Spotlight: An Annapolis Internal Medicine Physician: Michael Freedman, MD
Dr. Michael Freedman has been an Annapolis Internal Medicine physician since 1997 and has been awarded Top Docs honors 6 years in a row from Whats Up Magazine. Despite his exemplary reputation, Dr. Freedman was personally struggling with the pace and demands of seeing 30-35 patients per day.
In August of 2012, he took time off and began to formulate a solution. He wanted a practice where he could provide a much higher level of care and service in a setting that was fast, easy and accessible. It needed to have the same conveniences as salons, hotels and restaurants. It needed to be technologically cutting edge with online scheduling that was easy and fast, not bulky like today’s electronic medical portals. The phones needed to be answered by a human. He wanted to be able to communicate with his patients via text, email or virtually. He envisioned a system where patients could have a virtual visit and if they still needed additional testing, such as a throat swab, urine test or finger-stick blood test, they could practically drive-thru, have the test done in under 5 minutes and then take their antibiotics home (all quicker than a visit even to the pharmacy.)
He imagined an environment to be relaxing, with hard wood floors, local artists paintings, coffee, tea and water with lemon–something more reminiscent of a cafe or spa than a doctors office. And he didn’t want anyone to ever wait more than 30 minutes to be seen.
Although Dr. Freedman had been offered positions with MDVIP and other concierge practices, he felt the cost was too high.”I started with a goal of, ‘How can I provide really excellent care to a much greater percentage of patients?’”
Evolve, says Freedman, was the answer.
After spending months looking at different financial scenarios, speaking to legal experts on healthcare and reimbursement, he opened Evolve Direct Primary Care. Membership is only $35/month with $25 per visit–whether virtual or in-person. As a membership, the practice is not incentivized to make people come in for every little thing. Instead, Dr. Freedman and his Nurse Practitioners are more than happy to take care of things in the most convenient way possible for the patient: by phone, text, email, virtual or in-person.
Medicare/Medicaid and many commercial insurers do not allow for any type of access fee, such as a membership, so this model also meant not taking insurance. Concierge group such as MDVIP used to say their yearly fee was “for an annual physical” but after ACA mandated a free physical yearly, they changed it to a yearly fee for blood work. Other concierge services do something similar, offering a “suite of services” that equates to the amount of the yearly membership fee. The problem is they have to continuously change those services as things become covered or are found to be not clinically useful.
But not taking insurance has turned out to be a huge bonus for many patients. As more insurance plans include higher deductibles, more patients are looking for cost transparency. “What’s happening is with all these high deductible [plans], of $3,000 to $6,000 an annual deductible … is that people are going to primary care and they’re getting a bill for what the insurance would have paid, and everything is their responsibility, so they’re paying all this money anyway,” says Freedman. “My goal is to carve insurance out of the entire industry period so that healthcare insurance will not be part of primary care or urgent care.
I think we’re at this amazing time right now where primary care can get free of the insurance hassles that have haunted it for the last few decades. Dropping insurance lowers the office overhead immediately by 40% and that savings can be passed back to the patients and reinvested in technology, better communication and accessibility.
As Dr. Freedman continued to research, redesign and begin implementation, he found a small group of like-minded physicians providing a similar type of primary care, what would become known as Direct Primary Care. In Seattle, a 6 office medical group called Qliance was providing a very similar service, though slightly more expensive and was being backed by Michael Dell and Jeff Bezos. Another group out of California was MedLion which was franchising similar sites in California and Nevada.
So how is it working? After opening the doors in July 2014, Freedman has this to say, “… It’s just like working in heaven, Nirvana. We come in to work and there are hardwood floors, and there’s artwork hanging on the walls. It’s clean, it’s pleasant. We’ve got a hand-picked A-list team [of providers] … Everyone just loves coming in.” And most importantly, the patients love Evolve too.
Portions of this article were taken from a February 2015 Physicians Practice article, “Opening a Direct Pay Membership Medical Home.”
More about Dr. Freedman
Dr. Freedman was born and raised in Silver Spring, Maryland. After graduating from Springbrook High School, he moved to Ann Arbor and received his Bachelor of Sciences from the University of Michigan majoring in psychology and biology. He subsequently earned a Masters in Physiology from Georgetown University before enrolling at Hahnemann University Medical School in Philadelphia (now Drexel University) While there, he led a group which built the largest
student-run medical system for the homeless in the country, and was awarded the 807th Daily Point of Light by then-President George Bush.
Read more about the Hahnemann Homeless Clinics Project here.
On graduation from Med School, he also received the following awards: The Daniel Mason Award for Excellence in Cardiology; The Hahnemann Club Award for Academic Excellence, Outstanding Leadership and Loyalty; The Joseph A. Langbord Memorial Prize for Humanitiarism in Medicine; and The Student Affairs Committee Award for Outstanding Service to the Class, the University and the Community.
Dr. Freedman was accepted by his first choice for residency training at Emory University in Atlanta. He completed his residency in Internal Medicine in 3 years, receiving letters of recommendation from some of the most respected physicians in medicine. In 1997, he became Board Certified in Internal Medicine and moved to Annapolis to join Annapolis Internal Medicine. He has a special interests in Cardiology, Geriatrics and preventive/general wellness — both physical and mental.
Shortly after moving to Annapolis, he joined a small group of physicians who were providing medical care to the residents of the Lighthouse Shelter. This group, founded by Rich Bernstein, MD and Rich Colgan, MD, had recently begun seeing patients one afternoon per week on Clay and Washington street. Dr. Freedman was asked to assume the position of Medical Director. While with the Annapolis Outreach Clinic, Dr. Freedman personally grew the number of participating physicians from roughly 12 to well over 150. The clinic only included primary care doctors but Dr. Freedman added GYN and women’s services, Pediatric clinics, Psychiatric services, Orthopedic and Neurologic clinics, Dermatology clinic and many others. He arranged for free Radiology services through Anne Arundel Diagnostics–including CT scans and MRIs. He got AAMC to agree to donate surgical OR time for free and was able to convince the Department of Anesthesia to donate all of their time to surgery. He found members of the Surgical services including Orthopedics, Neurosurgery, General Surgery and others to donate up to 10 surgeries per month for free. Patient are able to be referred to any specialty at AAMC and be seen free of charge now. In 2007-2008, the demand for the clinic, which by then had relocated to a permanent position at the Stanton Center on Washington Street, was outstripping the space available in the building. He found more and more doctors who wanted to volunteer their time and with over 6,500 patient visits per year, he decided that another location was necessary. He and Bill West, who had become a close working ally, after many long arduous attempts, were able to convince AAMC to open a 2nd location which is now a Medicaid-type clinic located on Forest Drive. In fall 2011, Dr. Freedman stepped down from this leadership position to focus on his personal practice, running Annapolis Internal Medicine and raising his son.
While at Annapolis Internal Medicine, Dr. Freedman served as the Practice Administrator for over 10 years. He was privileged to build a loyal following of patients, many of whom he developed a very close, personal relationship with. He also was extremely well respected by the Specialist of Anne Arundel Medical Center and cared for many of the doctors, nurses and other staff from AAMC. As a result, his practice grew immensely. In addition to the above, he also served on the following committees: AAMC Medical Executive Board Strategic Planning Committee, AAMC Medical Executive Board Community Needs Assessment Committee, AAMC Information Technology Advisement Committee, and AAMC’s Strategic Physician Synergy group.
In 2007, Dr. Freedman re-certified for the American Board of Internal Medicine. In August of 2012, he went on sabbatical for personal reasons. In January 2013 he began planning Evolve Direct Primary Care. In October 2013, he re-certified for the American Board of Internal Medicine.