Direct Primary Care Doctor
Dr. Joel Fankhauser's transition away from fee-for-service overlapped with his decision to go into private practice. That said, his focus on quality patient care began before the doors of his DPC clinic even opened as well. Realizing the importance of building relationships and educating people about the Direct Primary Care model, Dr. Fankhauser and his team began engaging with prospective patients during the evenings after having worked a long day in his employed position. Enrollment efforts started when he and his co-founding physician partner employed a registered nurse in December 2014 to respond to inquiries through their website. This proactive step ensured potential patients understood the Direct Primary Care (DPC) model and felt confident about the clinic before it even existed.
The transition to this model wasn't without challenges—financial risks, noncompete clauses, and the need for a successful plan without fallback options loomed as the transition was on the horizon.
Building Trust Through Transparency
Early promotional efforts played a crucial role in establishing trust and transparency. The clinic held introductory meetings with potential patients, recording these sessions for live video content that was later edited and made available online. This content resonated with audiences and has remained accessible for nearly a decade. With a focus on personal connection over online presence, Dr. Fankhauser's clinic never had a large spend on advertising, yet they successfully attracted a steady stream of patients.
Identifying and Addressing Community Needs
One of the remarkable aspects of Dr. Fankhauser's practice was his ability to identify and target underserved groups. The clinic focused on foster families requiring Medicaid services, treating foster children with the same care and respect as privately insured patients. This inclusive approach not only expanded their practice but demonstrated a commitment to equitable healthcare, less expensive cost of care and higher quality access than the Medicaid patient without a DPC doctor.
Developing a Sustainable Practice Model
Situated in Bentonville, Arkansas—a rapidly growing community with significant healthcare access challenges—the clinic operates what can be classified as a hybrid model. They accept Medicaid foster children without charging them privately, leveraging the state's Tefra program to support children with significant medical needs. The clinic avoids routine billing to Medicaid due to its inefficiencies and low reimbursement rates, opting out completely for adult Medicaid, allowing them to maintain a more sustainable practice model.
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Comprehensive Patient Care and Community Engagement
Upon the clinic's opening, which managed to cover overhead costs on the first day thanks to strong patient sign-ups, the team was dedicated to providing comprehensive care. Their patient panel now includes individuals from newborns to those in their nineties, with higher rates of uninsured and Medicaid patients, and about 10% Medicare eligible patients. Dr. Fankhauser explains that the decision to opt out of Medicare was strategic, hoping older patients would continue using their services post-transition.
Adapting Financial Strategies for Patient Satisfaction
Financial strategies at the clinic aim to reduce administrative burdens and enhance patient satisfaction. They include certain low-cost labs in membership fees to avoid minor billing hassles (yes, you read that correctly… TO AVOID BILLING, which is so opposite of how a fee-for-service clinic is run), reinforcing their commitment to generous and patient-focused care. This approach makes a positive impression on patients, leading to word-of-mouth referrals.
Operational Insights and Staff Recruitment
Dr. Fankhauser underscores the importance of hiring medical staff who prioritize thoroughness, kindness, and generosity over similar personalities. Employee recruitment is primarily through referrals, resulting in a pleasant work environment with zero turnover due to dissatisfaction in ten years.
Physician recruitment, on the other hand, is approached with creativity, avoiding high recruiting fees by using social media and personal connections. This has led to successful hires where fellow physicians were drawn to the practice's ethos and community ties.
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Employer Partnerships and Healthcare Access
The clinic's DPC model appeals to small businesses, providing affordable primary care as an employee perk. Employers with fewer than 50 employees find this an attractive benefit, reducing absenteeism and enhancing job competitiveness. This model underscores the clinic's ability to adapt and meet the needs of diverse patient populations.
Dr. Joel Fankhauser's story is a testament to the transformative potential of the Direct Primary Care model. From its inception through innovative patient engagement strategies, to its commitment to equitable and comprehensive care, the practice has navigated the complexities of the healthcare landscape with resilience, innovation and never losing sight of the doctor-patient relationship being at the heart of his practice.
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