The doctor will see you now – or whenever you like – under a new subscription model aiming to make primary care more accessible in Cayman.
The founders of Primary Care Unlimited believe the new service, which includes unlimited GP visits for $60 a month, will help bridge an equality gap in healthcare provision. It is being launched by Optimal Healthcare clinic on Wednesday, 8 April, in a renovated facility at the Cayman Centre opposite the Airport Post Office.
Director Andrew Vincent said the business will use a new model that aims to put preventative care at the forefront by guaranteeing low-cost access to doctors for its patients. He said it would put accessible primary healthcare within reach for virtually anybody.
The government’s standard health insurance provision, known as the SHIC plan, currently allocates $400 per policy year toward GP visits, lab work, X-rays and prescriptions combined.
For the large portion of Cayman’s population on lower insurance tiers, that runs out fast.
“How far does $400 go? A consultation and a few blood tests, and it’s gone,” said Vincent.
The result is that a substantial cohort of the population avoids the doctor until it’s too late, he said.
Cayman’s chronic disease problem
Given the high prevalence of obesity, heart disease and diabetes in Cayman, Vincent warns that gap in access is critical. Those are all conditions that develop slowly, are detectable early, and respond well to guided intervention.
“If you don’t look after health, it erodes. It is much easier to keep your health in the right place than to let it degrade and try to fix it,” he said.
There’s a disproportionate impact on people in lower income brackets in the current system.
“The people with the most need have the least access,” Vincent added.
Dr. Sara Watkin, the practice’s medical lead, added, “The moment someone has to weigh up if they can afford the healthcare support they know they need, we’re losing our community’s health and wellbeing.”
The subscription plan
Members of the new service will pay a fixed monthly fee, initially $60 for the comprehensive tier and $85 at the enhanced tier. They receive unlimited GP consultations, a comprehensive annual medical and dedicated care coordination.
Where a member’s insurance generates a co-pay, it is absorbed within the membership. Where insurance is absent, there is nothing additional to pay.
The annual medical included at the entry level covers 80 laboratory biomarkers and 65 non-laboratory biomarkers – metabolic health, body composition, cardiovascular risk, organ function, hormonal balance and age-related conditions.
“At Cayman standard fees, the investigation panel alone is worth more than twice the full annual membership cost,” Vincent said.
While medication and secondary care still requires insurance, and the possibility of co-pay expenses, general practitioners (GPs) say they can work with patients to manage many conditions if they are detected early enough.
“There are countless patients we might see who are pre-diabetic, who have high blood pressure, that can be managed with lifestyle interventions before medication,” said Dr. Amanda Chisholm, one of the practice’s GPs.
“But if you have one consultation a year and you’re given this advice and you don’t see someone again for 12 months, you are almost 100% likely to run into some kind of complication.”
Global shift
The problem is not unique to Cayman. The biggest killers globally are now chronic, preventable and lifestyle related.
“Things have shifted so rapidly over the last 100 years in so many industries, apart from healthcare,” said Chisholm.
“There’s still a big focus on reactive healthcare – making sure the acute services are there … but less focus on proactive healthcare.”
‘Moral obligation’
Vincent believes this is the first time this model has been tried at scale in Cayman. From a business perspective, he argues, there are easier ways to make money. He stripped back costs by offshoring administration work and claims processing and building the facility in a space that is functional rather than flashy.
The patient list will be capped at 1,250 per doctor, with additional doctors brought in before that ceiling is reached.
“I’ve listened for so long to people saying it is impossible to provide truly affordable and accessible primary care,” Vincent said. “But I have always believed we cannot afford not to. It’s a health imperative, an economic necessity and a moral obligation.”
The practice intends to measure outcomes to build an evidence base and hopes the model will prove itself as a cost-effective means of healthcare delivery that public sector policymakers will want to mirror.
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It is not clear who the owners ot this business are and what qualifications and experience they have in this field. Currently I find most doctors charge around $150 for a consultation, so I’m not sure how unlimited visits can be made to include an annual medical for an annual premium of $720.
I’m pretty sure the some of the Dr.’s and Mr. Vincent are among the owners. But ownership aside how many times a year do you go to the clinic. It’s still a hassle so if people average 4x a year that would be $600 at your $150 rate.
Maybe that is just me, I prefer to avoid it. Also once they find something really wrong with you that isn’t covered. Otherwise you can go in for a sniffle but that might be 2 hours of your day gone for 15mins with a Doc.