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What is Direct Primary Care?

New care option enhances patient-doctor relations

By David Pérez, MD, FAAFP

Direct primary care (DPC) is a new way of receiving personalized health care from a primary care physician for a small monthly membership fee. In exchange for this fee, patients get unlimited access to their doctor. Depending on your day-to-day needs this can be accomplished by same day or next day in-office visits or, if more appropriate for your health circumstances, they can be addressed by telephone, text, email or even videoconferencing. The benefit to doctors is more time spent directly serving patients.

Some DPC offices include additional services for their members, such as in-office heart testing with EKGs, metabolic testing with glucose monitoring, and lung testing with pulmonary function tests. Many also offer blood testing and in-house medication dispensing at wholesale cost. To accomplish this, efficiencies were created through technology and elimination of non-patient focused tasks which in turn free up time for the physician to be accessible and flexible for patients’ medical concerns. All this translates into a patient-focused primary care model that looks to provide value to its members by saving them time and money. 

The idea of paying for health care directly has always existed but has largely been displaced by the growth of government and private health insurance. It wasn’t until 2007 when three doctors in Seattle decided they wanted to practice medicine free of insurance and developed the direct primary care model. Since then, their efforts have served as a model for the over 1,100 direct primary care practices in 48 states, serving approximately 300,000 Americans, according to DPC Frontier and the DPC coalition websites. 

Since DPC practices contract directly with patients, they are often considered concierge medicine. In this regard we are similar, but this is where the similarities end. DPC practices usually charge a small monthly membership which can be canceled at any time, whereas concierge practices typically charge a much larger up-front annual fee. Additionally, concierge practices may continue to bill insurance companies and the government for their services, whereas DPC practices, by definition, do not bill insurance for their services. 

Direct primary care doctors believe that eliminating the barrier to your doctor and allowing time for health interactions can fundamentally change health care in America. In fact, the American Academy of Family Physicians considers the direct primary care model to be consistent with their advocacy of advancing primary care. They say that DPC’s inherent goal of placing the power of the doctor-patient relationship at the center of health care can improve health and lower costs. With this goal in mind, DPC doctors across the country meet three times a year to discuss and collaborate on best practices and are constantly working to improve and expand the services they can offer their communities.

Most patients that have direct primary care memberships also have health plans. DPC works well with traditional Medicare, PPO and health-sharing plans. It is more difficult for DPC doctors to work with HMO-Medicare or other HMO insurance plans because these plans, by design, only allow for health care use within their limited network. In this regard, DPC practices always recommend that everyone have, at a minimum, some form of health insurance to protect against accidents, catastrophic illnesses and necessary hospitalizations. In some instances, for someone who has not purchased insurance, DPC is an excellent option as they can receive comprehensive primary care while working on getting basic health insurance.

If you are looking for a more personalized, accessible and affordable health care experience, know that you now have more choices and that direct primary care can be a great alternative to your current health care. Currently in California, there are approximately 35 direct primary care clinics, and that number is growing every day. 

Dr. Pérez is a board-certified family physician and fellowship-trained geriatrician with Premier Direct Care and can be reached at (760) 548.3400. www.premierdirect.care. He is also a member of www.DesertDoctors.org.

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