When Misty Beaver’s daughter fell sick over a weekend, she didn’t take her to the emergency room. Instead, she contacted her doctor who agreed to meet them at her office on a Sunday.
Dr. Clodagh Ryan, a family physician who lives in Western Springs and has an office in La Grange, gave the girl, who was suffering from strep throat, a shot of an antibiotic.
“We were there for 15 minutes versus me going to the emergency room on a Sunday and having to pay the co-pay,” said Beaver, who lives in La Grange.
Beaver, her husband, David, and three children, it turns out, are part of an exclusive club. They pay a membership fee of about $140 a month to be part of Ryan’s practice.
In exchange, they expect to receive better access to their physician including same day or next day appointments, longer appointments of up to 30 or 60 minutes, and deep discounts on medications and lab work. They also do not have to pay co-pays for office visits.
Although her patients usually have insurance, Ryan doesn’t accept it. Patients who are using the membership model, which is called direct care, often increase the deductibles on their insurance to high amounts for when significant health crisis or hospitalization emerges.
Ryan, who has been a family physician for about 15 years, decided this year to open a membership-based practice after growing tired of the administrative burden of being paid via insurance for the care she provides. She previously had a practice in Western Springs.
“I got frustrated with insurance. It really manipulates the way doctors provide care,” she said.
She said she couldn’t spend the amount of time she wanted with her patients.
“It was the wrong kind of work,” she said. “I wasn’t using my medical degree to its best advantage. When they (patients) got to see me, I’d have 10 minutes and my hand on the door knob trying to get to the next patient.”
Ryan, who previously had 900 patients, is limiting the number in her practice to 300.
Membership fees in Ryan’s practice are based on a patient’s age. A young person will spend $50 a month, a middle age person will pay $75 a month and a person over 65 will spend $100 a month. A family’s monthly fee is $140.
Ryan said not having to deal with insurance saves headaches for her and time for her patients. When an office visit isn’t needed, she frequently will deal with patients via text, email or by phone.
Tim Classen, an associate professor of economics at the Loyola School of Business at Loyola University, said increasing deductibles to high amounts is a trend in health care, and another reason why patients might choose direct care for their primary care.
“They (high deductible plans) have grown from less than 5 percent of the market 10 years ago to 25 percent today,” Classen said.
He said a benefit of direct care for their primary care is that patients can predict their monthly costs.
The physician, on the other hand, can also predict their revenue stream.
“It really provides revenue stability,” he said. “It attracts the kind of patients who are more proactive about their health care and are healthier.”
When Beaver’s daughter got strep, she texted Ryan photos of her daughter over a period of about five days to show how her daughter’s illness was progressing.
She is happy that she didn’t have to pay for a co-pay when an office visit isn’t needed.
“I feel like I’ve gotten my money’s worth already,” she said.
Ryan said the direct care trend started on the West Coast and is starting to spread to the Midwest.
“I feel like a little bit of a pioneer. I never expected to be that,” she said.
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