Doctor who started a solo direct primary care practice in 2022, breaking away from the traditional, insurance-based healthcare system, says business is still growing
By Chris Motola
Q: We interviewed you back in 2022 when you had first started your private practice, Athena Direct Primary Care & Lifestyle Medicine. How has it developed since then?
A: Yes, we opened in January 2022, so we’re on our third year now. The practice has been growing tremendously and I couldn’t be happier with the move we’ve made to break away from the traditional, insurance-based healthcare system where we’re all in a box where you have to do things based on certain protocols without the time to really listen, understand and partner with our patients. So, yes, we’re still early in this venture but the practice has been growing tremendously.
Q: What do you attribute the growth to?
A: I think there’s a tremendous need in our community for doctors who partner with their patients. It took a little for people to grasp the concept of direct primary care, which is a membership-based primary care practice. Because we live in a world of insurance-based medicine people aren’t aware of the advantages of having a partnership directly with a physician and cutting out the red tape of corporate medicine and insurance companies. But this is exactly what I do in my practice. I work for my patients. I’m here for my patients. And I’m not constricted within five-minute appointments to see my primary care patients.
Q: How much time are you able to give patients, on average?
A: I typically take one hour or even two hours to see my patients so I really have time to listen to my patients and create a treatment plan that really works for them. It’s a true, wonderful journey. So for me as a practitioner, as a physician, it’s wonderful to be able to apply my knowledge and my skills. I’m a triple-board certified physician. I have over 20 years of experience. I demand time with my patients. I cannot do good medicine in a five-minute appointment. With this practice I can take the time I need to dive into all aspects of the person’s health. I’m a strong believer in whole-person care, looking at all aspects of physical health, mental health, emotional health and putting all aspects of the puzzle together not only treating symptoms. It’s really fulfilling to me when I get to see patients improve and make a really meaningful change to their health. I’m happy to come to work every day. I’m in the middle of my career, so I hope to be able to expand services to more members of the community and find physicians to join us. There’s a huge need.
Q: Is the practice just you right now?
A: Yes, right now it’s just myself and my nurse. We’ve been interviewing other practitioners in the community, but it’s really important to me that we find the right match. My focus and vision for the practice to be very focused on preventive health, lifestyle intervention, nutrition, physical activity, stress management and sleep as means of staying healthy. Right now in the larger health system there’s a focus on band-aids, meaning if you’re sick you get a pill or prescription and off you go. We don’t want to wait until you’re sick to “fix” you. We’re not looking to just avoid disease and exist but to optimize health and thrive. So it’s very important to me that the team be aligned on those issues. We haven’t found that person yet, but I think we’re coming very close and have a few candidates who might fit the bill.
Q: How many patients are you able to manage with this model? What’s the ideal number?
A: That is the biggest limitation. I’m one physician. I can only manage about 10% of the patients that a typical primary care doctor can take in a traditional practice.
Q: What kinds of patients have been most interested in this model? Is it getting a better reception from older or younger patients?
A: Very interesting question. My youngest patient is 18; my oldest is 97, so I’m seeing the full range. I have a lot younger patients in their 20s, 30s and 40s who are very interested in optimizing their health and staying healthy. Because of the nature of my practice, there is some self-selection bias with patients. Regardless of the age, they’re people who value their health and are looking for guidance. But I do have a full spectrum of ages. I think the average patient would be in their 40s and 50s, with outliers on both sides.
Q: Do you use insurance at all?
A: That’s an important question. All services in the practice are under the membership fee. However, they can use insurance for all services outside of my practice. For medications, labs, consults, other prescriptions. I can put those orders in, and the lab or pharmacy can bill the insurance. That’s an important difference between my practice and concierge services. I’m not a concierge practice. I’m a direct primary care practice. I do not bill insurance for my services and there’s no fee for service, just the membership fee. Concierge services bill insurance in addition to their membership fee.
Q: When you came to the U.S. from Romania, did you have a sense that you’d want to try this kind of practice or did the idea develop over time in the U.S. hospital system.
A: I didn’t move to Rochester with the intention of opening a direct primary care practice. In fact, I didn’t have any idea that such a practice model existed. I worked in a traditional practice for 20 years and came to learn about the direct primary care movement around 2019, which has also been around for about 20 years in the U.S. but was pretty new to Upstate New York. I was already at the point where I felt like I couldn’t apply my skills the way I wanted to in the system. So I gave it a try despite it being a pretty new concept in New York at the time.
Q: How should other physicians go about deciding if this is a good model for them?
A: In general we need alternatives. We need options. People feel like they’re stuck in the system without options. Having a private practice isn’t for everyone. It carries a lot of risk. Being a business owner isn’t for everyone, but if you’re looking at going beyond what the existing system offers, this is a very simple alternative. It can be done. I’m the first in Rochester to prove that the concept works, but I don’t think I’ll be the last. I’m hoping the younger generation will see the value in doing things differently. If we want different results than what the system is producing then we have to.
Lifelines
Name: Laura Petrescu, M.D.
Position: Founder, and CEO of Athena Direct Primary Care & Lifestyle Medicine, Pittsford
Hometown: Iasi, Romania
Education: Grigore T. Popa University of Medicine and Pharmacy, Romania
Affiliations: Rochester Regional Health
Organizations: American College of Lifestyle Medicine; American Board of Internal Medicine; American College of Physician Executives; Direct Primary Care Alliance
Family: Husband, two sons
Hobbies: Classical music, playing piano, reading, winter sports