Dr. Raymond Kordonowy

Direct, Transparent, and Personal: Inside Dr. Raymond Kordonowy’s Approach to Care

From his early training to a pioneering practice in Florida, Dr. Raymond Kordonowy has built a career around challenging the status quo. Among the first physicians to experience hospital employment during the HMO boom, he saw firsthand how bureaucracy and third-party payers compromised patient care. Rather than accepting the system, he created his own path, developing a membership-based model that blends Direct Primary Care with inpatient advocacy, technology, and radical transparency. In this interview, Dr. Kordonowy shares his journey, his bold vision for a “virtual hospital,” and why he believes the future of healthcare belongs to independent physicians reclaiming their profession.

Starting Out: Education, Family, and First Practices

Dr. Raymond Kordonowy’s story begins in Kansas, where he studied liberal arts with a chemistry emphasis at the University of Kansas. He stayed at the same institution for medical school in Kansas City. During rotations, he realized internal medicine was where he belonged: “I liked the differential diagnosis. I always wanted to be kind of a patient’s main doctor.”

He married between his first and second year of medical school, started a family during residency, and eventually relocated to Florida, where his wife’s family had moved. After residency and a chief residency in Atlanta, he joined two private practices in Fort Myers. These practices eventually merged and sold to Columbia Health Care in the mid-90s, making him one of the first primary care physicians to experience hospital system employment.

This was during the HMO boom, a time when hospitals bought up practices, only to find the model unsustainable. “As we all know, history taught us that didn’t work out too well,” Kordonowy recalls.

Breaking Away from the System

Frustration with third-party medicine grew as he saw bureaucracy take over patient care. Medicare’s RVU payment system drove reimbursements down. Prior authorizations, administrative burden, and insurer control only worsened.

“I realized that the third-party system was destructive to my ethics and something I just couldn’t function well in,” he explains. He left his old group when they decided to stay in Medicare. For him, the path was clear: find a way to practice medicine on his own terms.

A certified clinical lipidologist, Dr. Kordonowy wanted to spend time with patients teaching lifestyle changes and managing complex conditions like diabetes and cholesterol disorders. But under Medicare, a half-hour counseling visit could bankrupt a practice. “If you’re going to spend a half hour trying to teach somebody about diabetes, pretty quickly under Medicare payment, you’re going to go broke.”

A Membership-Based Model

His solution was bold: bundle his services into a membership model, with direct contracts between doctor and patient. This approach would eliminate billing codes, prior authorizations, and dependence on insurers.

He structured pricing based on real operating costs, including diagnostic tools, staff, and technology. “I didn’t want to sit and submit codes for payment. It’s a huge drag on the cost of a practice to have to get your money from third parties.”

This model gave him freedom to innovate. Instead of waiting for a new billing code to try an idea, he could introduce services immediately. He also leveraged bulk lab pricing to offer patients transparent, affordable options.

The Inpatient Advocate Service

One of Dr. Kordonowy’s most unique innovations was the Inpatient Advocate Service. When hospitalist medicine displaced primary care doctors from inpatient care, patients lost continuity. He stepped in to restore it.

“I created what’s called the Inpatient Advocate Service,” he says. “It allows me to maintain my relationship and care with my patients, influencing and informing the hospitalist team with all the things I knew before the patient came to them.”

He would visit patients in the hospital at the end of his workday, help them navigate conflicting consultant opinions, clarify medications, and bring social context that hospitalists often missed. Patients were grateful: “They said, thank you for finally making yourself available to go to the hospital.”

The service became a cornerstone of his “Premier Program,” bundled into membership for patients.

Direct Care, Redefined

While he avoided the term “concierge” because of its elitist connotation, patients understood it differently: paying directly for better access. Over time, he embraced both the concierge and Direct Primary Care (DPC) labels, recognizing his hybrid model offered something unique, outpatient DPC with inpatient continuity. In other words, patients received the full benefits of a membership-based outpatient practice while still having their physician by their side during hospital stays, ensuring consistency of care in both settings.

The membership model also unlocked a new kind of patient relationship. Every new patient visit includes a broad health and wellness assessment, complete with antioxidant testing and lab panels. Lifestyle change is central, supported by continuous monitoring tools.

“Metrics is the new medicine,” he says. “When patients can see visually what’s happening, they’re motivated to change their behavior.”

Technology and the Virtual Hospital

Today, Dr. Kordonowy is pushing the boundaries of technology in DPC. His practice is piloting dashboards for blood pressure and heart failure management, integrating remote monitoring data, and working with AI to flag patients needing immediate attention.

“I envision direct primary care physicians becoming the virtual hospital,” he explains. “We can do telemetry, vital signs, medications, even coordinate with home health or infusion companies. A lot of problems can be managed at home if you’ve got the right support system.”

Having personally avoided hospitalization through his own practice’s monitoring, he sees the model as inevitable: decentralizing care, reducing reliance on traditional hospitals, and empowering patients.

The Power of Transparency

Patients respond strongly to transparency in his practice. Clear fees, direct lab pricing, and open communication create trust. Importantly, every patient is asked to set a personal health goal, which is then translated into SMART goals, specific, measurable, actionable, rewarding, and time-specified.

“For us, if we’ve got to hospitalize you, we failed,” he says.

Looking Ahead: ICHRA and the Future of Direct Care

Dr. Kordonowy is also excited about policy changes that support direct care. With the expansion of health savings accounts and the new ICHRA legislation, small businesses will soon be able to fund DPC memberships as employee benefits.

“This completely changes things,” he says. “All small businesses can now help pay for their employees to see doctors the way we are offering ourselves.”

For him, the future of healthcare is clear: patient-centered, transparent, technology-driven, and independent of third-party control. 

Dr. Kordonowy believes more private physicians will “leave the system” to reclaim their profession through Direct Primary Care. He sees doctors evolving beyond diagnosticians to serve as coaches, advocates, and even brokers for their patients. To do so, he says, physicians must strengthen skills in areas like functional immunology, genetics, and nutrition. As Florida chapter leader of the Free Market Medical Association, he champions a free-market solution that lets doctors deliver care without insurance interference. He predicts DPC will push insurers to focus on catastrophic coverage, lowering premiums and removing barriers from routine care.

The Practice Today

His Fort Myers practice, now home to three physicians, embodies this vision. Continuously adapting, the clinic embraces technology and a proactive approach that adds measurable value for patients. For patients, his practice offers a direct, transparent experience built on strong doctor-patient relationships and a forward-looking model of wellness.

Dr. Kordonowy’s work reflects a simple but powerful truth: when physicians reclaim autonomy, patients regain real care. His model blends tradition with innovation, showing that the future of medicine can be both deeply personal and radically forward-looking. For him, independence isn’t just about doctors, it’s about restoring health on patients’ terms.