Dr. Kellar McCloy, right, and his wife, Lauren, have opened a direct primary care practice at the North Glover Healing Center in Twisp.
By Sandra Strieby
Offers alternative to fee-for-service visits
Dr. Kellar McCloy and his wife, Lauren, have opened a direct primary care practice, Liberty Bell Family Medicine, in Twisp. McCloy began his practice with a soft opening in April and now has capacity to add new patients to his roster.
Direct primary care, or DPC, is an alternative to the fee-for-service system that has become the norm in the U.S. According to the American Academy of Family Physicians, DPC patients “pay their physician or practice directly in the form of periodic payments for a defined set of primary care services.”
Rather than billing patients’ insurance for primary care, DPC practitioners charge a monthly fee, which typically allows the patient unlimited office visits, virtual sessions, and access to the provider by phone, text and email.
At Liberty Bell Family Medicine, the membership fee includes routine health screenings and also covers most office procedures, such as wound care, wart removal, and certain health screenings. Patients enjoy discounts on lab work and prescriptions, and the McCloys hope to add imaging — such as X-rays and MRIs — to that list soon.
DPC got its start in Seattle in 2007 and represents a small but growing segment of American family care. DPC practices in Washington state register with the Office of the Insurance Commissioner. According to the Insurance Commissioner’s web site, DPC practices have three characteristics in common:
• They serve as your primary care provider for routine and preventive-care services.
• They include a set monthly fee.
• They Don’t involve insurance, so there are no extra charges, deductibles, copays or insurance billing.
Differs from concierge
DPC differs somewhat from concierge care. According to McCloy, “The main difference between concierge medicine and direct primary care is that concierge docs … charge a monthly membership fee for things that are not necessarily covered by insurance, and then they’ll see the patients in-clinic for all of those other things that are covered by insurance, and they’ll bill insurance for those things.” DPC focuses on primary care and does not provide the more expansive care that a concierge practice might.
DPC is not considered a substitute for insurance. It’s intended to cover the basics of family medicine, such as wellness visits, preventative screenings, and care for chronic conditions and routine illnesses and injuries. It doesn’t cover hospitalization, surgery, specialty care, or imaging, although McCloy can provide referrals and work with specialists and hospital caregivers as needed.
Pairing a high-deductible or “catastrophic” insurance policy with DPC can be a good strategy, said McCloy, giving patients broad coverage along with the benefits of a private physician who knows them and their health needs, and it may reduce the cost of primary care.
While McCloy generally will not bill insurance, he is working to enroll as a Medicare provider, and has a wait list for Medicare patients. “Medicare will be the only insurance that I will bill with my clinic,” he said in an email, “so that I can continue to take care of patients 65 and over and Medicare eligible, as this patient population is very important to me as well.”
The path to the Methow
McCloy didn’t initially know that he wanted to practice medicine, but working with underserved patients at a Memphis, Tennessee, clinic shortly after college convinced him.
“As soon as I started rooming patients and seeing the smile on their face when I was able to offer them the smallest amount of help, I knew that that’s what I had to do with my life,” he said. “I really truly did go into medicine to help people and to take care of people and to help them live their best lives.”
McCloy was exposed to the direct primary care model during a residency in Olympia. Working in a DPC provider’s clinic, he “saw how much time she was able to spend with her patients” and was impressed with “how happy her patients were. She had patients that were incredibly happy with the service they got with her, the time they had with her, the access they had with her.”
Following that residency, McCloy worked for Providence, Group Health and Kaiser. In those settings, he said, “I began to see more and more not only the patients’ frustrations with some of the insurance barriers and hurdles, but also doctors’ and the health care workers’ frustrations with insurance as well.”
While DPC may reduce the cost of primary care — in part by relieving providers of the administrative burden of insurance billing — McCloy says the main draw for him is the ability to form long-lasting relationships with patients.
“I think the doctor-patient relationship and continuity of care are two of the most important things about primary care medicine,” he said. “The increased amount of time that I am afforded with patients in direct primary care and the better access they have to me are two of the things that I love about direct primary care.”
When patients can see their doctor for 60-90 minutes whenever they want to, there’s time to talk about all of the things they may want to address, said McCloy, and “if we finish up a visit and something else pops into their mind that we forgot to talk about, they’ve got my cell phone number.”
McCloy’s hope is “to create great relationships with patients … and hopefully be able to take care of them for decades to come.”
Multi-faceted practice
McCloy has experience in wilderness, sports and addiction medicine, and hopes to use all of those skills in the course of his practice here. A long-time runner and skier, and former climber, McCloy knows the hazards of an active life and hopes that patients dealing with sports injuries will benefit from his specialized skills.
Addiction medicine became a passion for McCloy after residency. “In Olympia I got great training in it,” he said. He went on to work in a free clinic, which he found reminiscent of the Memphis clinic where he’d fallen in love with family medicine.
“It was just the true, roots nature of helping people,” he said. “These folks would come in in just dire straits. And, you know, we were there for them. We were empathetic. We were not judgmental … to see people turn their lives around is just magical … part of the reason why I went into family medicine.”
McCloy is also interested in partnering with local employers to offer direct primary care coverage for their employees. The option may be especially valuable for small companies that don’t offer health insurance benefits but may give employees a stipend to help cover health-care costs.
McCloy has known he wanted to live in Washington since he backpacked through the North Cascades when he was 18, and while he appreciates the learning opportunities that Olympia afforded him, he and his wife knew that “it wasn’t our long-term home.”
He and Lauren visited the Methow to celebrate her birthday a few years ago and, while looking up at Liberty Bell, “we just had the realization that this is the place.” They moved to the valley three years ago and are looking forward to putting down roots and raising their daughter here.
Liberty Bell Family Medicine’s office is located in the North Glover Healing Center at 214 Glover St. N. McCloy currently sees patients there on Mondays, Wednesdays and Fridays. You can learn more about McCloy, his practice and DPC at https://libertybellfamilymedicine.com.
