Scotland Family Medicine in Franklin County has a website featuring a classic Norman Rockwell painting of a young boy in a doctor's office with his pants pulled down, about to get a shot in the buttocks from the doctor.
Dr. Ken Rictor, who heads the practice, thinks his new medical model is really a throwback to Rockwellian times.
"Fifty years ago it was the doctor, almost like Marcus Welby, the one who was intimately involved with the family," Rictor said. "Knew the family, knew the kids, knew the parents, knew the grandparents, and took care of them from cradle to grave."
It's that kind of patient relationship he hopes to return to the marketplace with direct primary care.
On March 1, SFM will no longer accept insurance. His patients will pay $65 a month for adults, $10 a month for kids. A patient's membership will buy them total access in person, by phone, email, text, Skype and Facetime.
"They'll get 24/7 coverage, on-call, provided for your family, support, and unlimited visits to the doctor's office," Rictor said.
Rictor's patients will have to pay out-of-pocket for labs, generic drugs or X-rays, but Rictor says he'll provide them much cheaper by eliminating insurance bureaucracy.
"For example, a 19-panel lab test through insurance would cost $115. Through us, it's $13."
Rictor says his model, when combined with a high-deductible, low-premium catastrophic insurance plan passes muster under the Affordable Care Act. And he adds, for most, it will be cheaper overall.
"You are going to your primary care physician, and that's all you're using your insurance for, yet you're paying a huge premium for coverages you'll never use."
Rob Gach is a believer. He owns Ventura's Restaurant and Pizzeria in Fairfield. Gach says by only carrying catastrophic insurance and raising his deductibles, his premium dropped more than Rictor's fee.
"The math would be we pay doctor Rictor for the family plan and our monthly insurance plan drops greater than that so we get 24-hour, 7-day access, and we spend less money."
Gach said his 4-year-old son needed fluoride tablets at a pharmacy cost of $190 for 30-day supply. Rictor had a generic alternative, chewable form, that cost $10 for a 90-day supply.
Gach is going to enroll some of his employees in Rictor's plan, and the doctor hopes other employers will follow, enticed by the overall decrease in health care costs and increase in medical care quality.
"Somebody said it's like Marcus Welby with an iPhone," Rictor said with a chuckle.
Rictor's practice has 3,800 patients and admits only a couple hundred have signed up for direct primary care thus far.
But come March 1, he'll no longer accept insurance, and those patients will have a decision to make.
Rictor knows some may balk at the $65 a month but thinks education is important. He says right now many people don't even know how much they're paying for their own health care; it is paid for by employers or automatically comes out of their paychecks. He's confident that if we knew the true cost, the $65 a month would look like a good deal for better care.
"We can spend more time with the patient and it's more quality time rather than what numbers I need to plug in [for insurance companies] and what notes I need to take."