At the heart of what we do is acknowledge that every patient is an individual whose personal goals and needs must be recognized.  With the help of their Internal Medicine physician, they have the right to live the most productive and healthiest life possible.

The patient-physician relationship works best when both parties work together as a team.  This requires communication, developing a plan and then executing the plan.  I value your input.

Preventive Medicine

Prevention is key to good health and it’s rarely too late to take action.  We achieve prevention by getting to know you, your past medical and family history.  We spend the time to understand your personal goals and needs.  We address lifestyle changes, educate you on the most likely threats to your wellbeing and offer appropriate preventive screening tests.

Early Disease Detection

Throughout my training and career I have witnessed the importance of early disease detection.  Early detection will usually result in a much better health outcome, require less medical attention and save you tremendous amounts of health care dollars.

We accomplish early detection by performing a comprehensive annual exam and applying noninvasive technology to assess your various organ systems for disease.

Rapid Response

When you do become ill it’s important we get you back on your feet as soon as possible.  We achieve this by same day appointments or contacting Dr. Miloy 24/7 for urgent medical needs.  We also provide email access for less urgent medical questions or problems.  When traveling or geographically challenged, you will have access to telemedicine services for enhanced treatment and convenience.

Dr. Miloy – Background

On Becoming a Doctor

Welcome and thanks for stopping by!

Growing up I had strong interests in sports, science and helping others.  At the age of 15 I lost a very close friend to a drowning accident.  It was sudden, unexpected and could have been prevented.  It profoundly affected my appreciation for life’s fragility and compelled me to question the purpose of my own life.  His father was our family doctor and though initially devastated, he held onto the thread of his life’s purpose – the practice of medicine.  With humor, grace and service to others he continued to practice for many years and was a major inspiration.  I’ve always dreamed of practicing medicine the “Old Fashioned Way” like he did by taking time to personally know each patient and treat them with respect and kindness.  That dream has become reality with Optimum Health.  It allows me to apply the art and science of Medicine to serve others with dignity and respect.


I’m a native Texan and attended Texas A&M University where I earned a Bachelor of Science in Biology and Masters in Molecular Biology.  Afterwards, I attended medical school at Texas Tech University Health Sciences Center.  Internship and residency were completed at Providence Portland Medical Center in Portland, OR.


Medical Experience & Practice Interests

Throughout training I was very fortunate to have excellent mentors.  They each imparted wisdom and knowledge which has helped me to serve others.  The most important lesson was putting the patient first.

Internal Medicine was a natural practice choice as a holistic integrated approach to medicine resonated with me during training.  Respecting the mind-body connection is now at the core of my practice philosophy.

After graduating from residency I began applying this approach with an emphasis on lifestyle change and prevention. Working with other like-minded physicians my approach has continued to evolve.

I’ve been practicing Internal Medicine with a focus on prevention and wellness in Kerrville since 2002 and I’m committed to continue seeking ways to help people live the healthiest life possible.


David R Miloy MD

Ethos of Direct Primary Care

Optimum Health provides a more modern approach to helping to pay for Internal Medicine primary care called Direct Primary Care (DPC) that has been embraced by patients, physicians, employers, and policymakers across the United States.  The defining characteristic of DPC is a lasting and trusting relationship between a patient and his or her primary care provider.
Establishing this relationship is the key to achieving superior health outcomes, lower costs and an enhanced patient experience.

DPC accomplishes this by focusing on five things:

1.  Service:  The hallmark of DPC is adequate time spent between patient and physician.  DPC enables unhurried interactions and frequent discussions to assess lifestyle choices and treatment decisions aimed at restoring and promoting long-term health.  DPC practices have extended hours in which doctors can be reached, ready access to care, and patient panel sizes small enough to support this service commitment.

2.  Patient Choice:  Patients choose their own personal physician and are active partners in their healthcare. Empowered by transparency and accurate information at the point of care, patients are fully engaged in making their own medical and financial choices.

3.  Replacement of Fee-For-Service:  DPC eliminates the perverse  reliance on fee-for-service (FFS) incentives in primary care. These incentives distort healthcare decision-making by rewarding visit and procedure volume over value.  This undermines the trust that supports the patient-provider relationship and rewards expensive and inappropriate testing, referrals, and treatment. DPC is a simple monthly fee.  Fees must be adequate to allow for appropriately sized patient panels to support this level of care so providers can ignore the other financial incentives that distort medical decisions and compromise the doctor-patient relationship.

4.  Medical Advocacy:  DPC providers are committed advocates for their patient members within the healthcare system.  They have time to make informed, appropriate referrals and support patients when necessary outside of the primary care setting.  DPC providers accept the responsibility to serve as expert healthcare navigators for their members.

5.  Stewardship of Health and Healthcare Dollars:  DPC providers believe that healthcare must provide more value to the patient and the system.  Healthcare must be more patient-responsive, less invasive, and less expensive than it is today.  The ultimate goal is health and well-being, not simply the treatment and management of disease.