Direct Primary Care (DPC) – A health insurance option worth looking into?!
[Good morning friends!! Here’s an idea to consider if you’re frustrated with all the health insurance options out there! I’d never heard of direct primary care before, but a reader – and doctor – of the blog just emailed this over and thought it was worth re-sharing in case it’s a perfect fit for you. Just make sure to do some due diligence first as I’m sure there are some caveats in there :) You’ll find a map of DPCs you can search through to see if there’s any around you at the bottom of the post… Thanks for shedding light on this, Rachel! And glad you found your dream job!]
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J. Money!
I love your blog and devotedly update my net worth every month.
But you have complained about health insurance one too many times, my friend. You need to discover Direct Primary Care!
So I’m a family doctor, and we docs hate health insurance, too. Doctors end up working for the insurance company instead of for their patient – the insurance company mandates how much they can get paid per visit, and so docs have to see more and more patients per hour to make ends meet. Insurance makes up all these rules about coding the visits and diagnoses and procedures, and you only get paid so much for each of them, and you have to check off rather arbitrary requirements in each note that you write to get paid at different levels.
And then there’s all the paperwork you have to fill out and go back and forth on for prior-authorizations – basically the doctor has decided on a plan of treatment, but if the insurance company thinks it’s too expensive, the doc has to justify it to them. Because that is exactly how we love to spend our time, writing up paperwork to justify our plan of care to folks that have never been to med school!
I served in the Air Force for the past 8 years and didn’t have to deal with any of this (Tricare has different struggles, but at least I could get patients the care they needed without making them broke!). So when it was time for me to leave Active Duty, the last thing I wanted was to become suicidal over my next job (burnout rates for physicians are awful right now! Doctors hate their jobs!).
I love being a doctor and didn’t want to lose that passion, so I looked into my options. I specifically looked up the smartest doc I knew, who had retired from the Air Force, to see what he was doing now – and he was in a direct primary care practice. Solution!
Direct primary care takes health insurance out of the transaction for your basic day-to-day medical care. Rather like car insurance – you save your car insurance for expensive things, not for gas or oil changes that you expect. That helps keep car insurance at reasonable rates – we could do the same thing for health insurance.
You pay a monthly fee to have access to your doc, but then you get as much (or as little) care as you want/need. You still should have a high deductible health insurance in case of emergencies or accidents, but for most things, I can take care of you! I manage chronic conditions, treat skin problems, do biopsies, diagnose and treat sports injuries, inject joints, perform pap smears, help with pregnancy and breastfeeding problems, perform sports physicals and well child checks…
I do as much as I have ever been trained to do, and I love it!!!
I spend SO much more time seeing patients and reading up on how to care for them better, I write in my notes what I and my staff will find helpful for future reference (and DON’T have to stress about checking off the stupid little things that I have to in order to get a certain level of payment by health insurance).
We have cut out a TON of overhead because we don’t have so much paperwork to do for insurance. So we save money AND we save our patients money and we are all happier. Instead of having to have 2,000-3,000 patients to make ends meet, my goal is to have 600 (my boss/partner is already there, and has been doing this for the past decade, quite happily and successfully).
Can you imagine knowing 3,000 people and being in charge of their health?? That is just so many. 600 is a great number. And I can spend more time in every appointment (never less than 30 min), and always have open appointments for today or tomorrow if someone needs to get in fast.
Especially with all this covid madness, my patients are reaping the benefits! I’m keeping my patients at home as much as possible, doing a lot of visits over the phone or webcam, and we just called all our older patients individually to make sure they were doing OK. I just delivered some meds to a patient’s apartment yesterday to keep them home and safe. But my patients can call or email or text to reach me, 24/7, and I can talk them down from their worries and discuss how to best care for their families in this crazy time.
When it comes to $$: for young adults, my practice charges $60/month, older adults are $80/month. Which might sound pricey, but compare that with the cost of being seen for cash by an urgent care (where one of my many side hustles is for now) is $140 at MINIMUM – labs or xrays or medicines or anything extra will just keep jumping that number up and up!
We have a bunch of medications in our office that we buy wholesale and give to our patients at (almost) cost. We have deals with local imaging companies and labs for much less expensive cash prices. And there’s the convenience – instead of going to the doctor’s office (and waiting forever…), then pharmacy (and waiting), and lab (and waiting), we do all that in our office – the doc sees you, we get your meds for you, and draw your blood all in house.
So next time you’re mad at health insurance, just know there’s another way! I really hope that this is the healthcare of the future – it certainly makes sense to me. I love my job and my patients and practicing medicine so much, and this is a great way to do it.
If you want more info, a lot of articles have been published about DPC lately, plus there’s our own web site and my little YouTube channel, and a map of DPCs across our nation:
- Our website: PineridgeFamilyMedicine.com
- YouTube channel: Pine Ridge Family Medicine
- Good article: Direct care practices perfectly positioned to help patients during coronavirus outbreak
- Map of DPCs: DPC Frontier Mapper
Sorry for the long email! Hope it was helpful. Stay healthy!
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Thanks Rachel! It was helpful!!
Anyone here ever try this option before??! What did you like/didn’t like about it?
Thankfully we have decent insurance coverage now through my wife’s gov’t job, but there were a stretch of years there where we were paying upwards of $1,000/mo and getting CRAP in return for it! I told her something like this seems great for those who are self-employed, and she wrote back saying,
“We’ve definitely got a lot of self-employed folks as patients. AND small businesses that can’t afford full health insurance for their employees, but want to offer SOMEthing to take care of their people. Which I LOVE!”
So take from this what you will!
Here’s a couple more articles on DPCs I found while doing a quick search. It’s def. a “thing!”
- GoodRx: A Patient’s Guide to Direct Primary Care
- Consumer Reports: Pros and Cons of Concierge Medical Care
- American Academy of Family Physicians: Direct Primary Care
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