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Let me tell you a story about the day my car got towed.

My wife and I were set to meet for a weekday brunch—a rare treat. We were both coming from different parts of town and had separate errands afterward, so we drove separately. I took a bit of a roundabout route and arrived a few minutes after her, rushing so that I would not have to keep her waiting.

The large parking lot was shared by multiple businesses and was already packed. Thankfully, I spotted a few spots in an adjacent lot toward the back. I pulled into one and noticed a sign that read, “Parking for Patrons Only.” Perfect, I thought—I’m here for brunch, so I should be fine.

The meal was fantastic, but when I returned to the lot, my car was gone. Instead, I found a tow truck readying another car for towing. I asked the driver if he’d towed my car, and he confirmed it. I explained that I was a patron of the diner, pointing out the sign, but he shrugged it off, saying I was parked in the wrong lot. Apparently, “patrons” only referred to customers of a different building in the complex—a detail that was nowhere to be found on the signs near my car. I felt frustrated and, honestly, duped.

While I was still talking to him, a family arrived, shocked to see their car about to be towed as well. Fortunately, their car hadn’t been hooked up yet, and after pleading, the driver let them off for $120 in cash. How gracious! 🙄… The whole thing felt sketchy—unclear signs and paying cash to avoid a tow.

I was parked on the north side of the lot, and as I looked around, I noticed that other signs on the south side of the lot specified “No Restaurant Parking,” but these signs were nowhere near where this other family and I parked. I hadn’t intentionally broken any rules; I’d parked based on the only signs I’d seen. I decided to head into the property management office to explain the situation, hopeful that someone there would listen.

After waiting a few minutes, I explained to the property manager that the signage was confusing. I politely asked if they might consider reimbursing my tow fee or, at the very least, improving the signs to prevent future confusion. The response was a flat “No.” The manager insisted the signs were adequate and even mentioned that others had tried—and failed—to sue over similar incidents. She had no intention of taking accountability, leaving me frustrated but with little recourse.

I called for a Lyft to take me to the impound lot, and the driver turned out to be one of the bright spots in my day. He was a recent immigrant from Pakistan with a fascinating story. We got into a conversation about his education and the challenges he faced, especially with an ongoing medical condition called hidradenitis suppurativa (HS). HS is a chronic skin disease that causes painful nodules and abscesses. The condition had interfered with his studies, which ultimately led to him getting kicked out of the university. We continued our conversation until we reached the impound lot. As we arrived, he kindly offered to wait, just in case I needed a ride back. I assured him I’d be fine.

I spoke to an employee of the towing company over the phone and was told that I would be able to retrieve my car in 40 minutes. While I waited for my car, I realized it was time to call a patient back—someone I knew was struggling. The beauty of DPC is that I don’t need to be in an office to help someone. So, I called him from the parking lot, and we talked about his challenges for nearly 30 minutes. He was facing difficulties financially, emotionally, medically, and socially, and his situation had grown even more overwhelming. He mentioned that he’d recently thought about driving off a bridge, feeling his family might be better off without him. Thankfully, talking things through seemed to lift his spirits, even if only temporarily.

At the end of the conversation, I asked if I could share my own frustration with him, and he listened as I told him my towing story. I think we both felt better after that. The bond between patient and doctor in DPC is special—it allows for an exchange that isn’t just about medicine but about being there for each other, no matter where we are.

Finally, I was able to retrieve my car—for $332.73. I’m fortunate enough to have savings and a good job, but I couldn’t help thinking about others who might struggle to pay such a high fee. And I wondered if the man behind the counter, whose face was hidden behind a half-drawn blind, ever questioned the ethics of his work. I asked him if he liked his job, and he responded cheerfully, “I love it!” but didn’t elaborate when I asked him what he loved about it.

After I returned home, I debriefed with my wife and sent an email to the property manager, including photos of the confusing signage and again asking for reimbursement. Her response was the same: the signage was clear, and they were not responsible.

My Takeaways from This Experience

Accountability in Business: I wish more businesses, whether they’re parking lots or tow companies, were accountable, honest, and fair. Misleading signs and unclear policies benefit no one, and this incident has only reinforced my belief in the importance of transparency and good business.

The Value of Direct Primary Care: I believe in DPC because it’s a model that prioritizes people over profits. If my Lyft driver had had access to affordable, continuous care, I wonder how different his educational journey—and life—might have been. HS is tough, but it can be managed with the right care. DPC can help people navigate challenges before they spiral.

The Meaningful Choice of DPC for Doctors: If more physicians pursued DPC, we could move closer to a healthcare system where people are seen and treated as individuals, not numbers. While the financial rewards of a traditional insurance-based practice are tempting, DPC provides the kind of meaningful connection that helps both patient and doctor heal.

Stay tuned for Part 2 of this story, where I explore this entire situation even further.

Last night when it was dark I was walking over to Whataburger to pick up a Patty Melt that my wife and I were going to split for dinner. It was a great choice - we made salad at the house and were going to split a less healthy Patty Melt. It wasn’t a healthy option but it was exactly what we were looking for. Delicious, fast, easy to come by, and not too much of a hassle (I thought). That trip to Whataburger turned into the saga you’re about to read.

It was about 8:45 PM when I left the house. It was dark already. My street has pretty poor lighting. We live a few blocks away from Whataburger, so despite all of that I still decided to walk. We do walk quite frequently, though less-so in the dark.

I was about one block away from my house when I felt a pang on the top of my foot and I hit the ground. I looked back and found that there was a bent pole that was curving over the sidewalk, obscured by the darkness. After I hit the ground, I had a pain/prick in both hands because I landed on some thorns. I cussed, got up, heard a dog barking in the background, brushed myself off, and used my flashlight to examine my foot. I looked back and saw that I had tripped over a metal, rusty pole that was bent over the sidewalk.

I didn’t have any major injuries but I was wearing sandals and the rusty pole did pierce the skin, so I knew that I’d have to look into seeing if I needed my Tetanus shot.

I continued walking on to Whataburger, and after rounding the corner, I came across an unleashed big dog that seemed fairly aggressive. “Shit” I thought to myself. The dog lowered its head and started walking towards me. It reminded me of how Simba and Mufasa practiced hunting in the Lion King. I started yelling in order to try to scare it away, but it kept approaching, growling, barking, and snarling, so I turned and ran. I ran in the opposite direction of the dog, but I kept my head cocked looking at the dog to see if I’d have to try to defend myself. Running the opposite direction of the dog meant running straight into the (normally fairly busy) street.

No, I didn’t get hit. As I was running, I realized the possibility that I might get hit simply because I didn’t look both ways and my head was turned looking backward at the dog as I was running forward into the street. Thankfully, the dog stopped chasing me, I’m sure I cussed again, and I proceeded to Whataburger, after making it safely across the street.

I got my Patty Melt without issue and proceeded home. I walked on the opposite side of the street to avoid the dog, trying to bypass it by a couple houses, thinking I’d be in the clear then.

But I wasn’t. It found me and chased me across the street again through a parking lot. I’m sure I cussed again as I chose an alternate route home. On my route home, I pulled up a file on my Google Drive that had my vaccination history, but as I was looking I tripped and stumbled on an uneven curb. I decided it was probably time to stop being distracted and just make it safely home.

I got home, explained the saga to my wife, we laughed about it, and then I started trying to figure out what needed to be done.

I saw that my last Tetanus shot was in 2013. That shot needs to be re-upped every 10 years, or if you have a wound that you sustain that might get infected with tetanus, and you haven’t had a shot in 5 years, it’s time to re-up. So I decided that I needed to get a tetanus shot the next morning.

Thankfully, I’m a doctor, so getting a tetanus shot shouldn’t be difficult, right? I own a direct primary care clinic, and even though I don’t stock vaccines, I do know how to order them.

The next morning, I woke up and looked online at one of the medical suppliers I typically order things from and saw that the Tdap vaccine would run me about $50-60 per shot, without shipping. Well, I didn’t need 10 vials of the vaccine - I just needed one for myself, so I moved onward. Thankfully, Forest Park Pharmacy is a local, non-insurance-based pharmacy that makes things easy. When you call, you almost instantly get to speak with someone and get your questions answered. Several weeks before this, I believe I spoke to the pharmacist/owner there, Glenda, and was told that a tetanus shot would run about $50-60 - a reasonable price.

But then I remembered that I had just tabled at a Back to School event and that Tarrant County Public Health was doing a vaccine drive where they were charging $10/shot for children and $15/shot for adults.

It looked like the Fort Worth Main Campus was open that day so I figured I’d give it a shot.

I got to the building at about 8:50 AM. I went to the front registration and told the man there that I needed a tetanus shot. He looked over to his left and there were probably 2 dozen people sitting in school-assembly-like seats that I could only assume were there for vaccinations, probably back-to-school shots. He then pointed me over to a door behind me that said something along the lines of Travel Clinic and told me to go in there.

I thought, “Great!” - I might get in and out. So I went in there and told them that I needed a tetanus shot. They seemed ever-so-slightly annoyed and asked if I had an appointment. I told them I didn’t and they asked me to go out to where I was previously to ask if they were full. I did and the man told me they were full, so I returned to the travel clinic.

The travel clinic then gave me some forms to fill out. There were 3 to 4 forms in total. Each form had me write my first and last name, date of birth, phone number, email address, and physical address - 3 to 4 separate times. No big deal - that’s expected and I’m used to that in healthcare - so I did it.

The lady behind the counter then asked me if I had insurance. They actually asked me multiple times but this was the last check.

Keep in mind that I realized I’m wearing my “Insurance ≠ Healthcare” shirt. I told her I didn’t have insurance. And when I said that, I felt slightly embarrassed about it, but that’s a different story.

She said there was another form I had to fill out that acknowledged the fact that I didn’t have insurance. By acknowledging the fact that I didn’t have insurance, the cost of the vaccine would drop from $75 to $15. Thankfully, I didn’t have insurance.

I then was escorted back to a room and received the vaccine without a problem. I paid $15 cash after the fact.

After I got the shot, I asked the woman who gave it to me if they make money on the shots. I couldn’t imagine they did, and she confirmed that. Then I told her, “so, you lose money on the vaccines.” And she said no. I was somewhat confused. If they didn’t make money on them or lose money on them, then what other option was there? Maybe these were extra vaccines that they were trying to get rid of so they were selling them at a reduced price, but she confirmed that wasn’t the case.

I’m not 100% sure on the financing, and neither was the person I was asking (I think), but she supposed that maybe TCPH didn’t lose money, but the state did. She stated that TCPH gets these vaccines using a grant from the state. So sure, the state lost money charging $15 per shot, but TCPH didn’t. I guess that worked for me.

Overall, I was a happy customer. I was in and out fairly quick and got what I needed for an affordable price. I do have a couple thoughts, however.

1. I got lucky at the time I showed up. The main vaccine station was full so they sent me to this seemingly “overflow” area that serviced patients faster. One of my patients recently tried bringing his daughter in to this same place for her back to school shots and he said he waited for hours just to be told that they were closing. Maybe it wasn’t the time that I showed up, but the fact that I was white (something that everyone that treated me implicitly knew) that allowed me to get faster care. I think that’s got something to do with it. Because I spoke English and am white, I think I was privileged to receive the care that I did. Big claim, but it’s probably true.

2. I benefited significantly from not having health insurance. Simply by not having it, the price of the vaccine dropped from $75 to $15. Hypothetically, if I did have health insurance, it would still cost me more than $15 to get vaccinated. I would pay hundreds in monthly premiums and probably pay a copay or other fees in order to get vaccinated. Health insurance would have complicated something that should have been so simple, and it would complicate things while simultaneously raising the price for me. How does health insurance deliver any value to me as the insured in that case? What would I be paying for? Sure, health insurance is needed for catastrophic events, but in simple things like this, it just complicates things, increasing the hassles we face and the prices we pay.

3. I have to think that the reason that Tarrant County Public Health has a deal for people without health insurance is that they assume those people are typically underserved from a health or healthcare standpoint. It’s funny I was wearing my “Insurance ≠ Healthcare” shirt, so I clearly don’t believe that health insurance ensures a person gets healthcare or makes progress toward the state of being healthy. Sure, most people with health insurance probably do have easier access to healthcare and are probably more healthy than those without, but it doesn’t have to be that way. Not having health insurance is a surrogate, and a poor one at that, for not having access to healthcare or for being unhealthy. But that’s how it’s used in the healthcare industry, and that’s how it was used at Tarrant County Public Health. That’s how it was promoted in the Affordable Care Act - the goal was to get everybody health insurance, not healthcare, and certainly not health. I used to be a huge proponent of that! The assumption was that health insurance leads to healthcare which then leads to health; because that’s the assumption, and because I don’t have health insurance, it’s assumed that I can’t get healthcare, and it’s assumed that I can’t be healthy. None of that is true. Health insurance doesn’t promote healthcare and healthy life; it impedes it.

4. Why can’t we streamline these forms, people?! 3 to 4 forms, each with something that I have to write over and over and over again. How about one demographic page and then a signature or initials on the rest?

5. The financing of Tarrant County Public Health is confusing. Are they losing money on the vaccines that they give out for $10-15/shot or not? I understand the financing is probably complicated, but couldn’t it be simplified?

6. The job of the Tarrant County Public Health Department, and all health departments, for that matter, is HUGE. They have so much responsibility. Their job is to ensure the health and wellbeing of their residents. In addition to providing vaccinations, this also means helping clean up poles that are curving over sidewalks, helping deal with stray/mean animals, fixing sidewalks, and countless other tasks. But by being entrenched in the insurance-based system, their attention is diverted elsewhere, making them less capable to achieve their mission to use their “expertise to advance the community's health through accountability, quality and innovation.”

Our entire healthcare system is based on insurance. Insurance is the payer, so insurance is the controller. They who control the dollars control (almost) everything.

Let’s bypass insurance, fix the system, make healthcare affordable and sensible, and improve lives. Let’s start that here in Tarrant County.