Dr. Lucy Morris talks with Dr. Rodney Snead in an during a tour of the new C.A.R.E.S. Direct Primary Care in Anniston. (Stephen Gross / The Anniston Star)
Dr. Lucy Morris’ favorite part of being a family physician is learning about her patients.
As a soon-to-be direct primary care physician in Anniston, one of only a handful in the state, she hopes she’ll have more time to learn about and treat her patients than ever before.
“I like people, I like relationships and I enjoy treating people of different generations,” Morris said. “This is my dream … getting to spend more time with patients and it still not affect my income in a negative way.”
Morris’ direct primary care clinic will open to patients Monday at 1330 Leighton Ave. It’s a relatively new type of medical practice slowly spreading across the state and country that bypasses health insurance and copays, instead charging patients monthly membership fees for primary care services ranging from doctor visits to basic lab tests. Advocates of the concept say it reduces the cost of care while improving interactions between doctors and patients, resulting in better health outcomes.
The clinic is part of the Cheaha Area Regional Emergency Specialists in Anniston, which offers family and occupational medicine.
Dr. Rodney Snead with CARES is the organizer of the new clinic and will help Morris there when she’s unavailable.
“We’ve become increasingly frustrated with the inefficiency of how medicine is practiced,” Snead said of himself and his fellow physicians. “Direct primary care streamlines a lot of things and makes things much more efficient.”
Direct primary care works by charging patients a relatively low monthly fee, similar to a cable or Internet bill. Morris’ clinic plans to charge $60 a month for an individual, $100 per month for couples and $30 a month per child.
Member patients get unlimited visits by appointment with Morris for primary care services like chronic disease management, treatment for flu, lab testing and common antibiotic shots. Morris can still make enough money since she won’t have the costly overhead needed to handle insurance paperwork.
And since Morris won’t need to fill out paperwork to get reimbursed from insurers for every treatment, she can spend that extra time on her patients. Also, direct primary care physicians typically see far fewer patients in a year than their counterparts. Morris said she plans to see 600 patients a year. A regular primary care doctor usually sees at least twice as many patients annually, she said.
Seeing fewer patients also means shorter to no wait times and more interaction with doctors, Snead said.
“Many people delay going to see a doctor because they’ll have a copay or will have to wait for an appointment for several days,” Snead said. “With direct, you have an increased availability from your doctor.”
In a Friday email to The Star, Koko Mackin, spokeswoman for Blue Cross and Blue Shield of Alabama, the top health insurance provider in the state, said the company doesn’t oppose the direct primary care model, but does have reservations about it.
“A primary care arrangement is a choice that we appreciate, but we have concerns about the lack of visible consumer safeguards under these arrangements,” Mackin wrote. “Consumers may be exposed to the possibility of facing significant costs if they don’t have additional coverage for specialty treatments and pharmaceutical drugs that are usually not covered under a primary care arrangement.”
Morris pointed out that direct primary care is not a replacement for health insurance. Morris said she and other direct primary care physicians recommend patients still have insurance just for catastrophic care. Morris said the cost difference between a standard policy and high-deductible policy is commonly greater than a monthly direct primary care fee.
“This is for folks with all means,” Morris said of direct primary care. “It works well with poor people and with rich people.”
The direct primary care model has slowly grown in popularity around the country in recent years as some states have passed legislation to protect and regulate the practice. Alabama passed such a bill last year.
Dr. John Bender with the American Academy of Family Physicians, said about 3 percent of his 129,000-member organization use the direct primary care model — a jump from the less than 1 percent who used the model less than five years ago.
Bender said marketplace trends are driving the growth, including high uninsured rates and rising insurance plan deductibles. Bender said a subscription-fee model for primary care makes more sense than using insurance.
“Primary care is kind of like groceries since everyone needs it eventually in life,” Bender said. “We usually insure things that are improbable to happen.”
Dr. William Curry, assistant dean for primary care and rural medicine at the University of Alabama at Birmingham, said the direct primary care model could be beneficial for many areas of the state. Curry said that one possible disadvantage of the model is that physicians who use it generally treat fewer patients. Health experts say the U.S. is facing a primary care shortage, particularly in rural areas.
“So, if you think about scarcity, that could make things worse for the general population,” Curry said of direct primary care expansion.
Bender said that insurance bureaucracy and costly overhead pushes many physicians away from primary care to more lucrative practices.
“Many physicians just get burned out,” Bender said.
The direct model would instead help attract more physicians to primary care, helping to reduce the shortage.
Dr. Chad Williamson started his direct primary care practice in Fort Payne more than a year ago because he didn’t care for the traditional payment model.
“It lets me be a physician,” Williamson said of direct primary care. “I didn’t go to medical school to fill out paperwork.”
Williamson said the main thing his patients like about his practice is the convenience.
“My patients get an hour per visit … they don’t feel rushed,” Williamson said.
Staff writer Patrick McCreless: 256-235-3561. On Twitter @PMcCreless_Star.
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