We’d like to introduce you to Jonathan Wade, DO, FAAFP, a family physician who owns Orchard Health DPC, a direct primary care practice located in Nashville, GA. Dr. Jonathan Wade gives us insight into his intriguing DPC journey. Orchard Health DPC has grown with Hint Core as Dr. Wade decided to run his practice leveraging the platform early on.
Hint Health: How did you get started with your own practice? What was the defining moment that led you to begin your DPC journey?
Dr. Wade: I read an article about DPC in Medical Economics that interviewed Dr. Brian Forrest and his development of direct care. A year or so later I was at the AAFP conference in Orlando and just happened upon Dr. Forrest's lecture on DPC. I walked out knowing that was what I wanted to do. At that point I was fed up with signing charts and doing primarily contract work with telemedicine, ERs, and Urgent Cares. After leaving Orlando, I started planning my DPC practice with a long-time NP friend and colleague.
We opened our doors on April 1, 2018 with a 100-employee trailer plant nearby. We set our sights on targeting local employers to improve their health benefits for employees as well as the overall operations and "health" of the business. My business partner and clinical colleague, Bill Bryant, NP died unexpectedly in December of 2019, less than a month before we were to onboard an 800-employee business he had been instrumental in landing. I took his favorite picture of him and his fishing boat and framed it for the lobby as a way of continuing his presence with the practice.
Hint Health: In what ways has DPC improved how you practice medicine?
Dr. Wade: DPC has allowed me to practice medicine the way I have always dreamt of doing. Unrushed visits, a true feeling of family with my patients (as well as my office staff feeling that way with patients too), bringing true change to health and overall wellbeing of my patients, and the time to discuss lifestyle changes to fix problems, not just medicate them.
Hint Health: What aspect of medicine are you most passionate about?
Dr. Wade: Helping people to realize they have the power to make changes to their lives to fix and prevent disease. So many patients say they have never had a medical office explain things so well when it came to diagnoses, medications, or lifestyle changes.
Hint Health: What would you say is your defining purpose as a physician?
Dr. Wade: To help others find their best self.
Hint Health: How do you think DPC can transform healthcare in this country?
Dr. Wade: I know I'm biased, but I think every single person in the nation would be more satisfied with their healthcare, physician, and overall health. I think so many people miss the doctor-patient relationship that has been pushed to the side for data, MIPS, MACRA, etc. to take top importance to fee for service doctors and medical offices. MIPS is the "Merit-based Incentive Payment System that affects the majority of physicians in the U.S., dictating how physicians get penalized or incentivized through reimbursements depending on their performance metrics." MACRA is an acronym for the Medicare Access and CHIP Reauthorization Act. It is a landmark legislation aimed at changing Medicare payments to physicians. MIPS is one of the components of MACRA.
I truly feel the auto insurance analogy is so relatable to medical insurance and DPC; pay for the less expensive part of care (Primary Care) out of pocket, just like the "primary care" of your auto, and reserve insurance for truly catastrophic care when a safety net is needed. Unteaching that belief, that insurance is the gatekeeper to care, is critical to the growth and success of DPC. I truly hope my DPC brethren continue to educate their patients and communities so that we may one day find ourselves in a nation where direct care is mainstream and the norm.
Hint Health: How do you think insurance can be adapted to serve as a safety net for emergencies instead of the care gatekeeper it functions as today? What do you think is preventing this adaptation?
Dr. Wade: If health insurance, as a whole, was directed at truly catastrophic care coverage (a lot like car and homeowners insurance), we could lump primary care services under maintenance and preventative care (much like oil changes and lawn maintenance) which is paid out of pocket. By mimicking the way we utilize these other forms of insurance, patients can pay for the type and level of care they need or want, while maintaining the catastrophic insurance coverage for true emergent issues.
The barriers to this are varied and many. System resistance is paramount and would include insurance agents losing money on commissions, as well as individuals and employers having to cope with paying out of pocket for their primary care needs. Education is another component as many people feel that an insurance card gives them carte blanche access to labs, radiographic studies, and [prescription] medicines. They become frustrated when they still have to pay for these things due to their high deductibles; however, if they knew they would pay for these services upfront, they would at least be prepared to do so.
On that note, by paying up front, the cost of care and these tests would be far less and much more affordable. Change is difficult and spinning the way we pay for and manage health care would be tough for all involved. Doctors as well would have to learn to price their services and manage their patients more attentively as they are not relying on insurance companies to foot the bill for much of their care. I think in the end this leads to better care and better patient satisfaction.
Hint Health: We appreciate that you are a loyal Hint customer and would love to know what problems you were having prior to using Hint Core. How has Hint Core solved these problems?
Dr. Wade: We started back in 2018 with AtlasMD. Nothing against what they are doing nor the EMR platform they have developed, but at the time I felt that Hint and Elation were more scalable for my practice. The reports and integrations that Hint provides my practice was the major fix to the issues I was having prior to the switch.
Hint has allowed us to scale to over 1,600 members and provides great reports. Hint is always growing/developing/improving and that has been very beneficial to our practice and its ability to grow. Additionally, patients (especially employers) love the access to see payments and invoices, as well as to make changes to employee rosters.
For more information about Hint Core visit hint.com/core.