Dr. Winkes, you’ve made a change recently. Now that you’ve been practicing Direct Primary Care at Megunticook Medicine for a few months, what do you think of it?

It’s a pleasure! I am thoroughly enjoying the freedom of practicing direct primary care (DPC) medicine. The biggest difference that I am noticing is that I have enough time now! The model is new to me, of course; it still feels precious to have ample time to spend talking with patients and families- sometimes just about simple problems, but especially when we need to sort out more complicated issues. It is so satisfying to feel that I have enough time to provide truly excellent care!

For those who are less familiar with Direct Primary Care (DPC), can you describe it?

Of course! Direct Primary Care is a growing trend, both locally and nationally. I think of it as a return to a simpler model of care. In our (private practice) office, we charge a monthly membership fee directly to patients & families, rather than charge their health insurance for visits. This fee covers all routine office care, including some procedures which are not normally available in other area outpatient practices. This allows folks to save their health insurance for the times when it is truly necessary (such as major illnesses or emergencies) and it allows us to run a much simpler and smaller office. Since we are not trying to manage the complexities of the insurance coding and billing system, we are able to run the office much more efficiently. We have very few staff and both providers & staff get to know patients & families very well.

Access is excellent. It is really the norm, rather than the exception, for me to be able to say “I’d be happy to take a look, can you bring your child over later today?”, when a parent calls with an urgent concern or question. I thoroughly enjoy surprising folks from time to time, too, by just picking up the phone when it rings! I am not constrained by insurance regulations around face-to-face visits any longer, but can offer an opinion over the phone or via electronic messaging, if I feel that is medically appropriate. I do not need to carry a large panel of patients any longer, and therefore have ample time set aside to talk to folks (I’m finding it especially precious to be able to take ample time with teenagers) and even to do house calls (included automatically for newborns). It is lovely to be able to spend my time and energy on providing excellent care, rather than managing coding&billing issues or insurance based ‘quality metrics’.

Is this concierge medicine? Isn’t that expensive??

I always like to quote Dr. Pierce, the founder of Megunticook Medicine, on this. He describes our office as “the blue collar version of concierge medicine”, which I think is perfect! We have tried hard to set monthly membership fees in an affordable range for families, currently charging less per month than most folks spend on coffee - or certainly less than family cell phone plans! We are not “Hollywood doctors”, and the practice does not function - and is not priced like - a concierge practice on the West Coast. It’s just a simple private practice that runs outside the traditional health insurance based fee for service system.

I read an interesting article this week, on zestpeds.com, entitled “Will a Direct Primary Care Membership Actually Save Money?”, comparing average costs (deductibles, co-pays) in the insurance-based system vs. pediatric direct primary care practices. Everyone’s situation is different but I do believe that for many, DPC practice membership may be comparable - and in some cases even less - than access to a traditional practice would be for their family.

What should people do, if they are interested in learning more?

Call us - at 207-390-8570, or check out our website at www.megunticookmedicine.com We are always happy to chat with folks more about how the practice actually works, and if DPC might be a good fit for their family!