On a cold, rainy Monday night in November, the cozy lobby of Integrative Family Care (IFC) in East Walnut Hills fills with potential new patients during one of their regular information sessions.
Dr. Amy Mechley, cofounder, addresses the diverse group, ranging from infancy to middle age, and explains that their youngest patient is 2 months old and their oldest is 97. The practice caters to all ages and income brackets, although many are single men, freelancers, and people in the arts who have poor (or no) health insurance.
One couple with a baby is looking to switch to a more modern practice while an African-American gentleman in his 30s came in after viewing an IFC YouTube video while looking for alternatives to traditional doctors offices.
IFC, which has another location in Beacon West, started in July 2017 with this exact purpose in mind: to bring together a variety of people who are tired of insurance hassles and traditional, rushed appointments.
“We are part of a movement that is trying to make primary care primary again,” says Dr. Eleanor Glass, CMO and cofounder of IFC. “We are part of a movement who said that primary care can actually be done much more affordably outside of healthcare systems.”
Essentially, she explains, IFC is trying to make medical care accessible to everyone.
Patients pay a monthly fee of $80 for an individual, with an additional $30 per child. This buys unlimited access to medical care, excluding a few in-office procedures and labs, which are available for a nominal fee. It’s truly an all-inclusive approach.
“All your primary care, unlimited visits, texting with your doctor, video chats if you need them, online scheduling,” says Glass. “[It] is concierge-level care for the rest of us, for the working class.”
“More and more, the gap between the rich and the poor is widening, and that’s the people we serve,” she continues. Even people who are ‘insurance wealthy,’ people who just have really good health insurance, are less and less these days.”
She explains that the practice is for patients — both insured and uninsured — who want more out of their care, and are searching for affordable healthcare, which is different from health insurance.
Both Drs. Glass and Mechley encourage patients to keep their insurance if they have it, particularly for emergencies and specialists. However, they compare it to buying car insurance: You don’t use it to maintain your vehicle, you get it for catastrophes like accidents.
And with the rise of high-deductible plans, patients who feel like they are insured end up not having coverage until they meet their often-astronomical deductible, which is sometimes as high as $16,000.
“So,” says Glass, “you are basically uninsured. We can take care of the whole family for much less.”
And for patients who are uninsured, this is a way to access affordable healthcare.
By not billing insurance, IFC saves 40 percent in overhead, and they pass those savings onto patients with affordable lab work and in-office procedures not included in the monthly fee but far more inexpensive than what patients get through hospital systems.
There are no specialists in the practice, but the doctors refer patients to a list of people they trust throughout all the hospital systems in Cincinnati. And they’re both trained to do basic procedures, like removing suspicious moles and performing joint injections or gynecological exams. Again, since they don't bill insurance, it’s all more affordable for patients.
For example, explains Glass, a thyroid lab done in a hospital can cost $138 dollars. She can do the same bloodwork for $6.25.
It goes beyond insurance for Glass and Mechley, though. Both have experience with traditional healthcare systems and grew increasingly frustrated with the limits set through both hospitals and insurance companies.
“This is all about us being bread-and-butter family medicine doctors,” Glass says, “going back to that primary care doctor — we call it ‘old-fashioned medicine with a twist’ — it’s that old-fashioned primary care doctor who would serve most of your healthcare needs over the course of a lifetime, and I can’t do that in 15-minute visits as mandated by the hospital systems.”
When Glass heard about direct primary care, she got together with Mechley and conceptualized the business because both their interests have been in lifestyle medicine and integrative medicine, tenants of outstanding family medicine.
“Family medicine is very basic,” she says, “but what it takes is time and attention and a direct relationship between doctor and patient.”
“I think the current healthcare system can take wonderful doctors and turn them into bad doctors very quickly,” she continues. “It was turning me into a bad doctor … nobody is good when they are rushed. A lot of that is accessibility … we work really hard at being accessible, same day, next day [appointments] to the best of our availability.”
This allows both Glass and Mechley to really take time with their patients — to look at their whole story and assure them that if they aren’t feeling better — physically or mentally — they can always return quickly for another visit.
“I think that spares us having to do a lot of medication, antibiotics, and things,” says Glass, “because we can look at our people and get them in quickly and say, ‘I think you’re going to be able to pull through but if not, let me know,’ and most of the time I don’t hear from them, but knowing that we have that accessibility allows us to hold off and kind of watch things evolve, which is how it should be. The body knows how to take care of most things.”
She goes on to explain that family medicine is not just answering the question: “What’s the matter with you,” it’s also dealing with lifestyle: “What matters to you.” Both doctors talk about nutrition, sleep, and exercise to help people achieve their goals and nourish good health.
With that information, they help problem solve, which they call “motivational interviewing:” identifying small changes that someone can make to improve their health. There are, of course, patients who can’t make big changes and need medicine.
“We’re not against medicine,” Glass says. “Science is wonderful. [But] a lot of these problems — cholesterol, hypertension, sugars — are 100 percent reversible. It just takes time and coaching.”
Even with their open availability, both doctors maintain a work-life balance. Part of their story — as independent women going back into business for themselves — involves walking the walk: getting home on time, taking vacations, and focusing on their own health and well being.
“We’re doing this to save our own lives as well,” says Glass. “And it’s fun. I think Amy and I have both said multiple times that we’re practicing the best medicine we’ve ever done.”
Technological advances have actually helped Glass and Mechley get back to the basics and offer 24-hour-care without making huge personal sacrifices. All patients download a HIPAA-compliant app called Spruce that allows patients to text the doctors at any time, with a guaranteed response rate of two to four hours.
And, according to Glass, 60 to 70 percent of patients problems and questions can be handled that way, along with follow-up video chats and appointments if necessary.
“Having a membership to IFC makes me much less anxious about my health in general,” says Jordana Greenberg, a 31-year-old musician who has been with the practice for a little over a year.
“I can send a message or schedule a quick appointment and been seen immediately if I have any concerns or something non-emergent occurs,” she continues. “Dr. Glass always takes into account my personal preferences for approaching my health, and I cannot overstate the value of that.”
According to Glass, their practice isn’t unique, but they were “early adapters” in the Cincinnati area. When they opened, there were about 700 doctors doing the same thing nationwide, which is why it’s important to hold open houses, give talks in the community, show up at info sessions and health fairs, and host “walk with a doc” events that allow potential patients to feel them out.
They also do a “full-plate living” course on diet and nutrition once a year.
“I had a patient recently say to me: ‘You know, when you don’t have any health insurance, you worry all the time. Anytime you have a symptom, your worrying something could happen. It’s just so good not to have to worry alone anymore,’” says Glass.
“It’s a tough sell, people are very cautious with their healthcare dollar,” she continues, “but once they’re in and they see how easy it is, they never go back.”
To learn more about Integrative Family Care, attend a walk with a doc on Dec. 3rd or 15th at noon, or stop by the next info session on Dec. 5 from 5:30-6:30 p.m. The Dec 3rd walk and Dec. 5th open house are at The Edgecliff Building, 2200 Victory Pkwy., Suite 603, Cincinnati 45206. On Dec. 15th, the walk begins at 5222 N. Bend Rd., Cincinnati 45247. For more information, visit the website or call 513-457-4073.