Changing the Face of Primary Care in Central Kentucky

The Downtown Drs. Brown open membership-based practice

LEXINGTON “I feel joy,” says Ryan Brown, MD, when describing how he feels about his new medical practice. “It’s exciting to feel there’s a way to practice medicine that fits my personality.”

His medical partner and wife Cady Brown, MD, echoes his feelings by saying she feels “contentment, excitement, pleasure, and a little anxiety about the business part of the practice.”

At Lexington’s Downtown Drs. Brown office, located at the corner of West 2nd and Jefferson Street, patients receive what the Drs. Brown refer to as “Upbeat Primary Care.” Opened in September 2018, the practice aims to change the current model of doctor visits, where patients often feel as if most of their questions go unanswered. Patients notice the difference in the new practice.

Patients complain of common challenges in the traditional, high-volume primary care clinics. They find it difficult to schedule visits, and when they finally arrive, the wait time can be longer than their conversation with the physician. Drs. Ryan and Cady Brown felt those frustrations from a medical professional’s perspective. Compelled to practice medicine that puts patients first, they decided to open their own clinic.

Meet the Doctors!

The husband-wife team met while studying medicine at the University of Kentucky and later continued their education at Tulane University in New Orleans, the city in which they later married.

Though originally an East Asian history major, Dr. Cady Brown’s interest in medicine was piqued after studying abroad in China. In her words, “After this experience, I changed career arcs and applied to medical school. When it became time to choose a specialty, I knew I wanted something that would allow me to create long-lasting relationships with my patients. I also wanted to consider the whole patient, not just one organ system or area of the body. Internal medicine provided the perfect residency for me.”

“I wanted to go into primary care to give patients a voice and to address all of someone’s complaints and concerns, not just some of them,”— Dr. Cady Brown.

Dr. Ryan Brown, who studied psychology before pursuing medicine, says this of his passion for the discipline: “I went to medical school because I simply wanted a job that would allow me to have an important impact on people’s lives. I chose the field of primary care because no other type of medicine provides as intimate a physician-patient relationship.

Since their formative years, the board-certified Drs. Brown have served a diverse patient population through their work in primary care medicine. They now have two children, Nettie and Chet, and enjoy doing outdoor activities as a family.

A Change of Pace

Their years in traditional clinics proved less than fulfilling. The sheer numbers of patients demanded so much of the doctors’ time that they were forced to limit their patient visits, sometimes to a few minutes. This reality hampered their patient-first vision for practicing medicine. In Dr. Ryan Brown’s words, “Who are we really helping if we are providing care that leaves both the patient and physician wanting?”

He continues, “That’s when we realized this type of primary care — high-volume, rapid-fire visits — gave patients less than they deserved.” The doctors had to make a risky move. “I wanted to go into primary care to give patients a voice and to address all of someone’s complaints and concerns, not just some of them,” says Dr. Cady Brown. “Anything less than that feels completely antithetical to my drive and personality.”

Dr. Ryan Brown admits the traditional office drained him: “It was either I keep doing this for a while until I inevitably crashed and burned out, or we created a more viable care model so we can keep doing what we love for longer. We’ve always loved the work, but we had to create a new vehicle for that work that made us, and our patients, thrive.”

Ownership and Empowerment in Membership-Based Practice

By using a membership model of primary care, one study finds that patients receive improved care, with fewer hospitalizations, decreased dependence on specialists, and reduced pharmaceutical consumption because the primary care physician is able to take a much more hands-on approach. Without an overbooked schedule, membership-model practitioners can take more time to understand a client’s history and future objectives and then foster opportunities to help them meet those personal goals.

Downtown Drs. Brown will provide the venue to treat patients the way I feel they should be treated: with complete attention and compassion, and no eye on the clock,” adds Dr. Ryan Brown.

Food, Health, and Wellness on Forefront

Health and wellness, now trendy buzzwords found all over the media, can mean something different to each individual. As doctors within a membership model, the Drs. Brown can tailor their approach to training patients to live their healthiest lifestyle.

Food quality has taken a more prominent place in the health conversation. Both doctors emphasize the importance of “food that looks like food,” fewer carbohydrates, and moderate meat consumption when outlining their nutritional philosophy. Generally speaking, Downtown Drs. Brown are strong believers in the correlation between what people eat and their health, and they recognize food can be often be the perfect medicine. However, dietary needs vary from person to person, and the physicians work closely with various nutritionists to provide the most specialized care.

“Mens Sana in Corpore Sano”

The doctors encourage their patients to discuss their mental health, a vital, still overlooked component of health and wellness. Dr. Cady Brown explains, “Mental illnesses often present themselves in multiple physical symptoms. Primary care doctors see all the patient’s symptoms and watch their development more closely than many other specialties.” Patients feel more comfortable discussing mental issues with primary care first; they have fewer, potentially embarrassing, symptoms to discuss.

Dr. Ryan Brown specifically mentions gastrointestinal distress, commonly caused by stress, as a common example. Persistent symptoms, such as acid reflux or irritable bowel syndrome, often coexist with stressful life or relationship situations, which in turn can exacerbate physical damage to the body. These comorbid relationships between mental and physical symptoms motivate doctors to examine root causes and promote mind-body healing.

Unconventional Approach, Happier Patients

The doctors also surpass the traditional role of primary care physicians by providing more and unusual ways for their patients to have relationships with them. Some of the benefits include access to a robust network of professionals, including holistic medicine experts; their “Run/Walk with Your Doctors” program; vegetables for the patients from the Browns’ garden; and an exclusive newsletter each quarter. Most importantly, patients can even call or text their doctors with questions after hours.

Lessons Learned and Misconceptions

The doctors agree they’ve had many pleasant surprises since starting a practice under a membership-based model. Dr. Ryan Brown says that he’s enjoyed the wide variety of patients they’ve seen within their clinic – representing a diverse population spanning age, socioeconomic status, and more. “That definitely debunks the misconception that this type of clinic was created for an exclusive group of people,” he says. Dr. Cady Brown realized that she didn’t have to change her caring, thorough clinical approach and that she can provide the best care by practicing medicine as her most authentic self.

The Drs. Brown are currently accepting new patients through their fee-based program, but they expect their membership quota to fill quickly. As Dr. Ryan Brown says, “We’re providing fantastic care to a smaller number of members, and so far, it’s working really well for us.”