MENTOR, Ohio — How long do you have to wait to see your primary care physician?
According to the Ohio Academy of Family Physicians, by 2025 Ohio will have a shortage of 1,200 doctors. Nationwide estimates are between 55,000 and 100,000 by the next decade, and many believe those estimates are conservative.
But there's a new type of health care model that's cutting the red tape and giving patients direct access to their doctors when they need them. Pat Laffey experienced it first-hand.
When Laffey's brother had heart trouble, it pushed him to want to get checked.
"I reached out to my doctor, and they said it was going to be about a year until I could get into see her, and I didn't want to wait a year," he says.
So, he called Maple Health DPC in Mentor, a newer type of direct-care model for primary care. The difference? Dr. Rich Berry doesn't accept insurance.
"I'm insured, but I pay a monthly subscription," Laffey explained. "But it's well worth it for the convenience of being able to come in here and see him immediately."
Ashley Oravacz is in nursing school, and Physician Assistant Courtney Kozak was her main health care provider. When Kozak moved to Maple Health a month ago, Oravacz followed.
"There's no copay," Oravacz told us. "You don't even have to bring your wallet here."
Oravacz says she pays a $70 monthly membership and she, too, has insurance, but she's buying convenience.
"The phone rings once and Dr. Berry answers the phone," she said. "There's no waiting; it's very convenient."
Berry and Kozak are part of a growing trend of health providers disillusioned and overworked by the traditional health care model. Berry left his hospital job just over a year ago and started Maple Health.
"I found that when I was in my old job, I was looking after over 2,000 patients. People couldn't get in to see me when they needed me," Berry recalled. "When they did get in to see me, my time was limited, and we were just getting to the point where we were getting so overloaded with work that I was unable to do things properly."
At his direct-care practice, patients get time with him and 24/7 access. He and his staff provide women's health exams, blood draws, and medication at discounted prices for chronic conditions, although they don't carry narcotics.
"We do everything primary care," he said. "So, we do the annual physical, we even do our own labs in the office. We do sick visits, strep throat, sinus infections, orthopedic problems, knee pains, hip pain, shoulder pain, and then also certain procedures."
And there's no need to ask for insurance approval because he doesn't accept it — membership fees are based on age and whether the patient wants to see Berry or Kozak. Fees usually range between $70 to $120 a month.
"The membership fee basically pays for anything that we can do," Berry detailed. "So, when you come to see us for a visit, the visit is included."
Berry says his typical patient is between the ages of 30 and 50 and usually uninsured or under insured. Those who do have insurance usually have high deductibles, and he's starting to see more Medicare patients coming in for things that aren't covered on their plans.
Thirteen months since opening, he now has about 400 patients. He set a limit at 600 patients each for himself and Kozak.
"I know that I can comfortably see eight patients a day, 10 patients a day," Berry said. "I can still be available, I can keep the level of quality, I can still be answering my own phones, I can still be answering my own messages."
Kozak has been there for a month.
"I'm a new mom; I have an 8-month-old at home," she stated. "So, if anyone needs quality time at home and quality of life, I mean, it's definitely me, from this standpoint."
Berry says we're going to see more direct care models, but still only for those who can afford it.
"Direct primary care has actually been around for around 15 years, and if you go back probably five, six years ago, there was around 500 in the country," he said. "We're probably adding 50 or 60 new clinics a month across the country."
There is a difference between direct care and concierge care. Some points to consider regarding direct primary care:
- You can cancel your membership at any time.
- The Affordable Care Act (ACA) considers DCP an acceptable non-insurance program.
- Physicians don't accept insurance or participate in government programs.
- Some medical services aren't covered, and if the health issue is out of the scope of the doctor, the patient will be referred to a specialist. This means patients could end up paying out-of-pocket to a specialist, urgent care, or hospital.
To find local DPC practices click HERE.