A new membership-based doctor’s office has set up shop in Kennewick, joining others in the region and across the state offering a different model for primary care. 

Dr. Stephen Smiley opened his practice at 8101 W. Grandridge Blvd., Suite 120B, in Kennewick at the end of January. 

It was a big step to open his practice, becoming a businessman in addition to a doctor, but the care is worth it. And it’s not the first major change Smiley’s made in his career.

A Pasco High School graduate, Smiley worked on the East Coast for a while in national defense before pivoting to attend medical school.

“My grandfather was an orthopedic surgeon, and so I always thought that that was the career that I envisioned having,” he said. 

Returning home

He came back to the Tri-Cities for a family medicine residency at Kadlec after attending Duke University, then he spent three years at a private practice in Coeur d’Alene. 

During that time, Smiley had to see many patients each hour, causing appointments to be rushed and frustrating for both doctor and patients. Dealing with insurance was difficult as well.

He began talking with the owner of a direct primary care practice and decided that was what he wanted to pursue. That was a year ago, and now, his own practice is up and running.

“Direct primary care, it really, I think, makes the patient feel that they are heard ... that their doctor has time to spend with them,” he said.

As a direct primary care provider, Smiley takes on membership-based patients, meaning they pay a flat fee for care each month regardless of how many appointments they make.  

Membership costs $150 per month for adults and $40 per month for children of members, with no additional fees or hidden charges. 

“The great thing about direct care is if you don’t have insurance, now you have a primary care doctor that most likely can handle the majority of your issues,” he said. For services outside of the scope of Smiley’s primary care, like seeing a specialist or getting imaging done, having insurance can still be helpful.

For the membership price, patients get increased access to their primary care provider. And when urgent needs arise, a doctor is only a phone call away and patients can get in immediately.

Smiley’s practice also offers corporate rates on request for interested employers, and he can even set up a program for employers to pay for half of a membership rate, with employees paying the other half. 

Smiley chose to open his practice in the Tri-Cities because “my wife is from Pasco … and I’m from Pasco as well, and so I wanted to come back home and come serve my community,” Smiley said. 

The Smiley name is a familiar one around the Tri-Cities. His brother is Scott Smiley, the Army’s first blind active-duty officer, and his sister-in-law is Tiffany Smiley, who unsuccessfully ran for Congress in 2024.

Located at 8101 W. Grandridge Blvd., Suite 120B, in Kennewick, Stephen Smiley, MD, Direct Primary Care joins several other membership-based and direct primary care practices in the region as well as across the state.

| Photo by Rachel Visick

A growing model

The Kennewick clinic is one he hopes will be accessible to all of the Tri-Cities. It’s just down the street from Empowered Health, another membership-based primary care practice which recently expanded.

Other membership based or direct primary care practices have been popping up throughout the Tri-Cities. Remedy Health and Wellness last year moved to a physical location in Richland, and Total Care Clinics in Richland offers direct primary care options as well.

Increased patient access to doctors, as well as more frequent visits and flexible scheduling, are common themes among the clinics. 

Statewide, there were 81 direct practices registered in the state in 2024, the same number as in 2023, according to data from Washington state’s Office of the Insurance Commissioner, which puts together an annual report on direct practices. 

While 2024 saw 31,419 direct practice patients, down 0.8% from 2023, on a five-year scale, it’s clear that direct practices have been growing in the state. 

In 2019, 14,482 people were patients of a direct care practice, and only 34 such practices were registered in the state.

“I have that confidence that this type of a practice is needed in the Tri-Cities,” Smiley said. 

People have been responding positively to his practice, he said, and he’s been getting new members. He doesn’t have a specific cut off point, but Smiley will keep the membership in the hundreds in order to spend the time with the patients that they need.

Ordinarily, doctors serve between 1,500 and 2,000 patients at a given time, he said.

Smiley isn’t alone in this endeavor. His wife, Berta Smiley, has helped him in launching the business, researching business licenses and looking at potential locations. She also got the website up and running and now orders supplies, answers the phones and does the accounting. 

Go to: smileymd.com