Local Medical Practice Offers Direct Primary Care

(Last Updated On: October 1, 2016)

by Rich Lewis

We could discuss how much of a drag going to the doctor’s office it is today, but we’ve all done it. No one really likes jumping into that machine that runs patients through the mill as quickly as possible and, honestly, lets your insurance company determine just how sick you are and how much you should get better.

I mean, hey, at least we all have insurance of a sort now, right? And most of the folks working in that doctor’s office are there to do nothing more than that, rather than make sure you get healthy. It’s the malaise of modern medicine and we’re all in this game for better or worse.

What if it could be better? I don’t mean let’s all switch to herbs and aromatherapy or mega doses of vitamins or juice our way to everlasting health. I mean see a real doctor, be that doctor’s actual focus and there won’t be the specter of an insurance company hovering about.

Thanks to the idea of direct primary care, it can happen. In Greensboro, Vitral Family Medicine is putting the model into practice and putting the patient at the forefront of the medical experience again. Run by Drs. James Breen and Dayarmys de la Paz, Vitral Family Medicine is centered on working directly with the patient, you see your doctor “The underpinning of the direct primary care movement is physicians believing that third-party payers (health insurance companies, etc.) create a set of incentives between the patients and the doctors that isn’t always in the best interest of good medical care,” Dr. Breen explained. “When this is removed, it allows practices to commit to their patients and become better aligned to their patient’s needs.”

He explained that most modern medical practices need a huge staff not necessarily to attend to the patient, but to handle medical coding, insurance claims, billing, scheduling and a host of other non-medical tasks, plus management of the practice – which is most often not by a physician but by a business entity.

“That’s why most of the physicians at one of these practices needs to have between 2,500 and 3,000 patients just to cover all of those expenses,” Breen said. He further explained that while just about everyone in a practice might be wearing scrubs, many folks were working to make sure insurance companies and Medicare were properly billed or that no revenue opportunities were missed.

“This (direct primary care) model takes all of this out and turns the whole thing on its head. Our only overhead is what is needed to take care of the patients.”

So how does this work exactly? Breen explained patients at Vitral pay a monthly membership fee of $50 for an adult or $25 for a child. This covers all of their visits for the entire month, no matter how many they might need. At the visits, the patient is met at the door by their doctor and led into either of the two examination rooms that also double as the doctors’ private offices. There’s no assistant taking the vital stats or having to explain why you are there three or four times – it is all just between you and the physician. Exams and physicals can be taken care of, as well as any routine procedures like removal of skin tags, draining of an abscess or knee injections can be done.

If there is a need for a test or medications to be administered, those are provided at cost, with no additional profit for the doctor.

“On the labs, we’ve got negotiated rates that are five to 10 percent of the rates you would pay walking into a testing clinic or at a regular medical practice,” Dr. Breen explained. “Basic blood tests would run about $14, for example, because we aren’t marking them up.”

What if the doctors need to send you to a specialist for something or they advise you to get an MRI or other diagnostic service?

“In those cases, we will get in touch with the patient’s insurance provider and work out with that company where to send them and what the proper codes to cover the procedure are. I’ll then get on the phone with the MRI provider and get an appointment set and provide them with all of the necessary information and billing codes. I don’t make anything off of that, but it is something I can take off of the patient’s shoulders.”

It sounds good, but why would you want to do this, particularly since you are already required to carry health insurance and may be paying more for it than you feel comfortable with?

“Right now, you have to find a doctor within your provider’s narrow network, pray you can get an appointment soon, sit and wait in the doctor’s office and then have the medical decisions made based on your insurance. What if I could tell you that for an additional $50 per month, you could get a first class treatment policy? That all of your treatment would be from a doctor and that if you called in for advice or information, you got to speak with that doctor.

Would that be worth that $50?” Vitral Family Practice is very much a family practice as Drs. Breen and de la Paz are married. Both are also bilingual, speaking Spanish fluently, with Dr. Breen also being fluent in Portuguese. Of Cuban heritage, they took the practice name from vitral, a Spanish word for colored-glass windows – something they both feel symbolizes how their practice works.

“The glass is transparent as is our practice,” Dr. Breen said. “It is also a sum of all of its parts, just like those beautiful windows. And finally, those are an art, as is medicine.

If you’d like to learn more about Vitral Family Practice, please visit their website at or call them at 336-763-9077. They are located at 1903 Ashwood Ct., Suite A in Greensboro, NC just off of Lawndale Drive. !

RICH LEWIS is a father, husband, writer and cook who makes his home in Greensboro, NC.