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Dear Patient, 

I’m writing to announce an important change taking place at our practice. Please read this carefully as this change requires a response from you.

Dr. Gemie



In the last couple of years, insurance companies have significantly reduced reimbursement to primary care medical clinics. These changes have left our clinic with a few options to continue providing care for our patients. Our clinic has to see more patients in a shorter amount of time, or change the way we take care of patients and their families. If we do not make any changes, the reality is that the final option is to close the clinic entirely.

During my research into these options, I realized that seeing more patients in a shorter amount of time will reduce the actual health of the patient because we do not end up having the time to discuss the topics that actually keep people living healthy lives. This is why I opened my medical practice in Enumclaw 5 years ago. I wanted to see patients actually live healthier, more active lives, and now this style of care is being threatened.


We are all feeling the effects of the changes to the health care system both financially and in the experiences you have when you seek medical attention outside of this office. Many of you have reached two conclusions as well:


  • It’s expensive to be sick - and even more expensive when you are left dependent on medications to carry you through the day.

  • It’s very hard to manage your health proactively when the system requires you to be sick before it will help you.


As you may already know, we’ve invested years developing an expertise in what we believe is a better approach to managing health in partnership with my patients by addressing the causes rather than the effects of your health issues. Best of all, we have learned to design and use your lifestyle as medicine instead of always turning to medications.  


This fall, I concluded that it is time to change the way we practice and evolve the way we deliver care to you, our patients. I have undertaken to turn our practice into what will likely become a practice model of the future.  


What will change?


We are making a wide range of improvements to the practice and the service experience. Among other exciting things, we are expanding our team and bringing in new technology to support you in achieving and maintaining optimal health. To realize this vision means we make a fundamental change.


Today we manage the care of over 6,000 people. Like many doctors in our overcrowded system, I have had to accept that this is neither sustainable nor fair to my patients. To ensure sufficient time for us to work together as a team to reach your health objectives, I have made the difficult decision to reduce the size of our patient panel by roughly 50%.


This is a very difficult decision for myself and our team, but to allow better overall care for our patients, it was the only way to move forward. To be fair to everyone involved, I am notifying all 6,000 of you at once, and we will fill our available spaces on a first-come, first-served basis. When we reach our limit, we will add others to a waiting list as we do today.

Between now and February 28, 2024, I will ONLY accept enrollments from existing patients and your family members. On April 1, 2024, if any spaces remain, I will extend the invitation to our practice waiting list and others in the community. 


You may find more information and reserve your space in the practice here. I will also be hosting several group discussions. The dates for these events are:


Tuesday January 16, 2024 at 6pm 

Saturday January 27, 2024 at 3pm

Thursday February 1, 2024 at 6pm


To help us prepare, please contact our office at 360-762-3445 or by email at either to let us know your intentions or to register for a group meeting. We will be happy to answer your questions by phone or in the office as well.


I’m excited about this new direction for the practice and hope you decide to join us on this new journey. 


Yours in health,



Brian Hiller, PA-C 

and your Rainier Medicine Team: Rhonda Warren, PA-C Gina Gwerder, ARNP

Rainier Direct Care
Membership Pricing

  • Individual (Age 0-18) - Enrollment Fee Waiver with Adult Member and $540/year or $50/month

  • Individual (Age 19+) - $99 Enrollment Fee and $1,620/year or $150/month

  • Families - $150 Enrollment Fee and $300/month for two adults, then $20/month for each child OR $3,420/year for two adults and $216/year for each child

Contact Information

Call or Text



853 Watson St N Suite 201, Enumclaw, WA 98022

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