How do you bring the heart back to medicine? What was the experience of the last time you visited your primary care medical provider? Were you able to see the doctor the day you called?  How crowded was the waiting room? Was your time reading the waiting room magazine longer than the time with your medical provider? Does it seem that you see the back of your doctor’s head more than you see their face as they type furiously into their computer?

Today’s primary care physician has between 4,000 and 6,000 patients. Most physicians cannot afford to spend more than 10-15 minutes with their patients due to insurance paperwork requirements. Young family doctors are burning out with the demands of “fee for service” practices. Many of these doctors leave family practice to staff urgent care facilities or return to school seeking to move into specialty medicine with its reduced patient load and higher reimbursement levels.

We may long for the day of the family doctor who knew each of us by name and asked not only about our illness but asked about our life and our family. You can still find these doctors, but you must know where to look. An intrepid group of entrepreneur physicians and physician assistants are abandoning “fee for services” medical practice and embracing a more relationship-based medicine. This new service is called Direct Primary Care (DPC).

To use DPC, a patient pays a set monthly membership fee which covers as many same day or next-day visits as are necessary; as much one-on-one personal time with your provider as needed; 24-7 availability by text, phone, email or video chat; and discounted labs, prescriptions, and procedures. There are many advantages to the DPC model for the doctor as well as the patient.

The patient has affordable health care that can easily be budgeted just as one would budget a gym or a club membership.  DPC medical providers usually limit their practice to 400 to 600 patients, which results in appointment times being easier to get and little waiting when arriving at the office.  Acute medical issues are dealt with promptly rather than festering into a more serious condition waiting for an appointment opening.  Treatment of hard to manage chronic issues can be more easily scheduled. Time can be spent asking questions about treatment and treatment alternatives.  The after hours and weekend availability of telephone consultations gives peace of mind when faced with your own or a loved one’s sudden illness.  One patient called his DPC provider, “my curbside doctor”. I must admit that I did once pull up to my provider’s office without an appointment. My experience was just the same as if I had had an appointment!  I would strongly suggest respecting the doctor’s time and calling ahead if possible.

The advantages of the DPC model for the doctor revolve around practicing relationship medicine, the reason most physicians got into the field.  Spending time with the patient without having to rush.  Having time to listen and to become more connected.  Getting to know the patient.  Understand the patient’s lifestyle.  Discerning the patient’s unspoken concerns.  The practice of medicine becomes a relationship rather than a delivered service, which extends to the staff, too.  Without the hurry and rush of insurance filings and determining service designations, staff members can spend more time attending to patient needs, providing even something as small as a glass of water.

The office of the small-town doctor makes a comeback under the DPC model. There is more privacy with the DPC model.  Third party insurance carriers and plan administrators are removed from the equation. A real doctor-patient relationship exists.  Lab tests are done in the office with skilled, experienced staff members, who know the patient, taking the time to provide these private services.

DPC has proven to be advantageous to some local small businesses.  Some DPC providers offer a corporate membership plan to employers.  Business owners whose businesses fell below ACA requirements for providing medical coverage to their employees, could not afford to offer coverage, but still wanted to offer some medical benefit to their employees.  The corporations pay for the employee’s monthly membership fee.  Spouse and dependent coverage is paid for by the member employee.  Companies who have taken advantage of this plan have found their employees to be less stressed due to the affordable and accessible medical care available to their entire families.  The employer has employees who are focused on their jobs, are healthier, and are more likely to be at work than at home sick.

Another advantage for both employer and employee is the opportunity to use alternative pain therapies.  Two such therapies are “level 4 deep tissue laser” and “horizontal therapy” (developed in Germany and widely used throughout Europe).  These alternative treatments may be very effective for acute and chronic pain without the use of opioids or narcotics.  Doing this returns the employee to work quickly and safely since this treatment does not impair judgment.  The company has a productive employee, and the employee has a full paycheck rather than a partial disability payment.  Additionally, these therapies may be able to control pain to a degree where otherwise surgery may have been the only other alternative, again reducing lost time at work for both the employer and employee.

90% of all health care dollars goes to primary care.  DPC offers the opportunity to reduce these costs to a manageable, predetermined amount.  By using the corporate employee membership plan, companies can lower their health insurance costs by offering higher deductibles. They know that their employees and families still have affordable access to primary care through their membership.

While DPC providers avoid working with insurance companies to allow for more time with patients, some collaborate with medical cost sharing plans.  Medical cost sharing programs are usually faith-based ministries made up of individuals who unite together to support each other financially and spiritually in times of ill health.  These plans send the reimbursement for medical costs directly to the member who in turn pays the provider.

The horse and buggy doctor is gone forever.  “Dr. Judy”, as I call my Direct Primary Care medical provider, and her staff is bringing the heart back to medicine.  There is always a smile inside the waiting area and the exam room.  Compassionate, caring, and competent medical care can be found within a Direct Primary Care medical practice.

Reference: Every DPC provider is a little different in their fees and services provided. More information on DPC can be found at http://www.dpcare.org. A listing of organizational member offices is available on this site. Be sure to also check local area resources like Chambers of Commerce for DPC medical providers in your area.

 

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