Marketplace: For doctor, opening KagenMD in Park City has been a shot in the arm
Michael Kagen says business model allows for better care
June 16, 2017
Michael Kagen became a doctor because he was fascinated by human physiology and committed to helping people, like his father before him and his grandfather before that. But his passion began to wane when the reality of the work set in.
It wasn't what he had envisioned. He spent his days scrambling to see dozens of patients, but rarely felt like he was able to give the best possible care to any of them. He was frustrated and unfulfilled.
But rather than spending decades unsatisfied in his career or leaving the profession altogether, Kagen found a solution. He moved to Park City and opened his own internal medicine practice, KagenMD, which features a business model that alleviates the frustrations he encountered working in other doctor's offices.
Kagen's practice runs on a direct care model, meaning he charges an annual flat rate for his services — ranging from $1,200 for young adults to $3,000 for patients 71 and older — rather than billing insurance companies, Medicaid or Medicare. Freed from the constraints of traditional financing, Kagen can spend as much time as he needs with patients — his shortest appointment, for instance, is 30 minutes, and he can also meet with them via telephone or video chat.
Additionally, because Kagen is not forced to overbook his schedule, patients can see him without ever having to see the inside of a waiting room stuffed with sick people.
"The model opens a lot of opportunities," he said, adding that patients can reach him on a private number 24 hours a day. "It makes it much more enjoyable for me and much more convenient for my patients."
In addition to the convenience, Kagen estimates that he takes care of about 90 percent of his patients' health care needs. As a practitioner of internal medicine, he provides preventative care like cancer screenings and immunizations, as well as urgent care. He said he also helps manage the rest of his patients' care, such as writing referrals to specialists and coordinating with the admitting team during hospital visits.
When one patient was recently hospitalized after a heart attack, for instance, Kagen played an important role.
"I knew that his wife was going to be there and have questions," he said. "So while he was being treated in the intensive care unit, I was there to explain things to his wife and give her real-time updates about what was going on and help set her at ease. Then, after he's discharged from the hospital, I'm able to go to his house and go over his medications."
Kagen said that type of full-service care is the kind of work he's always wanted to do. But he never could in previous positions due to the burden of the typical financing structure. It wasn't until he saw several other physicians he respected using the direct care model that he thought it was possible.
"It's incredibly rewarding," he said. "To be able to help people's lives in a positive way, and the gratitude they have for that, is tremendous. It was really frustrating for me trying to see 25 people a day and spinning in and out of exam rooms and really not having time to listen to my patients and talk to them. This model of health care keeps me in medicine so I'm not going to burn out."
Kagen recommends that all of his patients also have health insurance, but he acknowledged that his model may work for people who can't afford coverage but see his practice as a more cost-effective way to fill many of their health care needs.
An option that may be better for others, he said, is to combine his services with a high-deductible insurance plan that is less costly on a monthly basis but ensures patients are covered if they need the kind of care he can't provide.
"People have different needs and medicine is a very personal thing," he said. "People have to decide if it's something they can afford and if it's something that works for them."
2200 Park Ave. Building D