Improving the healthcare system starts with strengthening the doctor-patient relationship. This podcast explores this concept with Dr. Kara Foster, an optometrist who has mastered the direct care model. This discussion covers transitioning from traditional insurance-based practices to a more personalized, patient-focused approach, offering insights and practical advice for other healthcare professionals.

Dr. Kara Foster, originally from Western Pennsylvania, graduated from the New England College of Optometry (NECO) in 2009. After graduation, she moved to North Carolina instead of returning to Pennsylvania. She appreciated the supportive community, excellent patient base, and full-scope optometry opportunities in North Carolina. Dr. Foster opened her practice in 2015, seeking autonomy and the ability to practice optometry that aligns with her values and goals.

Initially, she followed the conventional path of accepting insurance but soon found it unsustainable. The administrative burden and financial constraints imposed by insurance companies were not conducive to the type of practice she envisioned. This realization led her to explore alternatives, ultimately transitioning to a direct care model prioritizing patient relationships and comprehensive care.

Transitioning from an insurance-based practice to a direct care model requires careful planning, clear communication, and extensive staff training. Dr. Foster shared her approach and key steps in making this significant change.

First, she developed a fee schedule based on what she considered fair and sustainable for her practice, independent of insurance reimbursement rates. This fee schedule was designed to be transparent and straightforward, including comprehensive services that patients could easily understand and value.

Clear communication with patients was crucial. Dr. Foster and her team ensured that patients understood the benefits of the direct care model, including personalized attention and the inclusion of additional services, such as screening OCT and fundus photos, at no extra cost. This approach helped patients see the value in direct care despite the higher upfront costs compared to insurance-based practices.

Extensive staff training was another critical component. Dr. Foster trained her team to handle patient inquiries positively and effectively, ensuring that every interaction reinforced the value and benefits of the direct care model. This training included educating staff on the specifics of the fee schedule, the services included, and how to explain the out-of-network reimbursement process to patients.

One of the main advantages of the direct care model is its ability to add significant value to patient care. Dr. Foster’s practice includes several services that enhance the patient experience and provide comprehensive care.

Every patient receives a screening OCT and fundus photo as part of their regular exam. These advanced diagnostic tools help detect early signs of eye disease, allowing for timely intervention and better management of potential issues. By including these services in the standard exam, Dr. Foster ensures that patients receive thorough, high-quality care without the need for additional charges.

Another key aspect of the direct care model is spending more time with each patient. Dr. Foster typically sees one patient per hour, allowing for detailed history taking, comprehensive exams, and personalized recommendations. This extended time with patients improves the quality of care and helps build strong, trusting relationships.

Dr. Foster also emphasizes the importance of explaining everything in detail to patients. During exams, she discusses the findings, shows previous scans for comparison, and educates patients on their eye health. This approach helps patients understand their condition and the value of the care they are receiving, reinforcing their trust and satisfaction with the practice.

The direct care model benefits patients and healthcare providers, promoting a healthier work-life balance. Dr. Foster exemplifies this with her practice’s efficient and satisfying operation. Her practice runs from 9:15 AM to 5:00 PM, with early closures on Fridays and no weekend hours, ensuring she can prioritize family time alongside her professional duties.

With a schedule of seeing one patient per hour, Dr. Foster maintains a manageable workload, preventing burnout. Her small, efficient team includes a front desk staff, a full-time optical specialist, and an office manager who assists with optical duties, ensuring smooth operations and attentive patient care.

This positive work environment, free from the burden of excessive patient loads and insurance claims, fosters a supportive and enjoyable workplace for her team. Consequently, happy and satisfied staff enhance the patient experience by providing high-quality care.

For other healthcare providers considering the transition to a direct care model, Dr. Foster offers several pieces of advice based on her experience:

Dr. Foster aims to leave a lasting legacy in optometry by being a trailblazer in independent practice. She hopes to inspire other optometrists to consider alternative models prioritizing patient relationships and comprehensive care over insurance-based constraints.

In addition to her professional goals, Dr. Foster seeks to set an example for women in optometry. She wants to demonstrate that it is possible to run a successful practice while maintaining a fulfilling personal life. By involving her daughters in her practice and showing them the possibilities within the field, she hopes to inspire the next generation of female optometrists.