acid right but let's say dr hartman sensible and sends me back to primary care doc dr tom three weeks later i'm back with dr tom and you maybe have gotten a note from dr hartman maybe not that says thank you for saying peter beyond saying he doesn't have heart problems working out so you put me on over the counter prosecco what is what is that happened what has happened six weeks have gone by without me being treated for my symptoms it's inconvenient for me i've had to make appointments go visit wait three weeks and then wait three weeks again you have not had a primary care home model because you don't really know what's going on with me and and especially for all that you did. note and by the way it's pretty darn expensive yeah right and duplicate it so how would the co-op work and this is prototyping and starting in about three more months i come to see dr tom my primary care doc you have fifteen hundred patients why because what's been proven in group health the puget sound for example one of these good guy medical systems in washington state that the docs like it better patients like it better and you have better outcomes so we're not rewarding our docs

dr hartman. dr hartman sees me doesn't e.k.g. duplicative not hugely expensive but you multiply that by millions of times a year fee for service and it adds up he's going to and he's going to unquestionably do a stress test much more now than in the past twenty years because now they do stress tests at doctors' offices and the cardiologist office fee for service and they have a cardiology office visit so the cardiologist is paid for reading the being the stress test and the cardiologist office visit. she doctor hartman let's say decide this is probably reflux and so then decides to do what. everybody in my audience everybody that i ever talked to sent him to a g.i. doc but let's say this let's just say there are all right over in docility or of stomach acid right but let's say dr hartmann sensible and sends me back to primary care doc dr tom three weeks later i'm back with dr tom and you maybe have gotten a note from dr hartman maybe not that says thank you for saying peter b. on soon he doesn't have heart problems working out so you put me on over the counter price what is what is that happened what has happened six weeks have gone by without me being treated for my symptoms it's inconvenient for me i've had to make appointments go visit wait three weeks and then wait three weeks again you have not had a primary care home model because you don't really know what's going on with me and and the specialist referral and you did besides online note and by the way it's pretty darn expensive yeah right and duplicate it so how would the co-op work and this is prototyping and starting in about three more months i come to see dr tom my primary care doc you have fifteen hundred patients why because what's been proven in group health the puget sound for example one of th