|
Member Highlight: Isaac Higgins 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 December 2022 issue, we chose to highlight Isaac Higgins, CEO and Founder of Family Hospital Systems.  Where do you come from? We’re always interested in hearing about people’s backgrounds and childhood experiences. I finished up my high school here in Austin, Texas. I went off to the University of Alabama to get my Business Management degree, I went there on an academic scholarship. I ended up in the Honors program and went through several different classes really not knowing what I liked to do, like most people that are graduating the high school system and going into college. While there, I started exploring different avenues as far as getting into working with small business owners. I worked with some large corporations at the time doing marketing for them as well. What I really gravitated to was building websites and learning how to operate those, and doing things like Shopify, drop shipping, etc. Really understanding how to do lead generation, I really gravitated towards the digital aspects of that. So, combined with working with groups like Anheuser-Busch in college where I was out doing face-to-face marketing for Bud Lite and building digital marketing websites, I was able to develop some soft skills I brought home with me when I graduated in 2017. How did your family business start? At the time, my father was an ER physician working in a Level 1 trauma center over in Abilene, Texas really getting burned out on emergency medicine. He was seeing anywhere between 50-60, sometimes 70 patients a shift, having an average of about 5 minutes with each one before he had to move on to the next room. He was getting burned out on how medicine was practiced, so when we made the transition from Abilene to Austin in 2011, he was really contemplating quitting medicine and going into building car washes and storage units. But, through that transition, he came across a new opportunity in a new industry that was starting to emerge called “freestanding emergency rooms,” which is simply an emergency department that is detached from a hospital site. You can provide 27/4 emergency care, it comes fully equipped with emergency room physicians, imaging, labs, full-on nurse staff, everything you would find in a traditional emergency department. When we founded our first emergency room, we actually took an old Suzuki car dealership and renovated it into the first family ER. He and two partners were finally able to practice medicine the way that they saw fit, they weren’t dictated by some administration on ‘X’ amount of tests or ‘Y’ amount of scans that they had to do per month to meet quota. They finally had the flexibility to provide direct care to the community. However, the only frustration they had was working with health insurance, whereas with a small provider or small organization you can’t really sit down with large health insurance systems and get negotiated rates, it’s just not possible. We’ve always been working as these out of network facilities but trying to do right by the patient; by not sending them to collections, no balance billing, no surprise bills, and making sure that the insurance companies actually pay for what they’re legally required to pay. Out of that frustration, we created a brand new program that involved direct primary care and we used our new company called, Cage Free Care, that operates as a direct primary care network to incorporate all of the services that we do in our facilities, from the emergency room to the primary care to the imaging to the labs in a monthly subscription. We’ve been working with that program now for a little over 3 or 4 years and have been able to successfully implement this with employer groups, providing individuals and families direct access to our emergency department all for a monthly subscription cost of $125 a month where they have all inclusive access with no copays and no deductibles, it’s just direct healthcare. Through the evolution of our company, we grew into offering various different service lines in family hospital systems outside of the emergency department where it included primary care, outpatient imaging, outpatient labs, and bundled surgical cases. We also have a big passion for the recovery community where we work directly with a company called, Rise Recovery, to help those individuals that are suffering from substance abuse go through a short term medical stabilization at one of our facilities that will help them get off of things like methadone, suboxone, heroin, and alcohol, where we medical screen and stabilize them to move on to the next journey of recovery and assign them a case manager. We have a big passion as a provider first organization to find needs in our community and fill those needs with services. That is awesome. You also have emergency room services, direct primary care, and you’re starting to grow a hospital system based on these principles? As of right now we are a hybrid practice where we do take commercial insurance and we take membership. Where we see the future of healthcare heading is a full cash price, full membership based program that really where insurance has kind of overreached dictating what kind of antibiotics we should be prescribing, we need to push back as a community to where health insurance is really designed for catastrophic needs… There is a place for health insurance, it’s just not the extreme that it is today. If I had it up to my way designing a perfect healthcare system for the United States, I would get rid of the need of having a high deductible health plan that is HSA qualified and have every American allowed to do a health savings account. Then, I would design a health insurance program that met those catastrophic needs and then gave a discount to those participating with direct primary care. That would be the perfect system in my mind. I love that the ecosystem is starting to come out with all kinds of entrepreneurial approaches to solve this problem, ranging from something that works for an individual to something that works for companies who have more regulations to abide by. It is really an exciting time to be a part of this movement and I’m really impressed by the perfect trifecta that you guys have. Very often the people who design these things are not clinicians, don’t understand the business side or the marketing side, but it looks to me like you’ve really come up with a very interesting combination. Thank you, I really do appreciate that. We’re just a small healthcare system founded by accident honestly. We had no intention of growing into a hospital based organization. We were just a bunch of doctors trying to provide healthcare to their community, saw a need and started trying to fill that need. Along the way we picked up a couple of things as far as recognizing that health insurance is an ever changing market. What was your grandma and grandpa's insurance is no more. The days of zero dollar deductible and low out of pocket maxes don’t really exist, and if they do you’re paying outwards of thousands of dollars a month to have access to that healthplan. So, healthcare and health insurance are on a tipping point where something’s got to change and entrepreneurs are coming out left and right with all of these great, fantastic ideas. I think that naturally as health insurance has become unaffordable, there are more solutions that are going to come out that meet the needs and demand of the community and the population that are trying to access healthcare affordably. So, we’re excited to be a part of that movement and look forward to working with other providers and organizations that want to do something different from the traditional status quo. If you’re an employer looking for affordable healthcare, I really advice you to look at either a Health Rosetta or an open minded broker that can come in and not push the traditional status quo Blue Cross/Blue Shield plan that they have no incentive on driving cost down because they get paid on a percentage of the overall premium. So, really what you’re looking for is transparent brokers that do a fixed cost that can truly advise you on the best approach for you and your employees. And if you’re an individual looking for affordable access to care, look at direct primary care and a health share where you can get a discount and share with the community for anything that falls inside of that catastrophic need. There’s some really great options out there and I look forward to more coming out in the future. What kind of skepticism do you usually face when discussing any of the new healthcare models you mentioned? People are uncomfortable with change… Right now we’re in the early adoption phase where people… are forced to look at alternatives because they can’t afford a $2,000 a month health insurance premium. That’s another mortgage for most people so it’s this forced innovation that is happening in people being open to the idea of looking at these alternative healthcare models. Really when we present the DPC model that includes our emergency room and imaging at the labs and everything that we do, people are skeptical of the price. They say, “How can you charge $50 a month for primary care and keep your doors open?” Healthcare as a whole really is not that expensive, it’s all the middle men and all the layers that have been built in between in a system that’s designed to inflate the cost of healthcare. When you remove all of those middle men and what is health insurance today, all of a sudden healthcare becomes a lot more affordable. You’re based in Austin, correct? We have six locations here in Austin, North Austin specifically. Two in Omaha, Nebraska. The way that we designed the Cage Free model was to be a network of like minded individuals and organizations that wanted to do something different as the biggest limitation to direct primary care as it stands today, especially in the employer groups, is the access or the geography component. If I’m a large employer and I have multi-city or multi-state employees, I love the idea of DPC. I need something that can bring it together to implement that solution, where we have a platform that unifies the billing process and the accessibility for the employees. We want to bring in those like minded individuals to deploy that solution in the employer market and then also meet the geography needs of the individuals and families that want to do something different from the traditional status quo. Are you planning a location in San Antonio? We are. As of right now we are in the works of finalizing the certificate of occupancy of an old freestanding emergency room that shut down a little while ago.It’s going to be in the Northwest San Antonio market where we are going to be opening up probably in the beginning of February or late March, sometime around that time frame. Definitely send us an invitation for the ribbon cutting to that! So, what is one of the biggest obstacles that you’ve seen speaking of those agents that don’t like to see the cost inflation being fought? The biggest obstacle is getting through the hurdle of the broker. Sometimes when you talk to an employer, there’s a previous relationship of 10 years, going in there and saying that the broker has not been doing right by you isn’t always the best approach. I like approaching the broker first and letting them know that “Hey, there is an alternative model. Have you thought about this? What are your voices of concern with doing something like this?” And if I get the feeling that the broker is not doing the best thing for the client at that point, then I talk to the employer and let them know that there is an alternative option out there and this is the path that they would have to take to achieve that. If they are open to something like that then I will step in and start helping advise on that plan or I’ll find a partner of mine that might be better suited for their needs to advise on. That’s really the biggest hurdle because the employer trusts typically the broker that’s been with them for years and if you go in and disrupt that relationship, it’s sometimes very difficult. If we look at this situation from a human perspective, most brokers—this may not apply to all of them—but most brokers are victims of the system as well, right? They happen to have chosen a path where, in all frankness, they want to help but they have a system to work with. You have to be really understanding and educate yourself to see the big picture and break out of that limitation and work in different ways, but there are those brokers out there and they’re definitely a part of our network. Absolutely. And the biggest thing is healthcare is not one size fits all. Everybody has specific needs, like you mentioned, sometimes brokers are taught one way and this is how things are and they don’t go outside of the box. My favorite thing is to take one of those brokers and convert them into a free market minded person. How did you choose the name “Cage Free?” Are you a vegan? No, I’m not a vegan but coming from Austin, Texas we thought, “Well, how can we create a catchy name that kind of resembles ‘Keep Austin Weird’ but also incorporates some of the good wellness aspects of cage free eggs for example.” Whenever we were sitting down designing this company, my father and I, we were thinking what kind of name could meet the needs of how the system is right now and bring that Austin quirkiness to it. We thought, “What is the system currently like?” There’s a bunch of providers and patients locked in a cage and insurance companies are sitting there dangling the keys laughing the entire way. We said, “Typically, cage free eggs are better for you and here we are providing a solution. We’re the key to your healthcare. Why not name it Cage Free Care?” Out of that, we designed a system that gives patients back the key to their own healthcare. Tell me, what does the future look like for you and your ventures? Where do you see yourself in a year or 5 years? I would like to start working with more like minded providers who are tired of the traditional health insurance system. That’s really my first and biggest goal is to help individual providers and organizations break free of the traditional status quo. From there, helping those providers by introducing them to employer organizations that want to do something different from their traditional health insurance plan and really kind of growing that in the state of Texas and beyond. If we look at Texas specifically, there are about 180 independently owned, freestanding emergency rooms throughout the state of Texas that all are suffering the same issues that we expressed today about being these small independent facilities where they don’t have the opportunity to sit down with large health insurance companies and get negotiated rates. They’re all looking for an alternative model and my goal and hope is to band those together to provide a unified solution to the employer market and to the individuals. Here in the state of Texas but then also growing that outside of the state into other areas like our Nebraska presence and other states and beyond. To hear more from Isaac Higgins, 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=MTaXnTdn7vs 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
0 Comments
Member Highlight: Dr. Claire ZengerleThe 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 November 2022 issue, we chose to highlight Dr. Claire Zengerle, founder of Zengerle Medical Clinic.  Where is Cuero, Texas? “It’s about 90 miles from San Antonio, I would say South East of San Antonio.” For someone who lives in a city like San Antonio, can you explain what Cuero looks like because it’s a completely different setting, right? “It looks like small town America. It has an old main street with historic buildings downtown. It's the home of the Gobblers which is a well known football team in Texas, they’ve won state championships before and the community supports them. It has a wonderful courthouse, a nice downtown, good people, the usual train that runs through. I may not get the population right, I’m guessing 7,500 but don’t quote me on that.” Are you from Cuero? “No, I grew up in Corpus Christi. We lived in the north west part of town and I went to high school at Calallen. When I was growing up there, it had kind of a small town feel even though it was in the Corpus Christi city limits. I had a really wonderful time in high school and I still try to keep up with some of the people down there.” Usually, people have something formative that happened in their childhoods, either through what their parents did or their environment. Is there an event you recognize as something that has impacted your character? “I am the youngest of four girls. When I was 6 years old, my father passed away and my mother became a single parent. She only had a high school education and still had to look after her two youngest girls so she buckled up, went to college, and got her teaching degree. I think she did a very good job of all the stress and struggle of having to go to college, get a teaching degree, a teaching job, and put up with us going through high school. I was in athletics. I played basketball and ran track, and I always felt very supported in that. Some of the coaches were very good mentors to me… so I feel like I got a good work ethic there. I went to college at A&I at Kingsville, which is now a part of the Texas A&M system, where I was thinking I would be a coach. Then I kind of switched gears and changed my major so I ended up staying in undergrad for a good while and decided to try to get into medical school during that time.” Was getting into medical school difficult for you? “I didn’t get in the first time so I applied again. I got a job at the local hospital in Kleberg County in Kingsville and that helped solidify what I was going to do. The medical director, the physician who was an internal medicine doctor, was very supportive of me trying to get into medical school. I also had a health professor, I was a Health and Physical Education major, who was also really supportive. After I managed to get in, it was challenging working and going to school.” I know you’re a DO, was that something that was clear to you from the beginning? That you would go down that route? “I had applied to allopathic and osteopathic medical schools but the more I studied and learned about the osteopathic philosophy, I kind of gravitated toward that. It was kind of what I wanted to do because it incorporates all of the allopathic world but you learn additional skills in osteopathic manipulation and it’s kind of up to you how much you want to use that or not. It also stresses importance in how the musculoskeletal system affects the rest of the body being in tune. People think it’s kind of like a chiropractor but it’s not really chiropractic because there are so many different techniques. But yeah, I really liked the philosophy and still do. It kind of gives me more of an open mind, I think. It also allows people to have a bigger role in the decision making in their healthcare.” What was your professional journey? Did you regret certain phases? Also, how did you eventually decide that it was time to open a DPC practice? “I graduated then moved back to Corpus where I did my three year family practice residency at Memorial Medical Center. I was able to make some contacts here in town as I did moonlighting. I also did moonlighting in Referio Hospital, a little town south of where we live, and then I did a little bit of moonlighting in the ER here for one of the doctors that needed help in Goliad. Goliad is the next town down the road from Cuero. So, Cuero was helping manage the clinic in Goliad. It all just kind of fell into place. I was able to help pay back loans… It always kind of geared going back to this small town and starting a rural health clinic. We didn’t run the clinic at the time, the hospital owned it. We kind of contracted work for the hospital so we weren’t employees, we were contractors which changed over time. Then the hospital didn’t want to run the clinic several years later… So between myself and the two other doctors and one of the doctors’ spouses, who was the business manager, we had to kind of start all over and run our own practice–it worked out well. Although, I personally didn’t pay much attention to the management of it, I just wanted to see patients and not worry about it. I still had no intention of running my own solo practice at that time. Then the hospital wanted to buy the clinic, so we sold the practice back and became hospital employees. Management changed again and it kind of went south as far as my philosophy and how they wanted to run things. I decided I wanted to do something completely different and went to work for the VA Clinic in Victoria, Texas. I worked there for about three and a half years and that was a whole different ball game. The best part of the VA was the veterans. Taking care of the veterans was just awesome, they were good but the delivery left a little to be desired. Then I decided to do something different and I took it back to rural practice and worked at LaVaca Medical Center part-time from this past August until June. At that time I had decided I wanted to run my own practice and started looking at Direct Primary Care.” Explain to us what Direct Primary Care is and why you felt so compelled to start practicing along that healthcare delivery model. “Direct Primary Care is a different model of delivery of healthcare. I don’t bill any private insurance, Medicare, or Medicaid. It’s totally cash pay and because there’s no middle man, I don’t have to fight with insurance companies so the prices are significantly lower. Direct means I deal directly with you, the patient. In my office, primary care is just the patient and I. Also, one of the goals is transparency and pricing so there’s no surprises. I have almost all the prices listed on my website. I have a list that I can give to patients in the office that also explains my prices and membership prices. It’s been incredible and we’ve, so far, been very well received.” Direct Primary Care is not really familiar to people, how was that received in your community? “We didn’t really know how it was going to go because it is a whole new concept so, you know, you do have to do a lot of educating and explaining. SHANKX built a website for me and it was incredible… I knew I wanted to have someone who knew something about Direct Primary Care and of course, they did. They’ve been very responsive about making changes and constantly managing it. And the fact that I can get the prices there, explanations, and the forms, etc. Direct Primary Care is having access to me. If they’re a member, they can contact me 24/7 through an app called Spruce in which they can send me messages, pictures, documents, requests for appointments, telemedicine options, etc.” When was your opening? And how have you liked it so far, as a professional, since it’s a very different way of doing what you do? “It was on August 1st, and I’m very thrilled. I’ve been a lot happier in my practice than I have been in a long time. You know, the whole burn out thing was starting to kick in for quite a while, but I don’t have that anymore and I really look forward to it.” That’s super exciting. I really have to commend you for your fearlessness in being a business owner and jumping head in. What advice do you have for other physicians who are thinking about doing something similar? What should they have in place before they take the jump? “Boy, I still consider myself a newbie and learning on the fly and as I go. I would say… just do your homework, learn what Direct Primary Care is and see if it’s for you. I don’t know, it’s hard to imagine that after you start you don’t see how it’s for you as you’ll have such a better lifestyle…you can deliver more to the patient and not hurry them up. You can listen to them and take care of their needs and spend some time with them. If they want to be out in a hurry, that’s their call. It’s just going to depend on where you are, if you have to pay rent on a building or if you have your own building. We had a little bit of a different situation where we bought a building that needed to be finished out. Just do the homework, make sure you can get the lab prices, make sure you understand membership, see what the prices are in your area and be competitive with that.” And you are very reasonable, what are your rates? $49 a month. That means you pay less than a cup of coffee a day for a membership where you have access to me. Visits are $30 whether you want to come in-person or do a telemedicine visit. We have wonderful lab prices as well. Most of the tests you also don’t have to pay for. Established patients also get an hour long appointment which is amazing compared to the usual 15 minutes. As someone who’s interested in entrepreneurship and business ownership, I’m curious. Do you have a mentor or where do you learn currently with all that you’re having to do right now? Well, with DPC I’m going to have to give all the credit to Dr. Roger Moczygemba in San Antonio at Direct Med Clinic. I kind of bugged him to death and he’s been very helpful! I went up to visit him in San Antonio… he’s answered a lot of our questions and has just been very helpful. Of course, SHANKX as well have been very helpful and gotten me out of a bind many times. Any final thoughts? If there’s something I can help you with regarding your healthcare, let me know. We can do minor emergencies, skin biopsies, skin removals, annual exams, etc. most of your healthcare needs we can take care of. To hear more from Dr. Zengerle about her 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.linkedin.com/posts/shankarponcelet_entrepreneurship-texas-directprimarycare-activity-6976328879560945664-iqCM?utm_source=share&utm_medium=member_desktop 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 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 |
Archives
December 2022
Categories
All
|
RSS Feed
