Island doctor sets up new form of practice

Dr. Stephen Chappelle Caughron carries everything he needs from suture kits, a variety of bandages, exam tools and medications in his military-style medical bag that he takes with him on patient visits.


GALVESTON — A new medical practice in town features house calls, same-day appointments and cash-only care for less than the cost of most cable subscriptions.

Dr. Stephen Chappelle Caughron set out his virtual shingle earlier this month in Galveston. He follows a new economic model, direct primary care, which is membership based and bypasses insurance.

“I founded Island Direct Care basically to provide primary care that is simple, affordable and accessible, with no deductibles, no copays, no waiting, no hassles,” said Caughron, whose patients call him Dr. Chap, a short form of his middle name.

“It’s starting at $10 a month for children and $50 a month for most adults and that includes same-day appointments and house calls, as well as unlimited visits, free procedures and then wholesale pricing on additional costs such as diagnostic imaging or lab work.”

Caughron uses a model developed by a trio of doctors in Kansas City who don’t accept insurance. Instead, the Atlas MD group charges most adult patients $50 a month for unlimited visits, with reduced medication and lab costs.

Following that formula, Caughron’s goal is to spend more time with patients and less time jumping through the hoops of traditional medical practice. He’ll come right to your door with services that include checkups, blood tests, wellness and minor illness and injury treatment. He’ll then follow up with emails and phone calls. He also uses videoconferencing.

“It really returns that excitement to medicine to allow me to serve me as a primary care doctor and not be concerned so much about billing and coding like in the traditional model,” Caughron, who settled in Galveston in December with his BOI wife, Elise Dimuzzo Caughron, said.

Caughron was trained under the traditional model of medical practice at the University of Texas Medical School at Houston. A native of Andrews in West Texas, he was first drawn into emergency medicine from his work as a medic/fireman in Conroe.

“A quest for adventure led me to that,” he said. “But as I matured, I really started wanting to fix and prevent problems.”

Caughron was out of medical school and in a career in emergency medicine when bouts with burnout made him take stock and prescribe a different future. He decided to start anew with a primary direct care practice, setting up in Galveston. 

The practice includes:

• House calls and workplace visits;

• Membership plans that are month to month and require no contract;

• Quick responses to emails and Twitter messages;

• Integrative care, including consulting with other physicians, physical therapists, chiropractors and acupuncturists; and

• No contracts with managed care, such as health insurance, Medicare or Medicaid.

Caughron often sends patients to Rodney Nelson of Lifestyle Investment Solutions in Galveston to pair their health care with health insurance.

“We kind of think of it as you wouldn’t use auto insurance to fill your tank with gas or to change your oil,” Caughron said.

“So for everyday health care needs — like check ups, minor illness, or minor injury — it doesn’t make sense to use insurance. You use insurance for the large expenses that might require hospital care.”

Nelson also works with businesses to pair lower-cost insurance plans with Island Direct Care.

This outside-the-box medical practice is in its infancy, Caughron said. But the rewards outweigh the challenges.

“The most rewarding work I can think of is to be able to do something I feel a great purpose in, and I have the freedom and autonomy to actually do it,” he said. “It’s incredible.”


  • For information, call Dr. Stephen Chappelle Caughron, 409-276-8770, email, visit or search Island Direct Care on Facebook.
  • Upcoming events include a ribbon cutting and address at the Galveston Chamber of Commerce, 2228 Mechanic St., at 5:30 p.m. Thursday. Caughron also will be speaking on medical economics at a soon-to-be scheduled event at Oasis Juice Bar & Market, 409 25th St., in Galveston.

(4) comments

Miceal O'Laochdha

This is very interesting. I wish the good Doctor luck with this new endeavor and may just contact him myself.

Even with health insurance and a massive medical complex on the Island, medical care here, as elsewhere, can be a challenging series of events and misadventures. This new format (or is it actually a return to an older format?) may be a good alternative.

Thanks for the story. Useful news is always appreciated.

Steve Fouga

A revolution in medical care is occurring, right here on the Island.

Make no mistake, a medical care revolution MUST occur, or else the economies of several world powers like the U.S., Japan, China, etc., will tank as their populations age and their younger citizens demand health-care entitlements.

Revolution is inevitable, and it'll be interesting to see how it unfolds. It's great to see an Island physician playing a role. (Gee, free enterprise is a great economic model!)

George Croix

About as close as it's likely to get to the house calls and no insurance fighting of 50+ years ago. Old Dr. Cobb was practically a family member...

Mike Box

Great story. Good luck Doc!

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