The new way to practice medicine
Over the last few years, anybody living in Edmond has likely noticed the growth of urgent care medical clinics in the area. Nearly as common, but perhaps not noticed as much, has been the surge in the number of direct primary care providers in Edmond as well.
Family doctors in Oklahoma—reflecting a national trend—are increasingly leaving the traditional, pay-per-visit medical model to establish their direct primary care (DPC) practices.
Under this model of medical care, families and individuals pay the doctor a monthly fee. This fee covers in-person doctor visits, many other types of doctor care—including communication via texts, phone calls, and virtual visits—and, at many practices, minor procedures.
One Focus Medical
“We do chronic disease management,” said Dr. Jeff Davenport of One Focus Medical, a DPC provider in Edmond. “We do urgent care stuff. We do minor illness and minor injury type things and basically what you would expect a normal doctor to do. But instead of paying at the time of service, instead of taking insurance payments at the time of service, it’s just like a gym membership.”
“You pay a monthly fee and we take care of you.”
More common among doctors is the traditional fee-for-a-service model where patients pay their doctors’ offices for each visit — typically via the patient’s copay and health insurance.
For many doctors leaving the traditional model for direct primary care, the fee-for-service method leaves them overworked and leaves patients underserved.
“You have to see 25 people a day and there’s three hours of paperwork every day. It’s hard to take care of patients,” said Davenport. He added that the average traditional primary care doctor these days serves 2,500 to 3,500 patients, making it difficult for physicians in that system to provide quality patient care. “It’s hard to do a good job.”
It’s the reason why after spending eight years as a traditional doctor, he left the system to start One Focus Medical, one of the very first DPC model clinics in Oklahoma.
“I was the first doctor in the state, so I’m I guess the ‘OG’ I kind of jokingly refer to myself, as basically I was the first one to start,” he said, adding this April makes seven years since he first opened his doors.
Now, as a direct primary care doctor, he has fewer patients — around 650 presently — allowing him to spend more time with each patient and deliver them more personalized care and letting him devote more time to his own family and own health.
“It’s better for the patient because they have access to the doctor pretty much all hours.”
“It’s a win, win, win for everybody,” said Davenport.
Simple Primary Care Solutions
Dr. Steven King said he left the fee-for-a-service world and three years ago started Simple Primary Care Solutions, another DPC clinic in Edmond, to escape the “rat race and the pace” of the traditional system.
He felt the traditional system was unfair to doctors—as physicians often have to fight insurance companies just to get paid—and to patients—as they can often end up underserved.
“It’s no longer the doctor and the patient making choices,” said King. He explained that while in the fee-for-a-service system, an insurance company seems to make treatment determinations, in the DPC model, those decisions are made by the doctor and the patient.
“(Direct primary care) is a what I would call a more pure model and then there’s more collaboration between the physician and the patient.”
Primary Health Partners
The story was similar for Dr. Krista Schwarz with Primary Health Partners, another DPC provider with four clinics in the Oklahoma City metro area, including one in Edmond.
She shared that she nearly quit her more than 12-year career in medicine a few years ago due to the frustrations with the traditional system.
“To make that system work, you just have to see a lot of patients and you have to see them quickly and you’ve got all of these things you have to do when the patients come in to be reimbursed,” she said, describing patient load, time constraints and the burden of paperwork posed by regulations, Medicare, and insurance.
Schwarz would see a patient for a sore throat, for example, but would feel like she was merely checking off boxes for the appointment so that she could get paid.
“It just didn’t feel like it was the way that I wanted to practice medicine. I wanted to have time to spend with my patients,” she said.
After her last six years practicing in the fee-for-a-service system, she began looking into alternatives through which to practice — like concierge service or even volunteering.
It was then that she learned about DPC from the founders of Primary Health Partners and decided to continue practicing medicine with them.
Now, nearly three years later, as a DPC doctor, Schwarz knows she can provide better patient care.
“I really do feel like I have more time to spend with patients to really treat the problem versus, you know, ‘Hello! What’s your problem? Here’s your prescription. Check back with me in three months,’ or things like that,” she said.
“I can take care of every problem that they have, no matter what it is. There’s not a restriction because of the insurance but I really am a family medicine doctor who practices good old family medicine and if the patient needs me to do more, I certainly have time to research and look into things. Whereas before I might have referred them out for some things and now I can kind of take care of that in the office.”
A lower cost for patients
Concerning the cost of this alternative method of primary care, according to Davenport, the goal of DPC is to be affordable to the patient, a general unwritten rule among DPC providers being to provide primary care to patients for a cost less than a monthly mobile phone bill.
For example, a young family of four may pay $150 total for such a membership per month — $60 for two young adults and $15 for two children.
“It’s just a set fee every month. If they see me five times in a month it’s the same as it is if they see me once,” he said.
Most DPC providers offer a tiered approach to monthly fees. The fee is lowest for children, as they will likely require the least medical care, a little higher for young adults as they may require more, then again, a bit more for middle-aged adults and yet more for older adults, as they will likely need the most care. But each level is priced to be reasonable and respective of the care provided.
Additionally, while many DPC patients may not have insurance, many still do. Those patients with insurance only use it for more expensive procedures, like CT scans, MRIs, surgeries, and the like.
Even with those procedures, DPC providers can often direct both their insured and uninsured patients to providers where they can pay cash and spend much less than if they’d used insurance.
King said, for example, his clinic has an arrangement with a local lab allowing for special lower pricing for services as blood tests and such.
“(Patients) can use their insurance if they want but often if they pay cash for the labs, they’re vastly cheaper than actually even using insurance,” he said.
Like many DPC clinics, Simple Primary Care Solutions has a limited in-house pharmacy to serve prescription needs at a cost often less than many popular drug store chains offer.
“That’s a good deal. So there’s some value added perks to (DPC) as well,” said King.
King believes the reason many doctors have migrated to DPC is the freedom offered by the model.
“One of the main things I would say about direct primary care practices is that they typically tend to be very nimble in that, it’s not a big hierarchal organization that you’re dealing with — we can make changes to really do what’s best for the patient. You see something is working? Okay. Let’s do this and let’s make this better for the patient.”
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About Thomas Berger
Thomas Berger is the owner of Ciskus Creative, an Edmond-based creative agency focused on creating marketing content for small and medium-sized businesses.
Prior to starting his own company, he worked as the communications/marketing specialist for an Oklahoma City-based office technology company. Former to coming to the Oklahoma City area, he had worked as a career journalist for more than a decade — initially reporting for several newspapers in western North Carolina and northeastern Oklahoma and later as a multimedia journalist for KJRH Channel 2 in Tulsa.
Thomas has lived in Edmond with his wife Alison since 2013. He has a passion for traveling, photography, learning languages, landscaping and coffee roasting. He holds a Bachelor of Arts in English from Western Carolina University.