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Missionary work thrives in direct primary care

‘Customer service’ prevails over profits. Merriam-Webster defines “missionary” as “a person undertaking a mission and especially a religious mission.” Louisiana-based Todd Flowers, MD checks the box twice—having done missionary work across the globe, and now as a direct primary care physician.

For an increasing number of people, direct primary care is becoming their salvation in a healthcare system too often bent on bending people over for money, and making their quality of care secondary. Dr. Flowers decided to adopt direct primary care because,

“part of what drives me is taking care of patients and meeting them where they are. I finished med school and had big hopes and dreams of making a ton of money. I got caught up in that system of ‘let’s see how many patients we can see in a day.’ After three years, I was making more money than I knew what to do with, and I was miserable because I was seeing patients for seven minutes at a time. I was lacking a relationship with my patients.”

He decided to take a year off and did medical missionary work in such places as Nicaragua, Laos, Uganda, Zimbabwe, Honduras and Peru.

“I missed my practice patients. They gave me as much as I gave them. I wanted more, in a different way,” he notes.

After a year doing research and developing a business plan, he founded MIRA Direct Primary Care on July 1—inviting previous patients as well as the population at-large. He aimed to have 40 patients signed up by now. He’s at 132. He charges a monthly flat fee of $89.99 per patient for open access to his care. Office visits are included, lab costs are passed through, and there is no insurance entanglement. Depending on a patient’s health insurance plan, if any, he can refer to specialists where insurance coverage is in force.

He emphasizes,

“The biggest barrier is educating the patient population about direct primary care. Less than 10 percent of patients understand direct primary care. People will say ‘yes, neat concept,’ but think they can’t afford it. They’re brainwashed about health insurance. It’s almost a military industrial complex in healthcare that is pushing patients toward decisions that benefit the complex. ‘You have to pay the man.’ It’s not good. I really am loving taking care of patients. I’ve been invited into their homes, and saved them a tremendous amount of money.”

Examples abound. He did a hemorrhoid surgery in his office that at the low end of estimates was going to cost $3,300. He charged a total of $66.67 to cover the cost of lidocaine, laceration tray, meds and a $30 fee.

Recently, he diagnosed and treated a patient with major emergent abdominal pain, eliminating a costly visit to the ER.

“She had gallstones. The gallbladder needed to come out. She had no insurance. It would be $5,800 cash at the Oklahoma Surgery Center, and she would have had to travel to Oklahoma from Louisiana. We were able to find a local surgeon who did everything for $5,300 two days later. We also can dispense medications through the office, and were able to provide what was needed for our cost of two to four cents per pill.”

Dr. Flowers notes that this is in stark contrast to the typical office visit encounter-based system where often unnecessary tests are done to upcharge.

“It’s not good for the patient or the whole financial system,” he points out. “One patient came in and needed 63 cents worth of medicine. I treated her. We take care of indigent patients as well. Some ask why we would do that.”

The answer likely lies in the model of exceptional “customer service” where everyone wins. Patients get what they need at a very fair price, and judging from the rate of growth for his practice, Dr. Flowers will see plentiful profits.

This is the second in a series about healthcare “customer service” addressing patient caring. While there is much to lament about the decided lack of “bedside manner” afforded many under today’s ailing healthcare system, there are bright spots as well. This series focuses on exemplary healthcaring innovations that hopefully will spread quickly and help cure what ails us.


Mark Lusky is a veteran writer, storyteller and author, with 40+ years of public relations, advertising, marketing and journalism experience. Author of A Wandering Wondering Jew… and co-author of Don’t Get Mad, Get Leverage,  Mark (aka The Happy Curmudgeon) is the owner of a Denver-based marketing communications firm celebrating 36 years in business in 2018.


One reply on “Missionary work thrives in direct primary care”

Wow! Direct Care is revolutionary. Thank you for letting people know they have other options than the for profit insurance system we have now.

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