The Doctor’s In: Direct Primary Care in Minneapolis
IsaacEngholm, M.D. @DW labs Incorporated
On a recent Green Tea Conversations radio show, host Candi Broeffle interviewed Isaac Engholm, M.D. one of the first physicians in the Twin Cities to bring direct primary care at an affordable cost for middle- and working-class people. He provides a cost-effective option that gives his clients the freedom to choose optimal medical care on an individualized basis. The following article is an excerpt of the interview.
CB: Please provide us an explanation with what “direct primary care” is.Cities to bring direct primary care at an affordable cost for middle- and working-class people. He provides a cost-effective option that gives his clients the freedom to choose optimal medical care on an individualized basis. The following article is an excerpt of the interview.
IE: Direct primary care is a simple model of delivering health care to patients in which the patients hire their physician directly. This leaves out the need to use insurance and billing services and all of the premiums involved with it. Essentially, you subscribe to your physician for a monthly fee. Different providers have different fees. Mine, for example, is $75 per month. Once you subscribe to the physician, everything that physician can do for you with his or her skill set is available to you at that cost.
Often, direct primary care providers will be available after hours, before hours and on weekends for phone consultations. It is sometimes described as having a doctor in your family where you can just call or text for small things, such as “what is this rash?”
Where do you treat your patients?
I have an office space in downtown Minneapolis in the medical arts building, and I rent office space at the Bhakti Wellness Center, on France Avenue, in Edina. I also see patients by telemedicine and in their home, if that's what's needed. House calls are my favorite way to see patients as I see them in their natural environment and learn about their character and their personality through their home.
How much are your memberships and what is included?
Adult memberships are $75 per adult per month and children are $25 per month with a family maximum of $200 per month. I want to make this as affordable as possible so more people can take advantage of this type of personalized care.
I can see patients for anything under my scope of practice, which is the American Board of Family Medicine. I personally do not see obstetric patients anymore. But other than that, I see patients for routine annual checkups and travel medicine. I treat most aches and pains, even doing orthopedic injections in my office or in my patient’s home. I can order lab tests and radiologic tests. I can basically do anything that a typical urgent care or a family practice clinic would do.
What about if I have a large gash and need stitches?
If you called me and we could connect rather quickly, then I would have you come to my office or I would come to your home and clean up your wound and stitch you up. I would then come back and take out the stitches a week or so later. I always charge the cost of the materials to do the procedure, which for a laceration is about $15. The visit itself is included in the membership.
Can I still get lab tests done?
Of course. For blood work and lab tests, I use the Lab Corp vendor. I had a company called Freedom Healthworks that helped me negotiate prices, so if we needed to check your hemoglobin and see if you're anemic, for example, we would draw your blood right in your home, send it to Lab Corp and the cost to you would only be $2.81 for that lab test.
For X-rays, mammograms and ultrasounds, I have asked around to independent radiology clinics and set up a menu for the best prices around town. I can say that, if we thought you might have pneumonia and felt it was in your best interest to have a chest X-ray, then I would send you to a local radiologist and the cost for those images would be about $72. If you had a fracture of your foot or hand, depending on the number of images we would need, it might be around $100 for those images.
What happens if I think I need to go to the emergency room or I need to be hospitalized? What are my options?
I am not a staff there and I do not have privileges at the hospitals in the area. So, if my patients end up in the emergency room or in the hospital, then financially they will be responsible to take care of those costs, which is why I always really encourage my patients to have some sort of catastrophic coverage, whether it is through a cost share or a typical insurance plan. But the best thing about our relationship is that I have had patients call or text me or send pictures of themselves from the emergency room or hospital to get a second opinion.
I am here to talk with the providers at the hospital and help coordinate the patient’s care. Because I have participated in a portion of their care while in the hospital, the aftercare is much more robust. Plus, I can see them quickly after their discharge.
Monthly cost: $75/adult; $25/child; family cap $200/month. For more information and to sign up for a membership, visit DeployHealth.clinic. To listen to the full Green Tea Conversations interview from January 17, visit AM950Radio.com/green-tea-conversations.