Doctor cuts insurance waste with new model
Last updated 7/21/2020 at 9:36pm
Tired of paying big insurance premiums only to sit in a crowded waiting room to see a doctor for less than 10 minutes once or twice a year?
Dr. Amy Townsend says she has a better way.
Her Magnolia Direct Primary Care medical practice is located at 2845 Texas Ave, Suite 100, next to Orange County Building Materials in Bridge City.
It doesn't run on insurance.
"Insurance is why healthcare is so expensive," she says. "There's just this tremendous waste in healthcare. All of the bureaucracy needs to go away."
Direct primary care, Townsend explains, "is really a grass roots effort for physicians to change the model of healthcare, to function outside of insurance."
Direct Primary Care practices require small monthly fees up front, but patients are not charged out of pocket for each appointment. Patients are allowed to see their provider as often as they like for preventive, wellness and chronic care.
"This is like a gym membership or Netflix. You pay a monthly membership fee for everything we do in primary care," Townsend said.
"It allows a physician to remove a lot of waste -- instead of having 10-12 people in your office doing insurance coding. We're really trying to disrupt a system that's broken."
Without all the costly red tape, there's more time and lower costs for patients.
"Part of the problem with health insurance is there is zero transparency on what the cost of a procedure is," Townsend said. "It's basically just putting your trust in insurance companies. It's 'Let's have this stuff done and I'm hoping it's going to cover it and I'm not going to end up with this bill at the end.'
"But more and more people are finding that insurance companies are denying things and they are getting these surprise bills, things they weren't even anticipating.
"Again, the way that this is structured is to give a very transparent, every up-front pricing. People know what they're going to pay."
She says her practice will never have more than 500 patients, while the average doctor working under the insurance model may have as many as 3,500 patients.
"This model changes everything," Townsend said. "Not only for the patients; it allows me to spend more time with patients. Visits can be 30 or 60 minutes long, not the average of seven minutes for the usual outpatient practice."
Townsend knows about "usual outpatient practices."
She observed them up close the first two years after she earned her medical degree from UTMB, then completed her family residency in 2006.
"I worked in a private practice for two years and I felt, because of insurance, I couldn't give patients what they needed," she recalled.
"I actually transitioned to do hospital medicine. I saw patients at the hospital and took care of them at the hospital. I could get things done in the hospital."
Townsend worked as a hospitalist for much of the past decade but also worked for several years in hospital administration for Christus Southeast Texas and other hospitals.
She opened her Bridge City practice in March.
"I started planning this two years ago," she said.
"And it's challenging to get people to see that it can be done better. As soon as you tell them it's not within the insurance system, they think that it's going to be unaffordable.
"And this, actually, for a lot of people because their deductibles are so high, it's more affordable."
Townsend points out that membership in her practice doesn't cover hospital care or other catastrophic problems.
"Direct primary care is not a replacement for catastrophic healthcare," she said. "This allows the patient direct access to primary care. But we encourage patients to have some kind of catastrophic insurance plan.
"A lot of times those can be purchased at much reduced prices that a regular insurance policy."
She also said that she will work with patients who may already have insurance policies to provide the best outcomes, physically and fiscally.
"Some people have such high deductibles they choose to pay out of pocket for some things rather than have it filed on their insurance," Townsend said.
"I can order a routine lab panel and if someone has a high deductible like $5,000, they may pay $500 or $600. But if you pay out of pocket, it's literally like $40."
Townsend says she is available 24-7 for her patients.
"I want them to communicate with me. I don't want them to have to go to urgent care," she said.