Direct Primary Care

What is Direct Primary Care?

Direct primary care (DPC) is an exciting new system for receiving primary medical treatment. Direct primary care offers a streamlined system for receiving healthcare. It’s streamlined because it involves no third party insurers or reimbursement. Instead, patients deal directly with their primary care physician (PCP) and their office to pay for medical treatment.

Advantages of direct primary care include:

  • Lower overall costs
  • More personalized care
  • Reduced paperwork
  • No middleman
  • Easier access to appointments
  • All primary care services included
  • Increased access to doctors and office staff

Specific treatments and items included in a direct primary care plan will vary from physician to physician. What can be universally expected with DPC is lower costs and reduced stress from dealing with insurance companies.

How Does Direct Primary Care Work?

Direct primary care functions similarly to a traditional insurance plan, only with no insurance company. Instead, patients pay for ongoing support from their primary care physician on a monthly or yearly basis. This payment goes directly to the physician’s office, rather than to a third party. That means more of the patient’s money is spent on what benefits them, rather than being redirected to unnecessary places.

In many cases, direct primary care plans are cheaper than traditional insurance plans. DPC plans also encourage overall health by allowing patients more access to their physician without worrying about getting approved for visits by an insurance company.

While there are many benefits to a direct primary care plan, it typically must be accompanied by some level of health insurance. That’s because health insurance is required by the Affordable Care Act (ACA). Many people who elect to purchase a direct primary care plan pair it with a high deductible, low premium insurance plan.

A Movement Towards the Traditional Doctor/Patient Partnership

Direct Primary Care represents a movement back to the traditional relationship between Doctor and Patient.  The term Direct reflects the removal of the insurance industry from this relationship.  In my opinion the declining quality of care and limited access to care in the United States is a direct byproduct of the insurance industry inserting itself between the Doctor and Patient.  Insurance companies are a necessary part of the equation in healthcare for catastrophic events.  Much like car insurance or home owner’s insurance.  We would not expect to call our auto insurer to get an oil change or brake job, so why would we interface with our health insurer for a cold or routine evaluation?  Insurance is a necessity but it should be of the High Deductible/Catastrophic form.  This is not necessarily ‘health insurance’ but more ‘wealth insurance’ designed to protect you from a hospital should you have a major injury, cancer, or other catastrophic issue.  Currently the high cost of medical care is the number one cause of bankruptcy in the country.  Your only protection may be a high deductible plan to protect your assets in case a major event occurs.

Health Insurance in its Proper Role

For all other medical issues including preventative health and routine minor medical issues it will be incumbent upon the patient to find value within the current system.  Direct Primary care represents that value.  For a low monthly fee, often lower than a gym membership, you can have a direct relationship with your physician unencumbered by the insurance industry.   There are so many aspects to quality medical care that insurance companies will not reimburse physicians for.  In many cases these are the most important things a physician could be doing for you.  Things like coordinating care between specialists, answering questions via phone, text, or email, or just having the time for a truly rewarding interaction.  Many of these elements are not reimbursed so the physician is required to put the patient in front of him/her in order to bill the insurer for their time.  When a physician is able to interact directly with their patient without an insurance middleman all parties are aware of the costs and an assessment of value can be quantified.   This model reintroduces normal free market forces into healthcare and the efficiencies a free market can produce.

At Highland Personal Health we can provide excellent cost effective care in a comfortable and efficient environment.  Please contact us for further information and pricing.

Direct Primary Care in the Media

NBC Nightly News