In March 2017, Business Insider published an article praising “a new kind of doctor’s office,” one that bills patients monthly and doesn’t accept insurance, citing a growing trend in non-traditional medical care. This new practice, called direct primary care, could streamline doctor visits and help strengthen the patient-caregiver relationship. This is because many primary care physicians tend to feel pressured to squeeze as many patients as possible into a given day to maximize profits under the usual fee-for-service model.
Paying for direct primary care, according to Business Insider, is akin to paying a cell phone bill: people pay monthly fees that generally cover basic checkups, as well as same or next day appointments, as well as wholesale lab tests and prescribed medications. An added bonus is easy access to a physician: Video calls while on a family vacation, or the possibility of a last-minute trip to get some stitches even on a weekend. And there are no costly copays on top of the previously agreed upon monthly fee, since direct primary care offices don’t take insurance.
Business Insider drew comparisons between direct primary care and traditional doctor visits, aka family practice. In some estimates, there were up to 2,367 patients per doctor in those under the family practice umbrella, as opposed to between 500 and 1,000 for doctors practicing under direct primary care. Additionally, visits were substantially shorter with family practitioners, who spent 13 to 16 minutes with their patients while direct primary care physicians typically spent half an hour to an hour with theirs. The cost of blood tests traditionally varies depending on one’s insurance plan, while they’re wholesale or often even included as part of an exam under direct primary care. As mentioned before, prescription drugs require a copay under family practice, while they’re wholesale plus 10% via direct primary care.
Some individuals who pay for direct primary care still maintain their insurance coverage. Doesn’t this seem counterintuitive? To clarify, Business Insider explains that doctors use car insurance to illuminate how insurance works under direct primary care: car insurance is only used for accidents, not minor transactions such as oil changes. The same goes for health insurance: it would only be used for healthcare necessities that extend further than primary care.
Yet there are some concerns that loom as more and more people move towards direct primary care. Public health expert and professor at the University of Virginia School of Medicine Carolyn Long Engelhard explained the various risks to Business Insider. Engelhard’s major concern was that individuals may mistake a direct primary care membership as a substitute for having an insurance plan, which could pose a threat if the patient develops a complex issue outside of what is covered by primary care; they could easily run into financial problems.
However, if direct primary care continues to grow, insurance companies will have to adjust their plans as well. And as long as patients are educated on what all of their options now, it’s important that they are given the power to make informed choices for themselves and their families.