Whitefish doctor offers primary-care alternative

Daily Inter Lake, The (Kalispell, MT)

Jan. 2--Print Article

Todd Bergland was not satisfied working in America's insurance-based health-care system as a primary-care physician.

The Whitefish doctor said he was spending too much time on the computer, "checking X, Y and Z" for the insurance companies, but received precious little time to actually take care of patients.

"I went to medical school to take care of people, not to break their bank accounts," he said.

So Bergland decided to leave his position at Glacier Medical Associates and open his own practice, Fountainhead Family Med, a direct primary-care practice based on membership fees and not insurance. It officially opened for business on Jan. 1.

Fountainhead is located in a small and cozy renovated house on 844 Baker Ave. in Whitefish. Patients pay a monthly membership fee of $100 for adults 60 and older, $70 for adults under 60 and $20 for children younger than 18 if another family member is enrolled.

Bergland said that by eliminating the insurer from the relationship between the primary-care doctor and the patient, Fountainhead removes the main sources of excessive costs. Plus, he will not be incentivized to rush his patients' care and order excessive or unnecessary lab tests and imaging studies.

"I want to be the doctor for my patients," Bergland said, "So that means if something comes up late at night, like if one of the kids falls out of the bunk bed and has a laceration on their elbow ... I would want to have them contact me, and we'd sort out what's the best way to deal with this."

Depending on the situation, Bergland said he could have patients meet him at the clinic that night, see him first thing in the morning or he might even make a house call. In this way, patients are paying not just for the care they receive, but flexibility, peace of mind and an actual relationship with their primary-care physician.

"It's quite a bit easier on both sides when you're dealing with an acute problem and you as a doctor already know that patient's history and what's their work situation or their family situation. When you have that established relationship, it's just preferable and easier for everyone," he said.

"People might say, 'That sounds crazy, that's not how things work anymore,'" Bergland added. But he is adamant the "day-to-day" things in which he specializes should not be "horrendously expensive."

Bergland is not alone in his new venture; direct primary-care clinics are popping up all over the United States as primary-care physicians turn their backs on the insurance-based model.

In June 2014, there were 125 direct primary-care practices operating in the United States, according to Direct Primary Care Frontier, a website that maps the growth of facilities across the country. But as of this past summer -- as Bergland learned at direct primary-care conferences he attended -- there are now "literally thousands" of these clinics around the country.

Montana has few direct primary-care facilities compared to other states. Bergland's will be the third in Northwest Montana, in addition to Glacier Direct Primary Care in Kalispell run by Dr. Lexi Tabor-Manaker and pureHealth DPC in Polson run by Dr. Cara Harrop.

Bergland does not find the model's growth surprising, as most doctors are shocked by the "administrative burden" the insurance-based system places on them. He said the system puts "good people in a bad situation" as most doctors are often fighting against a system that keeps them in front of a computer or affords them little time with their patients.

"That saps a lot of their strength, too," Bergland said.

"Health care should be about interaction and caring and taking care of people," he said. "It's just the system that we're working in most of the time, which a lot of it is dominated by insurance, has made it more difficult to take care of people that way. I don't think insurance is adding value when it comes to primary care."

Through medicine and military service, Bergland has made a career out of taking care of people. After graduating from the University of Pennsylvania, the Army helped pay his way through medical school at the University of Vermont. He completed his primary-care residency at the Madigan Army Medical Center in Fort Louis, Washington, in 2005, before working for three years at an Army clinic at a U.S. military base in Stuttgart, Germany.

He also spent a year deployed with a tank battalion in Iraq.

But after working in the Army, it was a rude awakening to practice family medicine under the constraints of the insurance-based model. He said 20 years ago the system with which he worked in the Army -- which "was almost like an Atari machine" -- could tell him on the spot exactly how much certain medications would cost his patients. He still did not have that at an insurance-based family practice.

"Even with all the incredible tech that we have at our fingertips, that information is still hidden from us," Bergland said. He emphasized this was not the fault of his former employer, but the insurance companies who have an incentive to keep information opaque.

With his new clinic, Bergland is joining a new wave of thinking about American health care. He named his clinic after Ayn Rand's "The Fountainhead" -- one of his favorite novels -- because it is about an architect who "sees things very differently from the crowd. He designs buildings in a way that he thinks makes sense, and it's very different than sort of the prevailing opinion."

For Bergland, it's the direct primary-care model that makes the most sense in primary care and family medicine.

"This type of model was more in my mind when I decided to become a doctor," he said. "I'm motivated to try and help people out."

Reporter Colin Gaiser may be reached at [email protected] or 758-4439

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