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Montana doctors offer emerging healthcare model—subscription-based care

Posted at 2:39 PM, Feb 20, 2024

BILLINGS - PearlMed, a subscription-based primary care provider, is offering what the owners are calling a scaled-down, more convenient and personal approach to medicine in Billings.

The private clinic was first established by former St. Vincent's Family Practice physician Robert Wagenaar in November of 2021 but has since added former Billings Clinic physician Garett Williams to the team.

The business model is based on monthly or yearly subscriptions, with the goal that routine checkups or other small procedures can be offered at a discounted price due to the regular payments.

In total, Williams and Wagenaar care for nearly 80 patients, one of them being 26-year-old Billings resident Zak Robuck, who recently was in the market for a primary care provider after aging out of his parent's insurance plan.

"It's important to be able to get in and see your doctor whenever you need to," Robuck said Monday morning. "It was convenient, and the pricing was fantastic."

Robuck said he liked how personal the clinic would be. Both Williams and Wagenaar give out their personal cell phones to patients so that they can always be reached with any medical questions.

"I never thought of getting good service from a doctor, but I do now," Robuck said. "The change in service has been really noticeable. Any time I've had any questions, I could call them and they pick up on the first ring."

Robuck's satisfaction with the service is music to the ears of the providers.

"We wanted to distance ourselves from the insurance side of things to allow us more autonomy," Williams said.

Williams left the Billings Clinic after working there for nearly 10 years. He said the patient volume and high pace deteriorated the care.

"It was frustrating for them, and it was frustrating for us," Williams said. "We knew what they needed and wanted and expected. We agreed but knew we couldn't deliver."

Wagenaar is the one who started PearlMed in 2021. He felt similarly to Williams, after working at St. Vincent's for nearly a decade as well.

"What we were looking for is something that was going to build the relationship back between physician and the patient," Wagenaar said. "It had eroded pretty greatly."

For adults under the age of 40, the cost of the plan is $69 a month. For adults aged 40 to 64, the price goes up $10 to $79 a month.

Williams and many other primary care doctors around the country have broken off from larger hospitals. There are currently a total of 2,212 primary care clinics in the U.S. with 48 states and Washington, D.C., represented.

"My take on it is that all primary care should really be a direct primary care model where the patient directly contracts with me," Wagenaar said. "Some people think it's crazy to give out our cell numbers, but it works because patients can have their answers quicker and easier."

PearlMed is not the only subscription-based primary care provider in Billings. Flex Family Health Direct launched a similar service in 2023, also operated by local doctors.

It's a nationwide change that's already working for many patients like Robuck.

"Being able to get a hold of my doctor whenever I need to, being able to get in here the next day or even the same day," Robuck said. "That was a big part for me."