Member Highlight: Dr. Wes ClementsFMMA Member Highlight The purpose of our member highlights is to shine a spotlight on outstanding individuals who form part of a groundbreaking network as members of the revolutionary San Antonio Free Market Medical Association. For our June 2022 issue, we chose to highlight Dr. Charles “Wes” Clements, founder of Tailored MD.  The young adult phase of a person often shapes and sets those initial for people that they take in life. Tell us a little about that phase of your life. “I’m actually from West Virginia…a pretty small town about the size of Stone Oak here in San Antonio. I was introduced to medicine through ski patrol as my first kind of dabbling in medicine in general. That kind of got me hooked onto pursuing that as a career, I’d say. I went to undergrad and medical school in Huntington, West Virginia at Marshall University and then did a residency at University of Virginia. When I graduated UVA, half of my family moved to Texas and we decided to chase them all the way here to San Antonio. Texas is kind of where we set up shop here.” Oftentimes people who are involved in healthcare, they often have their parents or close relatives who were physicians themselves. Is that the case for you? “Yeah! So, my dad’s a family practice doc(tor). He definitely started that…he doesn’t have a family member or brother or parent in medicine, so he was a first generation and then now I’m a second generation.” Did you enjoy your time at med school? We often hear it’s quite rigorous to get through both financially and educationally. “Yeah, I actually like to talk about the finances of medical training a lot, because I feel like it’s not talked about enough. People just say, “Oh, worry about it later,” too much and, “No, you’ll make enough money as a doctor to take care of whatever debt you dig yourself into.” And most of the time, that’s probably the case, but the debt can get pretty extreme so I think it’s pretty important for future medical students, future trainers in medicine, to consider the debt load when they take on. I love to talk to students about that actually, especially when they’re undergrads and they haven’t started medical school yet because there’s some moves they can make that’ll probably help them out. But, fortunately, I made the decision to stay in-state in West Virginia for my undergraduate degree, so there were great scholarships available for people who were in-state so it didn’t accumulate much debt at all in that phase of my training. Then, yeah, medical school is expensive, and it’s rigourous, and you definitely can’t hold a job while you’re going to medical school, so it’s pretty much living off of a loan at that point. I think, at the time that I graduated, it was like $180,790 was the average medical student debt. I think it’s way over that now, probably like $300,000-$500,000 in debt by the time they finish.” So, we actually met through the San Antonio FMMA, and know that you adopt the same model as them in your clinic. Did you start out like that or did you start off with what we call a “traditional healthcare model”? “So, I graduated, like most students, with a lot of debt, so I was really drawn to the high salary, just work for insurance, work as an employed physician, and get a big bonus so I kind of just chose the highest paying position I could find in the private sector medicine and traditional-based insurance practices. The debt’s scary, so you don’t really want to go and start a risky, or what appears to be a risky, venture and starting your own practice with that kind of debt already. So I went through that traditional route for two years before I made a change to Direct Primary Care(DPC). We continued to live like residents mostly for those two years, so we were able to pay off that debt and create a buffer to start a practice. That’s why I actually really love to talk about (medical school debt). It’s just something that a lot of people are just not comfortable talking about, but I think we are all interested in it. I’m really passionate about it because I think that the debt really affects doctors and clinicians’ position on what they’re going to do with their career, whether they realize it or not. Why do you think that so many doctors are discouraged from venturing away from traditional healthcare? Well, (with DPC) you’re not going to get paid as much in the beginning and it’s scary to go into that position. …I don’t think we should expect anybody to take on a business model concept just out of the goodness of their heart. I think that for a real solution in healthcare, which I believe DPC and Free Market Medicine to be, I think it has to be economically feasible and attractive to the people working in that system. Like, it was clear to me I really wanted to do Direct Primary Care, it just wasn’t in the cards for me because of the debt. I think that, if people get themselves into a better position financially, and they don’t let themselves get too far behind, then they have the freedom to do a model of care, like DPC.” So, what is your business model? “I think our flavor is kind of the main flavor for what’s called “Direct Primary Care” or DPC. So, we provide primary care services like any other primary care clinic, but instead of billing insurance, we charge a simple, monthly fee of $100 that covers everything in the walls of our clinic. It’s a membership-based model of care, and a lot of people confuse it with concierge medicine because both are out of pocket. For concierge, they pay insurance and they pay a fee on top of that, generally a retainer fee, so it’s more expensive. It’s often for more affluent people who can afford and just want better service. People confuse us with them because we offer better service. We offer 30-60 minute appointments, same or next day availability. Half of the time, there’s no wait time whatsoever and you always have your clinician, you don’t just see whoever’s available. It’s not “assembly line medicine”, like I call it.” So, it’s concierge-level care, but without the heavy price tag that comes with it? “Yes, we get people looking for concierge services, plenty of affluent people looking for great medical care. But we also get people who can’t afford a traditional practice, we get lots of people who don’t have insurance, and lots of people, like almost everyone nowadays, who have high deductible health plans where, if they went to another practice, they may pay several hundreds of dollars. Whereas, if they pay us the same, they get entire months of care, even if we see them four times in a month, the $100 covers it. One other service we add on that’s great for people without insurance or high deductible care is we’ve created kind of a network of cash pay services in the San Antonio area where if somebody needs something, and they don’t have the insurance, we can get them a fraction of the cost for that service. So, if somebody needs a simple blood test, 90% of the blood tests we offer are $5 each, thyroid check is $5, A1C for your diabetics is $5, etc. A panel of labs that costs, let’s say $25 with us, would cost $200-$300 usually (with other clinics).” So, do you think it’s important for organizations like the Free Market Medical Association to be around in order to create more educated consumers in the healthcare space? “Yeah, I think these programs are so important in terms of changing medicine for the better and making people aware of these things. …I’m lucky because I’m in the field, so I know where to find discounts and stuff, but people can hire that for themselves by having a Direct Primary Care clinician for them at one of the five or six Direct Primary Care clinic locations that are in San Antonio and 1,500 that are in the United States.” Tell us a little bit about your practice. What does it look like when someone signs up for their first month with you? “Well, we just hired a new clinician, Nicole Graber, NP, and she’s already filling up her panel of patients. We cap at between 300-400 patients per clinician, which sounds like a lot, but I had over two thousand in the traditional insurance model, so trust me, that’s good care. So, when somebody joins, they can register directly online through tailoredmd.com, or if they have more questions they can submit a message through the message system on the website or by just calling the number it goes directly to, either myself or our office manager, Alejandra Zuniga. …they register online and then we always call them within 48 hours to schedule their first appointment once they register. We generally have same or next day availability, for even new patient appointments. When they walk in the door for their first appointment, we greet them at the door by name because we don’t have such heavy flow that we know who’s coming in and when. So, we greet them at the door and we spend up to two hours with them for that first visit, if necessary. Although sometimes we know patients don’t want to spend two hours with their doctor, and we respect that, so we average about an hour. Sometimes we’re in and out even quicker if they just want something taken care of. On that first visit, our main goal is to get to know their home life, their diet, their exercise habits, what they love to do, what their health goals are, if that’s weight loss or if it’s getting better control of their diabetes or if it’s just preventing disease or cancer screenings. We do all that stuff and we try to get it all taken care of effectively in the visit. Then, going forward, we’ll usually either schedule labs if they need that or any screenings, and the cool thing is because, unlike a traditional practice, we’re not paid to just have you come in the door as much as often. We do whatever’s efficient for you. We’ll say, “okay, get labs”, and just give you a call when we get the results. We also text our patients, so if someday needs a refill, they’ll just text us, “Hey doc, I need a refill”, and it doesn’t have to be this whole debacle…” Any upcoming things happening with your clinic? “Actually, I’ll take this opportunity to talk about an expansion project we have going on. We’re opening a program called SADPC, or San Antonio Direct Primary. I’ve been meaning to speak with Dr. Roger Moczygemba about this because I know he’s a big figure in the Direct Care community. So, SADPC is a coalition of Direct Primary Care clinicians to make ourselves more of a network and attractive to employers, if possible. I think the biggest barrier to DPC in terms of expanding is the consistency in the offering, and that’s a good thing and a bad thing. The DPC movement’s about individuality in practicing medicine and individuality in the business model that works for the clinician. So it’s kind of this pull on trying to make some standardization, but not so much that the clinicians feel suffocated. The website (for SADPC) is sadpc.com and that’s live now. There’s three clinics, myself (TailoredMD), with R2 Clinicians. There is also Bluebonnet DPC, which is opening in King Williams…if everything goes well for them, at the end of June.” Wow, it’s pretty amazing having all of these people trying to help in this growing movement! Yeah, it’s growing very fast, it’s kind of hitting that inflection point where it’s becoming that exponential growth, as we learned that it’s a really viable model that’s best for the two parties here, right? The patient and the person providing the care. These are the people that matter in terms of healthcare, so this isn’t worried about investors or these different private equity firms. This is true direct care. The patient’s the customer, not the insurance company.” What do you think the next two years hold for you? “Ideally, I hope we continue to grow Nicole Graber’s panel. Like I said, she just started this month and she is accepting new patients and that’s kind of TailoredMD’s goal. But I really hope to grow the Direct Primary Care movement in San Antonio. In terms of talking two years, grow(ing) SADPC, maybe getting another clinic on board with SADPC and get more employers. We can save employers tons of money on their insurance. Even if they want to keep insurance, there’s ways to wrap in DPC and still save 20, 30, even 40% on premiums with insurance. So, we’re hoping to grow DPC, for the sake of the patients, for the sake of the greater economic toll of healthcare, I just see it as something that needs saving.” To hear more from Dr. Clements about his insider’s perspective into the healthcare industry, make sure to watch the video interview, conducted by Shankar Poncelet, CEO of Shankx Web Development and a chapter leader of the San Antonio FMMA, below: https://www.youtube.com/watch?v=X_9ahF7Rmzc About the San Antonio Free Market Medical Association Organized in 2019, Roger Moczygemba, MD and Shankar Poncelet came together with the goal to lower the cost of healthcare in San Antonio through price transparency, reference-based pricing, and local connection.
The San Antonio FMMA recognizes the three pillars on which the national FMMA was founded by Jay Kempton and Dr. Keith Smith in 2014: 1. Price is not a product. 2. Value is mutually determined and requires transparent pricing and quality. 3. Cash is king, the equality of price is critical. The FMMA connects buyers and sellers of healthcare, educating and motivating them to work together based upon a mutually beneficial relationship built on the pillars. To learn more, visit https://SanAntonioFMMA.org or contact sanantonio@fmma.org This member highlight is brought to you by Shankx Web Development and Consulting. For more information, please visit https://www.ShankxWebDev.com
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Dr. Ray Altamirano, San Antonio Business Journal 2020 Man of the Year, standing next to his lion portrait
For our May issue of the San Antonio Free Market Medical Association, Shankx Web Development chose to highlight the outstanding Dr. Ray Altamirano of Casa Salud Family Medical Clinic .
Dr. Altamirano was chosen as 'Top 40 Under 40’ and ‘2020 Man of the Year’ by the San Antonio Business Journal. He has been featured in San Antonio Current, Fox News, La Prensa, The Kelly Clarkson Show and The Doctors.
His collaboration with other brilliant leaders in the medical community around San Antonio has been featured on local news outlets like KSAT this month for helping to contact trace by delivering to-your-door COVID-19 testing.
We have a home 24/7 for those who have tested COVID positive and they can come here to get treated.
How did you become involved in testing?
I reached out to people who were in this group of creative and eager social entrepreneurs like, 'hey, let’s find another way to get tests out there.' What we did is not a matter of competition, the goal is to test as many people as possible. When you look at the objective of testing it’s to help the current system in place, which is Metro Health locally.
What do you do specifically after testing?
I help those who test positive.
How has COVID changed visitations in your clinic?
These last few weeks with this demographic, there are so many courtesy visits that I’m doing without them paying because they can’t. I think [about] doing the right thing for people.
I saw a highlight of you on Univision where you said Texas could become the next epicenter. Is that still true?
It’s hard to predict who is going to get super sick.
Is there value in people of color joining the free market?
I’m from the south side. I’m very proud to be Mexican. I’m proud to cater this demographic that doesn’t exclude anybody but serves more blue collar workers that are just working contributing to this country.
Dr. Altamirano’s Drive
I wanted to be back in the community through primary care and I knew the only way that would work is to be outside of the world of insurance, so that’s why in March of last year I formed my clinic, Casa Salud Family Medical Clinic.
Casa Salud Versus Traditional Practices
There’s definitely more liberty to treat how I see fit. There’s luxury that I have working outside of the world of the networks of insurance. For me, I like staying fee-for-service mostly to fit my demographics. However, I have the luxury of having my ER job and I see my clinic as more of a service for people who don’t have insurance and I’m able to have some staff.
‘No Insurance’ and the Free Market Medical Association
It’s a matter of creating a free market and what I’ve learned about insurance and about labs that take insurance, about imaging centers, etc., is the prices they fill out are completely arbitrary. There are numbers much less than that they’re willing to work with if you’re paying with cash, So that’s definitely what I love about my clinic and how I feel that freedom.
Teaching Cost-Conscious Medicine
The most important thing that I’m doing outside of treating patients is training mid-levels. They learn conscious medicine, putting prices on what they need to do because that’s what people are most worried about.
Casa Salud and the San Antonio Community
I really like the service in my community. I think what I’m doing serves as a blueprint for anyone who wants to do that for their own community. If they want to train under me that’d be great. I tell everyone that there is a way to make money and you don’t have to be a specialist.
Zip Codes Matter
"The zip code where I grew up in, that’s where I focus my clinic. If you draw a line halfway, highway 90, in the middle of San Antonio, what you see is a 6-1 ratio for doctors in San Antonio in the south. There’s less care here for more unhealthy people. I have hope with the new medical school being nearby. If I could help capture them now and show them by thinking outside of the network of insurance, 'You’re free. You can make money. You can do it.' There’s no need to go anywhere else.”
Amar es Vivir: To Love is To Live
Pictured above: Member of the San Antonio Free Market Medical Association Dr. Ray Altamirano of Casa Salud Family Medicine Clinic holding his artwork from his collection that can be found on Facebook page ‘Amar es Vivir.’
I ran into a patient who needed knee injections, very expensive, he couldn’t afford it, so I was able to convince a pharmacist to sell it for me at wholesale and then retail it. I started selling all my art prints to pay for him and that got on the Kelly Clarkson Show, The Doctors, national TV. We were able to sell enough of my art prints to pay for this man and beyond him that we had people come and donating for other patients.
That’s how that evolved and the art is definitely me, it’s a hobby, release, a form of therapy for me. The name of my art is Amar es Vivir, more of a motto of how I want to live and that translates into my practice. My clinic is my gallery. Interview brought to you by Shankx Web Development and Consulting. For more information, please visit https://shankxwebdev.com
The FMMA was founded in 2014 by Jay Kempton and Dr. Keith Smith based on their mutual desire to fix our broken system. They founded the FMMA based on three pillars.
To learn more, contact sanantonio@fmma.org. 
Dr. Mark Haverkorn, DDS, MD receives a Nice List Certificate from Santa Claus during Open House and one year celebration.
FMMA Member Highlight
The purpose of our member highlights is to shine a spotlight on outstanding individuals who form part of a groundbreaking network as members of the San Antonio Free Market Medical Association. For our December issue, Shankx Web Development chose to sit down and chat with Oral & Maxillofacial Surgeon, Mark Haverkorn, whose clinic River City OMS, recently had an Open House and one year celebration. Congratulations, Dr. Haverkorn!
Joining the FMMA
Dr. Haverkorn joined the FMMA in fall of this year after hearing about the FMMA from the Surgery Center of Oklahoma. Dr. Haverkorn also belongs to the American Dental Association, American Medical Association, American Association of Oral Surgeons.
Locally, Dr. Haverkorn and his wife (also Dr. Haverkorn!) serve as board directors in the San Antonio chapter of the Christian Medical Association.
Why did you join the FMMA and how do you believe it will help your business?
I joined FMMA to get the word out. I really believe in being transparent about prices. We have all of our prices posted on our website and Facebook. Currently, River City OMS is the only Oral & Maxillofacial Surgery center with prices as low as ours. I’m hoping that other surgeons will follow and do the same and that coming together through FMMA will help.
What problem does River City OMS solve?
Are people wondering what you’re doing to the market?
No one’s angry, but I think a lot of people think it won’t work. In dental school, everyone wanted to be fee-for-service, which we are, but they wanted to be FFS with ridiculously high prices. Like $3,000 for a crown. No one ever talked about being fee-for-service at a price people could afford. They’re intrigued by it.
Who is Dr. Haverkorn?
Members of the SATX FMMA pictured left is Mark Haverkorn, DDS/MD of River City OMS, center is Chrissy Navejar, DO of Dominion Primary Care and right is Co-Founder of FMMA and CEO of Shankx Web Development, Mr. Shankar Poncelet.
What do you enjoy most about volunteering?
Giving back. I’m very fortunate that my wife is right on board. We’ve always liked to do charity. We like giving things away and trying to help people. This Wrappin’ Jack will be at Fiesta Texas and we’re collecting donations and sponsoring that. It goes to Family Services Association that started in 1903 serving underprivileged families. The average family makes less than $10,000 per year.
What’s one thing - either industry-related or not - you learned in the last month?
I learned about where the name Camp Bullis came from! There’s a colonel in the army that was fighting on the border in the 1800’s in the Indian War. I was always interested and then I found an article about it.
What's something about you (a fun fact) that not many people know?
I’m a Cattle Rancher! My father-in-law was a rancher so he taught me. My pickup truck is actually used for that.
Does RCOMS sponsor any entity?
We sponsor a football team! South Texas Rangers. Cops, firefighters, paramedics, everyone on the team is an active officer or relative. They’re growing. We also have a small ranch and we sponsor a local 4-H chapter. We also sponsor a couple of events the Christian Dental Association does every year.
Explain your passion for oral surgery and how it is represented in your company culture.
My passion for oral surgery started from seeing my dad, who was also a surgeon and then discovering there was a lot of variety in this field. We do trauma, pathology, cancer. Some do cleft!
Interview brought to you by Shankx Web Development and Consulting. For more information, please visit https://shankxwebdev.com
About the Free Market Medical Association
The FMMA was founded in 2014 by Jay Kempton and Dr. Keith Smith based on their mutual desire to fix our broken system. They founded the FMMA based on three pillars.
1. Price is not a product. 2. Value is mutually determined and requires transparent pricing and quality. 3. Cash is king, the equality of price is critical. The FMMA connects true buyers and sellers of healthcare, educating and motivating them to work together based upon a mutually beneficial relationship built on the pillars. To learn more, visit www.fmma.org/sanantonio or contact sanantonio@fmma.org. |
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