The healthcare industry, like any other, is meant to make profits. This means that leaders in the industry prioritize maximizing revenue and minimizing costs to ensure a profit for shareholders.

Within the healthcare field, maximizing revenue is accomplished through patient enrollment into insurance plans, increasing services to attract more patients, raising the cost of clinic visits, expensive pharmaceuticals, often unnecessary procedures and diagnostics, and drawing contributions from investors and donors.[1,2,3]

Companies reduce cost by strategically hiring PA’s and Nurse Practitioners who offer services similar and often equal to physicians at a fraction of the cost, understaffing, legally circumventing FDA safety and efficacy reviews of new medical products, rejecting insurance claims, and obstructing medical practice through the use of bureaucratic obstacles such as “prior authorizations.”[3,4,5]

What has happened as a result of this system is that patients continue to grow unhealthier while shareholders grow wealthier. Patients continue to experience long waits for non-urgent appointments, long wait times in clinic, short encounters with their providers, and obscure billing that continues to result in medical costs being the number one reported reason for bankruptcy.[4,5]

Unfortunately, Fayetteville and the surrounding areas are not immune to these problems. US News reports 467 family medicine practitioners operate in the area, but only 66 of them have at least a 4-star rating.[6] That’s less than 15%!

Healthline reports an even smaller number of family practitioners stating:

“There are 205 Family Medicine Specialists in Fayetteville, NC [+10 miles] and 26% of those with reviews are rated 4-star or higher. Popular hospitals in the area include Cape Fear Valley Medical Center, Southeastern Regional Medical Center and Cape Fear Valley Hoke Hospital.”[7]

Using population sizes reported in the 2021 US census, if every individual between the age of 18 and 65 were evenly distributed among providers in the area with at least a 4-star review from US News, each provider would have a total panel of at least 2,000 for primary care. This partly explains the availability reported on Healthline (See figure 1 below).

Now, Cape Fear Valley Medical Center (CFVMC) makes up the bulk of medical services in the Fayetteville area. According to Google reviews, however, CFVMC is viewed in a very poor light (See figure 2 below). Availability is also a problem with the majority of providers requiring at least a two week wait until the next appointment (See figure 1 below).

The second major medical service provider in the area is the U.S. Army. Fort Liberty has three primary care clinics (Byars, Robinson and Clark), not including WAMC Family Medicine (WAMC FM), and two satellite clinics (Linden Oaks and Hope Mills Medical Homes). All of these clinics have poor reviews with an average of 2.62 out of 5 (See figures 3-7 below).

In 2023, Tricare published their Report to Congress and reported Primary Care Manager (PCM) continuity for fiscal year (FY) 2022 was approximately 51%.[8] That means that barely half of patients had continuity of care with the same clinician. According to the same report, the high highest level of PCM continuity since 2019 was in the year 2019 at 58%! Are you serious?

The same report states that responsiveness on part of military treatment facilities (MTFs) to secure messaging was only 78%. The Joint Outpatient Experience Survey (JOES) included in the Tricare report showed that only 63-75% of those who receive services at MTFs reported that they were able to get care “when needed” in FY 22. It seems that despite Tricare’s relative affordability, both the quality of care and access to care are lacking.

TrueCare DPC will embrace the increasingly relevant and progressively necessary medical model of Direct Primary Care (DPC). Rather than participating in the nation’s shareholder dominated healthcare system, where the emphasis is profits at the expense of patient and clinician, TrueCare DPC will restore the patient-clinician relationship, remove cumbersome insurance company practices, undermine pharmaceutical price gauging, and simplify healthcare costs overall.

I plan to operate the practice in the Fayetteville/Fort Liberty area, offering personalized primary care, unmatched access to care, and transparent pricing. I hope to accomplish this by offering my patients in-person visits and a direct line of communication with me through text, email, voice, or video chat. Using a cash pay membership model, I hope to maintain standardized pricing that allows my patients to easily budget and prevent surprise billing.

Lord-willing, my practice will serve as a crucial alternative to the biggest primary care providers in the area. I will have the opportunity to practice the art of medicine in the way that is most appropriate for my patients. I will incorporate less “traditional” approaches to medicine such as health coaching, changes in diet, and exercise therapy, without risking a “refusal to pay” notice by insurance companies who prefer the often-excessive use of pharmaceuticals.

My goal is to accomplish my mission of restoring, preserving, and promoting health by combining allopathic and integrative medicine, placing a special emphasis on modalities such as exercise therapy and nutritional coaching, while preserving the judicious use of pharmacotherapy when necessary and appropriate.

I hope to serve patients between the ages of 5 and 64 at the primary care level, and specifically I hope that TrueCare DPC will be an alternative to Tricare for young military families in the Fayetteville/Fort Liberty area. And again, the cash pay model is intended to circumvent the cumbersome, bureaucratic and congested “healthcare” model that insurance companies (including Tricare) offer.

So! I hope you’ll join me as I set out to change healthcare here in America’s All-American City!

At the time of this writing, TrueCare DPC is on track to launch mid-January/early February of 2024. I’m still putting together essential legal and logistical pieces so make sure the practice is everything we’re praying it’ll be.

I invite you to follow me on IG @golfranr and like and follow the TrueCare DPC Meta Page 😊

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