Direct Care Q&A: Dr. Deborah Chisholm
Mike Miller · Sep 22, 2015
Dr. Deborah Chisholm’s “great joy” in developing relationships with patients has led to the creation of the Chisholm Center for Health, a direct patient care practice in Leroy, Illinois. The Samaritan Ministries member launched the practice on the last day of 2014. After her medical residency, Dr. Chisholm worked as an emergency physician for two years in Iowa, then stepped out of the workforce after she, her husband, David, and their two children moved to Illinois to be closer to David’s family. She had two more children during that time and also began teaching on nutrition. David is a certified personal trainer and massage therapist and a tutor in the Chisholms’ home-school co-op. Their four children are Daniel, 9; Joel, 7; Luke, 5; and Bethany, 2. Dr. Chisholm recently answered some questions for us about her DPC practice.
How is your practice different than a typical one?
The model of care we use at the Chisholm Center for Health is the Direct Patient Care model, or DPC for short. This type of practice is designed to simplify and improve access to quality, personalized care for individuals and families. In a nutshell, my clients hire me directly to take care of their primary care needs. In turn, I work directly for them, not an insurance company that reimburses me for my services.
There are no hidden co-pays for anything we can do at the office. We have complete price transparency and great wholesale pricing on labs and radiology when those things are necessary. Even better, we offer all-inclusive membership plans that give our clients a special phone number to access me for texting or phone calls, even after hours. I throw in home visits, too, as appropriate in certain situations. I consider it an honor when I get to travel with my black bag.
What are some of the advantages to your practice that patients most appreciate?
Our clients know they are highly valued here, and they know that if they have an urgent medical problem, they are going to be able to reach me and find out if they need to be seen. So often I can answer questions over the phone rather than requiring an office visit. Several times it has been so helpful for a parent or individual to be able to text me a picture of something like a rash and, if the quality is good, I can often give them immediate medical advice or reassurance. I also have the flexibility to be able to see patients after hours or on weekends and several times this has avoided costly ER visits.
What are some of the problems with regulation of health care that you are able to avoid by having a DPC?
What I love most about the DPC model of care is that it prioritizes the needs of the patient above all else. The patient is the central figure in this model of care, not an insurance company or health care organization. This grants me and my patients (or clients, as I like to say) the opportunity to decide together what is best for the client, and in most cases we can move along very quickly with diagnostic testing or treatments within my capability that an insurance company might oppose and choose not to cover, for whatever reason. It is not uncommon for me to be able to schedule a patient in need of an MRI within 48 hours of seeing them for a problem requiring such a test for further investigation. There are no insurance hurdles to jump to justify this, and the prices I have negotiated are unmatched for this area.
Frequently I order lab tests that help me uncover particular nutritional deficits causing health problems. Not only are my negotiated cash prices on these labs a tiny fraction of the cost of the same labs when billed through insurance (compare $157 for a common blood test, which is $1.65 through my office)—we also don’t have the risk of an insurance company balance-billing my clients an astronomical amount for labs they decide not to cover.
Could you elaborate on your slogan “A Better Model of Health Care”?
When I was brainstorming the idea for this clinic, it occurred to me that many folks are quite dissatisfied with so many aspects of medicine, such as delayed scheduling (can be days or weeks to get in), waiting room time with other sick people, and too little face time with your doctor once you are roomed. It goes beyond these inconveniences, too. Many people are looking for ways to improve their health and get to the root of their health problems, and, for the most part, managed medical care is designed to simply “manage” problems from a public health perspective. In contrast, my focus is to restore optimal health to each individual.
What I seek to offer, like many other DPC providers, is in stark contrast to this scenario. I strive to bring existing clients in the same day or next day if they have an acute medical problem. Usually we have one client coming and another one going, so there is no waiting room full of sick people. An average visit here is a leisurely 45 minutes. And I love taking time with each client to get to the root of a constellation of health problems and to specifically address any underlying nutritional deficiencies.
The membership plans I offer are simply the icing on this delightful “Better Model of Health Care” cake—membership plans make me accessible by phone, text, Skype, office, or home visit as needed, all for the same flat monthly charge.
Why did you join Samaritan Ministries?
My husband and I were introduced to Samaritan Ministries by a few different friends along the way. I must say, I was hooked after watching a few videos on the website! We knew very quickly what our monthly sharing amount would be, plain and simple. There were no complicated graphs or price tiers to navigate. My husband and I love the concept of sharing in real needs for others as they occur. We like having the opportunity to connect with other individuals or families at the time of their need, too, and to offer support through notes and prayers. And, we are so encouraged to know that our resources are being used for good and not for medical services we do not agree with, such as abortion.
What has your experience been with having a need?
Up to this point we’ve not yet had a publishable need! Maybe it helps that we have a doctor living at our house 24/7.