The story below is from our July/August 2023 issue. For more stories like it, Subscribe Today. Thank you!
Direct Primary Care practices are springing up in the Roanoke Valley, giving patients another choice in how they are treated and how they pay for it.
Editor’s Note: Learn more about primary care options and much more in our podcast medical episode, featuring Dr. Christy Arthur, RevIVe Hydration Roanoke and Top Docs 2024 cover winner Dr. Al Hagy, Jr.
“This is the way every doctor wants to practice medicine. The doctors want it, and the patients want it.”—Dr. Christy Arthur
The topic was Direct Primary Care (DPC) and Christy Arthur didn’t mince words. This is a type of care based on the retainer. Patients pay a monthly fee (usually about $100 individually, $150 for a small family) to the physician or nurse practitioner practice and when a problem arises, there is no additional charge for treatment, whether it’s a hangnail, the flu or a broken arm.
Roanoke now has a Direct Primary Care office founded by an experienced family physician (Arthur) and another founded by 11-year-veteran nurse practitioner Rachel Meadows. At press time, there was also the office in nearby Daleville of Dr. Russell Slayton, also a family medicine practitioner.
Here are the basics: DPC comes in “pure” and “hybrid” models, the former not billing insurance, and the hybrid mixing DPC and fee for service. The offices are generally small, serving about 500 patients where they might serve 3,000 in a traditional large practice. The smaller patient count means more time with each patient and that is one of the most significant draws, practitioners say. The downside is that specialists are not covered by the monthly payment and hospital stays are an extra expense.
Still, says Arthur, “Out-of-pocket lab prices are very reasonable. For example, a patient would pay only $4 for a blood count and $5 for an electrolyte panel. For many patients with insurance, it costs less to pay out of pocket at these discounted rates.”
DPC is growing rapidly nationally because, practitioners insist, it puts doctors back in charge of health care. That means, in most instances, that the physicians or nurse practitioners take more time with each patient; patients have easier access; and the health care professionals treat the whole patient.
Meadows had 19 total years of practice as a registered nurse and nurse practitioner at Carilion and Marathon Health before founding Restoration Direct Primary Care in September of 2021. She was frustrated with “barriers to people trying to access care.” An average of seven minutes spent with patients prevented that “total care” approach. She came to believe traditional care was limited in the quality of care it could provide, she says, so she began researching options and discovered DPC.
“I am able to provide personalized care for about 500 patients now,” she says. She does not practice obstetrics and gynecology, but she makes house calls and visits to newborns. “I have great work-life balance and [work] isn’t stressful. I’m not overworked.” She says she and her patients “talk while I am evaluating. We talk in depth about what’s going on in their lives and we come up with a plan.”
Gratifying? “It absolutely is,” she says emphatically. And she has time for her husband, Scott Meadows (“rock-solid support,” she says), and her 14- and-12-year-old daughters.
“I’m not saying traditional [medical] teams are bad,” she insists. “It’s just that the system is broken, stuck. They work hard. I’ve seen it, been in it.” In fact, her entire family is familiar with the challenges. Her father is a family practice physician in Giles and her mother his nurse; one brother is a primary care doc and the other is a dermatologist.
Christy Arthur’s experience is similar at Ultra Primary Care in Old Southwest. She is in practice with her husband, Dr. Michael Arthur, a functional medicine specialist. It is a specialty “that gets to the root cause” of problems, Christy Arthur says.
She was with Carilion for 17 years and she “heard about” DPC a few years ago at an American Academy of Family Practice conference. In January of 2023, she began lining up patients for her new practice. She remains a life coach for young physicians, spending two to five hours a week at it, she says.
In her practice, the medicine is pretty much “the same as I did [with Carilion],” but with the DPC difference figured in prominently. She even has a patient contact internet portal, orders labs and X-rays and refers to specialists when necessary. And she celebrates what she calls “total” independence … It is work as I envisioned it.” In late March, she was up to 30 patients with a potential cap of 450 or 500 as her goal, she says.
She says that traditionally female physicians tend to spend more time with patients and the new practice promotes that luxury. “I want to stay small,” she says, “because I value relationships.”
She and her husband work closely, but “we don’t have enough time together that we get on each other’s nerves.” They have 13-year-old twin boys.
“I do anything you would normally expect from a family physician,” she says, “and I have time to research the intricacies of a problem.”
And that is the point of DPC.
The story above is from our July/August 2023 issue. For more stories like it, Subscribe Today. Thank you!
