The Medical Record System for Direct Primary Care


I am not against EMRs (electronic medical records).  The key is that it has to work for me and not the other way  around. To be fair to these EMR companies, that will never work if all the doctor is trying to do is massage the note so they optimize his payment.  In other words, as long as the doctor is working for the government or insurance company, a perfect EMR will not exist.

What if the doctor didn’t work for the gov’t or insurance companies?  What if the physician put up his/her own shingle and charged patients a reasonable monthly fee to see them?  What would he/she use?  Personally, I considered going back to paper charts.  There are a few problems, however. One is office space.  The second is the on-call issue.  Being able to access charts 24/7 is a nice value to patients when they need a prescription, etc and it is nighttime or you are out of town.

I have been doing direct primary care for about  6 months now.  I am about half way filled and I started my practice from scratch.  In other words, I did not have a full panel to pull from when I made the decision that I was all in for DPC.  That put me at a financial disadvantage but it also meant I was not locked into any computer system.  I had seen some options for EMRs for DPC at conferences but the guy that really convinced me that this type of practice was for me was also the guy who has his own system.  Josh Umbehr at Atlas.MD is one of the pioneers in direct primary care.  Not only has he figured how to make his practice successful but he has also developed a reasonable costing cloud EMR for others to rent.  (Full disclosure: Josh has his ad on this site and I use EMR his product in exchange for that space).

So do I like the Atlas.MD product?  Absolutely.  Now there was some things to get used to, however.  I had used Allscripts, Centricity, and others so I was proficient in EMR use. The problem is that what I really was used to was writing a note so it codes correctly.  Trying to forget all that was tough.  I had to relearn how to make a chart that was about narrative and care.  I needed to make my notes work for me to protect me in case of a lawsuit but more importantly, tell a story so that I can continue with good care the next time the patient came.  The Atlas.MD product allows me to do that.  That isn’t its strongest advantage, though.  The Atlas.MD let’s me bill the patient monthly without having to think about it.  When patients join, they have to build their chart on my website (so I don’t have to) and then enter their credit card.   Each month, their fee is pulled and I get paid.  No fuss, no muss.  The Atlas.MD also allows me to use my smartphone for everything.  I can access charts, fax prescriptions, send text message, send emails, and so much more.  This EMR lets me do almost everything I used to do on the other products but in a much simpler way.   Oh, and each communication via email or text is automatically routed through the EMR and saved in the patient’s chart.   In other words, I don’t have to type it in later.

I wanted to do this review for a while now.  If anyone is interested in more information, just email me or go to the Atlas.MD website.  I do not get a commission or referral fee.  Could this product be better?  Sure.  Everything could be better and I think they really do a good job taking feedback to update their system.  There is a happy medium between wanting perfection in an EMR versus realizing you don’t need all those bells and whistles any more because you are not shackled to the gov’t or insurance system.  When you get to that point, like I finally did,  you realize that this product may be the best medical record system for your direct primary care practice.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  4 comments for “The Medical Record System for Direct Primary Care

  1. Joseph Sarnelle
    March 25, 2015 at 8:12 pm

    $3,600 for a 1 year subscription is outrageous. Almost as bad as the ABIM.

    • Doug Farrago
      March 25, 2015 at 8:13 pm

      It is a full EMR and a billing system in one. I disagree.

  2. Dr Thomas D Guastavino
    March 25, 2015 at 7:55 am

    Years ago we switched to digital X-rays because it made sense, no bribe, no punishment for not doing. Are there any physicians out there who would have switched to EMR on their own? Anyone?

    • Randy
      March 26, 2015 at 12:59 pm

      Actually yeah. I use Amazing Charts and am happy with it. Storing paper charts was an increasing burden and switching to EMR solved that problem, plus I saved a considerable amount on transcription. Overall I think the benefits of my EMR outweigh the downsides. Overall I like electronic prescribing too.

      The trouble for me is not the EMR, it’s the government pushing MU and PQRS. If I could just use the EMR so it’s useful to me and not worry about making Medicare happy, I can work just as fast as with paper records with much less storage space. When recordkeeping is larded up with a bunch of little boxes to check and stuff that has no bearing on how well I actually take care of patients, that’s when the EMR slows things down and becomes counter-productive.

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