EDMOND – Direct primary medical care is a membership model that is gaining in popularity across the country.
“One of the biggest (and most important) differences you’ll find between us and other traditional family practices is the number of patients we see,” said Dr. Jeffrey Davenport, a family-medicine physician who provides primary care and owns/operates One Focus Medical in Edmond.
“Most family docs in Oklahoma routinely include 2,500 patients or more in their practices. Others around the country are even more packed – 3,000 to 4,000 patients.” But with One Focus Medical, you’ll be part of an intimate family practice” that has about 680 patients, he said.
Direct primary care clinic membership “delivers personalized health care the way it used to be, and the way it should be now,” says the website for Dr. Brian Birdwell of the MainStreet Clinic in Lawton.
There are several advantages to a “concierge” medical practice, Davenport and Birdwell said.
• Patients have virtually unlimited access to their services. “After hours, weekends, holidays – there’s no bad time to receive medical care,” Davenport says on his website.
• Their patients have “extended, relaxed” visits. “I typically see my patients for at least 30 minutes, and these appointments often continue for an hour,” Davenport said.
Nationwide, face-time with a primary care doctor averages seven to 10 minutes, Birdwell says. But in direct primary care, “doctor face-time” averages 35 to 45 minutes. “Time with your doctor is not limited by a ticking clock.”
“I get paid to take care of people, not to just see people,” Davenport said.
• Both physicians provide same-day and next-day scheduling. “And my patients aren’t kept sitting in a crowded waiting room,” Davenport said.
Members of their Direct Primary Care clinics pay a flat monthly fee “and receive open access and attention to any pressing need.”
Davenport’s monthly fees are $60 for young adults, $75 for patients 50-64 years of age, and $100 for individuals 65 and older. For patients under 20 years of age, the fee is $15 per month but must include at least one adult parent/guardian.
“I make it affordable for the ‘average’ man and woman,” Davenport said. Moreover, if a visit to him saves them a trip to the hospital emergency room, “They usually come out ahead.”
Davenport, a graduate of the University of Oklahoma medical school, does not bill Medicare or private insurance (a/k/a third-party payers).
Most of his patients also carry insurance, he said. However, he urges his patients to pay for tests, such as MRIs, out-of-pocket whenever possible. “Many times it’s cheaper to pay cash than to go through insurance,” he said. With fewer patients, “I have more time to devote to each of my patients, and I talk them out of expensive testing more often than I talk them into it.”
Davenport said he refers his patients to specialists when necessary, and directs them to a hospital if a major emergency arises.
He fills many prescriptions from his medical office and sells the medications at-cost, no markup.
He sells only generics, doesn’t stock controlled substances such as opioid pain relievers, nor does he carry anti-anxiety medications. “I can’t even get pseudoephedrine” because the manufacturer of the decongestant Sudafed “won’t sell to private offices,” Davenport said. [Sudafed can be used to make illegal methamphetamine, although Sudafed itself is not addictive.]
Davenport said he stocks medications for cholesterol and diabetes, antibiotics, anti-inflammatories, birth control pills, meds for prostate conditions, gout, allergies, anti-viral and blood-pressure medications. “Nothing anybody would break in for.”
The tests that Davenport orders for his patients are cheaper because he has an arrangement with a nearby medical laboratory that “gives me great prices.” And, like medications, he bills the patient at-cost.
“I can get a lot of labwork for $40 or $50,” he said. For example, a Vitamin D test costs $28 “and that’s high.” A metabolic panel costs $4.14; a blood count, $3.54; a prostate blood exam, $9.45; a thyroid test, $6.06.
However, if the patient prefers, Davenport will send them to another lab “and let them use their insurance; it’s their choice.”
He owns the building in which is practice is located, and his wife works for him. A psychiatrist and a pathologist rent office space in the building.
DPC ‘A GROWING MODEL’
Davenport said he had a solo practice for three years and then worked in a hospital for five years. During those eight years “I worked at my desk during my lunch hour, catching up on paperwork.” He saw 25 patients per day, on average, he recalled, working at a clip of about 15 minutes per patient. “I saw the last one at 4:45 p.m. and then spent three hours on paperwork.” He would get home in time to read a bedtime story to his two young daughters.
His work week at the hospital was routinely 50 to 60 hours, he said.
Today he arrives at his office between 8:30 and 9 a.m., “I rarely stay after 5 p.m.,” and he works only half-days on Mondays and Fridays unless a patient requires immediate attention. Nevertheless, he is available to provide urgent care 7 days a week, he said.
“Do you want to be seen by an exhausted, burned-out, angry doctor versus a rested doctor who has plenty of time to give you personal attention?” Dropout, burnout and suicide rates are six times greater for doctors than for “average” Americans, Davenport said.
Direct primary care “has been around for about 15 years,” he said.
Davenport, 46, founded his DPC practice – “Mine was the first one in Oklahoma.” – a little over seven years ago, in April 2014, and Birdwell followed later that year. Direct Primary Care now has 31 locations in Oklahoma “and there are maybe 60 or 65 of us doctors,” Davenport said. Today there are more than 1,000 DPC physicians nationwide, he said. “This is a growing model.”