Cardiologists zero in on the heart of health care freedom, patient care

By Greg Feulner  ·  Jan 20, 2023

Trinity Heart and Vascular Group, started by two Samaritan Ministries members, celebrates health care freedom as well as fair pricing for its services.

Dr. Daniel O’Roark and physician assistant Nolan Hensley opened Trinity in August 2022. The cash-only practice, with offices in Greeneville, Tennessee, and nearby Johnson City, seeks to provide quality, comprehensive, outpatient cardiovascular care at fair, market-based prices.

A better model

Both men had worked in practices that use the health insurance model but knew there was a better way. With more than three decades of experience in cardiology, Dr. O’Roark brings years of knowledge and experience to the exam room. More than that, the men’s commitment to Jesus Christ and compassion for the sick and hurting motivates what they do and how they do it.

“A lot of what drives us is our Christian faith,” Dr. O’Roark says. “Historically, Western medicine and its excellence was rooted in the Christian worldview and life view, and our mission is to play our small part in recapturing that.”

One thing that helps Trinity to stand out from other practices is the providers’ full commitment to the patient-provider relationship, made possible by the practice’s insurance-free model.

Dr. Daniel O'Roark tends to a patient at Trinity Heart and Vascular Group in Tennessee.

Dr. Daniel O'Roark tends to a patient at Trinity Heart and Vascular Group in Tennessee. (Supplied photo)

“Because we’re free from third-party influence, we’re able, for example, to give a new patient an hour-long slot,” Dr. O’Roark says. “In previous practices, office time pressure was acute, with 15- to 30-minute time slots. For patients with complex cardiac situations, this simply isn’t enough time. Now we have plenty of time to gather the necessary information for making an accurate assessment, and, from that, we can thoughtfully take the best course of action with the full consent of the patient.”

Medical freedom

Trinity celebrates and encourages informed medical freedom for patients.

“We take pride in making sure our patients have a better understanding of what’s going on with them,” Nolan says. “They’re able to take time to consider if they want a procedure done and what that looks like.”

The difference is simply due to the cash basis of their practice, Dr. O’Roark explains.

“Patients tend to be more heavily invested in their medical care because they’re paying for the services themselves,” he says. “They consider if what is being proposed is reasonably necessary and effective.”

Dr. O’Roark says that Trinity focuses “on showing patients how medical insurance has been redefined.”

“Historically, insurance meant third-party payments for unforeseen, unpredictable, and costly illnesses, both short- and long-term, or trauma,” he says. “Currently, insurance not only provides payments for emergency care and surgical procedures, but for outpatient health needs as well, including routine checkups. That approach has created very high out-of-pocket expenses for the patient.”

Nolan adds that, “We want to make sure we are being cost friendly to the patients. We want you to be healthy, but we don’t want you to go bankrupt being healthy.”

No middleman

Cutting out the middleman means lower costs for the patient, the two men explain. “A contributing factor to high medical fees is that practices must spend a lot of money simply to collect their money,” Dr. O’Roark says.

“We can substantially lower the cost for our patients because we’re not paying staff to obtain prior authorization for testing or treatments or other dubious requirements imposed by third-party payers,” Dr. O’Roark says. “The problem is that huge amounts of health care dollars are going to middlemen, and it has harmed patients by interfering with the providers’ decision making.”

By avoiding the middleman, overhead costs are substantially reduced, resulting in lower, highly affordable fees, he says.

“So, we are trying to develop a parallel system without third parties,” he says. “Hopefully, in time this will expand to include more advanced medical service and specialty practices, and possibly even entire hospital systems.”

Cutting out the middleman also means better, more timely service, Dr. O’Roark and Nolan say.

Physician assistant Nolan Hensley explains heart functions to a patient.

Physician assistant Nolan Hensley explains heart functions to a patient. (Supplied photo)

“We are restoring the provider-patient relationship,” Nolan says. “For instance, we’ve had people come to us who could not get an evaluation or testing elsewhere in a timely fashion.”

And prompt treatment is important. In cardiology, it can mean the difference between life and death.

“Patients notice in our area that there’s a lack of access to good and timely medical care,” Nolan says.

That’s not the case with Trinity.

“If it gets to the point where we’re having difficulty getting patients in within two weeks or so, our practice objective is to recruit additional providers to keep up with patient demand,” Dr. O’Roark says.

For change, awareness is crucial

“Across the U.S., awareness of the problems with the insurance model is quite low,” Dr. O’Roark says. “Many people sense there is a problem, but they don’t usually understand what it is. Often, they have no idea what are the dollar costs associated with the use of their insurance, such as deductibles or out-of-pocket maximum costs.

“The day-to-day, ordinary outpatient care many Americans receive should not, in general, be paid for through medical insurance. When it is, it often results in unnecessary testing, low-impact treatments, or procedures that can drive up costs,” he adds.

Continuing a legacy

In God’s providence, Trinity’s Greeneville office was also once the office of the late Dr. Robert Berry, a pioneer for independent, cash-based medical practice in the area and a Samaritan member. Dr. O’Roark and Nolan took much inspiration from him.

“He was legendary around here for his Christian care,” Dr. O’Roark says. “About 10 years ago, I became very interested in this model. His influence was very prominent for us. We felt that with everything that has happened recently that the timing was right for this model in the setting of specialty care.”

So far, they haven’t perceived any meaningful opposition to their practice’s payment model by third-party payers or corporate medical systems.

“We believe in this model. Because of that, we are big supporters of Christian health care sharing ministries.”

Greg Feulner is assistant editor of the Samaritan Ministries newsletter.