqueness of DPC practices.
We are a partner-based holding company, not a private equity firm and not a national chain. We don’t want to roll up DPC practices and we don’t want to create a national chain. We want to support multiple community-based practices that are led by their founder physician with know-how and capital.
Our partners are highly motivated to grow their practice and grow DPC at large; they are great entrepreneurs who don’t need us to run their practice today but want a growth partner to make their practice - and the DPC movement as a whole - bigger and better.
mac@timshelhealth.com
Why I believe in DPC
I was drawn to healthcare to help people, but I didn’t feel like I was. Across roles with various healthcare organizations, I saw firsthand how insurance does not work for primary and preventative care. Insurance is for unpredictable, infrequent events. Nobody needs a middleman when they want to talk to their primary care doctor or the added cost and barriers that come with them.
I started my career in consulting trying to solve healthcare's inefficiencies with clients at large health systems, payers, and private equity firms. More often than not, we were helping providers rapidly scale so they could increase their market power and negotiate higher reimbursement rates. Or private equity firms reduced the quality of care to increase margins. I then switched to a software company that helped providers transition o value-based care, hoping these programs would reduce costs and improve quality. Our customers would frequently use our software to game the value-based care programs rather than improve quality of care, and the hundreds of metrics they had to track meant more time on admin and less on patient care.
I read the book Catastrophic Care and started talking to people, like Mike at Sesame, Jeff at Taro Health, and Andy at Crowdhealth, to learn more about the direct care ecosystem. I realized (like many others have) that direct care is the best solution to help clinicians provide affordable, high quality, proactive care. I went to CVS Health hoping to work on some of these direct care ideas at scale. As Direct of Pharmacy Strategy, I tried to introduce price shopping for customers, subscription-based services, and more direct care options through MinuteClinic. CVS works hard for its customers, but they are also limited by insurance companies and risk-aversion, and my ideas mostly stalled.
I went back to business school to work on startup ideas to expand direct care, like an insurance plan that used cash prices rather than negotiated rates, and an app that helped employees price shop for healthcare services and share in the savings. Ultimately I decided I wanted to be closer to direct care itself and the great physicians involved in the DPC community, so I started Timshel Health.
