Be direct: a new kind of doctor's office eliminates the insurance middleman.

• Author: Carloch, Karen
• Position: NC TREND: Private doctors

After 20 years as a primary-care physician, Kathy Weeks was flat-out tired of the pressure to see more than 25 patients a day and then spend hours filling out medical charts and insurance paperwork. So, she jumped off the "hamster wheel" of traditional medicine in 2015 and started a new practice last year that allows her to spend more time with patients.

At Blue Skies Family Medicine in Mooresville, about 30 miles north of Charlotte, Weeks no longer accepts health insurance or pays a staff to file claims. Instead, she charges a membership fee of $60 a month, or $699 a year, that includes unlimited doctor visits, same-day appointments, routine tests and discount rates on more complex tests. Patients may contact Weeks any time by phone, text or email. "It's not a paper mill," says Terry Ellis, a patient from Lincolnton. "We have a different kind of doctor-patient relationship."

Weeks is one of a small but growing number of U.S. doctors adopting a business model called direct primary care. By eliminating haggling with claims adjusters and filing reports, such physicians are able to lower overhead, see fewer patients and can earn as much as peers in traditional practices.

While concierge medicine typically targets affluent patients who pay $2,000 a month or more for easier access to doctors, direct care is a blue-collar version with fees averaging $75 a month. "It's the Honda model," Weeks says. "We're for the masses."

Direct primary care has grown from 146 doctors in the United States in 2005 to more than 8,000 today, says Brian Forrest of Apex, who started his practice in 2001. In North Carolina, he says, more than 30 doctors work in direct-primary-care offices, from small towns such as Cherryville to larger cities like Charlotte. They are a fraction of the state's 12,000 primary-care physicians.

Initially, Weeks thought most of her patients would be uninsured, although direct-primary-care patients still need insurance to cover hospitalizations and other costly services (as well as meet the Affordable Care Act's requirement). Instead, most have high-deductible plans with lower premiums. While some people might balk at paying for both a membership and insurance, Terry Ellis says it's a good deal.

Ellis, 63, is a self-employed health coach who has diabetes, high blood pressure and high cholesterol, chronic conditions that require her to visit her doctor eight to 10 times a year. She pays $388 a month for a $5,000-deductible insurance plan. She...