Northwest Colorado native opens region’s first Direct Primary Care practice
February 13, 2019
STEAMBOAT SPRINGS — It’s a movement growing across the country, driven by the idea of simplifying the delivery of basic health care needs and strengthening the doctor/patient relationship.
Dr. Catherine Cantway is the first Direct Primary Care (DPC) practice to open in Steamboat Springs.
Cantway was born and raised in Steamboat and recently returned to be closer to her family.
A 1999 graduate of Steamboat Springs High School and former barrel racing record holder, Cantway attended University of Colorado, Boulder before the University of Washington School of Medicine. She went on to finish a Geriatric Fellowship at the University of Utah.
In November, she began accepting patients at Bear Valley Medical in Steamboat, using a model that only exists in a few other places on the Western Slope.
“I was frustrated with the health care system in general,” Cantway said. When she wanted to be spending time with patients, “I was spending a majority of my time at the computer clicking buttons trying to get reimbursed by insurance companies. It wasn’t fun. It wasn’t why I wanted to go to medical school."
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And, Cantway knows she is not alone in feeling discouraged by the ever-increasing amount of paperwork required by her profession. Burnout among physicians is a growing issue.
While Cantway was spending "twice as long at my computer as talking to patients," she found out about Direct Primary Care.
She describes it as a movement by “primary care physicians to take back medicine, and a more authentic doctor/patient relationship.”
The system works through a monthly subscription of anywhere from $50 to $200. That gets patients unlimited access to their doctors, along with a number of included tests, procedures and screenings.
Cantway's practice is unique in her partnership with her sister and integration of mental health services into her practice. Jennifer Cantway, Cantway's sister, has more than a decade of counseling and therapeutic experience and specializes in child and adolescent psychology. The membership includes life-coaching sessions, mental health screenings as well as yoga classes. Jennifer works with people of all ages on a range of issues from depression and anxiety to goal setting and implementing healthy lifestyle choices.
"Because visits are longer, and patients can see us as much as needed, we are able to really get to know our patients and customize their care to their needs," Catherine said. "This helps reduce health care costs, because we do not use the shotgun approach to take care of people and just order everything for everyone."
Catherine’s monthly fee is $79, in line with the national average. She offers a second tier plan at $119 that includes x-rays and other basic in-office procedures. Catherine is also working with small businesses to provide a different option for employee health care.
“I don’t bill insurance. I don’t bill the government. I talk to patients,”Catherine said. “Most visits last an hour or longer.” Health care plans are made on a very individualized basis, she described. “It’s how medicine should be.”
There are around 1,000 Direct Primary Care practices across the U.S., with about 90 in Colorado, primarily located on the Front Range.
What isn’t included in the monthly subscription,Catherine works to provide at a low cost and negotiates with other providers for discounted services she can’t perform in her own office.
Using actual billing invoices from herself, family and friends,Catherine gave some specific cost comparisons between a local hospital and what she charges, respectively.
- Complete Blood Count: $123.45 versus $4
- Comprehensive Metabolic Panel: $345.32 versus $6
- Vitamin D: $247.06 versus $24
- Hip x-ray: $313 versus $100
- CT head scan $1,014 versus $600
Catherine includes things like urinalysis and EKG tests. Most labs are less than $10, she said, and most procedures (stitches, skin biopsy, pap smears, joint injections) are $30. Price transparency is a big part of her practice, Catherine said, with prices listed on her website. “I don’t want someone ever to be surprised by what they pay.”
Most DPC providers, including Catherine, recommend their patients have a high-deductible policy in case of major surgery or catastrophic injury or illness.
The movement is growing, Catherine said. “Physicians are happier doing the work they want to do. And patients are satisfied. The main goal is to provide high quality care at an affordable price.”
Critics question the number of patients required for a practice to be viable, suggest an incentive to limit care and express concern about undercutting existing health care delivery systems. They also question actual affordability for patients and their ability to get the care they need.
Advocates argue the DPC model eliminates the “fee-for-service” incentive, under which physicians may order unnecessary tests and treatments to increase the bill. They say DPC physicians are incentivized more on preventative care and keeping patients healthy in the long term.
One of the biggest challenges for Catherine and for the DPC model is the requirement in certain states that physicians opt out of Medicare and/or Medicaid. As is, Catherine cannot legally accept a patient covered by Medicaid.
Supporters of DPC are lobbying to address some of these issues through current proposed legislation.
Catherine said she’s excited to be back in her hometown and practicing medicine under a system in which she believes. The DPC movement is growing exponentially, she said. "There have been many studies done on the benefits of DPC practices, and they have consistently shown better patient satisfaction, better patient outcomes, more cost effective care, better physician satisfaction,"
Not wanting to “pay into a broken system,” herself, Catherine said she just wishes there was another DPC provider in town. “I’d be their patient.”