Melissa Hamiton, 44, never had great experiences with primary care physicians.
As a mother of four, she remembers taking her sick children to clinics and spending hours of the day in the waiting room. By the time doctors were available, they would spend only a few minutes in the exam room before moving on to their next patient.
The short time with her children’s physician was frustrating, and it also made her feel the money her family was investing in insurance was being wasted, she said.
“Having insurance is expensive,” Hamiton said. “My husband is a veteran so he’s covered, but just for me and my four kids that are still at home, it’s up to $1,400 a month without the primary care portion. That’s just astronomical.”
Nothing changed for years.
Hamilton’s family kept utilizing insurance until they discovered something new: direct primary care.
Through the direct primary care model, private practices opt out of accepting insurance plans and instead require patients to pay a monthly fee to receive primary care services. Instead of going through third party billing, patients pay fees directly to the physician.
Even though the model is relatively new, it has seen exponential growth in the past six years with more than 1,400 practices in the United States, according to a 2021 study from the National Library of Medicine. There are currently over 20 direct primary care practices in Tarrant County, according to DPC Frontier.
More people, including Hamilton, are choosing not to pay for insurance plans and instead choosing clinics across Tarrant County that are utilizing the growing health model. For physicians, direct primary care offers a new side of clinic ownership, one they hadn’t seen before.
To find a direct primary care practice in Tarrant County, click here.
‘Needs are taken care of’
Dr. Kara Farley has always been unhappy with the disconnect between patients and their primary care doctor. When she decided it was time to launch her own practice, she knew she wanted to offer something different.
“The reason I went into medicine was to have relationships with my patients and provide that quality of care for them, and with the 15-minute model spent with patients, you’re unable to do that,” she said.
Through extensive research, Farley discovered direct primary care through the Facebook group Real Physician Moms of DFW. She was able to meet a physician who was successfully running her own practice with the care model.
The model opened Farley’s eyes and she jumped in feet first, she said.
Farley opened Mid Cities Direct Primary Care in Grapevine in January 2021. The practice’s monthly fees range from $50 to $100 per person, depending on age, with a one-time fee of $150 to join. The practice is currently not accepting new patients, according to the Mid Cities website.
As members, patients have unlimited access to Farley and other physicians on her team. During appointments, physicians are able to spend more time with each patient rather than rush to see another since there isn’t a quota that needs to be met, said Farley.
“When patients started coming here, they saw the difference in the quality of care they get,” said Farley. “They usually get an hour to an hour and a half appointment. We go through their entire history. We cover everything that needs to be covered in one visit.”
Mid Cities had 50 patients in its first six months. Since then, the practice has grown and now serves more than 750 patients in North Texas.
In early 2021, Hamilton was introduced to Mid Cities Direct Primary Care by her husband. Upon hearing about the low membership fees, Hamilton was shocked but immediately intrigued enough to join the practice.
Hamilton signed up and now pays $400 a month for her entire family to receive primary care from Farley. The clinic has changed her life, she said.
“All of our needs are taken care of,” Hamilton said. “I can call (Farley), I can text her. I’ve texted her at 3 a.m. because I had a kid with a fever and I was in full panic mode. … I’ve been a mother for 26 years and I’ve never had such a good experience like this.”
The direct primary care model is also filling a gap for people who can’t afford to pay for insurance, but also don’t qualify for health assistance programs, said Dr. Alex Vilaythong, founder of Enlightened Health Direct.
“A lot of patients don’t have health insurance, but they over qualify for benefits from JPS or Parkland, because of being over income,” he said. “You’re talking about even a $1 disqualifies you. … I wanted to skip the middleman, which is health insurance.”
Like Mid Cities, Enlightened Health Direct also offers primary care services, but its monthly fees range from $39 to $95, depending on the age of the person. Since its launch in 2022, Enlightened Health Direct has grown to serve over 130 patients across North Texas.
‘Hard to compete’
As direct primary care clinics begin to gain popularity, there are several challenges to overcome. There is a lot of skepticism from patients to commit and that can affect the success of a practice, said Vilaythong.
“When you come out of residency, these big hospitals try to recruit you and they give you a nice salary and it’s hard to compete,” said Vilaythong. “It’s hard to turn that down and say, ‘No, I’m gonna go out on my own and start my own practice, start from patient zero and hopefully one person will pay me.’ That’s what is really scary about (direct primary care).”
Even though direct primary care helps with keeping her kids healthy, Hamilton worries in the event of a big hospital emergency. Without insurance, the medical bills could pile up. Hamilton said she and her husband are considering an insurance plan with a high deductible for emergencies, often known as catastrophic coverage.
But, Hamilton believes keeping her kids healthy reduces the chances of an emergency and that there are more benefits staying on her membership plan than getting off of it. She believes direct primary care is revolutionizing health care.
“I told my husband that I would rather not have the insurance plan than lose Kara,” Hamilton said. “She’s very much more accessible. She’s my friend now. I don’t just look at her as my doctor. I feel like health care really needs to go this way.”
David Moreno is the health reporter for the Fort Worth Report. His position is supported by a grant from Texas Health Resources. Contact him at david.moreno@fortworthreport.org or @davidmreports on X, formerly known as Twitter.
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