Join us on Full Circle for a candid conversation with Dr. Frank Okosun — internal medicine physician and 11-year private practice owner who built his patient base by doing the opposite of what the system rewards: real time, root causes, and no volume pressure. In this episode, he calls out the conflicts of interest in insurance consolidation, explains why the RVU system is quietly destroying primary care, and walks through the prevention model he's building — a 300-600 patient panel, same-day visits, and an 18-test physical that catches what standard labs miss.

0:51 From Meharry residency to 4,000 patients — building a practice from scratch

3:01 Why he left employed medicine — volume, referrals, and procedures over patient time

4:51 Physician costs are under 10% of healthcare spend — so why do doctors get blamed?

6:17 "Pawns in a bigger chess game" — the middlemen patients never see

8:20 Doctors on computers — documentation and prior auth crowding out patient care

11:06 UnitedHealthcare employs 10% of US physicians and owns their pharmacy and insurer

15:40 Root causes over symptoms — a $500 drug for an unemployed patient isn't treatment

19:44 For-profit insurance — prior auth as a payout reduction tool, not a care tool

22:43 Fix 1: Increase primary care reimbursement — the RVU system is the core problem

27:42 Fix 2: A flat monthly per-patient fee aligned with outcomes

33:33 The prevention model — a comprehensive executive physical, not concierge care

36:08 50% of cardiac events have normal cholesterol — standard labs miss the real risk

39:26 Dangerous silos — two doctors prescribing duplicate beta blockers to the same patient

43:19 300–600 patients, same-day access, 30–60 minute visits

46:00 Advice for new physicians — choose by passion and stay independent

51:16 The business of medicine — what 11 years in practice teaches that school never does

Guest: Dr. Frank Okosun | Internal Medicine Physician & Private Practice Owner

Host: Prerna | Circle Health