HAYDEN - Richard Samuel is helping bring the old-fashioned country doctor back.
During sweeping health care changes brought on by Obamacare, the Hayden family physician is making a change of his own, converting his practice from a discount/cash-at-time-of-service format to one in which patients will have his cell number and access to his services 24/7.
"I don't know of any other doctor in North Idaho doing this, but I suspect there will be," Samuel said.
The format Samuel is switching to on Jan. 1 is called "concierge medicine," also known as direct primary care in which patients pay a monthly fee to the doctor for unlimited care he offers.
"It's like a health club membership," Samuel said. "It's a retainer type of product."
The biggest hurdle, Samuel said, may be overcoming the past stigma tied to concierge medicine, that it's for the wealthy.
"The charge for this care has dropped to where it's now accessible to middle-class people," said Samuel, adding there's a movement nationwide to offer such care.
The cost for Samuel's service ranges from $60 per month for someone in their 30s to $125 for a patient in their 80s.
Patients, in turn, have access to all of the services and supplies Samuel offers, including, but not limited to, casts, braces, physicals, wart and mole removal, flu and other shots and checkups.
"It takes care of 90 percent of the medical needs people have," Samuel said. "Any procedure that I do will be covered."
Examples of services that aren't covered include lab work, X-rays and medications.
The membership does not take the place of insurance nor would it qualify as mandatory insurance needed under Obamacare, Samuel said. For those who have insurance, Samuel gives patients a code of the service he provides and patients bill their insurance directly.
Samuel said the benefits of concierge medicine include: better personal care because he'll cap the number of patients he has at 400 compared to 4,000 now, less waiting time, better doctor-patient relationships, avoiding emergency room costs in some cases and better health because patients will be more likely to see the doctor more often if they're paying a flat rate.
"The people who go to these practices tend to be healthier and more proactive with their health," he said. "If you pay up front, you're more apt to come in for preventative medicine.
"The key is to keep it small and intimate so people have all of their questions answered."
Samuel said those who may benefit most from the format include the uninsured, those who see the doctor often, those who have insurance with a high deductible or those who don't want to wait for appointments.
Coeur d'Alene's Ladina Merwin, a patient of Samuel's since 1997, said she's looking forward to the change and believes it will benefit her over the long run.
"I would tend to procrastinate on going to the doctor because I don't want to spend the money until I absolutely have to go," she said. "This way it's nice having that communication with the doctor at any time. It makes you take care of things before they get to a worst-case scenario."
Merwin said she likes having to pay a flat monthly rate rather than paying each time she sees the doctor, which can be three or four times a month.
"It's just a lot more convenient for us," she said.
Samuel said he realizes the format isn't for everybody.
"It's for a minority, but I think the minority is still very large," he said.
Samuel said, in extreme circumstances in which patients have had difficulties or can't make it to his office, he has gone to their homes. He said he's not worried that being available to his patients 24/7 will be too much to handle.
"There's the risk of being awakened during the night, but that's the risk this type of doctor faces," he said.