In this second take on episode host Stacey Richter speaks with Dr. Tom Lee, founder of One Medical and Galileo. The discussion centers on the survival of independent primary care practices in the current healthcare economy, the associated challenges, and the paradox of primary care.

Topics include reducing ER visits, managing downstream specialty spend, and the imbalance between CMS and commercial carrier payments to primary care practices.

Dr. Lee highlights the importance of 'enlightened leadership' and a 'value-focused mindset' in balancing efficient service operations with quality care. He also touches on the complexities of integrating technology and human-centered care, the importance of operational efficiency, and the challenges posed by current reimbursement models.

For a bonus sidebar conversation with Dr. Lee, click here.

=== LINKS === 🔗 Show Notes with all mentioned links: https://cc-lnk.com/TakeTwo-EP445

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=== CONNECT WITH THE RHV TEAM === ✭ LinkedIn https://www.linkedin.com/company/relentless-health-value/ ✭ Threads https://www.threads.net/@relentlesshealthvalue/ ✭ Bluesky https://bsky.app/profile/relentleshealth.bsky.social ✭ X https://twitter.com/relentleshealth10:30 What is the paradox of primary care?

12:47 Why is it hard to run an independent primary care practice?

13:29 What are the barriers to running an independent primary care practice?

14:09 Can you have fee for service and value?

15:53 "Value is more about a mindset."

16:49 What hidden waste is there in a primary care practice?

18:36 What do you need to have a value-focused mindset?

20:41 Why does access precede quality?

22:40 What are the nuances of a service business that make them challenging for managers?

23:27 How do you find the balance between fee for service and value?

30:07 EP438 with John Lee, MD.

31:04 How can you invest in quality without a value-based contract?

33:09 How do you address the trade-off between fee-for-service finances and investing in value-based care?

34:26 Where is the "productive middle"?

35:18 Dr. Tom Lee's message to payers.

38:45 Dr. Tom Lee's message for policymakers.