Navigating the Difficult Diagnosis

A Doctor's Diary

As a primary care physician you often see patients with similar symptoms or common ailments. And you might assume we have a one-size-fits-all diagnosis for many complaints. You’d be wrong. In fact, rarely are any two patients alike.

As a Direct Primary Care physician, I know that most people with such symptoms have minor problems that can easily be fixed in a primary care setting, but we always have to be alert to a story that is worrisome.

Every Diagnosis is Unique

While every patient is unique, some patients stick with you more so than others. Cancer patients, especially young ones, are foremost among them for me.

I am used to patients coming in with seemingly minor symptoms, like constipation or a tender breast.  However, two unique cases stick out for me as a good reminder of why Primary Care is so important and why I’m passionate about what I do.

Unlike the health care insurance model where patient-doctor appointments are strictly timed, diagnoses are dictated by insurance codes, and patients avoid seeking treatment because of hefty co-pays —  Direct Primary Care gives patients virtually unlimited time with the doctor and without financial stress or anxiety. 

In the case of these two particular patients, I remember that it was during our appointments – in an unhurried and comfortable setting — that each patient shared a story that added a worrisome dimension to the symptom in question. It was in the small details of their story.  Because we took the time to listen, exam and gather the full context that we sadly confirmed our worst fears…cancer.

So Now What?

Delta Direct Care is blind to insurance; most of the time we don’t even ask if someone has insurance. When the patient has any kind of insurance, there is no problem getting them into a specialist to review their case. But sometimes it seems all the worst-case patients have no insurance at all.

Direct Primary Care is not intended to replace insurance and is limited in scope to front-line care, but there is a difference: we never leave you in the lurch. Whereas some front-line health workers will “refer and forget,” we travel the journey with you.

We’ve Got Friends in Good Places

In the case of one patient who had breast cancer, we got her a mammogram, ultrasound, PET scan, two different biopsies and an oncology visit within 10 days. Of course, we couldn’t have done it without receptive partners at Peace Health, Epic Imaging and especially Compass Oncology, which helped us find funding for our patient.

We helped another patient find an affordable colonoscopy in Salem and helped another patient get a second opinion at Stanford. We
helped other patients find great surgeons who offered reasonable pricing for uninsured patients in places like Longview, Oklahoma and Maryland. The savings over local facilities were more than enough to cover airfare and hotel.


All of these patients were uninsured facing a difficult physical, emotional and financial road ahead of them. That’s why we make it our job to find resources that ensure nobody ever feels abandoned.

The Most Memorable

Sure there’s nothing better than telling someone they do NOT have cancer, but there is equally some rewarding in knowing that when I go to bed at night, I’ve done everything I can to advocate for my patient.

I’m so grateful for the members of our Delta Direct Care community. Their willingness to support, trust and take us along their health care journey and makes us better doctors.

If your’e not actively enrolled in a Direct Primary Care membership, check out Delta Direct Care. The investment in your health pays huge dividends over time!

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