The United States had long been the world leader in medical research and patient care. Across the nation, patients have access to top-notch healthcare providers, advanced diagnostic systems and leading-edge pharmaceuticals which help them to lead longer and healthier lives.
Unfortunately, despite the high standard of care offered, the United States healthcare system is broken.
Patients and providers are often mired in a maze of regulations and restrictions imposed by a patchwork billing and payment system controlled by large insurance companies. These difficulties can make getting access to needed healthcare more difficult, and they increase the stress felt by ailing patients.
Over the years, there have been attempts to reshape the healthcare system, including the implementation of Medicare and the Affordable Care Act. However, these efforts have not been entirely successful. Many patients still fall through the cracks of the healthcare system, failing to receive appropriate care and ending up saddled with onerous medical debt.
In recent years, many physicians across the country have decided to “opt-out” of the current healthcare model. Instead of having their patient treatments and billing arrangements determined by 3rd party insurers, these providers have developed direct primary care medical membership systems for their patients. Under these systems, patients receive all their primary care from their doctors by paying a monthly subscription fee.
In Hendersonville, a few primary care practices have adopted the membership model. One of them is Blue Ocean Family Medicine. Led by Dr. Kent Lofley, Blue Ocean Family Medicine offers a complete range of traditional family medical services.
“In our practice, we provide full-spectrum outpatient family medicine,” says Dr. Lofley. “Our services include preventive care, sick care, chronic disease management, physical examinations and treatment procedures. We also provide many medications and lab tests to our patients at cost, resulting in significant savings for them. One additional advantage for our patients is that we also offer Osteopathic Manipulative Treatments (OMTs), which provide a supplemental hands-on approach to diagnosing and treating illnesses and injuries.”
Recently, Hendersonville Lifestyle sat down with Dr. Lofley to find out more about his practice and how direct primary care works.
What prompted you to begin a direct patient care membership-based practice?
“I have always felt that the insurance model for primary care is bloated and unnecessary. After medical school, I decided that I wanted to find a way to continue to practice medicine, take excellent care of my patients and still be able to eat dinner with my family. A membership-based practice allows me to provide personalized healthcare and achieve work-life balance.”
How does your practice differ from traditional primary care providers?
“We believe that going to the doctor should be simple and affordable. So, we do things differently at our office. Instead of accepting health insurance, our patients pay a monthly fee, and we see them as often as they need for whatever health concerns that may arise. The monthly membership allows for a spread-out predictable cost.”
Do you work with insurance companies?
“No, we do not bill insurance providers and we do not bill Medicare. We believe that our patients who have insurance should save it for emergencies. They can use it to pay for things that we don’t provide in our office, including expensive prescriptions from pharmacies, specialized labs and imaging diagnostics.”
How do you handle specialist referrals, e.g. surgeons?
“Like any primary care practice, we refer to specialists when needed. For our patients who have insurance, nothing is different. They simply use their insurance for their specialist visits and treatments. For those without insurance, we work hard to find specialists who offer fair prices and are willing to work with cash-paying patients.”
How long does it typically take for one of your patients to get an appointment with you?
“At Blue Ocean, our number of patients is limited to 500-700, which facilitates our patient scheduling. Sick patients can usually be seen the same or next day. More routine visits are usually scheduled within one week. Our limited patient count also allows us to spend more time with our patients. Initial patient visits usually last 60 minutes, with follow-up visits lasting between 30 – 60 minutes. This extra time allows us to provide more in-depth diagnostics and care than traditional primary care practices.”
What factors should prospective patients consider when choosing a family care provider?
“When you choose a family medicine physician, you are choosing a coach, educator and coordinator for your health. The provider should be responsive to your concerns, open-minded about treatment options, and willing to consider your personal preferences and needs.”
Dr. Kent Lofley, D.O.
Blue Ocean Family Medicine
109 Hazel Path Suite 5,
Hendersonville, TN 37075