Prescription for change: Family practice to offer services for monthly fee

Dr. Craig Gustafson operates Appleton Clinics, a family medical practice in Grand Junction. Gustafson plans to soon switch to a direct primary care model in which the practice will offer patients services for a $79 monthly fee. (Business Times photo by Phil Castle)

Dr. Craig Gustafson operates Appleton Clinics, a family medical practice in Grand Junction. Gustafson plans to soon switch to a direct primary care model in which the practice will offer patients services for a $79 monthly fee. (Business Times photo by Phil Castle)

Craig Gustafson operates a busy family medical practice in Grand Junction, seeing patients who range in age from infancy to over 100 and diagnosing and treating a variety of conditions from common to life-threatening.

Gustafson says he loves his profession and the relationships he’s developed with his patients at Appleton Clinics over the past decade.

He’s far less enamored, though, with a health care system he says has erected barriers between him and his patients, concealed pricing and relegated the role of physicians in part to checking boxes and clicking computer mouses.

That’s why Gustafson plans to soon change the way he practices, offering unlimited primary care for a single monthly fee of $79. “It lets me get back to what I’m trained to do,” he says. “We’re here to practice medicine.”

There are numerous benefits to patients, Gustafson says, in offering improved access to health care at a set cost. There are benefits to small- and medium-sized businesses as well who pay for primary care for their employees and enjoy reduced absenteeism and increased productivity as a result, he says.

As a grassroots movement gaining popularity across the United States, the direct primary care model also offers the potential to ultimately change the way health care is delivered, Gustafson adds. “This is going to revolutionize primary care.”

Appleton Clinics will switch to direct primary care starting Oct. 1. But Gustafson expects to sell out available memberships under the new system before then. Dr. Jennifer Craig, a physician who practices with Gustafson on a part-time basis, will move to full-time as additional memberships are sold.

The monthly fee covers nearly all primary care services, Gustafson says, including doctor visits, examinations, hearing and vision screenings, urinalysis and X-rays.

Services for which Appleton Clinics has to pay — vaccines or blood work, for example — will be charged to patients at cost. The means patients will pay less for those services at Appleton Clinics than they would elsewhere, Gustafson says.

In addition, an in-house pharmacy will offer medications at wholesale prices that will be available directly from the clinic or shipped to patients, Gustafson says.

While adult patients will pay $79 a month for the services,  there’ll be no charge for two children per adult member. Additional children under 18 years old will be charged $10 a month.

In switching to the direct primary care model, Appleton Clinics will rely on monthly fees rather than insurance payments —  but in the process also avoid the bureaucracy, paperwork and overhead associated with insurance, Gustafson says.

The plan might not be well-suited for patients with insurance coverage that offers low deductibles and co-payments, he  says. But the plan works well for patients with high deductibles or those who have health savings accounts that can be used to pay for medical expenses. That way, patients have easy access to primary care as well as insurance that covers more serious ailments that require specialized care or hospitalization, he says. 

The chief advantage for patients is that they’ll enjoy unlimited access to primary care without the barriers insurance plans sometimes impose, Gustafson says. Patients can schedule as many doctor visits as they deem necessary and also can contact him by telephone or e-mail. If needed, Gustafson says he’ll even make house calls. 

Moreover, patients will know in advance how much services cost and can decide along with their doctor what services they need.

Gustafson expects he’ll be able to scale back on the number of patients he must see each day to maintain his practice, giving him more time to offer better care.

While the direct primary care model isn’t new, it’s regaining popularity, particularly among family practitioners. Gustafson says he recently attended a summit and was struck by the enthusiasm of the 300 doctors there. “They were literally so happy about what they’re doing.”

Meanwhile, the traditional health care system has created a challenging and frustrating business environment that’s prompted many physicians to leave primary care practices and forced patients to look for new doctors, Gustafson says.

Gustafson doesn’t want that to happen to him. “I love what I’m doing, and I don’t want to stop.”


A presentation about primary care services offered at Appleton Clinics for a monthly fee is set for 6 p.m. June 12 in Houston Hall Room 138 at Colorado Mesa University in Grand Junction. More information also is available by calling 242-1566 or visiting

Phil Castle is editor of the Grand Valley Business Times, a twice-monthly business journal published in Grand Junction. Castle brings to his duties nearly 30 years of experience in editorial management positions with Western Colorado newspapers. In addition, his free-lance work has appeared in a variety of publications, including the Washington Post. He holds a bachelor's degree in technical journalism from Colorado State University.
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Posted by on Jun 11 2014. Filed under Business News, Featured. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

Post Your Thoughts Below

  • Kendra Burke

    I would much rather spend my time with a doctor that’s trying to be transparent and trying to align with the values and the thoughts of those around him than go with the insurance companies. Some of the doctors that I meet on the website MillionaireMatch have expressed the problem that they don’t have enough patience with the insurance companies. So, good on you.


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