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Cash-Only Clinic Gaining Ground
Northeast Mississippi Daily Journal
October 26, 2009
Oct. 26—OXFORD — Want to see Dr. Tom Fowlkes at his clinic in Oxford?
Bring cash.
It sounds odd — maybe even a bit sinister — at first, since most Americans are accustomed to filling out reams of forms when they visit a doctor, and many expect to pay a co-pay. But the whole fee up front?
Fowlkes, a board-certified emergency physician, says prices at many clinics are set artificially high because insurance companies and government programs usually get a discount.
That leaves the uninsured or self-insured paying far more out of pocket.
Fowlkes’ typical office visit costs $40 — not much more than some people’s co-pay.
“I thought if I could open a clinic,” he said, “I could charge a fair and reasonable price for my expertise and my services that people would be willing to pay.”
Without a staff to file insurance and government program claims, and with a storefront clinic that shares a parking lot with discount stores, a grocery and a bank in the Oxford East shopping center, Fowlkes keeps his overhead low.
“I wanted to be away from the main part of the medical community — over here in a shopping center, where working people are,” he said.
He sends blood and other samples by courier to an independent lab, getting the results back overnight on his laptop computer. The lab can bill insurance companies, or patients can pay Fowlkes directly for lab work at discounted rates clearly visible in his office.
Fowlkes also leans heavily toward generic drugs. Especially in his role as medical director at the Lafayette County Detention Center and a residential drug— and alcohol-abuse facility, he has seen the ravages of high blood pressure, diabetes or other chronic conditions that went untreated because patients could not afford high-cost prescriptions after their free samples were gone.
“I keep the generic $4 drug list that most pharmacies have, and 90 percent of conditions can be treated off that list,” he said.
Growing trend
Fowlkes is not the first to use the cash-only model for his practice. Dr. Todd Coulter has operated his Midway Family Care in Ocean Springs on a cash basis for eight years.
“Number one, people like the predictability,” Coulter said. “They know exactly what it’s going to cost when they come in. We have a set fee of $40 a visit; in December we’re going to have our first increase in eight years to $50.”
