Dr. Jordan Shlain is an internist,= and founder of Private Medical, one of the longest-running concierge practices in the country, and a doctor who has spent 25 years arguing that primary care should never have been bundled into health insurance in the first place. His practice, and his writing on Substack at Don't Listen To Me, have made him one of concierge medicine's most direct voices, direct enough that the New England Journal of Medicine recently devoted a piece to asking whether his model has something to teach the rest of primary care.
In this episode of How I Doctor, Dr. Graham Walker sits down with Jordan to trace the origin story back to when a canceled business meeting sent Jordan wandering into a hotel lobby, where he talked his way into becoming the on-call physician for the Mandarin Oriental. That accidental job became San Francisco On Call Medical Group, then Private Medical in 2002, and eventually a 25-year experiment in what happens when a doctor's incentives and a patient's health point in exactly the same direction.
Jordan doesn't hedge. Insurance, he argues, is a financial hedge against catastrophic loss, not a mechanism for a doctor visit, and folding primary care into that system created most of the dysfunction physicians and patients feel today.
Graham and Jordan get into the actual economics of membership-based primary care, why fee-for-service quietly rewards a patient staying sick, what trust really means when it's stripped down to a promise instead of a marketing term, and why Jordan believes AI will only help physicians if it restores their agency instead of adding another layer of control.
What You'll Learn
- Why Jordan argues insurance was never built for routine primary care
- The real math behind a membership-based practice
- How a flat annual membership changes what a doctor is financially motivated to want for a patient
- The real definition of trust
- Jordan's prediction that 90 percent of healthcare could already move to email, text, and video
- What Jordan would eliminate from healthcare tomorrow if he could
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