A friend told them about a small primary-care clinic called SparkMD less than a mile from their house. The doctors didn’t accept insurance. Instead, they charged a monthly fee of $130 per family. That allowed visits as needed without any limits. When Lindsie went to check it out, a physician began with an in-depth conversation about the family’s health.

“It was amazing. She sat down with me for an hour and talked about everything,” Lindsie says.

Gunther, the Bergevins’ new physician, had long wanted to be a family doctor in her hometown. Working for a large hospital system, though, she was soon chafing under a bureaucracy that seemed to make too many of her clinical decisions for her, down to what tools and equipment she could use. Even worse, Gunther was paid based on her volume of patients and services billed.

She saw patients in 15-minute intervals and says she felt like a factory line worker. She’d later joke that she spent longer waiting in line for her morning coffee than she did with a patient.

“I was saying ‘I’m sorry’ all the time,” Gunther, 42, recalls. “I’m sorry I’m late, I’m sorry this didn’t get called in, I’m sorry this got forgotten, I’m sorry they didn’t give me the message.”

Burned out, she quit her job in 2014 and started her own practice. She borrowed about $200,000 to renovate an old red-brick law office on a leafy corner of downtown Boise, a few blocks from one of the city’s big hospital campuses.

Along with a nurse practitioner and a small office staff, she cares for about 600 patients. A typical primary-care doctor carries at least double or triple that load. More than half of Gunther’s patients have health insurance, often in high-deductible plans. Others are small business owners like the Bergevins. Most are disenchanted with the health-care system.


Last year, Lindsie Bergevin had a bad fever and what she described as “the worst pain I think I ever had in my head.” She called Gunther at 9:30 p.m. on a Saturday. Gunther met her at the clinic 15 minutes later. “She’s like, ‘Girl, you have a double ear infection, and the worst I’ve ever seen.’”

Bergevin walked out with an antibiotic and says that if Gunther hadn’t seen her, she would’ve gone to the emergency room, which could have resulted in a bill for hundreds or thousands of dollars.

Gunther tells her patients that belonging to her practice is not a replacement for having health insurance.