What if you paid for your health care like you paid to fix and maintain your car?
You have insurance for a crash — an unexpected illness or injury — but you pay a doctor directly for more routine maintenance like regular physical exams and prescriptions.
This new and growing model of health care will arrive in Summit County on Sept. 8 when Dr. Eric Gibb expands his Buena Vista practice to include a Frisco clinic.
Some call the method concierge care or subscription care; Gibb, a family practice physician, calls it direct primary care.
“We don’t accept insurance. Thank goodness,” he said. “Let me clarify: We recommend that all of our patients have insurance. What we offer is the day-to-day, month-to-month, old-fashioned care, very personalized care. It’s like having a doctor in the family.”
Originally from northern California, he started practicing about 17 years ago in Buena Vista and began by seeing about 15 patients a day.
Then, like many doctors in the last four to five years, he said, he was driven by more regulations and insurance headaches to hire more employees to handle paperwork and billing. To pay those employees and earn the same living he had been making 10 to 15 years earlier, he saw more patients.
“I was frustrated with the system,” he said. “Many physicians in traditional medical offices are burning out and leaving their jobs. On the other side, patients are frustrated and worried about the costs and quality of their care. It’s a lose-lose situation.”
He was seeing 25 to 30 patients a day and spending less time with them, which made both him and his patients unhappy, he said. Soon, he’d completed 50,000 15-minute patient visits over the course of his practice.
“When they started to be eight minutes, that was just the straw that broke the camel’s back,” he said, describing how he hoped patients wouldn’t raise another issue he didn’t have time to address. “That’s just not why I went into medicine.”
Gibb enjoys getting to know his patients’ stories, he said, as well as being active in the community. He now serves as an elected town trustee and directs the local home-health agency.
He switched to the direct model about a year ago and reduced the number of patients he saw a year from 3,000 to about 320. He now schedules hourlong patient visits and typically sees six to eight a day.
“Call it old-fashioned, but I prefer it, and, more importantly, my patients prefer it. It’s a more personalized approach that caters to where, when and how they want to receive their care — whether that’s via text messages, a video call or even a house call,” said Gibb, describing the change. “It just doesn’t seem right that people are so separated from their doctors.”
In the current insurance-driven health care system, caregivers are reimbursed only for tests and procedures and for face-to-face consultations and exams. Providers aren’t incentivized to help patients who call, text or email, and critics say the system pushes doctors to insist on office visits, order unnecessary tests and prescribe excessive treatments and prescriptions.
His practice, called Our Town Medical, will open a clinic in the former Alpine Market building at 301 W. Main Street, Suite 202, with the following plans: $195 per month for anyone over 18 and $95 per child 18 and younger when a parent or guardian enrolls in a monthly plan.
For the monthly fee, patients have 24/7 access to Gibb, his small staff and services including physical exams, tests and lab work, medications, nutrition and fitness counseling and massage. The fee does not cover x-rays, surgeries, hospitalizations and more specialized care.
Patients are still required by law to have health insurance for catastrophic situations, but they could opt for policies with less expensive monthly premiums and higher deductibles.
The direct payment model meant Gibb could reduce his staff from a high of 23 full-time equivalents when he practiced with two other doctors to just one nurse when he made the switch in Buena Vista. The change more than halved his overhead costs, savings he can pass on to patients.
He has since hired a nurse practitioner and is in the process of hiring a nurse for the Frisco expansion. If that is successful, as he believes it will be, he plans to add another doctor and nurse practitioner.
Dr. David Gray, an emergency physician who does house calls and provides urgent care mainly to Summit County visitors, praised Gibb’s model and especially his use of telemedicine — or answering medical questions and providing advice by phone and online.
“A lot of medical care should and could be handled that way,” Gray said. “I would like to see medicine go that direction as opposed to the highly regulated, ruled business that it is today.”
Besides him, the only other health-care provider in Summit not accepting insurance in preference of a payment-for-services model is acupuncturist Kevin Waldron, who opened his own traditional Chinese medical practice in October. Gibb will be the first provider in Summit to use the subscription model.