Bringing Direct Primary Care to Marquette

The journey from Marquette begins in search of Direct Primary Care

The open road beckoned, and this Marquette Family Doctor headed south to Kansas City, MO for the Direct Primary Care Summit last week. As you know, I am opening NorthCountry Health in September, which is a Direct Primary Care (DPC) Clinic in Marquette.  Direct Primary Care is an innovative, low-cost membership model for primary care delivery, and I wanted to meet other physicians from around the country who have made this model thrive in their communities. 

The trip down included a stop-over with Ryan’s family in Minnesota in addition to visits to Salisbury House and Confluence Brewery in Des Moines, where we enjoyed an award-winning Czech Pilsner (Katie) and a nice dry hopped IPA (Ryan).  The heat index was climbing with every mile, and we were missing the UP climate.  We arrived in Kansas City, MO in the late afternoon, and after some circling around, we found our Airbnb—a nice little apartment over a salon.  

Ryan and Katie at Salisbury House in Des Moines. This museum is the former home of Katie’s great-great uncle Carl Weeks. He made some really good business decisions back in the early 1900s. Carl’s brother Leo (Katie’s great-grandfather) made some different business decisions and did not own a house like this.
Ryan and Katie at Salisbury House in Des Moines. This museum is the former home of Katie’s great-great uncle Carl Weeks. He made some really good business decisions back in the early 1900s. Carl’s brother Leo (Katie’s great-grandfather) made some different business decisions and did not own a house like this.

Many miles and many smiles

The two days at the DPC Summit were inspiring, fun, educational and exactly what I needed.  I even met medical students and residents who were already exploring this as a career option, which was exciting.  I have attended many medical conferences over the years.  I must do so to maintain my certification as a physician.  Until now, I had never attended a conference where the focus was on sharing knowledge, building relationships, and encouraging other doctors along the journey.  This was a conference focused on solutions to problems.  The helplessness that we often feel as physicians and see in our patients within this nation’s healthcare system had been left at the door at this conference—this was a group of physicians who realized that we can optimize primary care one patient at a time and change the broken system on a community level.  

Katie and Ryan at the DPC Summit in Kansas City, MO. We didn’t get the memo that the evening reception was outside, so we are very sweaty in this photo. Next year we’ll bring a change of clothes.

Great MI connections sharing the secrets of DPC

I met those old-time family doctors—the ones who engage directly with their communities in their own welcoming offices. I found my community—those doctors who simply love taking care of patients and practicing medicine without anyone else getting in the way of the doctor-patient relationship.  

Newly inspired, very warm, and ready to return to the UP summer, we got in the car early on Sunday morning after a quick networking session with other Michigan DPC doctors (Dr. Adriana Raus, Dr. James Gendernalik,and Dr. Jennifer Houtman) and finished the many-hour drive at 11pm.  

Change is in the air here in Marquette, and I look forward to bringing Direct Primary Care to Marquette in September.

It’s almost Open Enrollment season for the Marketplace, and it’s the time of year where we all get confused about what kind of health insurance we should have.  I am writing a series of articles to answer questions about why Direct Primary Care works well with certain kinds of health insurance.  This third article is about Health Savings Accounts.

HSA (Health Savings Account)

An HSA is a Health Savings Account, and it is sometimes offered to people who choose a high deductible health insurance plan.  I wrote a separate post on high deductible plans.  An HSA gives you the opportunity to save pre-tax money in a savings account that grows interest tax-free.  There are annual limits on what you can put in (2022 is $3650 for an individual and $7300 for families).  When you take out the money to pay for health care expenses, that money isn’t taxed either.  In the world of personal finance, this is a fantastic deal.  At the same time, the benefits of an HSA tend to go to people who have the extra money to save in an account like this.  However, an HSA is a great way to reduce the amount of risk that you are taking on with a high-deductible insurance plan, because you don’t lose this money at the end of the year.  It is your money, and you can save it for when you do have an expensive year and are going to meet your deductible.  I like to think of an HSA is a form of self-insurance for catastrophes.  Low deductible plans don’t offer HSAs because you are asking the insurance company to take on more of the risk for your health insurance costs, and so you don’t get access to this deal.

FSA (Flexible Spending Account)

An FSA is a Flexible Spending Account.  I am including it here because it causes confusion when discussing HSAs.  An FSA is sometimes offered by your employer as part of a health insurance plan.  If you are getting your insurance off the Marketplace, you don’t have access to an FSA.  FSAs are nice because they are also a savings account where you can put in money tax-free and take it out tax-free to use for qualifying medical expenses (there are long lists online of what is allowed).  In my opinion, FSAs are annoying because you have to estimate the amount of money that you want to put in an FSA at the beginning of the year and then you have to spend it or you lose it.  As someone who has had to use leftover FSA money to buy first aid kits that I didn’t need because I didn’t know that glasses were an allowable expense, I find them less useful than an HSA, but they can pair well with a lower deductible plan to cover co-pays, dental work and…glasses!

Can I use HSA or FSA money for Direct Primary Care membership fees?

This can be a thorny issue.  I am neither an accountant nor an expert on the many rules from the IRS.  From what I have read, FSA funds can sometimes be used for DPC membership fees.  It can be up to the employer to decide if it is an allowable expense.  My best recommendation on the use of HSA money for Direct Primary Care membership fees would be to ask your accountant.  Even if you can’t use your HSA funds for your DPC membership fees, you can save that money basically forever, so you could wait to use it until you need to pay for an MRI or a knee surgery! 


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