We are a doctor and nurse practitioner team with over 40 years combined medical experience. Most of our experience has been internal medicine, although Dr. Major is a board-certified family practice physician and has even delivered a few babies over the years. During his 17 years in the Air Force, he had the honor of working at the Pentagon as well as in multiple other installations from southern Mississippi to Idaho as a provider for servicemen. Melissa has invested a large part of her nursing career in geriatrics and rural health population. Most recently we have been employed as hospitalist in the local area and have served the community throughout the recent/ongoing pandemic. Throughout the years we have consistently been told by patients we are easy to talk to and described as “down to earth”. These statements are generally followed up with them asking if we can see them on an outpatient basis as their primary care providers. We have had to regretfully tell them no time and time again, knowing with a certainty there was so much more we could do to help them, given the time.
The truth is time does matter, and it is not on your side. Current requirements for commercial insurance and Medicare reimbursement have led to an average 7-minute patient visit. Seven minutes to hear, contemplate and address exactly one complaint. Time constraints simply do not allow addressing multiple issues during a single visit, nor any in-depth education or plan of care discussion. Sadly, the time frame from diagnosis to achieving effective treatment of a disease process is severely prolonged in the current state of our healthcare system. It may require up to 6 months to achieve optimal blood pressure control when accounting for follow up visits and medication adjustments. Factor in illnesses that are not readily evident, it will be upwards of a year or more, simply to receive a diagnosis, likely involving multiple specialists, duplicate labs and lots of phone tag. Primary care doctors simply cannot practice medicine the way we know we should due to bureaucratic regulations currently in place. Medicine has evolved into a business, factoring out the patient’s best interest somewhere in the process. Investors, not medical professionals, make most decisions regarding your healthcare, and this is not based on anything to do with your health.
Average turn around for a patient to hear back from his doctor’s office when leaving a message, is 48 hours. The time-frame to issue resolution is generally a week or more. This convoluted, albeit unavoidable process, has led to an over utilization of our emergency rooms and produced a domino effect in our healthcare system. The issue seems to best be addressed at the primary care level, but currently cannot be. Closer management, frequent monitoring and increased education will certainly yield faster desired outcomes. This would, however, require a structure that would be radically different from what most patients are accustomed to functioning within. The disconnect between patient and doctor is crippling both parties. Red tape needs cutting, barriers need to be removed, and access must be restored.
We learned first-hand when Dr. Major had his own primary care practice upon separating from the military. It was immediately evident that the current civilian structure for PCP’s did not allow for proper patient care and produced poor outcomes. The contributing factors were numerous, the result was he simply could not care for his patients as they needed him to. The number of visits required daily (requirements for commercial reimbursement to meet productivity) and patient satisfaction scores defined you as a provider. It was a business at the end of the day, shareholders made the decisions, not medical providers. Of course, he strived for good patient satisfaction scores, but not at the cost of inappropriate treatment. This was disheartening to say the least. It pained him to have to limit addressing patient needs and be strong armed into prescribing unnecessary antibiotics in order to gain another new patient. At the end of one year, he transitioned to the position of hospitalist, and that is where he has been practicing since. Melissa joined alongside him upon completion of graduate school in 2017. She found she loved the interaction and patient management elements of being a hospitalist, however she frequently had to be reminded she ran behind schedule. Perhaps she talked too much to her patients and needed to be more mindful of time. The thing is, they needed this time, after all, that is what builds connections and is a necessary element of patient care. She began considering an ideal environment where connections were fostered, rather than severed due to time regulations. We knew to constrain ourselves to the regulations and requirements of Medicare/commercial insurance in our practice, was not going to work. We had to find another way.
The Genesis of Mbody
We considered many elements that would factor into the ideal environment, as well as researched current alternatives available. After carefully considering different payment structures, we ultimately decided on what is known as a direct primary care (DPC) practice (also known as retainer-based or concierge medicine). DPC practice is rising in popularity as an alternative way to access healthcare versus the private healthcare insurance marketplace.
You pay a monthly fee that is all inclusive of the primary care and preventive care services required, regardless of how frequently you need to be seen. This structure allows you to receive personal care at the discretion of a medical professional rather than the requirements, or restrictions, set by insurance companies.
Our practice limits our number of patients to keep our patient-to-physician ratio low and ensure a higher level of personal attention and service for each patient. This allows dedicated time necessary to individualize care provided.
We are a clinic for those who value one-on-one time and a personal, ongoing relationship with their doctor. As your personal providers we are here to help you manage and maintain your health.