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Bill Reed has chronic high blood pressure, requiring regular doctor visits. So he travels across town to the Chillicothe office of Dr. Shandra Basil—housed in a natural light-filled, stately old home across from the public library.

“Time is the big thing. I don’t think I’ve ever had an appointment that wasn’t at least an hour with her,” Reed says. That’s more than triple a national average of just 18 minutes, according to a . But the visit duration isn’t the only distinguishing factor of Basil’s practice.

After Reed gets his blood pressure measured, receives his prescriptions and maybe spends a few minutes talking local sports, he simply walks out the door: no bill, no paperwork, no insurance. Instead, he pays a for all primary care services. That’s because in addition to her role as an assistant clinical professor in OHIO’s Heritage College of Osteopathic Medicine, Basil, DO ’18, operates under a business model known as direct primary care (DPC).

“I like to describe it as a modern take on old-school medicine,” she says, “where patients can really have the patient-physician relationship—to the level of home visits when that’s necessary.”

Indeed, Basil makes home visits for newborns and for her elderly patients who are homebound or otherwise have trouble getting to one of her three offices in Chillicothe, Columbus or Johnstown, Ohio.

Basil first learned of DPC from a presentation about the model to her Family Medicine Club while she was a student at Heritage College’s Dublin campus. From that point on, she worked toward opening her own practice in 2021.

“On the Dublin campus, I feel like we developed a culture there that was very family-oriented. It was just a group of 50 of us; we got to know each other well and supported each other well,” she recalls, crediting that support with helping her become the physician she is today and instilling in her a desire to provide the same level of support to her patients.

Basil finds that the successes and challenges in treating her 300-some patients are often the same. “Being able to advocate for patients in a system that’s broken—I find that’s something we do on a regular basis,” she says. That might look like getting a patient into a specialist in a timely manner or calling about a lab overcharge on their behalf.

Ultimately, she helps her patients by simply providing access to primary care for those who cannot afford to pay for high health insurance premiums or deductibles before they even receive care—to say nothing of the additional costs accrued for said care. A lack of insurance or costs associated with a high-deductible plan mean such patients might forgo primary care that would prevent an even more expensive emergency visit. 

Direct primary care has been a fast-growing segment of the health care field over the past 10 years. Many see it as a viable alternative to the traditional fee-for-service model. both patient and provider satisfaction with DPC. Basil thinks the model is both patient-centered and physician-centered.

“The flexibility that it provides me to be a mom that shows up for my kids, just picking them up from school—most physicians don’t get to do those types of things because of the nature of the job,” she says. A DPC model allows Basil to set her own hours, and her time isn’t eaten up dealing with billing or health insurance.

Figures on health outcomes are harder to come by. “There is certainly Medicare data, Medicaid data, CHIP data, because that’s all public,” says Dan Skinner, professor of health policy at Heritage College. “But DPC is all private, so we don’t have any accessible information … to show they’re driving health outcomes.”

Skinner knows DPC is not the solution to the nation’s staggering health care problems. But, he allows, it helps many people. “Patients need health care,” he says. “This is a way to do it.”