Jaren Blake
@jarenblake.bsky.social
I'm a solo family physician in a Direct Primary Care clinic. College sports, ham radio, and wilderness medicine are my hobbies.
Where can I buy better care? For starters, if the country used a ICHRA style plan then they could buy the same for insurance but now the patient has more autonomy. If it is care then a lot of patients would like the option of having access to a DPC. We should subsidize patients, not companies. 2/2
November 9, 2025 at 5:50 AM
Where can I buy better care? For starters, if the country used a ICHRA style plan then they could buy the same for insurance but now the patient has more autonomy. If it is care then a lot of patients would like the option of having access to a DPC. We should subsidize patients, not companies. 2/2
Insurance and a health plan are two different things. The ACA bound them together and we ended up with worst and most inefficient components of both. You can't insure something that everyone uses--that's a plan. Insurance is for rare and catastrophic. It is inefficient otherwise. 1/2
November 9, 2025 at 5:46 AM
Insurance and a health plan are two different things. The ACA bound them together and we ended up with worst and most inefficient components of both. You can't insure something that everyone uses--that's a plan. Insurance is for rare and catastrophic. It is inefficient otherwise. 1/2
It's terrifying to think about the paucity of rigorous data about the harms and benefits of EMRs generally and switching between them in particular.
July 10, 2025 at 7:12 PM
It's terrifying to think about the paucity of rigorous data about the harms and benefits of EMRs generally and switching between them in particular.
This isn't the way but it's good to let the states experiment. 2 years ago I was on a committee that was asked to prepare for the high likelihood of reduced federal spend on medicaid. Many ideas increased access and savings but ultimately, we were stymied not at the state level but at the federal.
July 2, 2025 at 7:07 AM
This isn't the way but it's good to let the states experiment. 2 years ago I was on a committee that was asked to prepare for the high likelihood of reduced federal spend on medicaid. Many ideas increased access and savings but ultimately, we were stymied not at the state level but at the federal.
I think the effect on private insurance is more nuanced. There is data that the massive subsidies that medicaid offers insurance companies helps drive up costs. As providers, we see little of those subsidies so we forget about them. Also, the explosion of medicaid spending sure didn't lower costs.
July 2, 2025 at 6:47 AM
I think the effect on private insurance is more nuanced. There is data that the massive subsidies that medicaid offers insurance companies helps drive up costs. As providers, we see little of those subsidies so we forget about them. Also, the explosion of medicaid spending sure didn't lower costs.
We offer drinks and snacks. Dr. Pepper is the big winner. And Rice Krispies treats. The Kirkland granola bars are a close second.
July 2, 2025 at 6:41 AM
We offer drinks and snacks. Dr. Pepper is the big winner. And Rice Krispies treats. The Kirkland granola bars are a close second.
Something isn't right here. 1/3 will close? That wasn't the survey question.
June 26, 2025 at 6:43 AM
Something isn't right here. 1/3 will close? That wasn't the survey question.
We ain't dead yet. Thanks to leaving the system, my career has been more fulfilling, and I anticipate that I will be practicing for far more years. I know my patients by name, I joy in seeing them and my cost for care is 1/2 of what we pay the FQHC. Let's free up the workforce and let us loose.
June 25, 2025 at 6:19 AM
We ain't dead yet. Thanks to leaving the system, my career has been more fulfilling, and I anticipate that I will be practicing for far more years. I know my patients by name, I joy in seeing them and my cost for care is 1/2 of what we pay the FQHC. Let's free up the workforce and let us loose.
Perhaps in an ideal world employers wouldn't be involved in health care. Barring that, I think what we got here is the best possible solution. The patient contracts with any DPC and their employer reimburses them--not me. I am out of the loop and the employer meets the federal requirements.
June 25, 2025 at 2:49 AM
Perhaps in an ideal world employers wouldn't be involved in health care. Barring that, I think what we got here is the best possible solution. The patient contracts with any DPC and their employer reimburses them--not me. I am out of the loop and the employer meets the federal requirements.
Another member here too. IMO, more doctors would go to this model if more patients pushed for it. We even got the largest insurer in the state to reimburse a large portion of the subscription fees but it has been slow for people to sign on.
June 24, 2025 at 6:57 AM
Another member here too. IMO, more doctors would go to this model if more patients pushed for it. We even got the largest insurer in the state to reimburse a large portion of the subscription fees but it has been slow for people to sign on.
That's awesome. Way to go! We need more of us doing outreach like this.
June 9, 2025 at 4:19 AM
That's awesome. Way to go! We need more of us doing outreach like this.
Crickets. Well said.
June 9, 2025 at 1:43 AM
Crickets. Well said.
I can't speak for the other topics Mark mentions but the discussions around US health care reform are really quiet here. On Twitter there are robust discussions. I wish we had that type of discourse here.
June 9, 2025 at 1:42 AM
I can't speak for the other topics Mark mentions but the discussions around US health care reform are really quiet here. On Twitter there are robust discussions. I wish we had that type of discourse here.
I lament how this is happening but this is a major downside of gov't run healthcare. Insurance is for the rare and catastrophic. Primary care shouldn't be rare or catastrophic. In the long run, the sooner we stop allowing ins and gov't to control access the more autonomy our patients get back.
June 6, 2025 at 4:59 AM
I lament how this is happening but this is a major downside of gov't run healthcare. Insurance is for the rare and catastrophic. Primary care shouldn't be rare or catastrophic. In the long run, the sooner we stop allowing ins and gov't to control access the more autonomy our patients get back.
Your role as a daughter is far more important than your role as a physician. 1000s can be their doc. Few or one can be their daughter. Just find ways to love them.
May 28, 2025 at 5:37 AM
Your role as a daughter is far more important than your role as a physician. 1000s can be their doc. Few or one can be their daughter. Just find ways to love them.
I’m a fan of the PSLF but it has some perverse incentives as is. It incentivizes long residencies and fellowships. Getting 84/120 months for some subspecialties. Being able to wipe $500k of debt in a few years is way better than using an NHSC program that is focused on the underserved.
May 13, 2025 at 3:27 AM
I’m a fan of the PSLF but it has some perverse incentives as is. It incentivizes long residencies and fellowships. Getting 84/120 months for some subspecialties. Being able to wipe $500k of debt in a few years is way better than using an NHSC program that is focused on the underserved.
Or is it an argument against gov’t funded insurance/health plans? The private companies are following the rules, policies, and system set by the gov’t.
April 24, 2025 at 5:55 AM
Or is it an argument against gov’t funded insurance/health plans? The private companies are following the rules, policies, and system set by the gov’t.
I have been very unsatisfied with SquareSpace. Moving away this month.
April 24, 2025 at 5:44 AM
I have been very unsatisfied with SquareSpace. Moving away this month.
That would have been a spectacle to behold.
March 29, 2025 at 4:28 PM
That would have been a spectacle to behold.
Would that I could be there. I'm committed to activities here but one nice perk of being in solo practice is that I can make sure I'll be home for tip-off. Yeah, Newark. It feels like a Pace Picante commercial. Have fun abroad!
March 25, 2025 at 6:09 AM
Would that I could be there. I'm committed to activities here but one nice perk of being in solo practice is that I can make sure I'll be home for tip-off. Yeah, Newark. It feels like a Pace Picante commercial. Have fun abroad!