Direct Primary Care: A New Trend in Healthcare


The rising cost of healthcare.  Obamacare.  The Affordable Care Act.  It's all over the news and seemingly everywhere we turn these days.  Most people are unhappy with the trends in healthcare, but no one seems to have the answer.  No one that is, except for a small group of physicians making the radical departure from traditional healthcare.  The new trend, called Direct Primary Care or Concierge Care, is springing up in towns and cities across the nation.  This is where one of our very own locals hopes to be part of the paradigm shift.  

Meet Dr. Mike Wulfers of IndependentMD.  With more than 30 years experience he has come to understand, be influenced by, and react to traditional health care.  Dr. Wulfers says that it all started for him 2-3 years ago at a conference with a North Carolina Direct Primary Care physician.  He says, "It peaked my interest because I was so dissatisfied with what healthcare has evolved into in the last 15-20 years."

So what exactly is Direct Primary Care? I would liken it to old school care with advanced technology and access to modern medicine.   The way that most services work is that you pay a monthly membership fee which includes many advantages.  Dr. Wulfers fee is a sliding scale based on age and includes the following: small number of patients, top-notch referrals, non-ICU care for hospitalized patients, access to wholesale medicine, in office surgery with diagnostic and procedural tests, labs at wholesale rate, annual preventative check-ups, same day appointments and 24/7 access to your physician. Yes, you read that right.  24/7 access to your doctor.  This means that a Direct Primary Care physician is utilizing all the tools that modern technology can provide whether it's text, email, web based, phone or in person. 

What does this service mean to his current patients? For one patient it means a savings of $135 every month in prescriptions.  For others it means $3 lab fees, or immediate access to a physician instead of waiting a week to get an appointment.  For the senior population it means actual one-on-one time to ask questions. Dr. Wulfers says, "They can't get the time and attention they need anywhere else."  Speaking of time and attention, the average time a physician spends with patients is 7 minutes. This shortened time frame occurs for a plethora of reasons, including number of patients. The average patient load for a doctor can be between 2,000-4,000 people.  In the Direct Primary Care model, the focus is back on the patient.   Physicals are at least 1 hour, follow ups are at least 30 minutes and number of patients stays between 500-600.  Dr. Wulfers is accepting new patients but is almost full. He does not want to go too far over the 500-600 patient tier otherwise it will erode the concept of direct physician access. 

Sitting side by side in his warm and inviting office he explains, "One of the problems I've had in selling this practice is that people think it's too good to be true. That there must be some catch."  For anyone that has had the typical "hurry up and wait" experience of healthcare, or been shocked by a bill, the Direct Primary Care service would seem like a far off oasis in the dry and dusty landscape of traditional care.  With a cheerful expression Dr. Wulfers says, "I hope it catches on - it has the potential to revolutionize our healthcare system for the better."

Dr. Wulfers explains, "most people are more familiar with the term Concierge Care but I don't like it.  It sounds like it is only for rich people."   His patients all have varying degrees of income and insurance.  This practice is designed to support people so that they can get access to a physician and enjoy savings on things they need such as labs and medicine.  One of the things that stands out about Dr. Wulfers is his vast knowledge of the inner workings of health insurance. He says, "I learned about insurance to help patients understand it better."  He does see people with all varying degrees of coverage, but does not recommend that patients go without insurance.  If Dr. Wulfers had it his way, healthcare would be a mix of catastrophic insurance coverage, Direct Primary Care and a health savings account.   He feels as though the health savings account, "puts the consumer back into medicine.  Right now there is no incentive for the patient or provider to look for a better price.  People would be more inclined to shop around."

As I'm leaving, he tells me a story about Dr. Josh Umbehr from Atlas MD, a leader in Direct Primary Care in Wichita Kansas.  He said, "In March of 2013 we were driving to Florida. On a Sunday morning  I had my iPad and was Googling Direct Primary Care and started looking at the practice in Wichita... I sent the email and about 10 min later my iphone rings and it's Dr. Josh himself."  He laughs as he talks about his surprise in how quickly they responded.  But that is the main advantage of the system and that must have sealed the deal for Dr. Wulfers.

He said, "If I hadn't have tried this I would have retired. I would not have continued in private practice.  A lot of doctors are retiring early because they are sick of the current trends."  In a podcast by Dr. Josh, he sums it up by saying, "Direct Primary Care is really the kind of medicine that the people in primary care want to provide and have always thought was the root of medicine."  It sounds like Dr. Wulfers couldn't agree more.  He opened April 1st and says with a smile, "I'm having loads of fun!"



IndependentMD is located at 37 Doctors Park, Suite #1 Cape Girardeau, Mo

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