(An altogether typical response to the direct primary care model!)
I'll answer this with two thoughts:
"You don't expect your car insurance company to buy you gasoline."
An insurance policy is designed to protect you in the event of unforeseen disasters; fender benders, flooding, house fires, etc. Like fuel or auto maintenance, primary care is a necessary practical commodity. The majority of primary care is not "crisis care," but "health-care." It makes sense to pay for this type of service directly instead of making "claims" to a company that makes money by denying them and then paying extra to fund a complicated infrastructure of people who argue back and forth over what your plan covers and what it doesn't.
"Monthly membership in my practice will probably cost less than your monthly phone bill."
My practice will save most patients a lot of money. Exceptions may include patients who have insurance provided through Medicare or the military. Review your policy and assess what you spent on health care in the last year; include co-pays, medicines, urgent care or ER visits, and lab/imaging bills. Then look at the DPC model and weigh the pros/cons. Come by or call and I can answer your questions and explain how this could work in your case. Membership in my practice is an agreement between you and me; communication and clarity are key.
What sets you apart from other practices?
The DPC model skips the bureaucracy. It cuts the red tape. In refusing to recognize any interference with the sanctity of the patient/physician relationship, this option returns family practice medicine to its root values of clinical excellence and compassionate knowledge of every patient. In every aspect of family health care it increases accessibility, convenience, and affordability.
Is Concierge Medicine the Same as Direct Primary Care?
These terms are often used interchangeably, and are essentially cousins at two ends of a spectrum. A standard concierge physician charges from $500 to several thousand dollars per patient per month and limit their patient panels to 100-200 patients. Basically you pay more money for more access to your doctor. In contrast, direct primary care practices average around 600 patients per physician but charge much less; between $50 and $100/mo depending on the payment structure (family discounts/age of patient etc). DPCs have been described as "concierge medicine for everyone" and are generally priced to save the average patient/family money while increasing the level of physician access as compared to current conventional medicine.
Direct primary care is a healthcare model that allows us to actually put the patient first. That means treating patients when they need treatment, not rushing patients through appointments, and being there for patients regardless of the time of day. This is not just an advertising point; my payment structure, availability and schedule uniquely facilitate this type of care. The doctor-patient relationship is just as the name suggests – direct. I don’t accept insurance, instead I've chosen to work directly for you, the patient.
Do you see children?
Yes. I am happy to see children and have set up my payment scheme to attract young families. Actually, so far, most of the practice is made up of children! At this time, I am not able to provide routine vaccinations for young children but can work with you to arrange these at no cost through our local health department.
Can I contact you after hours?
Absolutely. Because illness and injury do not respect regular office hours, you may call me any day, at any hour.
Will I still benefit from joining your practice even if I don’t require frequent medical attention?
Yes! If you are relatively healthy this is a great way to save money without limiting your access to care. Many young Americans are switching to low premium/high deductible plans. Many don't have an option, as the costs of their current plans skyrocket. These plans force the patient to avoid the doctor until they are in a crisis! Rather than having access to all that a family doctor can offer (and prevent!) they skip straight to emergency room care where they spend thousands of dollars; often in a matter of minutes! This is not continuity; emergency rooms and urgent care clinics do not know their patients personally and are forced to provide cookbook "standard of care" responses while constantly worrying about being sued; this is reflected in their utilization of healthcare resources.
In wellness and therapeutic care alike, our great ally is time - large amounts of precious, irretrievable time given to you as you wish. Every visit, for whatever reason, will be easy-going in its thoroughness, and relaxed in answering your questions and addressing the need of the moment. Then, as the months and years go by, we’ll build a comprehensive, intimate knowledge of your health - invaluable understanding available in no other regimen of care.
As your patient, will I still need health insurance?
Yes. I recommend that my patients carry a "wrap-around" plan, thereby ensuring financial help should hospitalization or referral to a specialist be necessary. This can be a catastrophic (high deductible) plan, a health sharing plan or one of several plans designed specifically for DPC members.
If I have Medicare, can I still join your practice?
Yes. You will need to sign a one-time waiver declaring that neither you nor I will directly bill Medicare for medical services provided by me. Medicare will still cover all other aspects of your care including any laboratory testing, imaging, medications, or hospitalizations.
What happens if I need to go to the hospital or see a specialist?
In providing unprecedented physician access, I seek to prevent or reduce hospitalizations and specialty referrals. In those instances where these types of care are required, I will certainly continue to serve you during your hospital stay or to work closely with any specialist as an advocate in your care.
What if I need medical attention while I’m away from home?
Call me! While limited by the lack of a physical exam, I am glad to offer advice long distance. As your primary care physician, I feel a responsibility to be in the loop as health issues come up. Also I hope to know much more about you than a random urgent care or ER physician.