Local doctor aims to reinvent patient care and payment with new medical practice – Salisbury Post

SALISBURY — The pandemic has been an inflection point for many Americans.

People have changed career paths, moved and reshuffled their priorities – or at least cleaned out their garages.

Dr. John Bream, who oversaw the emergency department at Novant Health Rowan Medical Center when COVID-19 spread to the United States, found himself at a similar crossroads.

“I think COVID has exposed a lot of warts within the healthcare system,” Bream said.

While Bream would like to see an overhaul of how American doctors and healthcare facilities treat and bill their patients, he decided to start by opening his own practice.

Bream left the emergency room to enter the world of primary and emergency care. He opened Bream Medical’s first office at 721 Grove St. in Salisbury last week. Bream is joined at the practice by medical assistants Zack Briggs and Alfonso Rodriguez. Bream plans to open two more sites, one in Edenton and one in Stokesdale, in the coming months.

“The only thing I can help with is at Bream Medical, you will never be denied service because you might have COVID or you haven’t been vaccinated or anything like that,” Bream said. “I believe in treating all patients, no matter what, to the best of my ability.”

Dr John Bream, right, and Zack Briggs stand outside Bream Medical’s new office. Photo by Chris Jones Photography.

It was a general practitioner who first sparked Bream’s interest in medicine. Bream still has fond memories of visiting his family’s doctor, Dr. Vetter, in his hometown of Hamlet, North Carolina, a town of about 6,000 people near Rockingham.

“Every time I’ve been there it’s been great. I loved it and it was a great experience,” Bream said. “I had this phrase: Dr. Vetter makes me better. to be like Dr. Vetter.

Bream was also inspired by his grandmother, who worked in home care.

“That’s where the healthcare gene comes from,” Bream said.

Bream stayed close to home for college, studying biology and history at East Carolina University. He also earned his MD from ECU. During her medical residency, Bream moonlighted in emergency departments across the state. It thrived on the fast-paced, ever-changing landscape of the emergency room.

“I like that fast pace and I like doing a bit of everything, but not particularly doing one thing all the time,” Bream said. “I can see 30 patients in a shift and never see the same thing.”

After residency, Bream worked in emergency departments in Albemarle and Monroe before eventually being hired as assistant director of the emergency department at Novant Health Rowan Medical Center. He became full-time manager in early 2017, stepping in to oversee a bustling department.

“Running Rowan’s emergency department was a challenge,” Bream said. “I think, as people in the community know, Rowan is a busy emergency department. When I was in charge, we saw over 50,000 patients a year. This is a very high acuity area, which means there are a lot of sick people in Rowan County. »

Bream said his team was able to make significant gains, improving quality of care and patient satisfaction measures. When the pandemic started, a hectic emergency department initially became much calmer. Even with fewer patients at first, but stress was at an all-time high.

“It was changing every day,” Bream said. “As a director, I took part in all the planning meetings and there was a lot going on at that time. It was a stressful time to be a director because there was so much to do, but so many unknowns.

Meanwhile, Bream’s wife was nearing the end of her pregnancy. He recalls using the family’s outdoor shower before stepping foot in their house after a shift and not wearing his wedding ring at work – small precautions that seemed important when there were so many unknowns about COVID.

During his wife’s pregnancy, Bream experienced the healthcare system from a patient’s perspective. He was amazed at how little his insurance covered hospital bills. It made his wheels spin.

“There is a better, more efficient and more cost-effective way to make medicine that works better for patients outside of the traditional insurance model,” Bream said.

Bream also expressed concern about how some medical professionals were or were not treating patients. In particular, Bream said he was appalled by those who turned away patients because they had tested positive for COVID or had not been vaccinated.

“I started seeing a lot of patients outside of the emergency department with acute COVID because a lot of providers wouldn’t see them,” Bream said. “There are things you can do for patients outside of telling patients to go to the ER if their lips turn blue or they are short of breath.”

Bream seeks to address its two primary concerns, cost and patient care, through a subscription medical plan. For $150 a month, a patient gets one primary care visit, one urgent care visit, and 24/7 access to their provider. Bream believes that paying directly for services can save patients money in many cases.

By using telemedicine, Bream said he could provide services to patients outside of the normal 8 a.m. to 5 p.m. workday and could reduce costs. Bream plans to limit the number of patients he sees to ensure his staff can spend more time with them beyond the usual 15-minute appointment. Patients visiting Bream can expect appointments to last longer than 40 minutes, he said. Bream said he is also looking to ease the financial burden on patients by performing in-house lab tests at no markup.

Bream said he would focus on more preventative and holistic medicine and would not be afraid to think outside the box when it comes to caring for patients.

By providing better preventative care through the subscription model, Bream seeks to prevent patients from having to travel to the hospital and pay a large bill.

“The goal of this service is for you to have such good access to your provider that we should be able to avoid a significant number of hospitalizations,” Bream said.

Bream Medical will accept patients with conventional insurance plans and those without any insurance, in addition to those who choose to join the subscription model.

More information about Bream Medical can be found online at breammedical.com.


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Elaine R. Knight