It’s kind of like Uber or Airbnb for health care, Dr. Steve Baker likes to say.The outside-the-box thinking that’s changed the way people hail rides, book rooms and watch television works similarly to the way Main Street Family Medicine in Vancouver will provide health care. As the slogan of Baker’s practice goes, it’s “Modern medicine, the old-fashioned way.”Similar to a gym membership, Main Street Family Medicine in Vancouver provides primary care to its patients for a flat monthly out-of-pocket fee.The cost is $70 a month for ages 19 through 44; $85 a month for ages 45 through 64; $15 a month for ages newborn to 18 years with an enrolled parent; $30 a month for ages newborn through 18 without an enrolled parent; and $30 a month for ages 19 through 24 with an enrolled parent. The idea is called direct primary care and it’s growing, with more than 620 practices in the U.S., according to the Direct Primary Care Coalition.“We saw a big need in the community,” Baker, 57, said of his practice, which opened in late July. “There’s a group of people who make too much money to get government programs, but they don’t make enough money to afford to pay out of pocket for health insurance. They want to pay their own way. They’re not looking for a handout. But they’re just kind of stuck in the middle.”Baker has been practicing medicine in Vancouver for 23 years, and for the past 17 he’s taught doctors as part of a family medical residency program through the University of Washington and PeaceHealth.Right now Baker has about 40 patients, and only works the practice part time with three nurses, who together make up full-time coverage. His goal is to have 350 patients, and possibly in time add another part-time doctor so the practice can see around 700 patients. But keeping the patient base small is important for Main Street Family Medicine. Each first visit is always an hour long.