Tuesday, January 12, 2016 11:00 pm – Doctors making house visits is making a comeback in the pediatric world, and in southwest Missouri, one physician has added a twist to the concept. Dr. Martie Gravitt has ditched the traditional practice and created his own 24/7 direct primary care service called Gesundheit Pediatrics, LLC. Opened in 2014, Gravitt services house calls for children in the greater Springfield, Branson and surrounding Ozarks area.
“I always wanted to do house calls, like from the day I started medicine, and I didn’t think it was possible,” Gravitt said.
Since insurance does not pay for house visits for children, he did not think his dream would come true. According to Gravitt, a primary care model was started in 1996.
“When this direct primary care model started gaining some ground, then like, hey, that might be a way to make it work,” Gravitt said.
This concept however started out for those who could afford extreme high-quality care.
“It was originally (for) what some people call an elitist. The first clinic was in Oregon and they started out with a $15,000 per year membership fee, but it was a medical spa, like it was all the amenities. But it was really only for the wealthy.”
More and more direct primary-care services are popping up in the Springfield area, but Gravitt is the only one who does house visits.
“By the end of this month there will be 11 direct primary care doctors in Springfield,” Gravitt said.
Gravitt said his practice is more of a concierge because he exclusively does house calls.
“So it’s more of the service-oriented type practice. So it is direct pay, but it’s also 24 hours a day, seven days a week; I go to the patient, they text me, email, call whatever at anytime. So it’s unlimited access, as well.”
Gravitt has enjoyed having his own practice.
“It’s so much better. The patients love it. I’ve gotten several good testimonials just doing house calls and being available all the time.”
“(If) a kid’s got a fever at 10 o’clock at night, you can just text your doctor and find out what to do.”
By having his own practice, Gravitt can spend more time with parents answering questions, especially those with infants.
“It’s not rushed. That’s what I hated about the traditional practice was that you had 15 minutes and people were frustrated if you didn’t answer all their questions, and you’re trying to fly through everything that you know you have to cover.”
Gravitt currently has 70 patients, which is a significant amount less than he would at a traditional doctor’s office.
“Things have been way slower in growth than I expected. I’ve been open 20 months and I expected that I would be full by now, or at least maybe half way there.”
He hopes that soon he will reach his 300-patient goal.
Every day is different according to Gravitt.
“Like today, I’ve been nonstop texting people since 7 o’clock this morning, but I’ll have other days where I don’t get anything for an entire day.”
Text message questions about health have no boundaries as to what parents will ask on the spot.
“It’s all over the place. Like this morning, I’ve been relatively busy. I’ve had a kid with a fever that we can’t figure out for almost two weeks. I have several kids with constipation issues, that’s actually a really common pediatric problem.”
Gravitt said he has only had a few phone calls during the night since he opened his practice; however he did recall one phone call during the wee hours of the morning.
“I had a 4 a.m. visit last week. That was the first one actually in the almost two years I’ve been open that I had to get up in the middle of the night.”
If he is with another patient and is unavailable to answer his phone, callers will receive automated text messages.
“I have text responses that actually automatically reply if I’m with a patient because I won’t answer a call if I’m with someone else. But it will send them a message to let them know that I’m with a client and then they know that I’ll get back to them as quick as possible. Or if I’m driving they will get an auto reply that says if this sounds urgent, I’ll pull over.”
Gravitt says he hardly receives a text message after 11 p.m.
“People for the most part are respectful.”
Living near Saddlebrooke, Gravitt covers a 35-mile radius from his house.
Gravitt said he travels as far north as Willard and to the Arkansas border to see patients.
If more interest arises in Arkansas, then he may consider seeing patients a little outside Missouri.
“If I can get enough interest (in Arkansas), I’d actually get licensed in Arkansas, but it costs significantly more money to be licensed in each state.”
Naming his practice Gesundheit Pediatrics is two-fold.
“The Gesundheit Institute in Tennessee was started by Patch Adams,” Gravitt said. “He was all about patient care and patients not being a number and that sort of thing.”
Contradictory to popular belief, the German word Gesundheit actually means good health.
“So then when I answer the phone ‘Gesundheit, this is Dr. Gravitt,’ (the translation is) ‘Good health, this is Dr. Gravitt.’”
Instead of paying through insurance per each doctor visit, direct primary care is paid on a monthly basis.
“We basically kind of fall under this thing of retainer medicine where you pay a monthly fee.”
Gravitt said he charges based on the different age groups and the amount of times he will likely see a child in different stages of life.
• 0-3 year olds: $110
• 3-6 year olds: $95
• 7 and up: $50
Another uncommon feature Gravitt offers is he will see his patients through college.
“Most (traditional practices) kick them out right after high school, but they’re still adolescents until they’re like 24, whether they want to admit it or not.
“I think that 4-6 year gap in college isn’t worth losing continuity with a physician who knows you.”
College students have no boundaries when it comes going away for school.
“I’ve got a kid right now who’s 20 years old, but he goes to school in Texas, so I worked out a deal with his parents where they just pay for the months he’s home. If they need something in between then we can do individual visits.”
For growing his practice in the future, Gravitt said the first thing would be to hire a nurse practitioner.
“I get a lot of calls (for) people just wanting to do a single visit and I don’t want to promote that idea because that’s what an urgent care is, you know.
Having a nurse practitioner for a tourist area, such as Branson, he could cater to the single visits for the out-of-towners.
“If I had a nurse practitioner who could do one-time visits, and just come see them in their hotel room or at the resort or whatever, I think that would be fabulous.”
When Gravitt is not seeing patients, he likes to hike and spend time with his dogs.
“I just love the outdoors. I don’t hunt or anything, I just like being outside.”
Gravitt said he used to dance in college and fly planes, but due to his work schedule, he rarely has time anymore for his hobbies.
“Most of the time, I just play with my dogs.”
Gravitt has a wife and they have been married for three years.
Gravitt said the only downside to having a 24/7 practice is limited vacation time.
“I haven’t had vacation in two years. I have one weekend a month off that I do have another doctor who covers for me, but until I can afford a nurse practitioner or have a big enough practice to hire another doctor, I don’t have any coverage so that I could go out of town for a week.”
For more information about Gesundheit Pediatrics, visit gesundheitpediatrics.com or call 417-699-8682.