Today we’d like to introduce you to Rami Turner.
Hi Rami, it’s an honor to have you on the platform. Thanks for taking the time to share your story with us – to start maybe you can share some of your backstory with our readers?
I have lived in DFW area my entire life, Most of my family had some kind of personal business except that my mother became a nurse. I was a stay at home mom, tired and frustrated with short office visits to doctors for myself and my children and it seemed that a good diagnosis was hard to find. It would take several 5-10 visits to the doctor on one single subject to get and answer and trusting that they knew more than I did, I grew impatient or gave up many times thinking I must be okay because the doctor would not be concerned.
Little did I know that they were so constrained by time. It turns out that to make a living as a doctor, you must see at least 4 patients an hour which only allows for about 7 minutes of face time. I had a degree in Piano, I taught piano but after so many missed diagnosis that would end up in a crisis at the hospital before I would get a diagnosis and because I had a true interest in health and wellness, got brave (or crazy) and took premed classes to get into medical school and graduated Family Medicine residency in 2015 only to discover after 3 1/2 years that I had a debilitating autoimmune disease and was disabled. The disease is called Stiff Person Syndrome and it is very rare.
There are not many answers to this type of problem so I had to spend several years at home trying to figure out how to live my life without constant pain. I determined to find some “outside the box” solutions and did get some functionality back. I do have to stay limited in my activity to avoid a crisis but I have a Nurse Practitioner who can see most of the patients in the clinic I opened. I opened this clinic because I never want to see another person go to the doctor and not be heard. I tried so many times to tell doctors what was going on not only with my problems but with each of my children.
Opening a clinic is very hard and time consuming but it doesn’t involve a lot of manual labor.. Supervising others to adopt my philosophy about care has not been hard, As healthcare providers, we are all frustrated with the inadequate care that is left for us to give with the demands of multiple patients and I had to decide to begin the process of making a Direct Primary Care business where we bypass insurance altogether. This is because the insurance companies will decline one single lab and the patient will be left will a bill that is higher than the whole set of labs if I let the lab company bill us directly.
Insurance is proven to be fine if you have a catastrophe but if you do have some strange or unusual problem or need real care with your health decisions and test made by your doctor, there is no other way except to make 10 visits to have 7 minutes with your doctor over several years while you wait for a crisis or you go see a doctor who will take time to listen and then you start getting help as I work to figure out what you really need.
What people need is a comprehensive exam that includes emotional and support systems with help to correct these issues and also getting the right tests to catch things before they get to be too much. I find myself much more satisfied to work with the complicated patients in our office that I did for the years I spent on the 7 minute face to face time.
I’ll be honest though. There are days I wonder why I don’t go home and just collect a check for disability. The cost of running the clinic is high.
I thought my education in medicine was perhaps a waste of time but then someone sends a message thanking me for standing up for them and getting them help when no one else would and know that I not only changed their life for the better, but some would have died and that makes all the difference.
Would you say it’s been a smooth road, and if not what are some of the biggest challenges you’ve faced along the way?
Not at all smooth. I had a person who staked some money to help us get started. He didn’t stake that much but he wanted to “help”. He had to be sent home due to inability to understand the routine and standards in the office. I am still cleaning up on accounts that he made in my name but didn’t list me as even a user – Like GoogleAds and our phone and internet system. I get leads through videos but finding time has been hard. Our first EHR system was really bad and the biller and credentialist were all essentially a scam and we lost 6 months to not getting credentialled. that should have been a sign to just not take insurance in the first place but I did get credentialled. The EHR got a pretty good chunk of change from us as well as the credentialist who wasted my time and money. The person who staked money was working the front desk and was playing favorites with patients and would insist on a job that he would do and then didn’t do it. On top of all of that, I do work with quite a bit of pain everyday. If I don’t move, I will hurt. If I move too much I will hurt and so I have to balance that with about 54 doctor visits of my own a year. I get pretty exhausted. But I believe so strongly that people deserve the dignity of help when they see a doctor instead of the structured system we have now, I just can’t watch that happen to people in my office.
Alright, so let’s switch gears a bit and talk business. What should we know?
This is the Direct Primary Care clinic that offers a subscription plan for individuals and families for a monthly, quarterly or even annual plan to see the doctor or hear from the doctor as often as needed without worrying about the appointment cost. The labs are at rock bottom prices, the procedures are discounted 20-30% and in this way, patients who would normally pay $365.00 or more for an office visit for a chronic problem would instead pay $80-100 a month and not hesitate to come in for a few labs to make sure their medications are not hurting them. The price for the membership in the plan is about the same or less than a gym club membership or pet insurance. I have a pet with pet insurance and I paid over $200 for a blood test that would cost us less than $10.00.
What sets me apart? I listen, and I believe my patients. That is the quote from my patient. My nurse practitioner listens. She and I keep thinking about what is going on with them and look for ways to help. I am still thinking about it until I have something that I can try. I don’t give up and I listen to the patient. If you listen long enough, the patient will tell you what is wrong. I look for innovative ways to help. I investigate peptides to see what is safe, I consider overweight to be a clinical emergency due to the health problems it creates and I don’t blame the patient. Losing weight is hard. I look for the core issues and go after the entire problem as a whole patient, not just “a disease”.
I once saw a man while in residency who was on metformin. He was not good about keeping appointments, he ended up with kidney failure from the metformin. When he went to the hospital for the surgery for the ability to get dialysis, he died on the table of a heart attack. I saw several patients that were “adopted” into my practice throughout the years who were not ignored exactly but to save time, corners were cut. 3 that come to mind all had a serious cancer that had gone much further than it should have because of that situation.
We offer pain relief through non-invasive means and keep medications low by getting rid of the pain with a Stemwave machine that works for many people. If it doesn’t, I work to help reduce these problems with many other options. (I have a lot of experience with innovative ways to relieve pain). I offer opportunities for people to get genetic testing for cancer problems or consideration of diseases they may be susceptible to. I offer weight loss help and we of course handle acute illness, presurgical clearances, standard health and wellness care and what we offer most is people who care.
Can you talk to us about how you think about risk?
I am taking a risk right now that my health could suddenly fail. I take a risk that our finances could go belly-up if we don’t keep patients and if the Practice fails.
At this point, I shouldn’t take any more risks for myself. I am extremely careful about not leaving my patients at risk but I honestly went to the ER with a headache in spite because my own insurance didn’t cover the Botox that stops my headache. I failed to mention that I was doubled up in pain the day before from my stomach. It was so bad I had to pull myself together to drive 15 minutes home. So when I went in for my headache I mentioned the stomach was not being so friendly but was “better”. It was an “aside” mention. I had my appendix removed that night because it was severely infected. I have a high pain tolerance.
Pricing:
- 80-100 for individual memberships
- discounts for members in Direct Primary Care
- Stemwave is normally $150 a treatment but discounted when bought in a package.
- $49.00 for an initial evaluation on Stemwave
- Cash office visit is from $250 to $400.00
Contact Info:
- Website: www.devotedDPC.com or www.ramiturner.com
- Instagram: https://www.instagram.com/dr.tinman7/ and https://www.instagram.com/devoteddpc_kellertx/
- Youtube: http://www.youtube.com/@DevotedDPCDirectPrimaryCare
