Direct Primary Care:
Insurance Based Primary Care:
Relationships heal people. Rules, billing, coding, and checking boxes don’t. Direct primary care (DPC) practices provide a platform that allows for a relationship to flourish while simplifying the model to only two moving pieces, you and your doctor.
We can all agree that the healthcare system in the US has many issues, the one most near and dear to me is the shortage of good quality primary care. Primary care should be the foundation of our healthcare system and slowly that foundation has eroded away. Fewer and fewer new doctors are choosing family medicine as a specialty, and it is hard to blame them. Primary care is a difficult job, and more so, a difficult business, and trending toward an impossible one.
Seeing the challenges in primary care as a young conventional medical student, lead me to naturopathic medicine, and again as a primary care provider in the insurance system, led me to direct primary care. I feel fortunate as a provider to be in a state that is home to some serious innovators and champions of direct primary care. Washington state clearly defines direct primary care practices and supports healthcare innovation. At the federal level, they have also woken up to the DPC movement and slowly changes have been made to foster growth of DPC practices.
Seeing 30-40 patients a day is soul-sucking work when you know what a patient needs can’t be delivered in 8 minutes. The largest benefit of a direct primary care practice is time. Time is the largest determinant of a healthy patient-doctor relationship and successful outcomes. I can’t tell you how many times I have spent an hour with someone trying to figure out a complex issue and as the patient’s hand hits the door knob to leave the critical piece of information is revealed. DPC clinics allow for non-rushed long visits that are as frequent as necessary to get people healthy. We get to know our patients and it matters.
Insurance for routine care and management of common chronic conditions is a very inefficient way of delivering care. 40% of all primary care dollars spent is gobbled up by the insurance process. What if 100% of money spent actually went toward care? We would likely have very different health outcomes and we are beginning to see the research to back it up. A study by the British Journal of Medicine evaluating the work of Qliance, a Seattle based DPC organization, showed 35% fewer hospitalizations, 66% fewer specialist visits, 82% fewer surgeries, and 65% fewer ER visits.
The direct primary care movement was born out of the desire to serve. Through innovation and insisting on a better way, we are working, one clinic at a time, to change how we deliver and receive primary care. Everyone wins with this model and I feel blessed to have had inspiration and guidance from those who came before us.