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Celebrating 1 Year!
Dr. Howell’s patient panel has been growing, but is only a quarter of the way full. He has plenty of availability for new patients to be seen quickly. He is accepting patients of all ages.Dr. Howell is available by phone to answer any questions you might have about Direct Primary Care or you can set up a meet and greet to learn about his approach to medicine.
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Everyone knows you don’t get enough time with your doctor during visits. At Pillar Primary Care, we don’t work with insurance companies or their bureaucracy so we can spend more time with you caring for your health. When people spend more time with a doctor who knows them, they will get better care so they can live longer, healthier lives.
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Frequently Asked Questions
We advocate that all of our patients have an appropriate plan in place to help protect against the financial devastation that could occur from a medical catastrophe. It is wise to be prepared especially since medical bills are the leading cause of bankruptcy in the United States.
Most patients in our DPC practice have some form of health insurance coverage. These plans range from employer sponsored coverage to individual plans to Medicare and Medicaid plans. Additionally, some of our patients have found the cost sharing programs such as Samaritan Ministries, Medi-Share, and Liberty Direct a great pairing with their DPC membership.
However, having health insurance has never equaled having healthcare. With so many insurance plans now having a $5000-$8000 deductible, patients are paying everything out of pocket anyway. Insurance doesn’t kick in until something truly major happens.
A DPC membership allows patients to save money on healthcare and have a better relationship with their physician regardless of their insurance plan. So if your plan doesn’t cover much, come to our practice to save on your out of pocket costs. If your plan covers everything, come to our practice to have longer visits and more time to work through your health concerns. If you’re healthy, never go to the doctor, and have a fully paid for plan from your employer, then congratulations. You’re in a great place, but the majority of people in our area need help. That’s what DPC does. It helps.
It is a little known fact that prices for the same medical services can vary widely depending on the location the service is rendered, the affiliation of the service provider, and the method of payment. A CT scan at one facility might be 20% of the price of another facility. Yes, I said 20%.
We have spent a considerable amount of time researching the different options in our community and help patients navigate the system to find the best possible solution to their needs. For instance, one patient recently needed a CT scan that would cost him $1200 out of pocket if he utilized his insurance. The $1200 would be applied to his deductible as he hadn’t met it. At a different facility, he could get the same test for $400 if paying cash at the time of service and skipping his insurance. He opted to save $800 (which incidentally was enough savings to cover the entire cost of his membership for the year)! We have now been able to reduce the cost of that same test to $250 paying cash.
Each patient’s situation is unique and we believe having choices helps improve care and lower cost. Anytime outside testing or imaging is needed we sort through all the options for the patient and match them up with the choice that makes the most sense to them.
As of 8/1/22, we’ve been able to further lower the cost and have secured advanced imaging tests for 80-90% off the prices of local hospital associated testing facilities. For basic CT scans, the least expensive test in this category, patients can save over $2100 if they are a member of our DPC program. That’s three time the cost of membership. Talk about a return on an investment!
In the standard, insurance based medical world, walk-in clinics and urgent treatment centers have become the norm. These quick access options for very basic medical care developed out of necessity for patients to be seen in a timely manner. In the standard practice, walk-in clinics are the relief value for a clinician’s schedule that cannot accommodate an appointment for one of their patients in need. Now, to be fair, not every medical problem that shows up in a walk-in clinic or emergency room really has an urgency to it. Many concerns are very routine that could be addressed in the normal course of practice if there was availability in the schedule.
In our Direct Primary Care practice, we have a much lower patient panel, nearly 1/10th the size of a standard practice, which means we have much more availability in getting our patients seen in a timely manner. We can often offer same day or next business day appointments for our patients. Additionally, some of the concerns people use a walk-in clinic for can be addressed over the phone or via email for patients and physicians who have a well established professional relationship. Those episodes are just another chapter in the ongoing conversation they’ve been having about the patient’s overall health.
Some people aren’t ill, but they do get sick.
Given the relaxed and low stress setting of our practice style, many people have asked if they could just come in for a walk-in appointment or one time appointment if they need medical care. They don’t feel like they need a membership but would like a trusted physician to help them through a particular hard spot.
We certainly appreciate the compliment, but we’re interested in long term relationships with patients. Good medical care is delivered over time and patients need access to their doctor. Because of that, we only offer membership based care. In the long run, patients always find it is a better experience at a better price.
Medications account for some of the biggest increases in healthcare spending in the last five years. Each DPC patient receives a complete breakdown of the medications they are receiving. We look at why they are taking each drug and if it can be avoided or reduced. Often our own choices, such as our cookie habit or late bedtime snack, provoke our illnesses to be worse. The smallest actions yield the biggest rewards sometimes.
When medications are necessary we work through the list of options to help our patients pick the choice that works for them. This includes an analysis of price, side effect, and convenience.
PPC operates its own in-office dispensary. We can often price medications well below the retail market. Just like our DPC program, we do not process insurance at our dispensary for prescriptions written by DPC physicians. Patients can have their prescriptions mailed to their house for just the cost of shipping.
Medications purchased at retail pharmacies can vary in price widely. Once a medication is decided upon we shop the price using such services as www.goodrx.com and www.goodshephealth.com. It is common for a medication to be $50-100 cheaper between pharmacies right next to each other.
Additionally, we have established relationships with local pharmacists. As small business owners, they are committed to good service at a low price. They are experts at helping us sort through the maze of insurance prior authorizations. There are several good pharmacies just down the road from us and have been good partners for the Hardin Valley/Karns community.
Finally, patient assistance programs are available from every manufacturer. We help our patients determine which company to submit the form to and how to receive the best assistance.
No matter what medications our patients need, we work to find the best options for their situation.
With increased availability to the physicians and ease of scheduling an appointment, studies have shown that adult patients have fewer hospitalizations and emergency room visits when belonging to a DPC program. In one study reported by Qliance, adult patients in the program utilized the ER over 60% less than average and were hospitalized one-third fewer days.
However, if patients do need more acute care, we are available to help make the transition as smooth as possible. Hospital physicians can reach the physician on call 24hrs a day if needed and after discharge a follow up appointment is guaranteed to be timely.
Vaccines are a hot topic these days. I’d like to state on the onset that I and my staff are unequivocally in favor of protecting children and adults with vaccines recommended for their stage in life. In the last hundred years, vaccines have been part of the arsenal used to reduce mortality especially in children. Illnesses that were commonly fatal twenty years ago are now a rare occurrence. Hopefully, one day, we’ll eradicate many of these plaques much like what occurred with small pox. Once the danger passes, the vaccines will no longer be necessary. Until that day, we will advocate for every advantage for our children to protect them from an early death.
We can administer some vaccines for our patients. We do this at huge discount from local retail clinics. For instance, at the time of this writing, we offer Tdap vaccination (protection against tetanus, diptheria, and pertussis, or whooping cough) for about $50. The local retail clinic up the street offers it for $85.
That being said, many of our patients have alternative means to pay for vaccines and do not need to pay for them out of pocket. The state run Vaccines For Children (VFC) program offers free to low cost vaccines at the local health department for uninsured children (includes members of cost sharing cooperatives) as well as patients with private insurance. We work with each patient to develop a plan for them to obtain their vaccines at the lowest cost even if it isn’t through our office.
Most Pillar PC pediatric patients receive their vaccines on schedule through the Knox County Health Department vaccination clinic. This is the ethos of our practice, to protect our youngest, most vulnerable patients from pathogens that are fatal or permanently disabling.
I discourage the use of alternative or delayed schedules.
In plain language, parents seeking an unquestioning alternative vaccination provider should not join the Pillar PC program.