Melissa McElfish sits up straight as Doctor Richard Samuel feels her back, "Tell me if there are any tender spots that I should be concerned about," he says.
McElfish has had back problems recently after hurting it going up a flight of stairs while carrying a box full of heavy books. She's been in and out of the doctor's office frequently, and that doesn't bother her, because these visits aren't costing her a dime.
"I love it, I don't ever have to worry about going to the doctor now," says McElfish.
Instead, McElfish is only charged a monthly fee, and that fee is only based on her age.
"There are no preexisting medical questions in a sense that that would potentially raise the fee," says Samuel, who has gone the route of membership fees over traditional insurance for a little over a year.
"It's a lot more cost effective for some people," says Samuel. "And we cover a whole range of services, in fact, 90 percent of what the standard patient needs can be covered."
But McElfish isn't just a patient, a small business owner, she uses direct primary care as an affordable way to cover her employees.
"We wanted to be able to offer some sort of benefit to our employees, but something we could afford," says McElfish.
And small businesses are one of the reasons Samuel says this model is so successful. "Melissa pays on average, $50 an employee per month, whereas, the odds are pretty high she'd be paying four times that amount if she signed her employees up with one of the other insurance companies."
Membership fees cover what Samuel says is 90 percent of what a standard patient needs, Samuel suggests to all of his patients and employers they pair this coverage with other coverage, plans that would cover surgeries or specialized care
One of the downsides with direct primary care is even though patients are paying for medical care, direct primary care, in Idaho, is not recognized under the Affordable Care Act, so at the end of the year patients are still receiving a penalty fee.
Samuel says he is currently working with state officials to try and change that.