NASHVILLE, TN: ‘GracePointe Healthcare and Icon Pediatrics are evidence of this growing trend right here in Nashville.’

By Alex Tolbert, The Tennesseean

pediatric11:05 p.m. CDT March 10, 2015 – More and more doctors are opting out of health care’s traditional, fee-for-service business model. Instead, they are moving to a subscription fee model under which they provide unlimited care for a fixed, monthly charge. This movement is so strong that the industry has even coined a term for it — Direct Primary Care (DPC).

In Nashville, one of the earliest adopters of DPC was GracePointe Healthcare. Located in Franklin and started in April 2011, GracePointe was a pioneer of DPC for Middle Tennessee. Now, there’s another DPC practice in town. Icon Pediatrics, founded by Dr. Eddie Hamilton, is located near 20th and Charlotte avenues and focused entirely on children.

As a health care consumer, it can be helpful to know more about how this model of health care works.

Your child’s care on your schedule

We’ve all been there when it comes to our own care. You’re sick and need a prescription. You know what prescription you need because you’ve had the same symptoms before.

Your loved ones tell you to go to the doctor. Arriving five minutes early for your 2 p.m. appointment is rewarded with being taken back around 2:30 p.m. and seeing the doctor at 2:45 p.m. The doctor is out the door by 2:51 p.m., and you’ve received a piece of paper for the same prescription you knew you needed in the first place.

dpc startup 2015Now, imagine that scenario times three children. Many parents don’t need to imagine it — it is their reality. And with kids often picking up germs from other kids at daycare or elsewhere, the time wasted in doctors’ waiting rooms can really add up.

Icon Pediatrics’ first promise is that this won’t happen to you. By limiting the number of patients per physician, Icon not only ensures same or next-day appointments, but it also guarantees that you will be seen on time, every time.

While getting an appointment the same day is nice, and being seen on time is even nicer, sometimes it may be preferable not to have to see the doctor at all. Other professionals, such as lawyers and CPAs, are available to their clients via email and phone. At Icon, so is your child’s physician. The company promises email and phone accessibility to your child’s doctor, 24 hours per day, 7 days per week.

Trusted adviser in difficult times

Parents who have gone through the experience of having a child struck by a major accident or illness know the difficulty of navigating the sea of different specialists and medical facilities. It can be an incredibly frustrating situation to seek advice and make big decisions about your child’s welfare with specialists that have no relationship with your child.

Ideally, parents would have their child’s pediatrician by their sides when talking with the specialists. Then, after each specialist leaves the room, the parents and the child’s pediatrician would be able to talk through the treatment options together. The combination of the pediatrician’s medical knowledge and the relationship with the parents and child would allow the pediatrician to help the parents make a far more informed and confident decision.

Most pediatricians stuck in the fee-for-service business model do not deliver this. The fee-for-service business model does not allow the pediatrician the luxury of time to drive to the hospital, wait with the child and parents for the specialists to come around, and then talk through what may be a very emotional set of decisions.

The subscription model, on the other hand, allows Icon and many other DPC practices to provide this for patients. At Icon, for example, Dr. Hamilton goes to the hospital as the patient’s guest to be there as a trusted adviser.

More providers to opt for this new model

Medical providers operate in the fee-for-service business model because it is generally what the government requires for Medicare and Medicaid, as well as by private insurance companies. Even though it is not the best business model for primary care, providers accept it because of the patient volume provided in return for accepting payment from these sources.

More regulation, smaller fee-for-service payments, and Health Savings Accounts (HSAs) are causing more patients to be willing to pay a monthly subscription fee and more doctors to be willing to step out and change business models. GracePointe Healthcare and Icon Pediatrics are evidence of this growing trend right here in Nashville.

Alex Tolbert is the founder of Bernard Health, a company that provides noncommissioned, expert advice on health, Medicare and COBRA insurance and medical bill consulting. To learn more about Bernard Health, visit


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