PRIMARY CARE
Introduction
My name is Doug Iliff. I am an independent, private practice family physician. We've been delivering cost-effective preventive care through our family medicine office and Minor Med since for almost four decades. We know how to save money with generic drugs, and we know how to lower your risk of heart attack, stroke, diabetes, and cancer. My staff and I have only one priority: to keep you as healthy as possible as inexpensively as possible. We have no financial connection to the local corporate medical practices, and no incentive to make referrals or admissions except in the best interest of our patients. All we need is motivated patients to work with us.
I graduated from Shawnee Mission East, the University of Kansas medical school, the family medicine residency at Ft. Bragg, and teaching fellowship from the University of North Carolina-Chapel Hill. For six years I worked in the Stormont Vail emergency department while helping to start Cair Paravel School. Dr. Laccheo and I built the Jos. Warren building at 1119 SW Gage in Fleming Place, and opened our offices in 1986. The practice of medicine has always been a great joy, but the state of medical care leaves a lot to be desired. The greatest problem is that it is too expensive. For those without insurance, it is devastatingly expensive. Once I quit delivering babies, I found my interest turning toward this problem, and had the time to do so.
Our newest associate is Blaire Helgeson, DNP, who has assumed full-time duties with Minor Med weekdays.
What is Minor Med Primary Care?
It is an example of “direct primary care,” a way of providing high quality medical care outside of the insurance system. MMPC exists to save money by either preventing problems or treating them early, before they become expensive. I know this works, because many years ago family physicians were forced to accept insurance contracts in which we were paid a “per member per month” flat rate amount, and were on the hook for managing every medical expense for our patients. If we did well, we were rewarded financially; if not, we were punished. Dr. Laccheo and I made out like bandits, because we provided aggressive, proactive primary care. Many other physicians did not, and the program was eventually abandoned. MMPC goes back to those roots.
Who benefits?
Patients without medical insurance or with high deductible plans who are looking to save money by staying healthy. You can be seen for scheduled preventive care Monday through Friday, or for unscheduled urgent care from 9-8 weekdays and 9-3 on Saturday, at no cost. For employers who can’t afford expensive insurance for your employees, MMPC will give them high quality, inexpensive primary care services which are available outside normal work hours, so a trip to the doctor does not mean missing work.
Who qualifies?
Anyone age 50 or less.
What are the monthly subscription fees?
0-20 | $20 (children must be enrolled with at least one adult family member) |
21-30 | $35 |
31-40 | $50 |
41-50 | $65 |
51-65 | $85 (only available for current patients of Dr. Iliff) |
What is the enrollment fee?
$50
What tests and procedures are covered at no additional cost?
Complete blood count, comprehensive metabolic profile, thyroid stimulating hormone, lipid panel, CPK, PSA, HgA1c, microalbumen, urinalysis, urine culture, uric acid, sed rate, antinuclear antibody, rheumatoid factor, strep, flu, Covid, EKG, treadmill EKG (stress test), spirometry, 24 hour blood pressure, biopsies, and all x-rays.
What tests are covered at our cost, for which the patient will be billed?
Pap smear and biopsy interpretations, other laboratory tests, and immunizations.
What tests are referred to outside agencies which offer cash discounts?
MRIs, CT scans.
Are prescriptions covered?
No, but we almost exclusively prescribe generic drugs, which are inexpensive when you check on GoodRx for the best deal at local pharmacies.
How do I sign up?
Still wondering?
Here’s more information than you may have asked for:
The vast majority of patients between the ages of 0 and 50 are overpaying for insurance premiums. This is the healthiest time of life, and good primary care can keep it that way.
ObamaCare’s success depended on healthy, young people paying inflated premiums to subsidize unhealthy, aging populations. But this didn’t happen, and now the system is beginning to unravel.
For decades, the healthcare insurance system has cost our citizens much more than the rest of the world. Those with high deductible health plans (HDHP) or no insurance at all are the ones actually “winning” in our current system. In fact, they are probably the smart ones.
MMPC can make you even smarter. Here's how:
First, if you have any assets at all, you need some kind of health insurance. What you DON'T need is insurance which pays processing charges for colds or ingrown toenails. What you DO need is protection from emergency room visits or hospitalizations which, to protect their institutions from malpractice claims, will rapidly deplete your bank account.
Second, shop online for an HDHP attached to a health savings account (HSA). You'll be surprised how much less expensive it is to get a HDHP which will cap your hospital charges and protect you from bankruptcy. Put your savings into an HSA, which will grow every year and soon exceed your deductible-- this means that if you are diagnosed with an illness requiring long-term treatment or suddenly need emergency surgery, you won’t have to pay out of pocket.
Finally, if you have no assets which could be forfeited in bankruptcy, MMPC is still the cheapest way to stay healthy.
And that's where MMPC comes in.
Direct Primary Care Test
Answers follow
1. Do you have a high deductible insurance plan?
2. Do you want your personal medical information to remain hack-proof?
3. Do you resent having to subsidize old people with unhealthy lifestyles?
4. Do you want convenient access to health treatment and information?
5. Do you have Internet access?
6. Do you trust yourself to shop for a washing machine or automobile?
7. Do you need prescriptions for any controlled drugs on an ongoing basis?
Depending on the number of "Yes" answers above, we may have a plan that will leave you not only healthier, but wealthier.
Before we explain the test questions, we"ll describe a new concept variously known as "direct primary care", "concierge medicine", or "idealized medical practice". Basically, all of these involve bypassing the insurance middleman in the delivery of primary medical care. The patient makes an automatic monthly payment to a medical practice in exchange for a basket of services, ignoring insurance administration and billing.
Physicians have been tinkering with such practices for a decade, but ObamaCare has been a big stimulus because of the high deductibles associated with many insurance plans. If you're looking at a $5,000 to $10,000 per year deductible, all of a sudden you're more interested in staying out of the hospital or the emergency room.
A $5,000 deductible is all the motivation some people need. The goal is to keep you out of the hospital, including the emergency room. That's where your deductible goes up in smoke.
Answer Key:
1. A HDHP is a great incentive to start making good decisions about lifestyle and healthcare. That's where we can help the most. However, even with a lower deductible you may benefit from the convenience and comprehensiveness of direct primary care. We also recommend a Health Savings Account (HSA) in conjunction with your HDHP, which will allow you to build up a tax-deductible reserve over the years.
2. You've noticed that the State Department and Pentagon have been hacked. So how on earth do you think your medical records will ever stay safe from pimply Dutch teenagers or the Chinese Army? Wait! There IS a way! We use paper records for efficiency and privacy. Paper records are hack-proof.
3. Direct primary care is ideal for folks who take responsibility for their health through good habits, diet, and exercise. Much of your premium with a low-deductible plan is subsidizing the bad habits of other citizens. In addition, ObamaCare deliberately planned to overcharge younger adults to subsidize older adults, so the same reasoning applies to you.
4. The key to staying healthy, or minimizing expensive problems, is rapid access to competent primary care. If you go to an emergency room on Sunday with a pain in your stomach or a headache, your deductible is going to take a $2,000 or $10,000 hit when you just needed reassurance that nothing dangerous was happening.
5. We can save you a trip for some problems if we can get pictures on our computer, iPad, or iPhone to accompany a conversation.
6. To take full advantage of our services, you need to be willing to shop for health care services which we don't provide. However, we'll help you.
7. We won't prescribe maintenance controlled drugs. Short-term is OK.
Questions and Answers
1. Is this an insurance program?
No. You are paying a subscription fee for access to services in the previous month. You may cancel at the end of any month.
2. How does this interface with my insurance?
It doesn't. MMPC is completely separate from your insurance plan. If you have insurance, we may bill the company for some services so they apply to your deductible, but you will never see a bill from us.
3. I've read that Direct Primary Care practices feature long visits with the doctor and fewer visits per day. Is that how MMPC works?
No. Our providers have normal practices, and MMPC patients are treated just like everyone else. You'll get whatever time you need, but we don't believe in wasting time. The only difference is the payment system.
4. How is this different than "Concierge" medicine?
It costs a lot less, and provides the same convenience without "house calls," which are a value-free vestige from the Good Old Days. Only people with money to burn would choose Concierge medicine over Direct Primary Care.
5. Do you exclude any pre-existing conditions?
No, except we will not prescribe maintenance narcotics or amphetamines.