Membership medicine is the intersection of consumerism and healthcare. At ROAMD, we firmly believe this intersection can cure many of the ills plaguing the healthcare world, so we do everything we can to support physicians running membership medicine practices.

We’re incredibly proud of our fantastic group of physicians in the ROAMD network. Their mastery of medicine, outstanding business savvy, impeccable social skills, and humble desire to always keep learning ranks them among the rarest practitioners in healthcare and business today.

They’re here, collected into one group. And the minute another person with those characteristics walks in, their eyes light up, and they realize they’ve found their tribe.

ROAMD is an international network of membership-based medicine practitioners who want to be independent, but not alone^TM. We help practices with three things: care continuity, practice profitability, and connectivity with knowledge exchange.

Who Started ROAMD?

The foundation of ROAMD was set in 2017 when a group of physicians came together to form our PAC, Physician Advisory Council, to create a network for physicians by physicians.

Dr. Jordan Shlain, Founder of Private Medical, is one of our current PAC members:

“Our medical council is decorated with great physicians who understand the tenets of integrity, service, quality, and responsiveness. We are at a crossroads in medicine: small practice concierge physicians are not immune to the larger market forces of minute clinics, Apple Clinics, and many other large, well-funded businesses that want to compete. As ROAMD grows, we will be more resilient to these market forces. I believe in the power of networks, especially when mission-driven people create them.”

A Drive to Improve Healthcare

For its founders, ROAMD started with the realization that business savvy and medical care could come together to improve the quality of healthcare people receive every day.

We have seen that the status quo was broken. And once we saw it, we couldn’t unsee it — we couldn’t get past the problem standing right in front of us.

Starting something new would mean starting over. But we couldn’t simply continue as before. We could effect change. We could help, especially smaller businesses who didn’t have their feet set in the concrete of how things have always been.

So we chose to change the way healthcare operates.

From the time ROAMD was formed, it has been absolutely committed to helping these smaller businesses, these membership-based medicine practices, succeed, because they’re the ones creating a new norm.

They aren’t beholden to the existing status quo and aren’t addicted to a failing fee-for-service reimbursement system that feeds on quantity over quality.

The future of healthcare needs to be rewritten, and we are rewriting it.

Flaws in the System

You’d be hard-pressed to find someone shouting about how perfect our healthcare system is and that nothing needs to change. It’s no mystery why healthcare reform returns as a significant component of every candidate’s campaign platform every four years.

The following are some of the massive and systemic flaws that jumped out at the ROAMD founders when they considered today’s healthcare system:

How We Shop and Pay for Healthcare

One of the biggest problems with the status quo is how consumers shop and pay for healthcare services. It’s based on a system that isn’t built to be shopped; it’s built to be consumed.

As an illustration, consider if going out to eat operated like today’s healthcare system.

You walk into a restaurant and start looking through a menu full of food items; none have prices. You order, eat, and then leave without paying.

A couple of weeks later, your restaurant insurance provider sends you a letter explaining what you ate and whether they’ll pay for it. A few weeks after that, you get a bill from the restaurant. You have to pay the difference between what your insurance paid and what you owe to the restaurant.

Sometime later, you get another bill from the restaurant’s bartender. You’re surprised and call the restaurant to find out what’s happening. The bartender is an independent contractor who bills separately from the restaurant. Meanwhile, you’re still figuring out how to pay for your meal, wishing you’d known the pricing when you ordered the $5,000 steak instead of the $400 cheeseburger.

This is an absurd example, but that’s the point. We’d never go for this model in the restaurant industry, so why do we accept these standards in healthcare? But instead of making change, consumers throw up their hands and say, “that’s just healthcare,” because it’s how we’ve been trained to think about it.

What Insurance Is For

Another facet of the industry that can benefit from an absurd example is the role insurance plays.

If car insurance worked like health insurance, we’d file a claim not just for accidents but also whenever we needed an oil change, routine maintenance, or even just to fill up our gas tanks.

Car insurance doesn’t pay for these, of course. Why not? Because car insurance is for unforeseen events — like collisions or falling trees. It isn’t for the predictable necessities that accompany owning a car.

In car insurance, it’s silly to imagine a policy covering foreseeable expenses from simply using the vehicle. And yet, for healthcare, we adhere to a single insurance plan that covers unforeseeable accidents and routine oil changes.

Removing or minimizing the insurance involvement in primary care is a significant chapter of healthcare that ROAMD members are rewriting. Suppose a large percentage of primary care divorced itself from the insurance world and was replaced with more of the membership-based primary care dynamic. In that case, the overall costs of insurance should plummet.

There is a reason no one is campaigning for car insurance to cover oil changes. If we remove the equivalents of “gas,” “oil changes,” and other standard and predictable services from health insurance, it suddenly starts to align with how all insurance should work.

Quality of Care and Number of Patients

In today’s healthcare model, hospitals are required to function more like factories. As much as they focus on care quality, they still need a considerable volume of care to be profitable.

For example, consider the Readmission Reductions Program for hospitals. The way the incentive package was built doesn’t incentivize hospitals to eliminate all unplanned readmissions.

In truth, hospitals make a lot of money on those readmissions, and they rely on that revenue. That volume of readmissions helps the hospital factory complex survive.

We don’t claim to have a magic solution to fix the problem in hospitals, but we can say the incentive package as it relates to the broader vision for healthcare needs is broken.

We can also say with certainty that quality of care suffers if a primary care doctor has to have 3,000 patients in their panel to run a successful business. This is a massive problem within healthcare.

Physicians suffer.

Patients suffer.

And unfortunately, no one truly gets ahead in a world where one human is responsible for 3,000 covered lives.

Two Common Misconceptions About ROAMD

Misconception #1: We Only Want the Top 1%

One of the biggest misconceptions about ROAMD is that we only work with physicians who care for the top 1% of the population.

We’ve built an elite brand for successful, highly motivated physicians in private practice. Maybe because of this, some think we only accept members with very high membership fees. But that’s not true.

ROAMD has a wide range of members, from those who charge a nominal membership fee and members who charge more significant membership fees. Joining the ROAMD network has nothing to do with the size of your membership fees or how wealthy your patients are.

Instead, ROAMD is here to work with anyone who pursues a private membership-based medicine model and wants to continue to grow, learn, and thrive.

In ROAMD, everyone’s looking to add more patients, physicians, and/or locations. They’re trying to make a bigger footprint in this world.

There’s no judgment here. We’re cheering for all the practices that shift away from how things have always been. But the ROAMD network exists to encourage mutual growth and learning. “I’m content” is not a phrase we hear in our network. We exist to fight the status quo and provide support to our members, so their patients can live in a world where their physicians can genuinely care for their health.

Misconception #2: We’re Against DPC

Some have developed the notion that ROAMD is against direct primary care practices; again, this is categorically false. We are for DPC practices, and we want to help them grow. More than half of ROAMD members categorize themselves as DPC.

Creating Change that Matters

We are so proud of where ROAMD is today and of the direction in which we’re heading.

For most physicians, these aspects of healthcare are not taught in school or learned during the course of caring for patients. Our network aims to share this collective experience in an effort to improve the roadmap for ourselves and the next generation of membership-based medicine, concierge practice, and DPC physicians.

We’re here to change the healthcare landscape to create better experiences for doctors and patients alike.

Don’t accept the status quo.

Join us as we create change that matters, independent, but not alone.