Episode 56: Dr. Shane Purcell of Direct Access - Anderson, SC

Direct Primary Care Doctor

Dr. Purcell is a seasoned DPC Doc who has worked with employers and brokers.
Dr. Shane Purcell of Direct Access - Anderson, SC

Dr. Shane Purcell was born in Athens, GA and is a true Bulldog by birth. He graduated Mercer University School of Medicine after completing Armstrong State College in Savannah, GA. He went on to finish a family medicine residency in Anderson, SC were he continues to reside.

After completing residency, Dr. Purcell worked in private group practice for 3 years before opening his own cash-only primary care clinic in 2005. As he built his cash-only clinic, he was also working part time in a local urgent care facility. In 2008, he purchased a dormant medical clinic on the “wrong side of the tracks” and opened an urgent care and primary care clinic.

After gaining his freedom from third party captives, Dr. Purcell along with a colleague formed the first direct primary care clinic in Anderson County in 2015. Since then, he has been operating both his walk in clinic and the direct care clinic third party free. The Direct Primary Care model has brought about a restoration of a relationship with patients broken by third party middlemen. Now, he can offer more access and more of his time to patients. Dr. Purcell firmly believes that the direct primary care model is the last hope for health care in America.

Dr. Purcell is an active member in several medical organizations including American Association of Physicians and Surgeons, Free Market Medical Association, DPC Alliance and American Academy of Family Physicians. He is the former Chair of the Direct Primary Care Member Interest Group for the AAFP and a founding member of the DPC Alliance and the Carolina’s Free Market Medical Association. He was elected onto the Advisory Committee for the DPC Alliance in the Fall of 2018 and current still serves there.

Dr. Purcell is the author of Magic, Pixie Dust, and Miracles: A guide to Direct Primary Care and Employers that shares how to connect DPC with employers of all sizes. He has spoken about this topic and DPC in general at the DPC Summit, DPC Nuts and Bolts conference, Hint Summit, AAFP FMX, Carolina’s Free Market Medical Association, TedexFurman (see Dr. Purcell's talk below) and DPC Alliance Mastermind sessions. He continues to speak to residents and student groups about DPC as well

In today's episode, Dr. Purcell shares how he began down the path of Direct Primary Care. Through working with employers and brokers who support and build plans with the DPC practice at the center of healthcare, Dr. Purcell shares how his practice ballooned overnight by taking care of Anderson County employees. If you are considering working with an employer in the DPC space, listen to today's episode.


Dr. Purcell's Book:

Magic, Pixie Dust, and Miracles:

A Guide for Direct Primary Care and Employers

Dr. Purcell presenting at TEDx FurmanU

Dr. Purcell's Magic, Pixie Dust, and Miracles talk at the 2019 AAFP Summit

Resources Mentioned By Dr. Purcell

-Health Rosetta

-Catastrophic Care by David Goldhill

-The CEO's Guide to Restoring the American Dream by Dave Chase (FREE PDF DOWNLOAD)

-Other helpful Health Rosetta-certified brokers: David Contorno, Cristy Gupton, Carl Schuessler (all are on LinkedIn)

-Hint Summit - October 28-29th virtual conference. Tickets: FREE for Med Students, $99 for Hint users, $199 for non-Hint users

-AAFP DPC Summit


Welcome to the podcast Dr. Purcell.

Thank you. Good to be here.

So I have recently been reading your book obviously to prepare for this podcast interview, but what I really wanted to say first and foremost is one, if you guys, the listeners haven't heard of it, the book is called magic pixie, Dustin miracles, a guide for direct primary care and employers, but you go into describing how to work with employers I felt that reading your book, I really understood generally who are the players and how they can come together in the world of DPC. So just wanted to say that first and foremost,

That's great.

I tried to make it basic and straightforward, on a DPC level because we're, we, simplicity is what we do in DPC. How do we make it easy for patients? How do we make it easy for each other? We want to help each other. And so I wanted to describe, the situation of how we got involved with employers a little bit about our story is in there, but also things and topics to think about as you move into working with employers and in just a lot of general Information about, what is it, benefit advisor and different kinds of types of insurance and that kind of stuff.

And so people can have a general understanding, which is helpful. Was able to have a really good benefits advisor to write rights part of the book with me to give us some tips. And really the book is it's written by me for DPC folks for direct care physicians, but also it is for employers and it is for benefits advisors who want to work with direct primary care physicians, so they can understand where we're coming from as physicians.

So they understand all of the baggage that we bring to the situation. And so we can all work together to make some miracles happen. If that makes sense.

Absolutely. I want to take a step back and I want to ask you about before you even got into the world of DPC you've said that you were doing urgent care and you also had a private practice. Is that correct?

Yes, I did. So I had. I was a little, a lot different than a lot of current DPC physicians, which usually go right out of training and they go right into an employed position somewhere for a hospital system.

I'll work for a private office for two years after residency just to learn some things get some income generating and it became very clear right away that was not going to be something I could do long term, just because of the same problems we all have with the billing, the coding, the insurance interference, the paperwork not being able to really help patients like you want.

And so I I left that office and just started doing primary urgent care as a staff physician at a local urgent care center. And it was basically a 10 99 type of job. And I could just work certain hours and have certain shifts and I could go and take care of patients and leave without a lot of the headache, but I still wanted to do primary care and there was still a huge need in our community for primary care.

And this was about 2005 really before DPC was a way before it was a thing. And there wasn't even the technology to do direct primary care that we have today, where you have hint and Atlas and some of the cool ways that you can do The ACH and the direct draft and all this stuff where you can really make it a system.

So in 2005, I started a cash only clinic in the back of a gym. So I was doing urgent care as a staff physician, and there was so much need in our community. No one had a cash office in our community and years. And so I started a cash only clinic with pulling a lot of referrals from the urgent care where I was working, I would give out my card and say, Hey, your blood pressure is terrible.

know you don't have insurance, but I charge $45 a visit. And, you just come in and I'll help you with your insurance, with your blood pressure and your diabetes. I can also help you with your the next time you have a sinus infection. I can help you and save you about 150 bucks instead of coming here to the urgent care.

So I started that in 2005 and built up six or 700 patients that were coming in just doing cash basically, and still doing urgent care. then in 2008 and nine, this is as the story goes, the housing market collapsed and our economy tanked. So when the economy tanked, nobody wanted to pay for healthcare at all.

Nobody had any money. Everybody only wanted to. Just call me, call him my medicine. I don't, I can't come pay you. We ran into the same similar kind of problem with what people had last year with COVID. Nobody could go to the doctor because doctors close or they couldn't get in, or it was all telemedicine.

But the beauty of what we do in DPC now is that they were on a monthly payment. So they didn't, they continued to pay monthly. When the economy collapsed in 2008 and nine, really before DBC was even started there was no mechanism for me to get paid unless people came in. So that sort of the travesty of fee for service last year with COVID, if people don't come in, you don't get paid.

And all of our colleagues lost a lot of money because they couldn't get people to get in and get paid. So in 2008 I left the urgent care and started doing my own inner to care. I bought a building and started doing my own urgent care while continuing to do my own direct patient care.

The name of that, my direct, family practice clinic was ideal family health, and it was just cash straight cash. So I opened up an urgent care, bought a clinic started doing urgent care and I still did my primary care inside that clinic. And as the urgent care built up more and more started to hire people to help work urgent care.

And I was doing primary care. So you got busier and so I got back into doing more insurance through the urgent care blue cross and some of the bigger insurance plans, just because of demand for the urgent care.

And in 2012, I closed, we were so busy in our urgent care. I closed down my primary care office and just integrated those people into the urgent care and they could still come and see me and pay cash if they wanted to, but it was all through the urgent care. About that time is when threat primary care was really starting to take off.

Atlas has started, some of these companies were starting to where you could really make an easy system where you could keep someone's credit card on file and do a monthly charge, which we didn't have the technology before that really do that. And so I was learning more and more about direct care and thinking that maybe I could get back into doing direct primary care the way I used to straight cash.

And that's when me and my current partner sorta started talking about, how do we do this together? She was, she had been working for the hospital system here in our community for 17, 18 years. She'd never worked on her own. She didn't know how to do an office as far as the management side, the business side.