The doctor is in: Kallmerten will serve Lakes Region through direct primary care

BELMONT — A longtime Lakes Region doctor — one of three fired abruptly from Concord Hospital-Laconia’s internal medicine practice in September — is striking out on his own to open an office for direct primary care.

Dr. Daniel Kallmerten will open his practice and begin accepting new patients the first week of March, if all goes to plan. The new office is located at 171 Daniel Webster Hwy in Unit 10, on the second floor.

Kallmerten served the Lakes region for nearly 40 years, much of that period spent between Franklin and Laconia in their respective emergency departments. He finished his career at Concord Hospital-Laconia in the internal medicine department until he, along with Drs. Valentin Milchev and Gurvinder Bali, were fired unceremoniously, leaving thousands of patients without a primary care provider.

Milchev and Bali have since been picked up by Speare Memorial Hospital in Plymouth. Kallmerten got an offer there, among other facilities, but he’s decided to pursue a lesser-known model of health care: direct primary care. 

The benefits of direct primary care are numerous. Doctors can spend more time with their patients and they carry less of them on their caseload, too. It’s a fee-for-service, with clients paying a monthly fee to receive heightened levels of care and attention.

It’s something he’s often thought about over the years, but in the shock of his firing, Kallmerten found himself uncertain regarding his next steps. There were two options: get back into the game, or retire.

“I’m not sure if I’m retired or unemployed,” he joked with friends, family and colleagues at the time.

But he made his choice in November, and likely would’ve opened the new practice sooner if it wasn’t for a shoulder injury sustained while working ski patrol at Gunstock Mountain Resort. Now, he’s making the final preparations and looking forward to serving the community once again.

Operating under a direct primary care model will allow Kallmerten to spend more time with patients through a lower patient roll and easy communication facilitating both telehealth and office visits, he hopes.

“The beauty of it is, when you have a problem, you talk to your doctor,” Kallmerten said Wednesday.

The direct primary model could help provide workarounds to problems which exist within the traditional model: patients have limited access to their physicians and wait times can be exorbitantly long. For example, while working for the hospital, he generally spent about 20 minutes with each patient. Under the new model, he intends to spend 1 hour at minimum with each patient for an office visit, and anticipates intake could take around 2 hours for each person.

“I’ll have plenty of time to spend with people to talk about their issues,” he said. 

His career took an early turn from orthopedic sports medicine to internal medicine because, as he puts it, he “always had a strong desire” to help his friends and family and was never sure why. For Kallmerten, direct primary care offers “what medicine is supposed to be”. 

Following his firing from the hospital, around 100 of his patients reached out to him, wondering where he was going and what he planned to do next. Now, some of them have expressed interest in signing up for his service.

“I thought this was a great opportunity to try this and see how it works,” he said.

And he’s looking forward to the continuation of his career, practicing medicine the way he believes will most benefit his patients. He described a sort of “treadmill” effect working in internal medicine at a hospital, whereby patients are run in and through the practice with minimum time with their doctor because of massive caseloads. Those factors may contribute to early burnout.

“In my mind, that’s what hospital internal medicine is these days,” he said. “The only bad thing about direct primary care is that there’s a fee associated with it.”

For those interested in pursuing care under this model, Kallmerten recommends they maintain their health insurance, as it won’t cover their visits to his practice — that’s what the monthly fee is for — but it will cover everything else, such as prescriptions or appointments with specialists they’re referred to. He said he’ll always have access to the Concord Hospital Health System and will be able to order labs and imaging, but he’ll also be able to work with services provided by private practice.

Those interested in learning more about his practice should navigate to lakesregionimed.com or call 603-609-0689 as early as the first week of March. Specific rates are based on age and an individual’s specific situation per a conversation with Kallmerten. 

He’s looking to have around 200 patients to ensure he can offer the personalized service he feels patients deserve.

“I want to be able to focus on my promises here,” he said. “This affords me the ability to give some people free care.”

Kallmerten’s love for this community is what keeps drawing him back into the profession, he said. He started the lacrosse program at Gilford High School and coached it for 10 years, for example. That motivation to give back to his community influenced his decision to return to practice, but “maybe on my terms now,” he said.

“It’s a really wonderful community,” he said. “New England has four seasons and just a little bit of everything you could want in life — we have loved it.”