HEALTH CARE IS NOT ONE-SIZE-FITS-ALL
Slow growth is smart. I believe the Free Market will help provide affordable care for everyone. ~Dr. Brian Erdmann
Drs. Brian and Kim Erdmann opened Priority Medical Partners (PMP) in 2016 to get back to why they became doctors—put patients first, charge them less, and spend more time with them. They are strong advocates of the revolution, but the story and evolution of their practice reads a little like they were waiting for free market medicine to catch up to them.
Having worked for and within corporate health groups, urgent care centers and independent clinics since 2000, they were well-equipped to make a determination of what model would work best for the kind of medicine they wanted to practice in the place they wanted to be.
After several starts, over ten years and implementing varying degrees of free market principles, the Erdmanns converted PMP to a hybrid practice that brings back the doctor-patient relationship, provides high quality care for direct pay clients, but will accept insurance if it turns out to be in the best interest of the patient.
The Erdmanns agree that there are special challenges to being “pioneers” in a small town, where there are few self-funded employers or groups. However, accepting DPC membership, direct pay-per-visit and insurance means all 7,700 residents are potential clients. “We knew people would come with us from our previous clinics and independent practices. We realized that DPC may not work for all patients, but they can be cash patients, so, again, we provide services that work best for them.”
All too often, brokers dictate to employers what they will be getting from year to year and employers have no control over the costs. So, he regularly markets his practice to local businesses and assures employers they don’t have to wait for the federal government to create policies that help reduce costs for them or for insurance brokers to tell them how to provide their health care benefits.
He recently demonstrated to Oneida County the benefits of incentivizing county employees to come see them. “I love the free market medicine concept and I want to give credit to people like Lisa Charbarneau who believed in trying it and embracing it.” Lisa is working to promote the employee access to free market medical services and the Erdmanns are thankful that there are people willing to take those risks for employee patients. Not everyone jumps on board but they have found the ones who do are happy.
“Lisa looked at PMP pricing and pay-per-visit rates, which were 40-50 percent less than what they were paying previously so it is a win for the County. For our part, we don’t have to spend hours coding or doing insurance paperwork, so it’s a win for us. Plus, their employees see a doctor who knows them, paying nothing out of pocket; a win for them. We send a monthly invoice, and the county sends us a check. Everyone involved has greater control over their own part of the health care process and it is to all of our mutual benefit.
We chose this name because we are prioritizing the Doctor-Patient relationship.
The mission is simple; spend more time with patients, charge a fair price, and minimize bureaucracy.
“When patients and employers know the price of care up front, and they can build that cost into their personal and corporate budgets; neither is disincentivized to schedule a visit here. It’s more important to me that the patients are happy and, if we can provide good prices that will allow them to purchase even more care, then we have been good doctors. It’s also a selling point for the employer who chooses DPC; we can see the direct care patient at no cost, provide labs at wholesale so, for instance, a strep throat can be treated in a few days before it becomes a week of lost work or productivity due to a peritonsillar [bacterial-infected] abscess.”
PMP does some work with local insurers, and even Medicare when necessary, but as an independent practice, the Erdmanns are free to case manage each patient. Their knowledge of and experience in many health care models enable them to make recommendations for the best care for individuals and employers, whether it is DPC, health care ministry or direct pay. Brian adds, “I had one patient who was fortunate enough to have a $200 deductible with his current company plan. Our $79 membership had great value, of course, but it made sense for him to use his insurance and I was satisfied to do the extra work required to see him using his insurance to save him a lot of money.”
The kind of hard work required to operate this hybrid practice is not new to the Erdmanns. Their children were born during med school and residency, they worked on-call and urgent care in networks and independently for several years for corporate medical groups, often commuting hundreds of miles during non-compete periods. Kim moved out of the corporate space when she realized seeing a patient every eight minutes and working under too much oversight was the quickest path to burnout and not what was best for her patients; “When doctors have to rush, mistakes can be made,” Brian says.
What this means for the people in their town of about 7,700 people, is that with a little creativity and flexibility, no one is turned away and the Erdmanns are able to “keep the lights on” while they educate clients about and grow their direct pay side of the house.
Ideally, they are working toward an insurance-free practice with small overhead; operations they can control without layers of cost. “The hybrid model is a lot of work, but we are not in a big city, which is a lower-risk scenario. Our priority is Direct Primary Care but if we provide multiple options for payment, we are truly meeting the needs of the people who live here and, even better, businesses have another tool to recruit new employees to the small towns they want to live in. This is what will enable us to make it a success where we are and where we want to live.”
I think this model is a slam-dunk. ~ Lisa Charbarneau
Lisa Charbarneau says when Dr. Erdmann called her two years ago, he was just making cold calls. But his great reputation preceded him, and his presentation made so much sense to her. “We had a self-funded trust in place with the State of Wisconsin that enabled us to do some of the things he offered, within our own benefit plan, right away.” She says when she first approached other state plan members, they were familiar but cautious, so she invited Dr. Erdmann to present to them as well. “It blew their minds; they were amazed to learn how much money is tied up in administration in insurance and the resulting loss of quality care.”
In line with the Erdmann’s desire to maintain their practice in a small-town area, Lisa says a practice like this is critical because rural employees are rarely able see an M.D. but rather a nurse practitioner or a physician’s assistant. “Now we see Drs. Kim and Brian Erdmann; they provide annual general wellness, diagnoses, stitches, bloodwork and more. Our employees were tentative at first but once they started using direct pay and got to know them by their reputations, it made a huge difference. We are also working on the best ways to implement the expensive things; hip replacement, appendectomy, etc. With their continued support I think we will get there. Working with them and their proactive measures has already decreased our wellness claims by 50 percent in just two years and, as well, their passion and ability to explain things is paramount to our success.”
Priority Medical Partners Direct, SC • 580 Shepard Street , Rhinelander, WI 54501 • 715-420-1831 • Fax: 715-420-1829
What their patients are saying…
“I absolutely love the DPC model. I feel like the doctor/patient relationship is much stronger and personal and by cutting out insurance from the equation there is far less money going to waste. I always can get in right away and again feel like the relationship with my doctor is much more personal,
I’m not just a number.” ~ Justin H., Rhinelander, WI