At Cummins clinic, patients get more time with the doctor

COLUMBUS, Ind. -- Patients at most medical clinics around the U.S. know the drill: They walk into a doctor's office, where they sit for an indeterminate length of time, first in the waiting room and then in an exam room, where they eventually get to see a doctor for a mere 10 minutes or so. The fee could be $75.

That's not how it works at Cummins LiveWell Center, according to Jill Beavins, the medical director of primary care services. Here, an acute-care visit to speak with a doctor about a health issue such as high blood pressure or diabetes typically lasts 40 minutes.

"That would have been 10 minutes in my previous life" as a primary care physician at a conventional clinic near Indianapolis, Beavins says.

That 40-minute visit would typically cost $30 at the LiveWell Center, a new concept health clinic opened by Cummins Inc., the auto supplier and diesel-engine maker, in June. Cummins declines to disclose the cost of the center.

The extra minutes give doctors a chance not just to diagnose a problem, but also consider multiple approaches to solving it, including talking to a health coach about a lifestyle change.

The company's literature states: "Instead of just tackling the symptoms, we'll work with patients to get to the bottom of every health care issue."

Adam Palmer, Cummins' global facilities functional excellence manager, regularly visits the LiveWell Center's chiropractor and pays a flat fee of $20 -- so cheap he hesitates to bring it up with friends who don't work for the company.

"It's a little awkward to tell people my medical expenses can be so inexpensive when others don't have that benefit. It's a company that really looks out for the employee," says Palmer, who also has enrolled in cooking classes at the center and lost 12 pounds as a result of adopting a vegan diet.

To Beavins, the contrast between working at the LiveWell Center and her previous private practice is like night and day.

"In private practice, it's a diagnostic approach," she said. "The tools we had in our toolbox were much more limited. When you're in a high-volume private practice, it's hard to do justice to some of these conversations around diet and exercise in a 10-minute conversation. At the LiveWell Center, we have a lot more time."

Beavins and her fellow providers can spend more time with patients because they're not working on a traditional fee-based model employed at many hospitals and clinics, says Dexter Shurney, Cummins' chief medical officer and the man largely responsible for the LiveWell Center concept. 

"Our doctors are on salary. In regular health care, there's a fee for service," says Shurney. "The more patients you see, the more you get paid. In this situation, there's no incentive to have a patient come back three times for a follow-up." 

The LiveWell Center is run on Cummins' behalf by Premise Health, a Franklin, Tenn., health care management company. 

Most of the 46 employees are Premise employees, though specialists regularly make visits. 

Says Shurney: "All of our fees are transparent. People know exactly how much they'll have to pay upfront. There is no guesswork, none of those explanations of benefits you get in the mail where you don't know what you're reading. We all love to hate those, right?"

It's not just the fee schedule that's unconventional. The breezy waiting room scarcely looks like a waiting room at all. Patients are greeted at a desk and wait an average of about five minutes before seeing a doctor or other specialist.

The center was designed by Indianapolis architecture firm Axis Architecture + Interiors. The high-ceilinged interior is airy, with natural wood and light streaming in from all directions. The center stands out in Columbus, a city known nationally for its numerous architecturally significant buildings.

"We visited Apple, Facebook and Applied Materials to help us with the design," says Shurney.

There's a Zen Lounge at the front, a room where patients can sit and quietly relax before an appointment. The patient rooms are arranged around a series of medical bullpens where providers work, so most examination rooms have separate entrances for patients and for medical personnel.

Patients needing help with benefits or medical questions can ask at a counter called the Health Hub, which is patterned after Apple's Genius Bar. The building's roof drains into a series of water gardens that divide the parking lot.

Staff members wear color-coded attire. Doctors, nurse practitioners, the pharmacist and optometrist wear navy polo shirts. The hosts wear green button-down shirts.

Shurney says the teaching kitchen was one of the most difficult elements to justify when it came to costs.

Two other big decisions also had to be made: whether to include a dental clinic and a gymnasium. The company decided against both.

Tom Linebarger, Cummins' CEO, says the company is studying how to spread the best elements of the LiveWell Center to 55,000 Cummins employees in 190 countries.

"Our intention is to get the ideas of wellness and total health to employees everywhere the best we can."