Direct Primary Care: Dr. Bruce Jung
Posted by Jed Stuber on Apr 30
The following article was originally posted at http://samaritanministries.org/drjung/
We asked three Direct Primary Care doctors, who are also Samaritan Ministries members, to tell us about their practices and how they benefit patients. Here Dr. Bruce Jung tells us about his practice, The Doc Shoppe. We also included Dr. Jung’s comments in the article “Member doctors adopt new model for primary care” in our May 2015 Samaritan Ministries Christian Health Care Newsletter.
How is your practice different than a typical one?
The Doc Shoppe has a number of unique features that distinguish it from a typical clinic. The most obvious one to potential patients is that we do not directly accept payments from third-party payers like Medicaid, Medicare or health insurance carriers. We have gone back to the “good ’ol days” of primary care where we bill patients directly for our services. This helps to keep our costs down as my only employee is one nurse administrator.
A second difference is our monthly membership program. For just $50/month a person has essentially unlimited access to me by way of phone/text/email and as many office visits as they need. This fee also includes over 100 standard laboratory tests as needed and almost every procedure I can perform in the office.
A third distinctive which people notice is unhurried visits and short wait times. Since my goal is to have 600 to 700 patient members per provider, we can accommodate 30-60 minute face-to-face visits with the doctor. Patients don’t have to feel bad when they bring in a list of concerns to me, nor do I feel pressured to rush them out the door to get to the next patient. Plus I do not have the financial incentive to limit patients to only one problem per visit that I used to feel. I can manage patients in the way that is best for them and often most convenient. We frequently handle problems by phone or text and have utilized modern cellphone camera technology to help with diagnoses of rashes or other readily visible conditions.
What are some of the advantages to your practice that patients most appreciate?
Besides the ease of accessibility to, and the amount of time with, their doctor, our patients are usually quite surprised at the significant discounts we arrange for ancillary services and tests. For example we can now obtain a foot X-ray that used to cost our patients $600 at a local hospital for only $45 at a neighboring orthopedist’s office. Similar saving percentages are available to our patients for MRIs, CT scans, physical therapy, ultrasounds, EMG/NCVs, colonoscopies and EGDs. These outside agencies bill The Doc Shoppe for their services and we just pass the cost on to our patients. Patients appreciate the discounted prices, the ancillary service providers appreciate that I pay them immediately and we appreciate that our patients can get the tests we need them to have in a timely manner.
Additionally, patients have also come to understand that I work directly for them and not for their employer, the federal government or a health insurance company. In the past I was mainly paid by these other third party payers and so in essence was working for them and not the patient. In a typical fee-for-service office a patient is not much more than a tool from which to obtain the best ICD-9 diagnosis code possible to justify the highest reimbursable CPT procedural code possible to bring in the most revenue possible with each encounter. In our model I am paid directly by the patient and so I am motivated ethically, financially and medically to do what is in their best interest alone.
What are some of the problems with regulation of health care that you are able to avoid?
Members of healthcare cost-sharing ministries, like Samaritan Ministries, benefit the most from our service structure. They automatically are classified as one of the nine exemptions to Obamacare and all its regulations, plus they have unlimited primary health care access at The Doc Shoppe. For a family (of any size) all of this is available for less than $150/mo. It is even less for couples and individuals. We have a graph on our website which shows that Christian families with both a Samaritan Ministries and a Doc Shoppe membership can save over $20,000 per year on healthcare costs compared to standard health insurance plans (I used the Silver plan on the Kentucky Exchange for comparison purposes). We have really tried to spread the word through local advertising to Christians in our area.
From my personal perspective as a physician I have “dis-enrolled” from Medicare, signed off of Medicaid and become “out of network” with insurance providers. It is amazing the number of forms, statements and regulations that come to providers from these groups that are both too complicated to understand and equally as difficult to implement. We still happily see patients who belong to these groups and many patients who are electing to forego insurance altogether despite the penalties. (By the way, we encourage our patients to have catastrophic insurance or a cost-sharing plan.)
Could you elaborate on your slogan “Affordable, Quality, Compassionate, and Patient-Focused Healthcare”?
Most of our clients grimace when I inform them that I was seriously contemplating naming our facility, “The Quack Shack.” I was under the delusion that such a name would be quirky enough to attract attention and creative enough to use for branding. By God’s grace I heeded my wife’s advice and went with “The Doc Shoppe” instead. However, I still use Q-U-A-C-K as a humorous acronym for my “elevator speech” when people ask what I do for a living.
“Q” stands for quality We want people to receive the best possible primary care from a family physician that we can offer them.
The “U” is for understandable. We want people to know what unfamiliar medical terms mean and to be able to comprehend in their vernacular the diagnosis, treatment plan and my recommendations for pursuing a certain line of diagnostic testing or treatment protocol. We also want them to be able to understand the cost of their care so we make our pricing completely transparent.
The “A” represents affordability. We want people to get a good value for the healthcare dollars they budget for primary care. We are convinced that our membership model of direct primary care can save our state thousands of dollars, and that it is the least expensive one in the country. We also intercede for our members by negotiating the best price we can for x-rays, labs, other diagnostic tests, referrals, procedures and therapies.
The “C” is my personal conviction that Christian physicians should be characterized by honesty, integrity and compassion, being sincerely devoted and committed to their patients’ wellbeing. It also means that my patients can count on me bringing a Biblical, eternity-based perspective to the care I provide.
The “K” is simply for the kindness of Christ that I want to characterize our interactions with everyone… patients, sale representatives, mail lady, delivery personnel, IT consultants, whoever.
Why did you join Samaritan Ministries?
I evaluated Christian cost-sharing ministries over 10 years ago when I was both convicted about trusting God for my family’s health and also fed up with the increasing costs and decreasing services “covered” by insurance companies. I joined Samaritan Ministries after evaluating the options available in our state at that time and then presented cost-sharing ministry options to my Christian physician partners. Some of them are members as well. Now I happily promote SMI to patients, friends and family who I believe meet the requirements of membership. We have seen many of them become SMI members.
What has your experience been with having a need?
I inform skeptical Christian patients that I have used SMI for personal needs on at least three occasions. It has “worked” as intended. One of my daughters required an ER visit for pneumonia acquired on a mission trip to Mexico. Another time my wife required gynecological surgery and I needed a hernia repair. SMI members came through for us each time. The wife of our former pastor was an SMI member and had a very expensive cardiac operation for a congenital heart defect and it was completely paid. These examples are usually sufficient to ease my patient’s doubts about SMI’s effectiveness. I realize that past performance is no guarantee of future success, but the Biblical framework on which SMI is based is eternal. I also rejoice that my sharing is being used to pay actual health care expenses of God’s children and not to fund (unethical medical or wasteful administrative) activities of which I do not approve.