Understanding Direct Primary Care: Overview Of DPC Practice

New York is saturated with primary care physicians, yet why is it so hard to book an appointment with one on an urgent basis? Traditional Primary Care is exhausting, for both physicians and patients, as well as time-consuming and fruitless. 

Physicians face a tough work-life balance, while patients on the other hand, strive for hours just to get a 15-minute appointment with a tired, frustrated doctor. Cherry on top: heavy insurance fees and redundant copays and deductibles after each ‘fortunate’ consultation with a primary care practitioner. 

But, will there ever be a solution for this broken physician-patient-insurer relationship? There already is. We call it Direct Primary Care; physicians and patients might refer to it as a lifesaver. 

What is Direct Primary Care?

The Direct Primary Care model arose as an alternative to traditional primary care with subscription-based payment plans vowing to reform the way classic primary care works. Traditional primary care is hectic – and completely defies the concept of preventive healthcare due to lengthy gaps between physician appointments and unsatisfactory consultations. 

In primary care, patients suffer the consequences of delayed appointments with doctors, leading to late diagnoses with little room for cure. In primary care, physicians too, suffer from burnouts due to an overwhelming patient load which affects their quality of practice, and hence, their mental and physical well-being. 

But, should we put all the blame on doctors for lacking in providing basic preventive healthcare? 

Another evil which contributes to the declining rate and quality of healthcare – and is quite worthy of taking most of the blame – is insurance. Insurance brokers tend to render you bankrupt by making you invest in fee-for-service premiums which vary and increase as per demand. 

Instead, insurance plans are put in place to help take the load off your shoulders in emergencies, hospitalizations, and surgical procedures; not to  leave your bank account dry after every visit to your GP.

Key Features of Direct Primary Care

• Subscription-Based Model: Patients pay a periodic fee (monthly or annually) for comprehensive primary care services.
• Direct Physician Access: Establishes a direct and ongoing relationship between patients and their direct primary care physicians.
• Affordability: Typically offers cost-effective pricing, eliminating the need for traditional insurance for primary care services.
• Extended Appointment Times: Provides longer and unhurried appointments, allowing for more thorough discussions and personalized care.
• Preventive Focus: Emphasizes preventive care and wellness, aiming to address health issues before they become more serious.
• Transparent Pricing: Offers clear and transparent pricing structures, promoting financial transparency between patients and direct primary care physicians.
• Reduced Administrative Overhead: Streamlines operations by minimizing involvement with insurance paperwork and administrative burdens.
• Holistic Care Approach: Addresses the overall health and well-being of the patient, often incorporating lifestyle and wellness guidance.
• Enhanced Access: Improves accessibility with same-day or next-day appointments, electronic communication, and telehealth options.
• No Copays or Hidden Costs: Eliminates additional out-of-pocket expenses, providing clarity and predictability in healthcare costs.

How Does Direct Primary Care Work?

Direct Primary Care (DPC) works by revolutionizing the traditional healthcare model. Instead of navigating complex insurance systems, patients pay a simple subscription fee for unlimited access to their primary care physician.

This subscription covers comprehensive and personalized care, longer appointment times, and a focus on preventive services. With the direct and transparent relationship between patient and physician, the result is improved access, affordability, and a more patient-centered healthcare experience.

Considerations for Starting a DPC Practice

As a newly board-certified family medicine physician, establishing a primary care practice in a busy and hustling city as New York can be a bit tougher than expected. The competition is fierce, and real estate tends to be pricey.

But, let’s suppose that you do succeed in opening a primary care practice – then what? If the patient load doesn’t kill you first, it will probably kill your chances of serving quality care to your patients, causing them to change insurance plans and head to another primary care practice.

If you are just starting out, or thinking of switching to direct primary care model, there are a few things you should consider before jumping on the bandwagon:

• Be Treatwise With Your Investments and Savings:

Outline your budget keeping the requirements of opening a DPC practice in mind. After you do so, get in touch with a good real estate agent within the vicinity of the area where you plan on opening a practice. Or, you can do some legwork from scratch and research about the places where you can establish a DPC practice and still bring in patients. 

• Hiring Adequate Staff

Apart from holding an office, you need an experienced staff such as a receptionist, nurses, and technicians to help you grow your practice. Your office will also be incomplete without a working administration office, which is by far,the primary lead in bringing profit to the table.

Recruiting can be tough, especially for someone who has no connections and is poor at networking. But, there are always professional recruiters and businesses that can help you staff your office with professional personnel. 

• Define your Pricing

DPC is different from traditional primary care practices, in a way that you don’t have any intermediary insurance company interfering with your practice. With no insurance company on board, you can define your own subscription plans and establish a reasonable pricing for the services you provide. 

DPC practices usually offer subscription plans which vary from person to person based mostly on patient demographics and age. DPC practices also offer family subscription plans which might come in handy for families to get discounts without altering the quality of services. 

Establish a sustainable panel of patients as per your comfort, for instance, around 300 – 500 to attend to per month. As you expand and hire more direct primary care physicians in your DPC practice, you can increase the panel of patients depending on the doctor’s availability. 

Your DPC subscription plans  need to bring in a dignified margin of profit so that you can stick to your oath of providing quality healthcare to patients and foresee a good future for your practice. 

• Hire an Experienced Lawyer

Get acquainted with a lawyer who specializes in DPC core policies and managing legal affairs of DPC practices. You also need to have a malpractice insurance plan so that your practice and staff can be defended against threatening lawsuits.

DPC Benefits for Providers

• Limited Patient Panel and Quality of Care

As mentioned earlier, direct primary care physicians have the leverage to treat patients at their own pace. With a sustainable pricing model and a limited patient panel in business, physicians are able to attract and treat patients who aim to develop a stronger interpersonal relationship with their doctor. 

Providing quality care to a limited number of patients day after day is ideal in preventing physician burnout. Not only does DPC  help in prevention of illnesses, but also promotes a healthy work-life balance for the provider. 

• No Administrative Headaches

As there is no involved insurance company in place to handle the administrative end of the business, physicians can save overhead costs that would be spent on hiring staff for managing and interacting with insurance companies.

DPC Benefits for Patients

• No Heavy Premiums or Co-pays

In DPC practice, patients get to pay a fixed subscription fee monthly for services inclusive of extensive consultation visits, lab and imaging services, and easy refills of specific medications. DPC also provides patients with the satisfaction of investing in a foolproof and sound primary care practice which has no hidden overhead costs or sneaky deductibles and extensive co-pays.

• Intimate Relationship with Physician

With DPC, patients will no longer complain of physician inattentiveness, limited consultation times, and tedious waiting times just for a simple follow-up or a condition that is likely to worsen in the near future. Plus, with DPC, patients have complete access to their primary care doctor and can either book a visit on the same or the following day, or even consult via online chatting messengers directly.

DPC Benefits for Employers

• Fixed and Cost-Effective DPC Subscription Plan

Insurance companies can cost an arm and a leg to employers who are either initiating a start-up or facing financial discrepancies due to inflation. DPC can allow employers to choose a fixed subscription plan for their employees so that they can foresee expenditures pre-hand and have nothing to worry about skyrocketing premiums.

• Loyalty and Productivity of Employees

Direct Primary Care practice allows employees to book urgent visits with their physician for attentive and immediate provision of care. This not only urges employees to take fewer leaves away from work and improve productivity, but also helps employers to gain their staff’s loyalty. 

Direct Primary Care vs. Concierge Care

– Direct Primary Care (DPC):

• Affordability: Generally more cost-effective with transparent, subscription-based fees.
• Accessibility: Emphasizes increased access to primary care services for a broader demographic.
• Preventive Focus: Prioritizes preventive care and comprehensive services within the subscription.

– Concierge Care:

• Cost Structure: Often involves higher fees, including an annual retainer or additional service charges.
• Exclusive Services: Provides a more exclusive experience with additional amenities beyond basic medical care.
• Patient Demographic: Tends to cater to a more affluent patient base seeking a more personalized, luxury healthcare experience.

Understanding these distinctions helps individuals make informed choices based on their healthcare preferences and financial considerations.

The Final Verdict

Instead of considering DPC as a primary care model, think of it as a preventive care model which is accessible to a fixed panel of patients. Not only does DPC reap benefits for both physicians and patients, it also helps employers gain leverage over their competition and promote a healthier workforce. 

By the time you luck out to book necessary follow-up visits with your primary care doctor, you realize you are already hanging on by a loose thread – your condition takes a toll on you resulting in hospitalization for immediate care.

Frequently Asked Questions

If you want to learn more about Primary Direct Care then read these blog posts: Why choose membership-based Direct Primary Care? | Direct Primary Care: solving health insurance affordability issues | Here’s why DPC Healthcare Services should be your first choice | Understanding Direct Primary Care: Overview Of DPC Practice

– Disclaimer –
This blog is for informational & educational purposes only, and does not intend to substitute any professional medical advice or consultation. For any health related concerns, please consult with your physician, or call 911.