Nationally, it’s becoming increasingly rare to work for a privately owned practice as a health care provider. But in the Flathead Valley, many have made the jump to try to give better care to their patients. 

Whether it was frustration dealing with health insurance companies or wishing they had more time to talk to patients during appointments, many independent health care providers in the region say they had reasons for wanting to break away from a larger institution. 

Across the U.S. in 2024, 42% of physicians reported working in a wholly owned physician practice, an 18-percentage point drop since 2012, according to a 2025 report by the American Medical Association.

Only 35.4% of physicians had an ownership stake in their practice in 2024, 18% below the 53.2% share in 2012 and less than half the magnitude of the shares, around 76%, of physicians who had an ownership stake in the early 1980s, the AMA report continues. 

There’s no doubt it’s expensive and time consuming to start a medical practice, but some providers in Northwest Montana have found success in their endeavors. 

Montana Imaging Center opened its doors in late 2024, with its owners aiming to provide more options for imaging services in Northwest Montana. It’s the business’ second location, the first being in Missoula. 

Business Manager Tate Kreitinger said all of the physicians who own Montana Imaging Center previously worked at Logan Health and started the practice to give an independent option for patients looking for imaging services. 

Located on U.S. 93 north of Kalispell, Montana Imaging Center offers both magnetic resonance imaging, also called an MRI, and computerized tomography scans, also known as CT using Canon brand machines. A general X-ray machine is expected to be added soon. 

When the imaging center opened in Kalispell, staff had two main goals: Give patients immediate care and remain a low-cost option. 

“One of the reasons that we believe we have found a niche in our community is the fact that we are able to get patients in very quickly, most times within two to three days. That’s a real plus for us, that’s one of our foundational principles is to be able to get patients in immediately,” Kreitinger said.

He said prices for MRI or CT scans are oftentimes a third of the price of what patients get when they go through a hospital for those services. The center also accepts insurance, and though provider’s orders are necessary to schedule an appointment, Kreitinger stressed that patients can request to go to Montana Imaging Center during conversations with their doctor. 

 Even though prices are kept low, quality is not sacrificed — Kreitinger said it was important to have had a good equipment partner. They use Canon equipment at the center, such as the Canon Aquilion Prime SP CT system. 

When radiologists start at the center, he said they are very impressed with the quality of images that come out of the facility. 

“Having a good quality product, having a good equipment partner, having local investors and doctors .... and then I would say strong backing financially. We’ve been able to secure that financing through local banking. So we’re pretty happy that we’ve been able to surround ourselves with local companies and businesses that allow all of our dollars to stay local,” he said. 

Before opening up the Kalispell location, some patients were driving to Missoula for imaging services. Positive feedback has come from patients, but it’s not the only area the center is seeking input from.

“Quite frankly, providers are our customers as well, and we received very high compliments from the providers in the valley who are looking to get their patients in quickly at the lowest price,” he said. 

Providing a good patient experience is the core mission for many independent providers. Glacier Medical Associates opened in 2001 and was founded by a small group of physicians who came together with the goal of delivering exceptional patient care without the influence or ownership of a hospital system.

Glacier Medical Associates is now the largest independent primary care medical group in Montana, according to Director of Human Resources and Operations Ashley Mulcahy. The group’s 25 providers offer 12 services: urgent care, primary care, newborn and pediatrics, men’s health, women’s health, geriatric care, immunizations, procedures, laboratory, Coumadin clinic (medicine that treats blood clots,) colonoscopy and a med spa. 

Dr. Jon Miller, a family medicine doctor, has been with Glacier Medical since 2001. At the beginning, the idea was to expand the scale of services provided to patients. 

“The ability to provide urgent care services to our patients ... as well as an expanded lab service that allowed us to provide the typical type of labs that we do in primary care and urgent care on a much quicker basis than having to send them to a reference lab,” Miller said.

While Glacier Medical Associates’ original location is in Whitefish, the clinic expanded to include a Columbia Falls location in 2020 to offer services to more residents. The latest expansion opened in Evergreen in July, with the continued goal to meet people where they are by providing primary and walk-in care in the community.  

Dr. Jeremy Jennings, pediatrics and internal medicine physician at Glacier Medical Associates, said what services to offer at the clinics is determined by patient feedback and interest from providers. 

“When you get that large kind of nucleus of medical providers in one place, you’re going to have a variety of interests. We all try to practice the aspects of medicine that we really find fascinating or that we think we’re the best at. I think we offer a pretty well-rounded variety of services based on the big group of experts we have on those topics,” Jennings said. 

It’s that kind of enthusiasm that makes providers interested in joining Glacier Medical Associates’ team, Jennings continued. 

“People that have seen our model and see that we enjoy what we do. We really enjoy our work and we give providers the leniency or the opportunity to kind of craft their own practice,” he said. 

The model of physician or shareholder ownership is something that many doctors find attractive, particularly those who want a say in how the practice develops, according to Miller. 

“It does require some longer hours with meetings and that kind of thing. But we receive satisfaction from being able to have the final say on what happens here, how we take care of patients, how we expand services and what our mission and values are — the buck stops with us,” Miller said.

This means everyone has “skin in the game,” according to Dr. Courtney Austin, pediatrics and internal medicine doctor with Glacier Medical Associates. Because it’s a business run by the providers, there is an obligation to make sure it’s a place that people in the community want to work.  

Glacier Medical employs 110 people compared to the 60 who were part of the practice when Austin joined 13 years ago. 

Even with growth, the mission remains the same. 

“When a patient comes into a clinic, sometimes it’s a very high stress situation. I always tell our nurses we don’t see people on their best days. A lot of times they’re scared, they’re anxious, and trying to kind of peel off those layers to allow people to have a positive experience can be life changing sometimes,” Austin said. 

FOR SOME providers, scaling up is the opposite of what they want for their practice. Dr. Todd Bergland opened Fountainhead Family Med in 2020, looking to provide a “small town family doctor” experience for his patients. 

After working at Glacier Medical Associates for several years, he had become aware of the direct primary care model, which has patients pay a monthly membership fee for services and forgoes health insurance. 

Back then, he thought that if Glacier Medical Associates sold to a hospital or corporate group, that would be the push he needed to start his own direct primary care clinic. However, that never happened, and as he neared his 50th birthday, he had to ask himself some tough questions. 

“It kind of became, ‘Well, is this what I want my career to be about?’ And I decided that I just have to do it, I have to leave and open a direct care clinic while I still can,” Bergland said. “And it’s been huge, I wouldn’t go back to the insurance world in a million years and it’s because I can take care of people the right way.”

The number of patients he sees hovers around 500, which he said is his limit for people he can see and give adequate care to in a timely manner. 

His Whitefish office is a cozy, cottage-like house, with warm wood details and just one exam room. Bergland’s office, where he holds meetings with patients, features a stone fireplace and comfortable leather furniture. All of these choices are intentional, with Bergland wanting to make visits a comfortable experience for his patients. 

Though all of this atmosphere seems like it would come at a premium cost, Bergland has never wanted to provide a service that his customers cannot access. His practice only includes two employees: himself and his physician’s assistant, Terri Williams.

Fountainhead Family Med’s monthly membership fee covers all doctor’s visits, after-hours access and in some cases, house calls. The membership model also offers “significant discounts” for services such as lab tests, medications, imaging and pathology.

The direct care model made sense to Bergland, whose background is in Army medicine. 

In 2005, Bergland completed his chief resident year at Madigan Medical Center in Tacoma, Washington, and was then stationed in Stuttgart, Germany. His three-year assignment in Stuttgart was interrupted by a 13-month deployment to Iraq, where he served as a tank battalion surgeon during Operation Iraqi Freedom. 

After seven years of active duty, Bergland left the Army and moved with his wife Glenna and their 3-month-old daughter to Whitefish in 2009. His family had no trouble settling in the area, but he missed the simplicity of how health care worked for those in the armed services. 

He said the big difference in the military is that the doctor doesn’t worry about whether the patient can pay for their care or not, because the government is paying for it. 

“It’s easier to find out how much a medication costs because there aren’t a whole bunch of different pharmacies and a whole bunch of different insurances,” Bergland said. “So even like providing cost-effective care is more streamlined and easier in the military than it is in the civilian world, where the prices of everything are sort of opaque, intentionally.”

Direct primary care doesn’t cover everything, as most doctors recommend patients still hold some level of health insurance, mostly to cover emergency or specialty care, according to the American Medical Association.

Bergland said the model works perfectly for his small practice. He wants to know all of his patients and be able to spend time with them at appointments, not arguing with insurance companies.

“The system now creates an environment where providers feel like they have to see a lot of patients to be able to make money. There’s all this ridiculous paperwork that has to be done to send to the insurance company to get them to pay — if they are going to pay for anything. So, it’s not a good system,” he said. 

Reporter Taylor Inman may be reached at 758-4440 or [email protected].

    Dr. Courtney Austin with a young patient at Glacier Medical Associates. The practice is the largest independent primary care group in Montana. (Photo courtesy of Glacier Medical Associates)