Oh Gravity. . .and Self Care!

So, the other day I was walking down the sidewalk, and Gravity got me—my dress shoe heel landed on a tiny pebble, and I fell forward, landing hard on my left knee and right hand.  Of course, the first thing I did was look around to see if anyone noticed (they didn’t), then I picked up my empty Starbucks cup and what was left of my pride, and walked back to the office.

And you know what?  That fall was humbling.  I’m fine (just a bit bruised!), but it made me realize two things:

1.  Don’t underestimate the effect of gravity.

2. I should have changed my stupid shoes. 

You see, as I was heading out, I even entertained the idea to change into athletic shoes.   But, I decided not to because they did not match my work clothes, I was taking a short walk at lunch, and what could possibly go wrong with that idea?  Somehow, in the course of growing up, I got the idea that opting for “comfort” in any aspect, but especially regarding my physical body, was optional and a waste of time. 

It goes hand in hand with the idea that “self-care” is non-essential and “extra”.

And now, I write before you recovering from a nasty fall that was self-induced by a poor footwear choice (and neglecting the importance of taking care of my body!), and I proclaim that self-care is THE top priority!

I also realize that my idea about self-care has needed to shift.  It isn’t always about massages and bubble baths.  It’s about listening to my body and not neglecting it. It’s about establishing habits that nourish and serve me, and it’s about saying no to everything else.

So, I thought it might be fun to share with you my “Top Ten” self-care list:

1.       Wear the right things.   Too cold?  Wear a jacket.  Too warm?  Take off a sweater.  Walking to Starbucks?  Wear sneakers. 

2.      Just go to the bathroom.  A full bladder makes everything more difficult.

3.      Get up and move.  I never think I have the time—until I have spent 10 minutes scrolling.

4.      Drink water. Stock up on water bottles, and bring one to work daily.

5.      Recognize when I am hungry, and if I need to eat something, eat something! 

6.      Curl up on the sofa and read a book.  Even when it’s not raining.

7.       Savor that first cup of coffee.

8.      Change the sheets at least once a week. I love the feeling of freshly tucked and laundered sheets!

9.      Remember that ice cream makes my stomach hurt. Just say no.

10.   Spend 30 minutes in the morning writing, listening to music, dancing and enjoying the solitude.

As we enter the hustle and bustle of the busy season, what needs to be in your Top Ten?  If “taking better care of my body” is up there, we are open to partner with you for optimal health.  Just schedule a complementary phone call. And, for the remainder of 2023, the $200 onboarding fee is waived!  It’s our holiday gift to you.

FREEDOM!!!

There are a lot of parallels between American independence from England and Ultra Primary Care’s independence from corporate medicine and insurance! 

And, in the past six months, since I have opened Ultra Primary Care, I have enjoyed more freedom in every aspect of medicine.

I love the freedom to dive into research about problems like long CoVID or new ways to test for skin cancer.   Having extra time allows me to share personalized, up-to-date recommendations for the best care at the right time.

I love knowing that my schedule accommodates patients’ needs, no matter what they might be.  And, I love being able to see patients virtually—even for things like sore throats, sore joints, and sore backs.  It’s gratifying to guide patients through a virtual examination to glean the necessary information to get everyone better sooner.    Did you know that in many cases, I can get a better-detailed look at tonsils with a phone camera than I can in real life?   Virtual examination has come a long way!  And that means that patients have many more options for evaluation.

I love the freedom to send a quick text or portal message to check in as patients make progress with new diets, exercise habits, starting a new medication, or undergoing tests or procedures.  Because “medicine” really isn’t limited to office visits!  Having that ongoing thread of communication allows us to get to know each other, so there is more trust, more care and more health.

The freedom to do medicine differently means medicine that works FOR patients.

Need more freedom in your medical care? Sign up for a complementary 20-minute meet and greet phone call where we will talk about your medical needs, talk about how direct primary care works, and determine the next best steps forward. 

Let freedom ring! 

What happened when I got on stage (it’s cringe worthy!)

So, I did a really scary thing on Thursday May 4, 2023.

I got up on stage and told my story about three absolutely CRINGE events in my life—

Three farts.  One in yoga class.  One in front of the pastor. One during a pap smear. 

And, they were all connected by a mantra. 

But it is the third story that is the message of my blog today.

Because getting a pap smear is traditionally thought of as a cringe-worthy experience all in itself, and it’s my mission to change that for women.

At Ultra Primary Care, we aim to make these difficult things easier, whenever we can.  And that includes pelvic examinations and pap smears.

While we can’t avoid the stirrups and traditional “table”, we have made the environment at inviting as possible. 

• Instead of sterile tile floors, you get a warm and inviting carpet.

• Instead of vinyl exam room chairs, you get comfy sofas, a view of the star, and a glass of water.

• Instead of fluorescent lights, you get chandeliers.

• And instead of a rushed, “herding cattle” experience, you get a relaxed, peaceful moment of self-care.

View from the pap table

A beautiful chandelier and NO fluorescent lights!

We also  offer discounted billing for the pap test as well, so there’s no stress about unexpected medical expenses.

Because there are enough cringe-worthy moments to life.

Getting a pap smear shouldn’t be one of them.

Sign up now for the Ultra Primary Care difference.

What about supplements?

Recently you all have been asking me a lot of questions about supplements, and their role in health and wellness.  Many of you are very interested in a natural approach to wellness and wonder how direct primary care can fit with that mindset.

The short answer is that supplements absolutely make a difference in health and wellness.  The long answer is that they won’t help if we aren’t clear about what we are treating, or if you are taking the wrong ones!

My role, first and foremost, is to listen to you, and help you communicate to me how your body is working, (or not!) or what you hope to be different.

Once we have a better understanding of the problem, we can look at all the possibilities to develop a wellness plan that starts you on the path to ultra health. And, since Dr. Michael is a functional provider,  I often “sideline” consult him to learn the cutting edge research about different supplements and how they can help certain illnesses. 

One drawback to supplements is that the quality can vary greatly, between manufacturers, and even between different lots within the same manufacturer.  This is because supplements are not regulated by the FDA.

That’s why, at Ultra Primary Care, we use FullScript, which is an online supplement pharmacy. If we determine that a supplement will help you, I enter the specific supplement into Fullscript, where you log in and order it after receiving an email or text.   Then, it’s delivered right to your door.  This eliminates all the worry about what you are “really” taking with drugstore brands.

Direct Primary Care, like we provide at Ultra Primary Care, allows us the time and connection to determine what really matters to you.  And it allows me the time and access to resources to ensure that you receive top quality advice, support and supplements.  Lifestyle is the cornerstone of numerous medical conditions. And I love that direct primary care allows us to focus on lifestyle fundamentals, so you can achieve ultra health.

Curious to learn more about how we might partner together? Schedule a complementary call, or email me with your questions!

Happy St. Patrick’s Day

St Patrick’s Day has always been a fun holiday (maybe because green is my favorite color!).  I’ve always enjoyed celebrating, and I love the idea of luck—this magical force that is on your side.

This past year, I visited Ireland on a walking retreat, and that experience clarified two things for me:

First, I rediscovered that I LOVE medicine, and I needed to keep practicing as much as I needed air, water, and shelter.

Second, I learned what it feels like when I can trust that my comfort and needs matter, and will be taken care of.

The Irish love a good story, so indulge me as I share this one with you here—

One day, we set off on the Dingle Way, and our plan was to walk to the next village over, about eight miles.  It was one of those days where the rain was sideways, pelting our faces, laced with slivers of sleet, our hair whipping as we walked along the shore.  My “waterproof” hiking shoes were SOAKED within five minutes, and what started as a fun adventure quickly became a slog with wrinkled feet and miserable bone-chilling cold seeping into my core.  I looked over at my hiking partner, and her face was full of pain from an aching hip, blisters on her toes, and a day made for dementors’ delight.  We finally rounded a corner, and there, in front of us was the sweetest “true mirage” I have ever seen—The Stonehouse Restaurant. 

The Stonehouse Restaurant, Ventry Ireland

It wasn’t even a question. We trudged up the hill, opened the front door, flooding the beautiful stone floors with a torrent of water.  The restaurant-owner, David, immediately came over, welcomed us, directed us to the warmest tables right next to the wood burning stove, and mopped up our puddles while the waitress brought us all steaming hot fragrant bowls of vegetable soup and platters of fish and chips with Irish coffees all around.  Not once did either complain, as we descended upon their peaceful oasis with our cold hands, dripping packs and hungry mouths. Our comfort was their primary concern.  They made the Irish Coffees extra strong and regaled us with Irish tales as we all bailed on hiking for the rest of the day and waited hours for our ride to take us to the next stop, staying long after closing time for the restaurant.  By the end of the long afternoon, The Stonehouse felt like a second home, and we wondered how we had ever been strangers. 

That experience has stayed with me, because it was my first experience with Irish luck—this magical force that is always on your side.

And just like the Irish, at Ultra Primary Care, your comfort is the heart of the experience, and you always have someone on your side.

Our office is bright and inviting, and we often meet in our “parlor” for initial consultations, complete with a fireplace and comfy chairs.  We don’t have a waiting room, because we don’t want your schedule to be held hostage by ours, and we take the anxiety out of medicine by giving you the assurance that comes from knowing someone is in your corner, bringing a piece of that Irish luck to Roanoke, Virginia. 

If this sounds like something you need in your life, schedule a Meet and Greet phone call to feel the Ultra Primary Care (and Irish!) difference. We’d love to have you.

Happy Valentine’s Day!

I have to admit, I have had a love-hate relationship with Valentine’s Day through the years.   

For some reason, my romantic relationships often ended right around Valentine’s Day, so it was a holiday associated more with a broken heart than romance.  I even accused Hallmark of making up the holiday in an attempt to sell more cards (did you know it’s the second busiest holiday for sending cards—only Christmas is busier!)  In fact, in medical school, a bunch of my single friends had a “not bitter” dinner to celebrate their friendship and mold the day into a celebration that honored where they were in life. Through the years, my notion of Valentine’s Day has softened, and I now see it as a day to honor all the relationships in our life—friends, lovers, co-workers, family and pets.

And, while our ideas of relationships have broadened, one relationship is often neglected—our relationship to ourselves. Self-love.  To quote Whitney Houston, “Learning to love yourself, It is the greatest love of all”.  And it truly is, because our capacity to love others is only as deep as our capacity to love and accept ourselves.  And it’s the hardest relationship for me to get right.  It’s a work in progress, and I have much more self-compassion now than I used to, but there are days I still fall prey to that deep-seeded belief that, “I have to do to be of value”.  Truth is, we are all infinitely valuable before we even do a single thing.

So, on this Valentine’s Day, not only do I want to honor you all—fellow supporters for Ultra Primary Care, I also want to ask you to honor YOURSELVES.   What it would look like to be your own Valentine?  Take that feeling that you want the very best for them and direct it toward yourself.  Really take a moment to sink into that feeling.

What might you do differently?  What would you do more of?  I’m willing to bet that taking good care of your physical body would be high on the list.  So, I encourage you to schedule your preventive physical examination if you haven’t already.   Respect and take care of your body for the wondrous miracle that it is. 

And, if you need a partner to help you in this self-care journey, we are still accepting new patients at Ultra Primary Care, and would be honored to work with you. Reach out at drchristy@ultraprimarycare.com, or schedule a phone call to learn more at the button below:

Having a doctor is like having a money tree. . .

Every day I wake up to new messages about the economy, inflation and recession, and we are all careful to spend money wisely.  It can be very tempting to feel that spending money on healthcare is unnecessary if you are “healthy”. Why would you pay for something that you only use when you are sick, if you are rarely sick?

So, I’d like to take a moment to look at this differently, from the perspective of an “insider” who has been in the traditional fee-for-service sector for a long time.

Having a primary care doctor means you have someone in your corner who really knows YOU and your history, and that knowledge is priceless—it’s like having a money tree.  Because when you have a medical partner keeping you healthy, you feel better, you do more, you are rich with life, and you can avoid spending lots of money on unnecessary tests and studies.

A few weeks ago, I saw a longterm patient who was having trouble with frequent urinary tract infections. She had been referred to urology by another specialist, and that doctor wanted to do extra testing. We chatted a few minutes, and she also told me that she had been having more trouble with her mood, and she had been prescribed a certain type of medication to help (by another doctor).  I remembered that she had been on chemically similar medication about ten years ago, and it caused her to have urinary problems.

I prescribed a different agent for her mood and asked her to write me in a few weeks to let me know how she was feeling.

The urinary symptoms were gone, and she canceled the studies to evaluate for the recurrent infections.

And, her mood was also doing much better on the new agent as well.  She was thrilled to be feeling better.

Because I knew her history, we were able to avoid spending lots of time and money on testing, and she was able to feel better faster (and that may actually be the closest we can get to money growing on trees!). 

If you are ready to invest in your health, I would love to talk with you by phone to see if we could be a good fit, and get you scheduled for an initial consultation.   Just click the link below:

It’s Finally Here!!!!!

Happy New Year!    

It’s an exciting time for us at the Center for Ultra Health with the official opening of Ultra Primary Care on Jan 9, 2023.  I can’t wait to start seeing patients again, in a new way!

Many people have asked me how I am feeling during this time, and while I am so very excited, I also feel so free—

Free to communicate with and treat patients in person, virtually, by phone and by portal message, depending on the patient’s needs and medical appropriateness.

Free to use coaching and other modalities to take a whole-person approach to healthcare

Free to help patients get started on a functional medicine approach to healing when necessary

Free to help patients save money on lab bills and other costs

Free to practice medicine the way I have always wanted to—with enough time to discern the underlying medical problem, to research the possibilities and to restore people to their ultimate best.

It feels like a free, fresh start to go with the New Year, and I am so honored to be starting this journey with all of you.

Together, let’s transform the way medicine is done!

The Greatest Holiday Gift—Cheers!

Where everybody knows your name—

When I was growing up, Cheers was popular. You could walk into the bar, and you were greeted by name.  You were seen.  You belonged. 

There is something profoundly healing in being seen, isn’t there?

And yet, when I was in fee-for-service medicine, I was seeing so many patients that it was hard to “see” anyone.  And the pace was so fast because the only way our office could generate income was by having people come in for office visits.

By the time I left fee-for-service, I was completing an average of 25 office visits a day.

In the community, I’d sometimes observe people looking my way and I couldn’t remember their name.  I felt a lot of shame because of the increased demand and fast pace of the fee-for-service system.  When I dreamed of being a doctor, I didn’t dream of having to rush through my day so quickly.

The thing I am most looking forward to as I open my DPC practice is “seeing” you, my patient.

It’s a gift to have the opportunity to do things differently now.  And I am looking forward to sharing this gift with you, especially during this holiday season.

And I don’t mean “seeing” as in an office visit.  I mean it as in seeing your creativity, resourcefulness and wholeness, honoring your health journey, helping you achieve “ultra” health, and living life to the fullest. 

I am now accepting new patients—click below if you are ready to enroll. You will be asked to fill out a brief form so we can set up a quick phone call to start the onboarding process.

I look forward to “seeing” you.

Membership fee of $200 is waived for the next 10 days only!  Give yourself (or a loved one!) the gift of being seen. 

We take all the insurance*. . . but we don’t bill it!

The most common question I hear when I tell people that I am starting a direct primary care is, “Do you take insurance?” 

My answer: “You don’t need insurance to see me.  Insurance can cover the cost of medicines, additional tests and studies, but 90% of what I do is covered by your monthly membership fee”.

In the past, you would see your doctor for an acute problem.  You’d probably get a prescription, take it for a few days and be completely better.  However, much of medicine now is chronic disease management, which requires frequent changes to the treatment plan.  This results in lots of messages to the doctor, giving feedback about the treatment plan or unexpected side effects, and what to do next.

In traditional fee for service, the only way the doctor gets paid is to ask you to come back into the office.

Compensation is aligned with inconvenience in the traditional system.

The DPC model honors both the patients’ and doctors’ time by decoupling reimbursement from the office visit.

It allows the flexibility to provide service in the most efficient and effective manner for both parties.  This means that I have more time to answer portal messages, or I can even call or video you to adjust the treatment plan and talk about the next steps.

A recent article highlights this issues and explains how other systems are adapting.

So, I take all the insurance (aside from Medicare and Medicaid).  I just don’t bill it.  Your monthly membership fee allows you to get the care you need, when you need it, and the peace of mind to know that you always have a doctor in your corner. (and in many cases, flexible spending dollars and Healthcare Savings Account money can be used to cover the monthly membership fee)

And that makes all the difference.

*we are not currently taking Medicare or Medicaid, but plan to in the spring. We can add you to a wait list.

Happy Halloween—(Better known as Permission Day!)

I love Halloween, although I’ve always thought it is a “mixed message” holiday. 

We should avoid scary, dark places, unless it’s Halloween when we revel in the adrenaline rush that comes from a jump scare.

We should avoid sugar.  But, on Halloween we are allowed to beg for it from strangers as we go door-to-door threatening “tricks” if we don’t get what we like.

We should be ourselves, except for the one day a year when we get to pretend to be our inner villain, or superhero, or goofy alter ego.

Halloween is a big permission slip—to disobey, to indulge and to pretend, and I am here for it!

And in a way, membership in a direct primary care like Ultra Primary Care is another permission slip.

It allows you the permission to gather the support you need to take responsibility for your health. 

It allows you greater access to medical advice (besides Dr. Google!). 

It allows you the freedom to do things differently, and to live life more fully.

 And. . . we are now accepting pre-enrollment! Enrollment fees are waived during the pre-enrollment period for the first 100 to sign up!

After you fill out the form, we will email you with the next steps to becoming a member of Ultra Primary Care!

May we all embrace the permission to do things differently!

Doctor’s Hate This. . .

Doing things that make the least sense for the patient and the physician because some insurance administrator or government agency will only pay the bill if it is done a certain arbitrary way. In other words, we hate B. S.

They say that compassion fatigue is contributing to burnout, and compassion fatigue is defined as, “indifference to charitable appeals on behalf of those who are suffering, experienced as a result of the frequency or number of such appeals.”

But the Oxford dictionary is wrong. 

It’s not the number of the charitable appeals that are the problem. 

It’s the inability to alleviate that suffering because of infuriating insurance restrictions and constrictions.

Anger is a natural response to a perceived feeling of powerlessness in the face of injustice.  And these insurance edicts make everyone angry.

But that anger has no outlet in medicine, so compassionate physicians compartmentalize and push it away, put our heads down and do the next thing and the next thing and the next thing because we so desperately want the best for our patients.

But here’s the thing about anger.  It’s energy that needs to get out; it’s there to be the fire for change.  When the change doesn’t come, it burns away at the soul and changes the physician.  She burns out. Until she does something different.

I was lucky enough to spend some time last week visiting a couple of direct primary care practices here in Virginia (thank you Edson Family Practice and Kaya Health!), and there were three things I noticed immediately--

The first was that the work of the doctors matched the patient needs, NOT the insurance needs. The palpable frustration from doing unnecessary tasks was completely absent, and it felt like a breath of fresh air.

The second was that the doctors were cheerful and talkative.  They weren’t cramming all these silly insurance hoops into the day, so they had the time to attend to what really matters—the patients, the staff, and perhaps most importantly—themselves. Never once did they look at their watches. Time was abundant.

And the third was that the staff were positive, energetic, and happy to accommodate the needs of the patients—because they had the time and flexibility to do so.  A patient could come in and drop off a urine, get diagnosed with a UTI, and get treatment in a matter of minutes. When patients are getting the care they need, it makes life better for everyone—staff included.

So, while doctors hate doing things that make no sense, the joy we feel in doing the right things in the right way at the right time is priceless.

I am looking forward to being free of insurance restrictions, so we can all experience the freedom and lightness of medicine that truly alleviates suffering. Thank you for helping to revolutionize medicine, so we can all heal!

Curiosity—the cure for almost everything

Way back in 1998,  I was at the doctor’s office with a UTI, and I was a medical student.  I didn’t have a primary care doctor in the area—I was under a UVA health plan that covered me only in Charlottesville, but I was doing most of my rotations in Roanoke.  So, I had driven about 30 minutes to the only urgent care in the area at that time.  The doctor diagnosed me with a bladder infection. I asked for a relatively cheap, older medicine. She knew I was a medical student, and she said, “Haven’t you done microbiology?  E. Coli is almost always resistant to that medication! No, we will give you Tequin”.  I also knew that the doctor was only partially right.  While the urine culture may show resistance, the drug I asked for was concentrated in the urine and could overcome the resistance.  But, I didn’t say anything. She was the doctor, and I was just a med student.  I took the prescription for Tequin.  It made me dizzy and nauseated (and was taken off the market for problems with glucose levels a few years later).  But that experience has stayed with me—it’s true, you do remember how someone made you feel.

To a certain extent, medical education trained doctors to be diagnosticians and fixers, teaching the technical side of medicine—like fixing a broken car.  And yet, humans aren’t machines.

After I found coaching, I realized that while it is absolutely my responsibility to know the most I can about diseases and treatments, it’s also my responsibility to understand every patient’s unique circumstances; to honor their individuality while trying to fix things together.

Coaching is defined by the International Coach Federation as “partnering with clients in a thought-provoking and creative process that inspires them to maximize their personal and professional potential.” It assumes that clients are “creative, resourceful and whole.”  

Coaching puts the client (in this case, the patient) in the driver’s seat.  In that situation, it’s my job to ask the right questions so you can see things differently.  In medicine, this process is called motivational interviewing, but coaching takes it a step further because it asks the coach to meet the patient where they are, help create moments of awareness, and let the potential unfold.   There is very little teaching—it’s all about helping the patient find the best path for them.   

Imagine how different that interaction would have been if the doctor had started off with curiosity, by asking, “So, you have a urinary tract infection.  I know you are a medical student, and you probably have some thoughts about this. Is there a particular treatment that you feel may work best for you?” 

Because curiosity may have killed the cat, but it cures the patient.  And that makes all the difference.

If you’re interested in experiencing the “coaching difference”, I invite you to join Ultra Primary Care. We will be accepting enrollment in mid-October. If you aren’t already on the e-mail list, be sure to sign up here.

If you are interested in receiving coaching from Dr. Christy Arthur, book a discovery session here.

What I realized (about what insurance really covers)

Insurance doesn’t pay as much as I thought. I recently looked at my personal insurance rider, and I am responsible for all medical costs up to $2000 except for routine medical care! That means, in scenario #1, I would be responsible for $1325!

Here’s an example of how hidden insurance costs can add up—

The Old Way:  Let’s look at what happens when you see your primary care doctor in the traditional, fee-for-service system.

1. You wake up with a cough, and call to get an appointment in a few days. You have the appointment, and it costs a co-pay of $25.  Your doctor does an x-ray that day and sends it out to radiology.  Your doctor bills insurance $125 for the whole visit.

2. Some time later, you get an EOB (explanation of benefits), which shows that you owe an extra $20 for that visit.  The new $20 charge is for the “co-insurance”.  In this case, that’s 20% of $100.

3. Then, you get a bill from the radiologist for $40.  They charged $200 for the x-ray and the interpretation, and you had to pay 20% of that bill. 

4. You aren’t better.  You call your doctor back.  You get an appointment in seven days. While waiting for that appointment you get much worse.  You go to Urgent Care and pay the $75 co-pay. 

5. They send you to the emergency room, where you have a CT, receive IV antibiotics, and are sent home after eight hours. The emergency room co-pay is $200, and then you have 20% of the $1000 bill from the ER. You return to work after two weeks.

---

The New Way:  Let’s look at the same scenario from a Direct Primary Care standpoint.

1. You pay your monthly direct primary care membership fee (you can use your flexible spending dollars to pay that fee).

2. You wake up that morning with a cough, and you call me. I see you that afternoon, virtually. You pay NOTHING.  I order an x-ray and radiology reads it. You use insurance, and it still costs you $40 (20% of $200).

3. You aren’t better. You call me.  I need to assess you further, and offer an in-person visit the same day.  I call in an antibiotic and tell you to use over the counter cough medication.  You use your insurance to pay for the medications, which are generic, for $10.

4. I check in with you by phone the next day, and you feel like you are getting better, but the cough is keeping you up.  I call in a different cough suppressant, and you get some sleep (the biggest factor in getting better).  It costs another $10.

5. We do another phone check-in and you tell me you are getting better.  I tell you to call me for more shortness of breath, a new fever, or feeling weaker.

6. You have the peace of mind knowing that if any of those things happen, you will be able to get the medical care you need.  You return to work in a week.

---

Now granted, there were a lot of assumptions in the scenario above. Needing to go to the ER is a worst case scenario, and doesn’t happen often. And, even if you are able to access care early, sometimes an ER visit is unavoidable. But, in general, earlier access to care and treatment translates to an earlier recovery.

The beauty of direct primary care is that it allows me to keep my panel small and manageable because of the monthly fee. That fee essentially preserves your access, and it means that you can get the care you need when you need it.  The peace of mind that comes from knowing I have your back can make all the difference.

Insurance Charges:

Co-Pay: office visit $25

Co-Insurance office visit: $20

Co-Pay Urgent Care: $75

Co-Pay Emergency Room: $200

Co-insurance ER: $200

Medication: $20

Total (if deductible is met): $540

Total (if deductible is not met): $1325

Direct Primary Care Charges:

Monthly fee: $100

X-ray fee: $40

Medication: $20

Total: $160

Dr. Christy Arthur’s Journey to Direct Primary Care

As a child, I suffered from recurrent bouts of strep throat, and I got to know my pediatrician, Dr. Gower, very well. Even though I was just a child, his patience and presence allowed me to feel heard. From the age of nine, I have wanted to do for others what he had done for me—treating me compassionately so I got better faster.

When I started practicing family medicine at Carilion, I enjoyed forming relationships with patients. Spending time talking about what was going on in their LIFE (not just in their disease) fulfilled me and inspired me. And over the years, my panel grew. In 2021, when I departed traditional fee-for-service medicine, I was listed as the primary care physician for over three thousand patients. My schedule was packed, and I was consistently frustrated that not only were the demands to physically see patients in the office increasing, the administrative side tasks (like fighting with insurance to get a CT scan approved) were becoming more numerous. In addition, I had taken on many administrative responsibilities, and it was challenging for me to delegate or ask for help. The result was that I was feeling stressed and rushed, I was not showing up as the physician I wanted to be, and it was taking its toll on me and my family.

Then, the CoVID-19 pandemic happened, and we all learned that the next day isn’t promised and it became more urgent to make each day count. I journaled, hiked, took up mountain biking, re-dedicated myself to meditation and practicing yoga, and all of that allowed me to slow down and listen.

And, two things became very clear. The first was that when I thought about medicine, one part I liked the most was the coaching. It required deep listening, asking the right questions, meeting the patient where they were and helping them figure out how to move forward. Several of my friends are life coaches, and they encouraged me to become certified. After completing a program through the Healthcare Coaching Institute, I am an Associate Certified Coach through the International Coach Federation, and I have opened my private coaching business, called More Than Doctor. And while I enjoy helping young physicians to see things differently, coaching them through the stresses of the medical system helped me to see things differently too.

And that led to the second thing that became clear. Continuing to practice medicine in my previous hospital-owned practice was not allowing me the environment I needed to pursue my purpose. I shifted to working in a flex capacity, filling in for doctors throughout the New River and Roanoke Valleys. And, I fell in love with medicine again. The flex pool doesn’t have all the administrative burden of carrying a large panel. I had the opportunity to practice in smaller offices and I liked the collegiality a small practice affords. At the same time, I missed “knowing” my patients, getting to see them more than once, and continuing the story into the next visit.

I had learned of direct primary care years ago when I went to a conference in April of 2016, but I just wasn’t ready. It has taken six long years for that seed of inspiration to take root and grow, and now I am finally ready for this next step. All the pieces are falling into place, I have the support of my husband and family, and THIS is what I have been seeking.

The direct primary care model makes possible what I was missing the most—more time with patients, so I can use coaching skills; flexibility to do things differently, so I can structure my schedule with time for coaching and medicine; and time for self-care, so I can be the type of wife, mother, physician and coach that I was meant to be.

My vision is to impart inclusive, sustainable, revolutionary human care with great compassion and mutual respect through use an inclusive direct payment system that allows our patients to receive mental and physical care in a timely, respectful and compassionate manner, so they can achieve ultra health and we can all heal. I want each patient to feel welcomed, respected, and well (not just free of disease, or “better” from an acute problem). I envision using coaching to help patients overcome mental issues that are contributing to physical issues, and I will continue to coach individuals who aren’t members of Ultra Primary Care as well.

It’s been a worthwhile journey to have brought me to this specific point in time, on the precipice of opening my own practice, delivering medicine in a way honors you, the patient. I can’t wait to share this dream with you—I believe everyone deserves to live their purpose. Thank you for helping me live mine.