In this episode of the Concierge Medical Marketing Podcast, Dr. Tanner Moore shares his journey into Direct Primary Care (DPC) and the founding of Clearwater Health. He discusses the challenges of the traditional fee-for-service healthcare model, the importance of patient relationships, and how DPC offers a more fulfilling practice for physicians. The conversation highlights the benefits of DPC for both doctors and patients, emphasizing the need for a return to personalized care and the potential for a better work-life balance for physicians.

Chapters
 

00:00 Introduction to Direct Primary Care
05:15 The Journey to Clearwater Health
09:59 The Impact of Direct Primary Care on Patient Care
15:17 Navigating the Transition to DPC for Physicians
 

Steven Schwartz (00:24)
Hello and welcome to the Concierge Medical Marketing Podcast. I’m your host, Steven Schwartz, and it’s truly my pleasure to have Dr. Tanner Moore as our guest today.

And before we started recording, we had a great conversation about your background and how background in the military and what led to Clearwater Health. So for our listeners, can you just take a few moments and share a little bit about your background where you went to school and residency in the military?

Tanner Moore, MD (00:51)
I’ve had a kind of a great run up into direct primary care that everything prepared me to do exactly what I’m doing now. So I was raised on a big farm in West Virginia. And so naturally I wanted to go to West Virginia University. My whole family had gone there. And I…

majored in pre-med studies of biology and then went to West Virginia University School of Medicine. I was the class president there. But more importantly, I joined the military in medical school. they, so they were paying for my school, which was an awesome experience during the summers. I would get to go do these austere environment trainings. And that was really speaking to me. And I was realizing that I really liked the, the sensation of like being alone and unafraid in medicine. And so I applied for something called the World Track at West Virginia, West Virginia University. And it’s,

a

very rural state, right? Like there are still, there’s still at least one county in West Virginia that meets the criteria as being a frontier in Pocahontas County. And so it’s, it’s an austere place to practice medicine. And I’ve got into that rural track and was able to do a bunch of extra training and go to these tiny little outlying clinics and critical access locations and stuff. And realized like how, how needed good primary care was for the average American.

and what a just massive deficit there was of great doctors practicing primary care. And so I knew like, okay, I’m going to become a family doctor. And I wanted, I want to be able to do this like primary care in an austere environment type medicine. So I needed to choose where I was going to go to residency. So I went to Martin army residency. And it, the thing that really took me about that residency was that they said, you know, we train you to be a doctor, not in

back then it was 2017, but instead to be a doctor in 1817 where you can go out and do it all. They were like, you’re going to deliver babies, you’re going to treat sepsis, you’re going to see amputations, you’re going to do everything. You’re going to run the ICU, see the ER, do follow-up appointments, be inpatient, all this stuff. I was like, okay, that’s exactly where I should be. And so I went to residency there. It was a super high speed experience, but it was the experience of the fee for service system. mean, TRICARE is just Humana. So when you’re working,

in tri-care and in the military, you’re having the insurance experience where you have to do these prior authorizations and all this other stuff. And you’re seeing seven minute appointments and everything. So I was looking for any way I could possibly get away from residency for a little bit. And one of the best ways was getting positive action. And I was the academic chief resident. And so had the opportunity from just doing well on some of the exams and things like that to get what we call positive action in the army, which is where they’ll send you to a special school.

So I got to go to airborne school, which made me a paratrooper. And then more importantly, I went to flight surgeon school. When I was at flight surgeon school, everyone else there was also a family doctor and internist and they all looked burnt out and know, dead behind the eyes kind of appearance except a couple guys who were in the national guard.

And I asked them what was different about their style of practice that they were still fresh and enjoying it. And this was back in 2018. So it was four years into the direct primary care movement.

But they told me like, hey, we’re running a direct primary care practice. Our patients pay a low monthly membership in exchange for like same day access. We do house calls, we dispense medications, we get their labs, imaging and prescriptions at like a 95 % discount. And we only need to see like five to six patients a day to be like more than solvent and make more money than we would.

in the fee for service system. And I was standing there with like five or six other residents when they told that story. And I think all of them were like, I don’t really get it and walked away. And I was like, light bulb. I’m never thinking of anything else again. This is what I’m going to do. And so I pulled up the podcast app and there was like one dude making podcasts back then about DPC. And he had been making them for two or three years at that point. And I think I listened to every episode within three days. And ever since then, I haven’t thought about anything else. Like I knew

that day that like I’m getting out of the army as soon as possible. I’m opening a direct primary care practice and I’m going to be an old timey family doctor with a black bag. And so when, when I was going through residency and I was telling other people about it and I was rotating at other hospitals and moonlighting and stuff in the army because COVID happened. I went moonlighting everywhere and was like working in ICUs and ERs and stuff and interacting with a lot of private sector civilian doctors.

And they were all like, man, I love this idea. I just wish I could do it. But being a civilian doctor, you know, I had to pay for my own medical school. I have so much debt. I could never do it myself. And so I thought, what if we could design a direct primary care practice that would help doctors get out of the fee for service system, kind of escape those golden handcuffs and come into direct primary care where they can actually be the great doctor that they described on their med school application essay.

And I thought, what we need to be able to do is offer them a competitive salary with a better lifestyle and the opportunity to be a better doctor in our practice. So we opened Clearwater Health DPC with exactly that mission. We provide the real estate, the staff, the electronic medical record, the panel, most importantly, because that’s the hardest part, and then the salary. So we give them a guarantee like, hey, you’re going to come out and it.

Instead of making $240,000 a year as a family doctor in North Carolina, I think the average is like $190,000 a year. And they see 25 to 35 patients a day. So instead of that, we said, how about you see six patients a day and we pay you 240. Or if you want to see 10 patients a day, we’ll pay you $400,000 a year. Just because the math is so different, because in direct primary care, you don’t have this massive administrative burden.

So we’re able to liberate those funds and pay them to the person that’s actually in the exam room delivering the care.

We’ve already had, you I just, we kind of just launched in August, like I was saying. So, but we got the cart in front of the horse and we brought it on our first large employer before we had even launched. So we had to negotiate free real estate, which was awesome, but they gave us some onsite locations and I had to swing in and see those people, which hadn’t been the plan. And they’re an hour and a half from our house. So I’m just like commuting three hours a day to get them taken care of. But it was a great experience to figure out how to work with large employers because they’re an entirely different beast.

And then we just onboarded our first new employed physician. And it’s been great to be able to see him just be liberated and see what it’s like to have the whole world at your fingertips and really no left or right margins that you have to work within. You can just do whatever you can find on the free market. So if somebody like doesn’t have insurance and needs an echo, you can just go onto Google and find like, okay, well, you know, this, this baby ultrasound center actually can do an echo for like,

5 % of the cost that wake med would do it or something like that. And then they can send it to us and we’ll send it to a cardiologist. There’s like a million ways to solve problems. And that’s what that rural track being in the army, all those things taught me how to solve problems, especially in deployment. We, you know, you’re only supposed to do your whole job is to turn nos into yeses for your commander. So it was a great experience on problem solving. And that’s what I’ve gotten to do now. But we were going to talk about marketing and that’s been, that’s been a huge learning experience.

Steven Schwartz (07:59)
Yeah, I mean, just so far, so many amazing nuggets of what you shared, certainly your background and your desire to provide medicine in sort of the quote old timey way of house calls and personal relationships that just simply doesn’t exist in the insurance based fee for service model. And it seems like, I mean, literally everything was really lining up for you to pull together Clearwater Health.

Tanner Moore, MD (08:28)
Yeah.

Steven Schwartz (08:28)
not just

for yourself and for patients that you’re seeing, but truly to help the other physicians who are experiencing burnout with that, know, death behind their eyes comment that you made. the Concierge Medical Forum I attended back in October near Atlanta, so many folks were talking about burnout and they wanted to have a DPC or concierge practice because they were literally so burned out and not just

Tanner Moore, MD (08:40)
Yeah.

Steven Schwartz (08:58)
not just burned out, were feeling like they were missing stuff. They were missing quality.

Tanner Moore, MD (09:04)
You can tangibly

feel that you’re being a bad doctor when you’re in the fee for service system. And I think that’s what causes the burnout. It’s not exhaustion. It’s a moral injury from having your value set insulted by the healthcare system you’re working within. So you know, like.

we’re supposed to not harm our patients, but we do a ton of financial harm. know, we’re the number one driver of bankruptcy and inflation in America to the point where when I’m working in the ER, I still moonlight for fun in the ER. And I feel like I should apologize when I walk in the room and somebody’s come to the ER for something that might not be necessary. Like they came in for a rash or a minor laceration that should have been seen at their primary care clinic.

because like just the ER alone is going to charge them a thousand dollar facility fee. And then they’re going to charge for me to see them by like a $1,200 physician fee. That’s before I’ve even ordered anything. That’s before we’ve even gotten started, you know?

And these problems should have just been like easy and easily accessible to get taken care of. Like for example, I had a mom recently who she called because she had just gotten a call from her kid’s school. And the teachers told her that her child had fallen off of something on the playground and got a laceration on the back of their head and they were bleeding a lot. So they were going to send them to the ER unless she could, and they were going to send them by ambulance unless she could pick them up and take them herself. So she was on her way to the school.

And she was frantic and called me and said, Hey, what, should we do? We’re going to the ER. And I was like, well, you know, a head laceration and a kid, they bleed a lot. It’s a very well-vascularized space. So just send me a picture when you get there and tell them to hold pressure until you arrive. Well, when she arrived, they had been holding pressure for 10 minutes and it wasn’t bleeding too bad anymore. So I said, how about just take him home and I’ll be there in a few minutes. So I was able to go to her house and at their.

you know, in the kid’s little bedroom with like a town rug on his floor and him sitting on his bunk bed with his mom comforting him, I numbed him up and put in a couple sutures and rolled out TBI or concussion and, you know, put a little bit of Neosporin on the spot and told him to come back in a week and I’ll take the sutures out. So no extra charge with that. That’s just part of what people receive by having a direct primary care doctor. And that’s what our grandparents all had.

And we got away from that because there were massive financial opportunities for shareholders of these portfolios and healthcare companies and health insurance companies, but not because it was better for anyone, not because it was better for your doctor or the patients. We got away from it because it was profitable to make it difficult to see your doctor. that, know, traditions are solutions to problems that time has forgotten. And we’re just returning to the tradition of having that direct access and a relationship with your physician.

Steven Schwartz (11:48)
I love it. Thank you for sharing that story. actually interviewed a different physician recently whose practice is essentially a web-based virtual triage for orthopedic issues. Someone’s playing ball or whatever and they twist their ankle and usually that ends up a trip to the emergency room sitting around for three to six hours and when it comes down to it,

Tanner Moore, MD (12:07)
Yeah.

Steven Schwartz (12:14)
you know, it’s, you know, elevate ice and ibuprofen or something, and there’s nothing broken. And they said literally within 15 minutes, they can provide effective triage of that and say, Nope, just go home, elevate ice and ibuprofen, as opposed to, know, you have to go to the emergency room and get this thing dealt with. And it like having a an orthopedic physician in the family is how they sort of pitched their service. And similar to what you just shared with us,

Tanner Moore, MD (12:18)
Yeah, I just can’t be.

Yes.

Steven Schwartz (12:44)
You know, that trip to the emergency room could have easily been what? $2,500, $3,000 or more. And through your practice, your time, it’s included. So it’s not a financial harm to that family and not having to deal with the trauma of going to and dealing with a traditional busy, crowded, stressful emergency room. So kudos to you. Thank you for that story.

Tanner Moore, MD (13:08)
Absolutely.

Yeah. And that’s how we market it as well. We say like, this is like having your doctor friend, know, somebody that you can text if you have a question. And that goes a long way, especially for moms. Most of what they need is reassurance that everything’s going to be okay. And so like one of the most busy points of our day is bath time. Cause they’ll be texting us, what’s this rash? Is this something we need to be worried about? And I can just say, you know, no, that just looks like a viral xantham or contact dermatitis. Or sometimes like that’s silly. That looks like bullis empatigo. And we need to

see them tomorrow or something, know, so it’s super helpful.

Steven Schwartz (13:40)
Well, I really appreciate you taking the time to join me on this interview today. And I hope that there will be many physicians who are either finishing up med school and residency or those that are existing physicians who keep hearing about DPC and deciding that, gosh, is this a direction I’d really like to go? Is it something I can do?

If someone wants to have a discussion with you and see if working through your company is the right fit for them, how can they get in touch with you?

Tanner Moore, MD (14:15)
Yeah, they should just call me at 910-586-1960, or they can message me at [email protected]. So that’s dr.moore @ ClearwaterHealthDPC.com. And then I’ll send you the flyer that we use to recruit physicians so that they can see more information about what a DPC offer usually looks like, even if they were to go to one that was a little bit different from ours. And I would just say to make sure that they’re

make sure that they take into deep consideration what exactly it is that they want from going into DPC because if they’re thinking they’re interested in being a DPC doctor, then it’s critical that they

They pursue an opportunity that gives that prioritizes being a doctor. Cause what I think a lot of them think is I want to go into DPC, but I don’t want to be, I don’t want to start my own practice. And that’s, that’s valid. I’ve found like, you don’t want to try to be a DPC doctor and then wake up in a year and discover that you’re actually an entrepreneur, which is two very different lifestyles and mindsets. So if you’re interested in just being a DPC doctor,

then pursue an employment opportunity. And if you’re interested in being an entrepreneur, then DPC is a very valid and solvent business that you can go into. But make sure you know which one of those you actually want to drive towards before you get started.

Steven Schwartz (15:30)
I also appreciated what you said before, is that a DPC doctor truly can have a strong income with less stress, seeing fewer patients every day, and sort of the fear of being on call 24-7. You essentially can train, educate, guide your patients to save the really critical stuff for business hours so you have a chance to be refreshed

and rested from getting a good night’s sleep and having a weekend off with your family. But that this is truly a great opportunity for a physician to have the career and the lifestyle, the income and minimal stress that they really want. And in doing so, to be able to have the best outcome for their patient. I’ll give you the last word. Anything else to add?

Tanner Moore, MD (16:27)
Yeah, absolutely. On that point, I really think that in the years to come, you’d have to be a fool or a masochist to choose to go into the insurance-based system if you had opportunities in DPC. Because like you were saying, DPC gives you the opportunity to make more money, be a better family member, and be a better doctor. Health, wealth, and time are the three fundamental human commodities, and DPC pays us in all three of those.

Steven Schwartz (16:53)
love it. Tanner, this has been really great having a chance to chat with you and to share your message so that people can reach out to you if perhaps working through your company for them to become a DPC physician is basically making it easier for them to do so without necessarily the same stress and hassle of the quote entrepreneurial path of doing it themselves. Follow the pattern that you’ve set up for them.

Just a quick thing I do want to mention before we hang up here is that through my company, Concierge Medical Marketing, we are here to help concierge and DPC practices grow and thrive with their digital marketing. That’s my piece of the puzzle. And we are here to help not just an existing physician who’s maybe trying to go from a 3000 patient panel in the insurance space to their own DPC practice. We can help with that transition.

or those that have a practice and maybe they’re trying to get to 300 or so patients and they need to grow, we can help with a growth program. And one other thing that people seem to forget is that when you have an existing full panel and even a waiting list, it’s very important that you nurture your existing patients with emails, with newsletters, with text messages, with social media posts, the things to keep your practice in their mind. So through Concierge Medical Marketing, we can help nurture your existing patients and wait list

So that keeps your practice in their mind and they utilize it. They feel good about it and they continue to renew year after year. So if anybody needs any help from me, I’ve written a book called the definitive guide to winning with digital marketing for concierge medical practices. That book is available through our website concierge md.marketing. Feel free to go there, put in your email and click the button and our system will send you a link where you can download the book free of charge. I’m available if anyone has any questions about digital marketing, help them.

grow their practice. number 772-304-2420. And with all that being said, Dr. Tanner Moore, thank you for your time today. Truly my pleasure to have you as a guest on our podcast and please keep up the great work that you do.

Tanner Moore, MD (19:06)
Thank you so much, I enjoyed it.

Steven Schwartz (19:08)
Wonderful. Have a great day. Everyone will see you on the next episode.