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Discover the future of Direct Primary Care at Hint Summit 2D—September 24-25, 2020

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An Unconventional Approach to Fix What’s Broken in Modern Medicine


Dr. Ellie Campbell was in the first grade when she realized she wanted to be a doctor. "It was never a choice for me,” she says, reflecting on her early passion for medicine. “It wasn’t an easy path, but I never doubted it."

Flash forward fifty years: Today, Dr. Campbell owns a thriving membership-based medical practice, Campbell Family Medicine, in Atlanta, Georgia, where she practices holistic, integrative, and functional medicine with no plans of stopping anytime soon. Her secret to success? Taking the path less traveled—in matters of medicine and money.

When Dr. Campbell realized her training in family medicine had evolved into a passion for functional medicine, she quickly learned she would need to create a practice that allowed her to provide the very best service to her patients while still earning a living. Moving to a membership model allowed Dr. Campbell to establish a sustainable practice and deliver consistent and thoughtful care at the same time. But she didn’t stop there. Her background in community health care compelled Dr. Campbell to establish a unique tithing system that not only gives back to advocacy organizations but also provides scholarships for patients of limited means.

Dr. Campbell’s unconventional approach to family medicine has yielded dramatic results for both her patients and her practice. Now, her greatest hope is that the lessons learned while traveling her own path will pave the way for others to explore how a specialty-focused Direct Primary Care practice might improve patient treatment and prevent physician burnout.

Functional Medicine: A New Way Forward

With an education in osteopathic medical care—a practice that values the body-mind-spirit connection and relies on a partnership between physician and patient—Dr. Campbell has long valued holistic healing. Describing her training, she notes, “Doctors of Osteopathic Medicine (DOs) recognize the body as a unit. You can’t have one single sick part; either the whole organism is healthy or it’s not.”

It’s with this perspective that Dr. Campbell left medical school to embark upon an allopathic residency at the Medical College of Georgia. There she established a foundation in physiology and family medicine that would serve her greatly in years to come. But something was missing. No matter how devoted she was to following leading industry experts’ recommendations, she didn’t see much change in her patients, except for an increased load of prescription medications.

"I was following the very best guidelines, but all my patients did was get fatter, more diabetic and more depressed,” Dr. Campbell notes of that time. “Rates of cancer and heart attacks only increased. It seemed that the longer my patients took medicine, the worse they felt. I didn’t know why we were getting these results; it just didn’t feel right.”

Meanwhile, Dr. Campbell continued to rely on her osteopathic roots for guidance. When possible she encouraged her patients to try home remedies, like castor-oil packs or supplementing antibiotics with probiotics. Her recommendations, unusual for a typical allopathic doctor, caught the attention of her compounding pharmacist. He encouraged Dr. Campbell to attend a conference on bioidentical hormone replacement therapy (BHRT) assuming it would align with her interests. He was right. Focused on uncovering root causes rather than symptoms, the conference was a revelation.

"When you treat patients root causes instead of their symptoms, patients get well and avoid the damaging overuse of prescription drugs. Functional medicine is really root-cause resolution; it’s a framework for evaluating patients’ symptoms and creating a care plan that makes them better and sometimes—but rarely—requires medication. The human body wants to be strong, healthy, and integrated. When we remove impediments to that basic but critical way of being, we make things better."

That life-changing conference was fifteen years ago—and the first step on Dr. Campbell’s journey to achieving the level of patient treatment and care she boasts today.

Value-Added Medical Care

Dr. Campbell’s holistic, integrative approach isn’t just a passion; it’s also a specialty—and something she believes all Direct Primary Care doctors should have, whether it’s sports medicine or BHRT. She explains, “If we’re going to have a model in which the doctors are providing care to the patients, the doctors have a responsibility to create a value-added practice for their patients.”

For that reason, she finds functional medicine the ideal form of medical care for Direct Primary Care physicians:

"I believe that the very best value added is a functional medicine practice. If you’re a primary care doctor, most of what you see is chronic disease, and there’s very little satisfaction in being a prescription-writing machine. On the other hand, if you have a functional medicine model in which you’re listening to the patient’s story, creating a framework for reversing disease, and peeling back the layers of the onion to get to the root cause, the patient actually gets better. Once the patient’s healthy, the doctor still gets paid and doesn’t have to work as hard.”

“Everybody wins,” she concludes, a truth she sees consistently in her work today, but was unable to achieve prior to embracing a direct-care practice.

As Dr. Campbell delved deeper into functional medicine, she found herself struggling with the community health center she worked for at the time. The model was numbers driven rather than outcome driven, and Dr. Campbell was pushed to see more patients in an effort to increase office revenue.

The compounding pharmacist who initially encouraged Dr. Campbell to go to the bioidentical hormone conference had continued to follow her career. He sensed her discontent and encouraged her to consider a cash-pay practice model. At first, Dr. Campbell balked. She knew nothing about running her own business. Nonetheless, she decided to attend a conference for the Society of Integrated Medical Practice Design (SIMPD), known today as the American Academy of Private Physicians (AAPP), where she learned about different payment models from direct-pay to concierge practices.

The move proved beneficial in every way—except financially. “I started by charging an hourly rate,” Dr. Campbell says.

"For three years, my nurse made more money than I did, but I was incredibly happy, and I had incredible outcomes. My patients got better than ever: I got more people off their prescription drugs, reversed hypertension, reversed diabetes, and reversed asthma. It was an amazing time, but I was very poor."

For every hour that Dr. Campbell spent with her patients and collected payment, she spent another two hours creating their care plans, reviewing their labs, and writing their narrative reports. Her hourly rate was really a third of what she was being paid. Even though she loved her work, the model proved unsustainable. The answer was a membership model with fewer patients.

"The membership model provides better results for the patient because they get more focused attention and it also allows me to charge higher fees. I reverse-engineered my rates so that I have more time to do the things that matter most to me. I’m currently at about 200 patients. For the level of complexity required by each patient and the amount of time that I like to spend in the office, that’s enough revenue.”

At the end of the day, Dr. Campbell is a family doctor who prides herself on developing a close relationship with her patients while creating the best care plan possible. The harmonious combination of functional medicine and her direct-pay model lets her do just that.

An Innovative Approach to Tithing

Because of Dr. Campbell’s background working at a community health center, she had a profound desire to give back when her membership model took off. She recounts, “I told my husband, ‘I don’t want to be the doctor that only takes care of the most elite and well-off people in the city. I want to serve the broad range of socioeconomic classes.’” Yet, the thought of giving away memberships for nothing made her uncomfortable.

During her tenure caring for indigent patients—persons without insurance and ineligible for government-subsidized assistance—she’d learned that giving away something for free didn’t lead to real value. Instead, she decided to implement an unusual two-prong tithing policy based on 10 percent of her practice’s profits each month. The first half of that percentage is split equally among her four staff members to be donated to a charity of their choice. The other 5 percent is applied to scholarships for patients unable to afford the regular monthly fees.

The invitation-only program requires members to complete 15 hours of community service in order to earn 3 months of unlimited membership. The nature of the community service is determined by the patients, and in the event they are too infirm or too old to complete the necessary hours, a family member can do it on their behalf.

For Dr. Campbell, it’s a win-win-win: “The patient wins because they get to have space in the membership that they wouldn’t otherwise be able to afford. The community wins because it gets vicarious community service—15 hours I don’t have time to do that my patients can do for me. My accountant wins because it allows me to quantify the amount of charity care that I give without giving away the bank.

"If every doctor in our city gave 5 percent of their time to their patients in return for community service, we would have the cleanest sidewalks, the best landscaping, the safest neighborhoods, and the best and healthiest patients. I think it’s a fabulous method, and I hope other physicians consider giving it a try."

Putting it All Together

Giving back to the community; treating patients holistically, without relying on pharmaceutical prescriptions; and embracing a direct-pay practice may not be the norm today, but they’re all important ways that burned-out doctors can reinvigorate their medical practice and increase their longevity.

As Dr. Campbell notes, the average allopathic physician practicing traditional medicine eagerly awaits the first opportunity to hang up her coat, but the average functional medicine doctor will happily wait to retire until the age of 75.

"For doctors who are pondering giving up medicine,” Dr. Campbell says. “I encourage you to take a few functional medicine courses and consider a direct-pay model that allows you to reverse-engineer your hours to determine the number of patients you want to see and the kind of lifestyle you want to have. It brings joy back to your life, your practice, and your patients and their families. I see functional medicine and Direct Care as the antidote to what’s broken in medicine."

Tags: Direct Primary Care, Physician Stories, Medical Practice Management

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