Written by: Marcy Stamper
At Liberty Bell Family Medicine in Twisp, Dr. Kellar McCloy practices modern medicine the old-fashioned way – taking the time to listen to patients’ concerns, doing tests and procedures, and prescribing treatment – all without having to clear it with an insurance company.
Dr. McCloy, a board-certified family-medicine physician with additional certification in wilderness medicine, practices what’s called direct primary care, or DPC.
DPC differs from traditional medical care in several key ways. Patients pay a monthly fee that allows them to see Dr. McCloy for as many encounters as necessary. But one of the biggest differences is that, aside from Medicare, Dr. McCloy doesn’t accept insurance. That distinction gives Dr. McCloy the freedom, based on his professional judgment, to order the appropriate tests and provide the care needed for each patient.
And, because blood and lab tests aren’t processed through the insurance-based model that’s used for most health care in the United States, the tests are generally significantly cheaper. Whereas a full blood panel can cost more than $300 when billed through an insurance company, Dr. McCloy can usually run the same tests for just a few dollars.
“I just get to do what makes sense, and to take care of patients without insurance companies dictating this or that,” he said.
Dr. McCloy was first exposed to DPC at a medical practice during his residency in Olympia. What he saw was a dramatically different approach to care, where both staff and patients were happy.
After completing his family-medicine residency at Providence St. Peter Hospital in Olympia, Dr. McCloy worked in a couple of traditional primary-care clinics in the Olympia area. One was part of the largest HMO network in the Pacific Northwest, and the other accepted all types of insurance.
Dr. McCloy and his wife, Lauren McCloy, moved to the Methow Valley in 2020 to live and raise their daughter, Ruby, who was born at Mid-Valley Hospital in Omak in 2021. After a couple of years of working for companies that provide care through telemedicine to patients across the country (Dr. McCloy is licensed in all 50 states), he decided to open his own DPC practice. Dr. McCloy launched Liberty Bell Family Medicine in Twisp in late 2022.
“It’s been a true joy. I love this way of practicing medicine – it’s what I dreamed of when I went into family medicine,” Dr. McCloy said. He still works a couple of days a week from the Methow Valley for a telemedicine company, filling another important niche by providing primary care for underserved patients throughout the country.
At his Twisp clinic, Dr. McCloy typically sees patients in person. They get Dr. McCloy’s e-mail and cell phone number so they can consult him as needed. Since his approach is flexible, he’ll do tele-health consultations when effective and/or most convenient for a patient – for example, when a patient is unable to travel or a problem can be diagnosed remotely.
Another aspect of the traditional medical model is that patients generally have to come in for an appointment or schedule a telemedicine appointment, in part so the doctor can bill insurance and get paid. But with direct primary care – and options for communicating by secure text and email – simple issues can be managed easily and conveniently. Patients really appreciate the direct communication and access to help when they need it, Dr. McCloy said.
Liberty Bell Family Medicine accepts patients of all ages. Patients pay a monthly fee, but they don’t have to commit to a minimum contract.
Dr. McCloy favors direct primary care because it allows him to build long-term relationships with his patients and to provide comprehensive care that’s rooted in an in-depth understanding of each patients’ health care needs. He also sees non-member patients – including visitors to the Methow Valley – for acute and urgent-care needs.
Part of the challenge with the conventional medical model is that a physician is expected to see two dozen patients a day, Dr. McCloy said. But in his view, that’s not enough time to thoroughly read medical records, understand what’s going on for a patient, and to provide the care and education needed. For Dr. McCloy, a busy day is six to eight patients, with an hour scheduled for every patient visit.
Dr. McCloy believes that the standard medical insurance system is excessively expensive for primary-care needs. It’s a system that too often doesn’t cover needed care, which creates a gap that can interfere with basic health care, he said. Still, he encourages his patients to purchase insurance to cover unavoidably expensive things, such as specialty medications not available in generic formulations, specialist care, surgery, and hospitalization.
Combining the Liberty Bell Family Medicine monthly fee and a high-deductible insurance plan can be less expensive than the traditional fee-for-service model, with its insurance premiums, copays, and deductibles, Dr. McCloy said.
DIRECT PRIMARY CARE
The DPC model is still relatively unknown. It was started 20 to 30 years ago by a handful of Seattle physicians who had the idea of foregoing billing insurance companies – and instead charging monthly fees – to free up the time to be enjoy practicing medicine again. The goal was to provide quality care at a predetermined cost so that patients would know what to expect. Direct primary care has steadily grown in popularity – it’s now practiced across the United States. In Washington, DPC practitioners are registered through the state Office of the Insurance Commissioner.
The economic reality of the fee-for-service system, where more than 40 cents out of every dollar spent on health care goes towards insurance billing and overhead, means doctors have to see more patients just to make ends meet, Dr. McCloy said. His economic model allows him to invest those savings into the clinic and patient services instead.
Many of Dr. McCloy’s patients found direct primary care because they’d become frustrated with the conventional medical system and were looking for the personalized attention and in-depth exams they can get through Liberty Bell Family Medicine. Some chose it for the relationship it builds with their provider, while others needed to see a doctor for a medical concern and didn’t have insurance – or didn’t want to wait months for an appointment, Dr. McCloy said.
Patients can often get an appointment with Dr. McCloy in Twisp for the same or next day. And, in an era where most clinics address just one issue per appointment, Liberty Bell Family Medicine aims to make appointments as long as necessary so that Dr. McCloy can take care of everything on the patient’s list.
For people with a chronic medical condition that hasn’t been adequately addressed, Liberty Bell’s approach can be a relief, with the doctor dedicating the time, energy, and brain power necessary to address the issue, Lauren McCloy said.
"THE COOLEST THING EVER"
Dr. McCloy didn’t start out pursuing a career in medicine – he actually studied French, English, and economics, thinking he would be a teacher. But he got hooked on patient care after a summer job during college at a family-medicine clinic in Memphis.
At the Church Health Center, which served the working, uninsured population of Memphis, Dr. McCloy checked in patients and took their vital signs, assisted providers with procedures, and helped run the clinic dispensary.
With his language background, he accompanied the doctor on trips to care for patients in Haiti. Those trips were an inspiration, showing the potential of working as a family physician, Dr. McCloy said.
“The Church Health Center was an innovative model – the essence of practicing medicine at its core. It was the coolest thing ever,” he said. So Dr. McCloy began pre-med classes at the University of Memphis, followed by a move to New Orleans, where he was accepted into a masters in pharmacology program, followed by medical school at Tulane University.
Dr. McCloy completed his family-medicine residency training in the Pacific Northwest after he and Lauren traversed the country in a 1978 Airstream that they renovated themselves. Dr. McCloy also has a background treating people with substance-use disorder at the Olympia Bupe Clinic.
Dr. McCloy loves family medicine because it gives him the chance to do a little bit of everything – care for patients from infancy through old age, perform procedures, look at X-rays – essentially, to provide a full spectrum of care. He emphasizes preventive care, working with his patients to help them get good nutrition, quality sleep, and regular exercise.
It was his dream to be able to practice medicine this way, Dr. McCloy said.
Liberty Bell Family Medicine is in the North Glover Healing Center in Twisp. Dr. McCloy can be reached at (509) 337-5005 or admin@libertybellfamilymedicine.com.
More information is at www.libertybellfamilymedicine.com
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