Prescription for the future? Clinic offers services for monthly fee

Dr. Jamie Faught did something recently that many of her colleagues could probably only dream of:  She gave up a conventional medical practice to start one that’s free of the rules and paperwork that go with health insurance.

The new enterprise is called Appleton Clinics Idaho and is based on the direct primary care model, said Faught, who previously was a doctor in private practice in Grand Junction, Colorado. She has lead Appleton’s second location in Eagle at 1675 E. Riverside Drive since October.

So far, patients are pleased with the membership model, said Faught, who is confident that the business will grow in time and add staffers.

The memberships aren’t insurance. Appleton Clinics clients often pair membership with a high-deductible health insurance or “catastrophic” plan to cover specialists, hospitalizations and the like, said Faught.

“With this business model, our providers won’t be gone in a year,” said Faught, talking about the provider churn that happens when employers switch insurers, which could mean forcing patients to look for new doctors.

The first Appleton was launched in Grand Junction by founder Dr. Craig Gustafson. “They wanted to build on their success there” with a strategic expansion, said Faught of the business.

A look at the demographics revealed the fast-growing Boise-metro area would be a good place to open a practice that operates outside the insurance realm and covers all primary care services, Faught said, including doctor visits, examinations, hearing and vision screenings, urinalysis and physicals.

Services for which Appleton Clinics has to pay – vaccines or blood work, for example – are charged to patients at cost, said Faught, adding that adult patients pay $99 a month for the service. There’s no charge for two children per adult member.

Patients, in turn, get their primary care needs met, all without having to file insurance claims, meet deductibles or fork out copays.

“You can go as often as you need,” said Faught, who used to feel rushed in her former practice and spent any free time requesting prior authorizations from insurance companies to treat patients.

Burnout was looming, said Faught, who now is reenergized in her profession. She also finds it personally rewarding to spend more time with patients and delve into their lives to help prevent any ailments from getting more serious.

“We want to make a living, but we’re not in a rush to meet our overhead,” said Faught of the Appleton Clinics business philosophy. “We want patients to feel very comfortable here.”

Time-starved primary care providers are often in too great a hurry to refer patients to specialists when they can easily do some of the work themselves, said Faught, who removes skin tags that a dermatologist might treat and can attend to a nail fungus rather than sending the patient to a podiatrist.

“We also have a nutritionist on staff,” said Faught, referring to the role diet plays in health. Rounding out the staff roster are a physician’s assistant, two medical assistants and two office employees.

Faught and other providers say direct primary care can deliver better care, reduce costs for individuals and businesses and cut overall health care costs by eliminating the overhead that comes with filing and managing insurance claims. The clinic also provides the kind of preventive care that keeps people well and heads off the need for more costly treatments.

While still a small part of the health care industry, the number of direct primary care practices nationally has grown from a few in the early 2000s to more than 700 today, according to the Direct Primary Care Coalition.

“This is a relatively new movement, but it is really gaining traction,” Faught said.

Also carving out a niche in the direct primary care world in the Gem State is Dr. Jim Brook, an osteopathic physician practicing in Idaho Falls.

He, too, doesn’t take any insurance, collecting directly from patients and “eliminating the hassles of managed care.” His average fee is $55, including labs, medications and house calls. “The fee is based on the time spent, not on insurance codes,” said Brook on his website.

With his hands-on approach, Brook said his overhead is about a quarter of the typical family practitioner.