DPC Dr. Efe Sahinoglu out of Birmingham, Alabama

Healthscient Interview with DPC Dr. Efe Sahinoglu

DPC Dr. Efe Sahinoglu out of Birmingham, Alabama

We at Healthscient are big fans of the rapidly emerging Direct Primary Care practice model. Dr. Efe Sahinoglu opened Birmingham Direct Primary Care in Birmingham, AL in mid-2018. We recently sat down with Dr. Efe to hear about why he chose this model, this market, and what he’s seeing so far.


Why did you decide to practice Primary Care? What was the attraction?

Dr. Efe:

I was attracted to the prospect of longitudinal care. I like the idea of a continuous physician-patient relationship and being there to support a patient every step of the way throughout his or her life. Prevention, treatment, and assistance in coordinating care with specialists are all a part of continuous care and that’s important to me. Being a family medicine doctor allows me to provide care to patients of all ages and genders and allows me to provide care over the span of many years. I’ve seen so many patients with medical problems that could have been easily prevented through proper medical guidance and a healthier lifestyle. Many of these patients didn’t have easy or affordable access to a primary care physician and so their highly preventable or manageable conditions became worse and worse and increasingly problematic. The importance of a good primary care doctor – a “care quarterback,” if you will – cannot be overstated.


Why did you establish a Direct Primary Care practice (DPC)? What is the appeal?

Dr. Efe:

The Direct Primary Care model allows me to take the time to listen to a patient’s concerns without putting them on an assembly line of 30 patients a day. I can focus on caring for patients and solving medical problems rather than wasting time on medical insurance coding, paperwork, and other interferences. My patients can keep in touch with me – and also help me monitor the course of their progress or treatment – which can be done through text, phone, email, or some type of video conferencing like Skype as well as office visits. I like the ability to spend more time with patients during office visits (like 30 to 60 minutes rather than 7 to 10 minutes per visit) and patients like same or next day appointments and no waiting in our lobby!


What exactly IS Direct Primary Care in your words? What’s its promise? What’s the difference between DPC and a typical primary care practice?

Dr. Efe:

It’s the care I always envisioned providing to patients. It’s not the traditional primary care model where the doctor has about 7 minutes per appointment to try to provide comprehensive and preventive medical care. Seven minutes or so is all the time a doctor can devote to each patient in a typical primary care practice because the physician has to see 25-30 patients per day just to stay afloat. As a side note, this kind of relentless and unrewarding work is the primary reason for rampant physician burnout. Direct Primary Care is about the patient, not the practice. Time, easy access, affordability, focus, and longitudinal care greatly, greatly benefit the patient. Fortunately, the model is good for physicians, too. Being freed from the burden of billing and a mountain of time-consuming administrative requirements translates to being a better, more attentive doctor. Lasting, meaningful relationships are formed and care becomes more collaborative.


Who should consider joining your DPC practice? Is there an “ideal” patient?

Dr. Efe:

Direct Primary Care is ideal for just about any type of patient. Generally healthy people of any age, people managing multiple chronic conditions and medications, people beginning to experience age related illnesses, families with kids, college students away from home, and young people just getting off a parent’s insurance plan due to age are all suited perfectly for DPC.
People concerned about the cost of quality care can benefit. The actual cost savings this type model provides, of course, depends on the patient case by case. For example, a common feature of DPC is wholesale medication and lab pricing. Just the savings from wholesale drug pricing (dispensed from the practice) can more than pay the membership fee for a patient requiring multiple, ongoing medications. Busy people who just hate going to a doctor’s office because of the huge difference in wait time and facetime with the physician will love DPC. Not only is there convenient access and no waiting, but many, routine medical problems can be handled over the phone. Time is money for everybody. On a similar note, DPC is also ideal for college students who are busy with their studies and may prefer to use technology to communicate with their doctor rather than go through the hassle of trying to squeeze in an appointment between classes. Often, parents of college students feel relieved that their kids, who may be miles away, have access to quality, concierge style medical care at an affordable price. Patients who require frequent monitoring by their primary care physician will appreciate the “no co-pay” feature of Direct Primary Care.
Cost savings are important, of course, but ultimately Direct Primary Care is perfect for any person who values an ongoing physician-patient relationship, values expert, focused attention, or who values quick, easy and convenient access to medical care.


Did you transition from a traditional practice or start from scratch?

Dr. Efe:

I started from scratch, despite many traditional practice positions being available to me. I felt that running my own DPC practice was financially appealing for a younger physician fresh out of training with lots of medical school debt. After going through my training, I did not want an “administration” to tell me how to see my patients and to be continually telling me to “hurry up!” I wanted to be a doctor – practicing medicine – rather than be enslaved by medical insurance coding and paperwork.
During my medical school and residency training, no one really taught me how to start my own practice – especially not a DPC practice. (Dr. Sahinoglu notes that the majority of his practice management courses in medical school were focused on proper coding. Geez…)


How do you feel about your decision so far? How are things working out?

Dr. Efe:

I knew it would be tough starting out. Many people have not heard about the concept of Direct Primary Care as it really hasn’t made its way down here (Birmingham, Alabama) like it has in some other cities or states. So, it is taking some time to educate the general public. However, I’m just excited to be part of this movement and it’s definitely exciting to see its growth here in Birmingham – slow though it may be. I’m really looking forward to the years ahead. I have no doubt that the Direct Primary Care model is going to continue to spread throughout the greater Birmingham area as people start to become aware of the option.


So, why DID you choose to set up your practice in Birmingham, Alabama?

Dr. Efe:

I spent 20 years in Alabama and really just wanted to stay in the state and serve its great residents. About a quarter of this time was in Birmingham, including my medical training. I loved the diversity, the small city feel with the bigger city advantages. I have family in Montgomery and the rest of the state is quite accessible from Birmingham. Also, I noticed the DPC model wasn’t well known to Birmingham (at the time of this interview, there was only one other DPC clinic in the city) and wanted to help make this model of providing quality, affordable primary care more available to the good folks of Birmingham.


Well, finally then, what would you like the good people in the Birmingham, Alabama area to know and how do they get in touch with you?

Dr. Efe:

This model is for everyone. Whether or not you have health insurance. Young or old. If you would like to be part of a 600 person patient panel rather than the typical 2000-5000 and if you want a physician to truly know and care for you and your family. If you like the idea of no co-pays and if same or next day appointments are attractive to you. If you want longer facetime with your physician when needed and want to be able to communicate via text, phone, email, video conference or office visits. If you want access to greatly reduced medications and lab costs. Check us out at:

About Dr. Efe Sahinoglu

Efe Sahinoglu, MD, is a full board certified family medicine physician. He is from Montgomery, Alabama. He attended Auburn University (Auburn, Alabama) where he finished his bachelor’s in chemical engineering with honors, and worked as an engineer before attending medical school at the University of Alabama School of Medicine. He received his third and fourth years of clinical education from the Medical School’s main campus in Birmingham. Afterwards Dr. Sahinoglu completed his family medicine residency at University of Alabama Family Medicine Residency Program.

Wearables Are Revolutionizing Healthcare

A major component of achieving good health that results in lower healthcare costs is prevention.
That’s a no-brainer. Additionally, early detection plays a key role in the prevention of acute health problems and emerging conditions.

The rapidly growing wearables industry is helping make both prevention and early detection more readily attainable than ever before. And as wearables keep getting better, they continue to do what made them great in the first place: encouraging and nudging us to exercise more, sleep better, and eat well.

And all of these great innovations (in wearables) that we’re seeing right now are likely just the beginning.

TechRadar, a self-proclaimed gaggle of geeks who research and report on the latest technology products and trends, describes the inventive wearable industry this way:

“It feels very much like we’re reaching a tipping point: ever-smaller, ever-smarter devices are making the previously impossible possible, enabling us to learn more about our bodies and how to look after them. Plenty of technologies promise to change your life, but wearables genuinely will.”

Just ask Deanna Recktenwald, whose watch warned her that her resting heart rate was surging. Her kidneys were beginning to fail.

Sarah-Jayne McIntosh’s Fitbit warned her of a similar condition, helping her avoid possible cardiac arrest.

New Yorker William Monzidelis was alerted by his Apple Watch to seek medical attention. At the hospital, he learned that that he had suffered an erupted ulcer and received life-saving surgery.

There are scores of stories of doctors being able to better diagnose and determine courses of treatment for patients who present as unable to communicate by digging in to archived health data on the patient’s wearable device.

To put it succinctly, we’ve come a long way from simply counting steps.

L’Oreal, the beauty firm, recently launched a wearable UV sensor to help protect against skin cancer. Their new wearable is tiny, fits on your thumbnail, and tells you when it’s time to get out of the sun.

There are practical uses for wearables too, like Carelink, who creates wearables that can locate and help dementia patients who may be prone to wandering.

In Closing

Here at Healthscient, we agree with TechRadar: the wearables market is poised to revolutionize everything. You can read their full article on wearables here.

If you haven’t already, be sure to sign up for Healthscient email updates. You’ll be the first to receive our free e-Guide titled “5 Steps to Better Health at Lower Cost” and we’ll deliver it to your inbox in the days ahead. For a sneak peek, see this infographic below and our related blog post!.

Unexpected medical bills

How To Lower Your Risk of Receiving an Unexpected and Costly Medical Bill

We hear the horror stories time after time. Someone has received necessary medical attention and then gotten stuck with a bill their insurance company has refused to pay. The doctor or hospital informs the patient that she’s on the hook for it and the payment is often beyond budget.

Take Brittany Cloyd’s story for example, which was shared and published by Vox Media.

[Brittany] was doubled over in pain when she arrived at Frankfort Regional Medical Center’s emergency room on July 21, 2017. “They got me a wheelchair and wheeled me back to a room immediately,” said Cloyd, 27, who lives in Kentucky.

Cloyd came in after a night of worsening fever and an increasing pain on the right side of her stomach. She called her mother, a former nurse, who thought it sounded like appendicitis and told Cloyd to go to the hospital immediately.

The doctors in the emergency room did multiple tests including a CT scan and ultrasound. They determined that Cloyd had ovarian cysts, not appendicitis. They gave her pain medications that helped her feel better, and an order to follow up with a gynecologist.

A few weeks later, Cloyd received something else: a $12,596 hospital bill her insurance denied — leaving her on the hook for all of it. Her insurance company denied the claim – saying an ER visit for ovarian cysts was unnecessary and inappropriate.

How was she supposed to know?

Or like Scott Kohan’s story, another eye-opening story shared by Vox Media.

[Scott] who woke up in an emergency room in downtown Austin, Texas, with his jaw broken in two places – the result of a violent attack the night before. Witnesses called 911, which dispatched an ambulance that brought him to the hospital while he was unconscious.

“The thing I remember most was my lips were caked in blood and super dry,” Kohan says. “My head was throbbing, so I touched the top of my head, and I could feel staples there.”

Kohan called for a nurse, who explained that he would need jaw surgery that night. In the meantime, he tried to check whether the hospital — Dell Seton Medical Center — was in his insurance network.

“I was on my iPhone lying there with a broken jaw, and I go on the Humana website and see the hospital listed,” Kohan says. “So I figured, okay, I should be good.”

Except he wasn’t: While the emergency room (where Kohan was seen) was in his insurance network, the oral surgeon who worked in that ER was not. That’s how Kohan ended up with a $7,924 bill from the oral surgeon that his health plan declined.

How could he have known that?

These stories, and many others like them, are part of a project by Vox to uncover, document, and report on such cases. These stories are real. And there are a lot of them.

So the questions become, “How do you lower the risk of receiving an unexpected, high dollar medical bill?” “What can you do if you find yourself in a similar situation?”

Here’s a practical list our team has put together to help you lower the risk:

  • Know your insurance plan (backwards and forwards) before you actually need to use it. Be knowledgeable about the can’s and can not’s, the do’s and do not’s, and the will’s and will not’s. Know your stuff.
  • When possible, have an advocate with you at the hospital. Drag along someone you trust who will ask good questions and help you make good decisions.
  • Never sign any kind of financial responsibility or insurance waiver before getting the necessary pre-authorizations unless absolutely necessary due to the urgency of your situation. If you need life-saving surgery or treatment right then – go ahead! Sort it out later. BUT – if you are presented with a waiver that requires you to assume full responsibility for payment simply to accommodate the hospital or doctor’s schedule – wait it out. Time slots frequently open up unexpectedly and you may be pressured to move ahead for the sake of the efficiency of the provider. Don’t do it. Get your pre-authorization.
  • As a bit of an aside, be aware of ambulance costs. These can sneak up on you. There should be a line item in your insurance plan. Uber may be smarter. Read more about it in this article by Kaiser Health or in this summary article by Frugal Nurse.

But let’s face it, sometimes it doesn’t matter how careful you are, as the stories above illustrate. Other times you are simply situationally incapable of making careful, informed decisions. And a whopping, unexpected medical bill is the result.

What to do then?

  • Don’t take it at face value. Contact your insurance company. Explain the situation. Argue like crazy. Ask about their appeals process. You’re the customer.
  • Know about the resources in your state that advocate and represent you. Consumers Union – an advocacy group within Consumer Reports – has a great online tool to help you know about agencies in your state that will help you appeal and negotiate high, unexpected medical bills.
  • Many states have laws on the books to prevent this kind of behavior by insurance companies. More legislation is on the way across the country. How about your state? The Commonwealth Fund may be able to help point you in the right direction.
  • Haggle. No kidding – haggle and negotiate with the originator of the denied claim. Very often, they are more than willing to reduce fees and work out payment plans with you. They just want to get paid.


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