What if you could go to the doctor’s office and not be hit with a co-pay?
That’s what internal medicine physician Dr. Jonathan Figg, 31, promises to offer through his new direct primary care facility in Jackson, called Jackson Hole Direct Primary Care. He saw his first patient Sept. 6.
The direct primary care model, Figg said, does not involve insurance. Depending on your age, patients pay a monthly membership fee — $50 a month for patients between the ages of 18 and 44 years old, $75 a month for patients who are 45 to 64 years old and $100 a month for patients who are 65 years old and older.
“It’s all inclusive of my services,” Figg said. “That covers as many office visits, home visits and tech visits as my patients need. It’s kind of like an access fee on an ongoing basis.”
It also covers procedures Figg can do in office. What he does charge for, Figg said, is the cost of wholesale-priced generic medications — which he says he can usually get at a 95 percent discount for insured patients — lab work and scans.
“The benefit of having a doctor in this model is that you’re basically on retainer,” he said. “You’re paying me to be available as your doctor.”
The model will break down, he said, if people try to use him as a fee-per-service doctor. He said he has the right to accept or not accept patients accordingly and that they would lose the opportunity for ongoing care if they try to cheat the system.
He’s not affiliated with St. John’s Medical Center.
“I don’t have to charge co-pays, patients get a lot more access to me and I can offer a whole lot of extra services,” Figg said. “That doesn’t really compute well with hospitals. Doing this model allows me to focus much more on preventive care, health and wellness.”
Figg finished his residency at the Easton Hospital in Pennsylvania and went to medical school at the Ross University School of Medicine in Dominica. He’ll be board certified in internal medicine once he gets the results back in a few months and said he has “all the same qualifications and does all the same things that other doctors in internal medicine do.”
He and his wife, Dr. Camille Mellijor-Figg, who works at Jackson Hole Women’s Care, moved to Jackson with their young son at the beginning of July.
Figg said the direct primary care model is growing across the country. He discovered during his residency that there were “many hoops I had to jump through to get the care for my patients from an insurance company. I was tired of it. It’s not worth the fight when it doesn’t have to be there.”
“Primary care doctors finally got sick of being stuck in a box with all of the other high-priced care,” Figg said. “The Affordable Care Act probably contributed to this.”
With only one insurance provider in the state, Blue Cross Blue Shield of Wyoming, Figg said costs are even higher. He’d like to practice medicine without the “middleman looking for a dollar to get things done.”
“So if we can get away from the insurance-based model, then we can make things cheap again,” he said.
The insurance-based model, Figg added, is plagued with paperwork and metrics that he said “nobody knows what to do with.”
“Every new piece of paper takes away from time with my patients,” he said. “My quality metric is if I’m providing good health care for a patient, and a patient is doing well and feeling well they’ll continue with my service. I don’t think insurance companies’ metrics are the best thing for my patients.”
If you have insurance you can still see Figg and choose whether to bill your insurance. If you’re on Medicare you can also still see Figg, but it would be out of pocket.
“Unless someone asks me to, I don’t send my health information to anyone,” Figg said. ‘It stays between you and your doctor, and I think that’s the way it should be.”
That said, he still thinks people should have medical insurance.
“You don’t know if you’re going to get cancer or hit by a bus,” Figg said.
Figg’s practice is different from other doctor’s offices most people have visited in the past. He’ll have no nurse or no staff — he’s running a lean operation, he said — and no waiting room.
“I can be low-cost and I can spend time with my patients,” Figg said. “Right now in the U.S. the average primary care visit is about seven to 10 minutes long and probably half of that, the doctor is looking at a computer screen or thinking about the next patient. Because I don’t have to deal with that, I schedule at least 30 minutes an appointment.”
If you need scans or a blood draw after an appointment, that can be done at Emerg-A-Care or, in some cases, off site. If a patient needs a CT scan or MRI, they will need to go to Teton Hospital or St. John’s. Figg said he’s trying to negotiate cash prices with other facilities. He said he can’t guarantee getting basic medical care done at his practice will be the cheapest in town, but he values transparency and no hidden fees.
“My main goal, which I think is sorely lacking in health care, is to be transparent with pricing,” he said.
He said that without a waiting room full of patients, they can be seen right away — as well as call, text or email him when they have questions about medication and things like that.
Jackson Hole Direct Primary Care is now operating in space that Figg rents from Dr. Brent Blue at the Emerg-A-Care clinic on Tuesdays and Thursdays. On other days he’ll do home, office and other kinds of visits. Visits can be scheduled at JacksonHoleDPC.com or through Figg at 307-264-5828.