When Bastyr University medical graduates Dr. Tamoro McDonald and her husband, Shane, sat down to draw up a plan for their future medical clinic, they settled on two main ideas.
First, as personal experience had already shown them, by bringing health care providers skilled in a wide range of treatments under one roof to deal with maladies tied to multiple systems in the body, they could significantly speed up a person’s healing process.
Their clinic would offer such “integrated medicine.”
Second, so patients wouldn’t have to break their bank accounts to get the care they needed, it would be a direct primary care clinic, DPC, which is an alternative to medical insurance that legislators wrote into state law in 2007. Unlike primary care, DPC cuts insurance providers out of the equation, supplanting them with direct financial relationships between patients and their health care providers.
Call it Shane and Tamoro McDonald’s way of moving beyond merely complaining about the preposterous cost of health care to actually doing something about it.
“People should not have to decide between buying groceries and getting good health care,” Tamoro said.
In May 2018, the couple opened Docere Integrated Medicine at 4329 A St. SE in Auburn, one of only two DPC clinics in Auburn.
Opened it with a bold prediction for the future.
“I believe direct care and integrative medicine will bridge the gap in the health care system,” Tamoro said.
And one major surprise.
“When we built the business, we thought 95 percent of our people would be cash-paying and wouldn’t have any insurance. But what we have actually found since blew us away: 98 percent of our patients have insurance, but they’re not getting the care they need because of the system that they are in,” Tamoro said.
As state law forbids a direct primary care provider from accepting medical insurance within its walls, Tamoro explained, the payment arrangement at Docere is more or less like a membership: patients pay one flat fee each month for access to all of the clinic’s physicians.
Tamoro, a 1982 graduate of Auburn High School, earned her bachelor’s degree in nutrition science and her doctorate in naturopathic medicine from Bastyr University.
As a licensed physician in Washington state and the clinic’s co-medical director, Tamoro practices family medicine for people of all ages. Trained as a primary care provider, she works Western and natural medicines into her practice to give her patients the best care she can.
Her particular interests, however, encompass environmental medicine, GI health, nutrition, food allergies and sensitivities, physical medicine, natural family planning, women’s health, IV nutrient therapies and chelation therapies.
Shane, the clinic’s director, is a decorated military veteran, a former police officer, and a recent graduate of Bastyr University, from which he simultaneously earned a Masters of Science Degree in Acupuncture and a bachelor of science degree in Natural Health Science.
When the couple met, Shane was working in insurance, but after many talks with his future wife, he decided he, too, should go back to school. He studied acupuncture.
“Part way through school, knowing we would be together and wanted to open a clinic, I realized that I could heal a knee in six weeks with my modalities, and he could heal one in six weeks, but if we worked together, we could heal it in two,” Tamoro said.
That’s how integrated medicine works.
“Depending on the severity, we can rehab a knee in two to four weeks, because we use all of our modalities. If we put your knee through chiropractic, we make sure it’s in alignment. The chiropractors here are naturopaths, all trained in [bone] manipulation – we don’t call it chiropractic – followed by physical therapy, and then manually stretching. Then we take that person, now that their knee is somewhat relaxed – at least it’s in alignment – and we deliver them over to acupuncture, which can put needles in to help healing and circulation,” Tamoro said.
As a primary care provider, Tamoro said, her job is to bring down the inflammation in the back, shoulder, knees, neck, whatever. The clinic also has prescriptive rights, so staff can recommend an over-the-counter medication or write a prescription for an anti-inflammatory or muscle relaxer.
“What’s important is we always want to be able to offer somebody the natural way, natural things that don’t have side effects, that don’t hurt your stomach like anti-inflammatories do. We have things like that in our dispensary. We have a lot different things where all the different modalities come together to help heal somebody quickly,” Tamoro said.
But the clinic leaves the choice of treatment to the patient.
Tamoro estimates she spends more than 50 percent of her appointment time taking people off unnecessary medications, especially in cases where somebody hasn’t paid close enough attention to which medications work with other medications, and which do not.
“We educate people on side effects, you know, ‘You can take this natural product or you could do acupuncture, and we could get you off of that.’ I’d say 95 percent of the time, people want off their medications. They don’t want to be on a list of them.”
Whatever Docere can’t handle as a primary care provider, it refers to image specialists, cardiologists, pulmonologists and others.
“And I do all I can to keep the work local in Auburn,” Tamoro said. “I have gone toe-to-toe with some of the labs to get rock-bottom prices for cash-paying people. There are programs out there where we can get inexpensive medication as well,” Tamoro said.
Something else that distinguishes Docere from other health care providers is that whereas many doctors only offer 5-10 minutes of “face time” to a patient, Tamoro is known to spend hours with a person, trying to figure out how to help.
Such was the case with one young man who came to the clinic suffering from extreme, lifelong, head -to-toe eczema. Until then, the eczema had resisted the healing efforts of every doctor visited. Two hours into the interview, however, Tamoro. nailed the problem: the kid was missing a critical enzyme in his system.
Within three weeks, excepting some areas in the crease of his arms, the boy was eczema free.