Getting What You Pay For
Rediscovering health care beyond the reaches of insurance companies, and rigid pain management diagnostics.
By Yvonne Butts-Mitchell and photos by Turner Photography Studio
“Something needs to change in health care. More providers are going to have to buck the current system because it’s time we start looking at the whole person, focus on wellness, and meet people where they are instead of waiting for someone to get sick,” says Jeanna Moats, nurse practitioner and owner of Hub City Family Practice, which is located at 19426 Leitersburg Pike. That philosophy is changing the face of health care and bringing forward thinkers like Jeanna to Hagerstown.
Jeanna had more than three decades of experience in health care and 20 years as a nurse practitioner before her growing frustration led her to open her own office in 2015 — shortly after Maryland became the 21st state to allow nurse practitioners to work independently of a physician. “Accommodating all the insurance requirements and trying to pump people through in 15-minute slots in the big practice was over-whelming,” she says. “We built this practice to be patient focused, not insurance driven. Our patients tell us all the time they want to be somewhere where someone will listen to them. We’re returning to the day of the GP (general practitioner) and we take our time with our patients.”
Shopping The Health Care Market
As a result, Hub City Family Practice operates as a fee-for-service practice. Patients can choose to pay cash for visits, tap into their flexible spending accounts, or set up their own health plans with Hub City in the model known as direct-to-primary care. She also builds partnerships with employers who are self-insured. Those employers pay a monthly flat rate that covers primary care services for each employee, regardless of the number of visits. Either way, Hub City’s payment structure cuts through the financial red tape, and removes delays and complications dictated by the insurance industry.
Dr. Mike Gaudiose, named 2018 Pennsylvania Family Physician of the Year, is one of Jeanna’s former co-workers, and now, her patient. He has watched her work and values her as a medical professional. He also understands the vision for her practice. “Although Jeanna trained in traditional Western medicine, she has great interest in complementary medicines. One advantage of not being tied to insurance is that her patients have access to all of those, too. Another advantage is patients aren’t tied to any one health care system when they require specialized care.”
“Health care isn’t about the patient anymore; it is a marketable commodity,” says Jeanna. “It has been proven that primary care reduces overall health care costs — and 95 percent of what comes through primary care can be treated by a mid-level practitioner. It took a leap of faith to open, especially as a cash business, but we already have a waiting list. People have to be their own advocates now — and sometimes that means shopping around. We’re here because we want to empower people to have better health care at an affordable rate.”
Human Performance Refined
Doug Bertram, founder of Structural Elements, shares much of Jeanna’s philosophy about patient focus and a move toward emphasizing wellness. A broken wrist in his high school years prompted Doug to challenge the way patients are perceived and treatment is delivered — and it influenced his approach when he opened his first orthopedic wellness clinic in 2013, which is now growing as a franchise. The sleek look of his glass-front office in Fountain Head Plaza reflects the work he and his staff do to deliver “human performance refined,” an approach they liken to fine tuning an engine. Among his other credentials, Doug is a licensed acupuncturist and self-proclaimed bio mechanic. “I love it when people refer to me as an engineer,” he says.
“That’s how we view ourselves — as body engineers,” says staff member and licensed massage therapist Danielle LaRock. “Everything in the body is connected. We are always assessing, looking for root causes and the structural imbalances that lead to injuries, chronic pain, and illness. We are always working toward the positive, not fixing the negative.”
Beyond physical therapy, Structural Elements blends in dry needle acupuncture, deep tissue massage, chiro-practic manipulation, and sessions in their LAB (Learn and Apply Balance) unit to build individualized plans that move patients beyond pain and malfunction to total body wellness. “We work with athletes looking to maximize their performance, but also with anyone who just wants to feel better and improve their quality of life while running after their grandkids,” Danielle adds.
“We have to get results or our patients won’t come back,” Doug explains. “But we don’t want to see the same people in here all the time. That means their current plan is not working for them. Pain is not an obstacle. It’s an opportunity to set new goals and adopt a new lifestyle.”
Like Hub City Family Practice, Doug, too, has opted to work on a cash basis, outside of the constraints of health insurance. “In the insurance model, if someone presents us with knee pain, you can only work on the knee — and that might not be the root of the problem,” he notes. “It may take something more to come up with an actual solution, and we have the freedom to do that. The cash model supports wellness.”
Patient Ben Pierce has been investing his athletic strength, agility, and stamina into ballet for the past nine years, and in 2016, it earned him a spot with the Western Maryland City Ballet Company. Now 13, Ben is fighting knee pain and symptoms of Osgood-Schlatter disease, a painful condition many young athletes experience when bones grow faster than muscles and tendons. “I’ve been growing really fast this past year,” says Ben. “My muscles and tendons can’t keep up, and my knees really hurt. My program at Structural Elements has helped me maintain my dance schedule through the week.” Ben is determined to be a professional dancer and his treatment plan is working. He has been awarded a full scholarship for this year’s summer intensive with the prestigious School of American Ballet in New York City.
Partnering As Coach And Teammate
Dr. Christopher Clark is a new physician in Hagers-town who works closely with Structural Elements. He brings a specialized background in interventional pain management and musculoskeletal medicine to his practice and, like Doug, works to design complementary treatment plans. Whether that includes acupuncture or regenerative injections, his goal is always the same: relieve pain and improve quality of life. He works with all payment options to help make that happen.
“I came to town to bring that one-stop shop for people with any muscular, skeletal, or spine complaint,” says Dr. Clark, who opened Premier Spine and Sports Medicine, located at 1165 Imperial Drive, in October of 2017. “There is a misconception that a pain doctor will just give you a pill. Our patients come here and trust we’re going to work together to take care of them, drug-free and surgery-free. Our initial consultation includes a physical to figure out what’s causing the symptoms, and then we work to correct that environment. The condition of your immune system, your electrolytes, even your gut health all play a role in your pain. It’s an algorithm; we start by asking questions: Have patients tried good, conservative therapy including massage and/or acupuncture — the first step in treatment? As we start to reset their system, we get them off medication and change the way they experience pain.”
Like Jeanna and Doug, Dr. Clark’s personal experiences influenced his business decisions. A chance opportunity to volunteer for an acupuncture treatment freed him from years of knee pain caused by a sports injury, leading him to integrate that treatment into his practice. “Although acupuncture has been around for thousands of years, that’s been voodoo in a typical medical practice; but with one treatment, I felt like I had a brand new knee,” he recalls.
Acupuncture was also the answer for patient Brenda Barlow, who had years of back pain after four decades at a desk job and several car accidents. “I tried exercises. I tried therapy. I tried chiropractic. Nothing worked,” Brenda admits. “Dr. Clark did an MRI first, then tried an injection, but it didn’t last. When he asked me what I thought about acupuncture, even my oncologist supported that. The pain is gone. I will always have some soreness, but I can live with that. This is the most well I’ve felt in years and I have already referred others.”
During his fellowship, Dr. Clark worked in an office that brought complementary medicines together under one roof, including acupuncture and chiropractic. “There weren’t many of those around at the time, and it opened my eyes to what could be,” he says. “I think that kind of integrated medicine is what’s next on the horizon. People are looking for something more comprehensive; they want an exceptional experience. They want a doc who sits down and listens. In this practice, I advocate for treating you, not just managing your pain. I’ll be your coach and your teammate.”
