Consulting, Care, and the Direct Pay Future with Jacki Kment, PA-C, MPAS, DFAAPA

In a compelling Derm Dispatch conversation, Renata Block, PA-C, sat down with Jacki Kment, PA-C, MPAS, DFAAPA, a physician assistant in Lincoln, Nebraska, and owner of Integrity Dermatology, to discuss her pioneering journey with the direct pay dermatology model. With 30 years of experience as a PA—27 of them in dermatology—Kment has become a go-to resource for clinicians interested in breaking away from the constraints of insurance-based care.

“After the first couple of years, just due to our growth, we gained a lot of attention from PAs and NPs across the country being interested in direct pay dermatology,” Kment shared. She initially fielded calls and emails during her nights and weekends, but it quickly became unsustainable. “I decided to start a consulting business, which allowed me to focus on those individuals who were truly interested... versus those who were just curious.”

When asked what advice she would give others considering this path, Kment distilled it down to a clear roadmap. “Do your homework. Really take time to thoroughly research, investigate and plan before implementing. Reach out to those who have done this... consider investing in a consultant to help you plan and succeed.”

She stressed that motivations matter. “If your drive is to simply make more money from the get go, then you might get frustrated, because it is a new practice model. It can take time... I would say, also having enough financial reserve to handle the building of your practice over time, because there's lots of variables.”

Kment noted that even with 2 decades of patient relationships in the community, growth wasn’t instant. “For us to get to a full schedule, I mean, it was a good couple of years... We're not spending a lot of money in advertising more by word of mouth.”

Looking ahead, she is considering expansion and succession. “We're currently exploring the opportunity to expand our practice, there’s a suite opening up next door.” Her vision includes finding “a like-minded PA or NP who’s interested in the direct pay model... and provide stellar customer service.”

Despite interest from investors, she’s protective of what she’s built. “My concern about that is just the unlikelihood that they would actually continue the direct pay practice model.” Kment reflected on her journey with appreciation. “It is a really refreshing and rewarding practice model... I wish I would have done it sooner.”