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Holladay physician forgoing insurance plans

Doctor will charge patients a flat yearly fee for services

Published: Monday, Jan. 4 2010 12:00 a.m. MST

Dr. Michael Jennings, a primary care physician, works to get cable lines run in his new office building in Holladay in December.

August Miller, Deseret News

HOLLADAY — Dr. Michael Jennings has been wielding a hammer as much as a stethoscope in recent days, readying his new office for patients who will simply pay a flat fee for his services.

No more insurance forms, no more long hours at his desk. Jennings said he's had it with spending as much or more time on paperwork as he does with his patients. And that's going to change.

So lately, he's spent his weekends with building contractors in his new office, putting the finishing touches on what will be known as Personal Family Physicians in Holladay.

"It will be my own group practice that doesn't work with insurance companies. We'll work the financial arrangements out with our patients and we work for them." Those who sign up will receive all the services offered at the clinic for a flat fee of $1,800 per year for the first member of a household, $1,500 for the second, $1,200 for the third and $1,000 for any additional family members.

"Payments can be broken down however it's convenient for the patient. The reason we do that is we want the continuity of a long-term relationship with them." While many people use local urgent care facilities where they walk in and pay cash, those are usually one-time, acute-need situations that don't provide preventive care and maintenance.

"We don't place a limit or cap on number of office visits," he said, noting the clinic will offer basic primary care services but no X-rays. In-office lab work is covered as are many of the lab tests that must be sent out for testing.

Because most people's needs for medical attention revolve around the services he can offer in-house, Jennings said he's looking to serve patients "who feel they can't find or afford insurance."

Jennings said he's starting the practice on his own, but the office has been built to house three providers. "As we grow, I will bring in partners. Each person will have their private doctor and that's who they will primarily see."His desire to get back to patient-centered medical care is spreading among medical providers nationwide, to the point that a new organization has been created to help foster relationships between such doctors. The Society for Innovative Medical Practice Design (www.simpd.org) now provides a growing menu of services and benefits for those who are leaving traditional practice behind, including discounts on malpractice insurance, a listing service so patients can find participating doctors and an agreement that members will care for each others' patients when necessary.

Regional meetings and conferences have been planned across the country, featuring "how to" seminars for those who want to convert their traditional insurance-based practice. The organization also lobbies Congress on health care legislation and provides networking opportunities. Jennings and one other Utah physician are currently listed as members, along with dozens of doctors in other states.

Evolving health care reform legislation now before Congress poses potential challenges to doctors like Jennings, who are changing the structure of their medical practices without a clear understanding of how the evolving legal landscape may impact their work. And as lawmakers keep sloggin away at evolving legislation, it's not clear he'll know any time soon what the specifics will be.

Even so, he gets much the same reaction from his colleagues, with whom he has worked for decades. "A lot of envy, really, because the concept gets back to the idea of a pure patient/doctor relationship. No doctor goes to medical school dreaming of the hours they will spend doing mindless paper work, yet that's what so much of our energy is spent on and it's so frustrating.

"This concept of practice allows us to put all those wasted hours into what really matters: dealing with patients and their needs."

Because 40 percent of his overhead won't be devoted to processing insurance claims, Jennings said his patient population will be limited to about one-fifth of the typical patient load that is found in most primary care offices, meaning he can spend much more individual time with patients.

He believes he's catching the beginning of a wave that will sweep through medical profession.

"I think in the future, we'll see more physicians opting out of government programs and even private insurance programs. To continue participating is just too onerous and restrictive," he said.

"Health insurance should be prevention against catastrophic loss," rather than trying to be "all things to all people," he said. If viewed in that light, people could afford to purchase insurance to cover a medical catastrophe, and then rely on primary care providers who provide services for a flat fee for the bulk of their care.

"Our idea of what health insurance coverage should be has become distorted. If we expected the same level of service from our homeowner's insurance, they'd be sending people out to change our light bulbs and sweep our gutters."

e-mail: carrie@desnews.com

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