Meet Dr. Melissa Black of Empower Family Medicine in Decatur

Today we’d like to introduce you to Dr. Melissa Black.

Dr. Black, let’s start with your story. We’d love to hear how you got started and how the journey has been so far.
After nearly a decade of service as an assistant professor medicine at Emory University School of Medicine, I made a thoughtful decision to begin a new medical practice. In the words of Dr. Flacker, my faculty mentor, “Eventually, all really great chefs want to open their own restaurant.” Perhaps the same is true for physicians.

Learning from families, colleagues and communities have been the foundation of my education and training. Originally from Upstate New York, I came to Georgia to complete a family medicine residency at Atlanta Medical Center, the old “Georgia Baptist” in 2006. For pediatrics rotations, I worked at Children’s Hospital of Atlanta, Scottish Rite, a local center of excellence in the care of children. As a part of my obstetrics training and later my own pregnancies, I was mentored by Dr. Lorne Campbell M.D. in the use of hypnosis in childbirth which led to an interest in neuroscience and the impact of the brain on health and wellness. After residency, I completed a fellowship in geriatric medicine at Emory University in 2007 and acupuncture training through UCLA.

I then worked as an assistant professor of medicine for Emory’s Division of Internal and Geriatric Medicine for 9 years. My work included taking care of some of the sickest and frailest community members in the clinic, hospital, long-term acute care and nursing homes settings. I moved to the City of Decatur in 2013 to raise children and enjoy the walkability, great schools and great people that define Decatur.

As I celebrated my 40th birthday in 2015, I found myself yearning, like many of us, for a slower pace of life – more time to spend with my patients in thoughtful conversation and care, and less in commuting and paperwork. This is the inspiration for a clinic centered not on administration or insurance demands, but on doctor-patient relationships – an ideal medical practice.

When I began the journey, I unexpectedly discovered a group of like-minded physicians doing the same. Over 500 physicians nationwide are cutting the insurance cord to provide affordable physician services directly to patients at a low cost, a model called direct primary care.

Great, so let’s dig a little deeper into the story – has it been an easy path overall and if not, what were the challenges you’ve had to overcome?
The move from being part of a large institution to become self-employed feels like a bit of a free fall. The skill set of diagnosing and treating complicated illness was one I honed over twenty years, but building a unique business from the ground up was entirely new. For an introvert like me who is happier at home with a cat in my lap and a cup of tea than knocking on doors, it has been a new challenge. I found advice and help in unexpected places. When I purchased a sign for my office door, the shop owner introduced me to a local business networking team where I could learn business skills and networking from others. One of the members there needed to recruit a doctor for a service trip to Honduras and I was able to travel to Honduras with the organization HOI as a result. One of the other volunteers was an emeritus business professor at Georgia State University. He gave an outstanding talk on quality and marketing strategies to the small business owners of rural Honduras. I enjoyed learning from a master surprisingly in the mountains of Honduras.

It especially hard to market a medical practice outside of insurance. People ask, “Why would I see a doctor that doesn’t take my insurance?” Outside of the insurance model, there is so much more I can do for patients. When you accept insurance based care, you accept all the pre-negotiated rates for physician fees, imaging, drug prices and hospital care. But the actual cost to provide this care is only a fraction of those pre-negotiated rates. We waste a lot of money on healthcare by marking up the price of medications and inflating the cost of medical visits due to the high overhead it takes to run a large practice. There is also the cost of valuable time lost when it takes weeks to get an appointment and hours to get into the exam room. Direct primary care bypasses all that and gets to the heart of the matter, which is the works of Hippocrates is to “treat often, cure sometimes, comfort always.”

Empower Family Medicine – what should we know? What do you guys do best? What sets you apart from the competition?
Empower Family Medicine is the first ideal clinic in metro Atlanta. An ideal clinic begins by asking people in the neighborhood what they think would make seeing a physician ideal. My practice is built around just that. In the words of neighbors, an ideal clinic includes:

– People take the time to learn about me.

– Ease of scheduling and changing appointments

– Short wait times

– A doctor who looks me in the eye and does a hands-on physical exam

– A real person answers the phone starting at 8 am or so

– Easy medical records access or transfer online

– Someone answers the phone during the lunch hour

– If I call and ask to talk to the doctor they let me

– Easy parking

– Ability to e-mail my physician

– I get to see MY doctor the majority of the time, not the doctor of the day

– Non-shaming

– Doctor always has enough time to answer my questions

– Same or next day appointments for urgent issues

– Serve the uninsured

– Someone greets you, asks your name and what is going on with you before your insurance

– Humanizing not alienating

– Personal relationship with an accessible doctor

– Doesn’t feel like a factory

– Holistic approach to disease using natural supplements when possible

– Compassion from the staff

By combining these ideas with the magic of direct primary care, I am able to exceed people’s expectations. Benefits of direct care include:

– Wholesale medication dispensing: By bypassing insurance, I am able to order medications for people directly through a wholesale pharmacy and dispense them at cost. This at times saves people more than the cost of their monthly membership, sometimes hundreds of dollars a year.

– Imaging and testing at as much as an 80% discount: When a person needs imaging or testing, I locate test site for them that has the lowest cost, helping people keep their out of pocket expenses low.

– After hours care: If someone needs after hours care, I do my best to accommodate them they are always cared for by a physician who knows them.

– Home Visits: For homebound elders or adults with limited mobility, I will make home visits and courtesy visits to the hospital or rehab center to help coordinate care.

– Specialist medical advice: When specialist consultation is needed, I can submit case summaries digitally to a specialist case review service for advice to help guide our care plan. By implementing their advice, we can often avoid the time and cost of a face-to-face specialist referral altogether.

What has been the proudest moment of your career so far?
The proudest moment of my career was the day I opened my own medical practice. My mother had a lovely plant delivered to my office. It reminded me of the time she had a large bouquet of flowers sent to me on my first day of residency, the delivery of which interrupted a group lecture and made my cheeks rosy. The arrival of her simple gift to my own medical practice symbolized my coming full circle from a trainee with a vast future ahead to an accomplished physician breaking ground in new models of care. Medicine is a humbling profession, but to be a physician is a true calling and one I am proud to claim.