Q&A: Drs. J. Ashley & Holly Parker found freedom with their DPC practice

Time is everything for Drs. J. Ashley and Holly Parker, the husband and wife team at Freedom Family Medicine in Wilson, North Carolina. After 13 years in working in a traditional family practice, they opened their DPC clinic in March 2016. They wanted the freedom to spend more time with their patients, not just treating their ailments, but getting to know them, sharing Christ with them, and praying with them.

“There is a peace of mind in knowing that we had plenty of time to treat each patient's needs. They don't leave our office with a list of questions or problems that were not handled.”

Here are the Parkers’ answers to questions we recently posed.

How is your practice different from a typical one?

After working in a traditional family medicine practice for 13 years, we left and opened a Direct Primary Care (DPC) office, Freedom Family Medicine, in March 2016. As a DPC provider, we differ from traditional family medicine offices in many ways. We do not take any money from or bill to insurance companies, Medicare, or Medicaid. We do have members (patients) who have coverage from each of those entities, but all our members pay the practice directly, either on a monthly fee or a yearly fee. The majority of our members, however, have no insurance and come to us because we are the most affordable option and because the DPC model allows us to give them great service.

We also have several small businesses in our area that pay for their employees to have a membership in our practice. Those businesses cannot afford, and are not required, to provide health insurance for their employees, but they want to give their employees some sort of health benefit, so membership at our practice works very well for them.

Another difference with our practice is that we see far fewer patients each day. We schedule one patient per hour and leave space open to work in one extra patient each hour. So, a typical day consists of 10-12 patients, as compared to 25-30 patients per day at our old office. This keeps us from feeling “pushed” in the room while we are with a patient. There is a peace of mind in knowing that we had plenty of time to treat each patient's needs. We are also able to leave the office at a more reasonable hour so that we can spend quality family time together.

More than anything else though, the DPC model has allowed us to integrate our faith into our practice more than ever before. We worked at a Christian medical practice before, but the time crunch often prevented us from sharing as much as we would have liked. At Freedom Family Medicine, we openly share Christ and pray with our patients, and we have time just to sit down and have general conversation so that patients know we genuinely care about them.

What are some of the advantages to your practice that patients most appreciate?

From a patient perspective, this is a huge advantage to the DPC model, but there are many more. As noted, they get up to an hour of time for a regularly scheduled visit, so they don't leave our office with a list of questions or problems that were not handled. Also, since we leave one slot open each hour for work-in patients, our members can be seen in a prompt fashion when they are sick or have an urgent issue. Since we see fewer patients each day, there is very limited wait time. We only have space for five people to sit in our waiting room, and I've never seen that full! Every member gets an email and an after-hours phone number that both come directly to our cell phones. They can communicate directly with their doctor 24 hours per day, seven days per week. We also make house calls or meet members at our office after hours, when appropriate. Many a member has been able to avoid a long ER wait for stitches! Currently, we also see three patients in an Alzheimer's unit at a large local nursing home. That number has been slowly growing as family members of other patients in the facility see us interacting with our patients and their family members.

What are some of the problems with regulation of health care that you are able to avoid by having a DPC?

One of the biggest headaches in medicine today is the ever-increasing health care regulation. When doctors are paid by third-party payers (insurance, Medicare, Medicaid), they are required to collect lots of information and document lots of things that often are not pertinent to the reason a patient is coming to the office that day. If they don't do all of this exactly as required, they may not get paid for a visit or they could even get penalized. Every diagnosis and every procedure has to have a specific number; every visit has to be billed with a specific code that is determined based on the complexity of the visit, and the amount of information gathered. All this extra information gathering and reporting in the form of numbers and codes takes away valuable time from the doctor-patient interaction and requires hiring many more employees just to handle all that information gathering and submission.

At our office, since no payment is received from a third party, we can keep it simple. We ask and document only what is necessary to take care of the patient, and, most of the time, we don't have to worry about attaching any numbers or codes that provide no benefit to the patient. The only exception would be when we have to get a patient's insurance company to approve payment for a particular test that has been ordered. Also, by avoiding all of this regulation, we are able to keep our staff numbers more limited and thus decrease overhead costs. This is one of the main ways that DPC practices are able to keep costs down for their members.

What’s the motto or theme of your practice?

We don’t have a motto per se, but this comes the closest and is directly off our website. I think it speaks for itself and is fleshed out by what we have said as above:

“Freedom Family Medicine is a Christ-centered practice. We believe that faith is central to life and, as such, it is a big part of medicine. In all we do, we strive to put God first and to love others as we love ourselves. At Freedom Family Medicine, we hope that you will feel as if you’re taking a step back into the past when doctors had the freedom to practice medicine to its full extent and the time to focus on good health care for the entire family.”

Why did you join Samaritan Ministries?

We joined Samaritan Ministries back when we were still employed by our old practice. Though they paid for a large portion of our family health plan, it was still getting too expensive. We believed that we were supposed to handle our finances more responsibly. We also liked the fact that Samaritan Ministries handles things more like the Bible instructs us to do. Christians take care of each other’s needs as they arise instead of depending on government or some wealthy for-profit business. So, we dropped our health insurance and joined Samaritan Ministries, and we haven't regretted a day.

What has your experience been with having a Need?

Thankfully, we have not had to submit a Need since being Samaritan members. We have friends and patients who have, and we have heard of no issues. We have, however, enjoyed being able to help others and pray for them when they have been in need.