Member doctors adopt new model for primary care
Mike Miller · May 01, 2015
By Jed Stuber
For many years, third-party payers for health care services have been an increasing barrier in the relationships between doctors and patients. The growth of government involvement in health care is adding even more interference. An article about problems in the Canadian health care system gives additional insight into what may be in store for patients in the U.S. Trying to find satisfactory primary care medical service can be frustrating and may become worse.
But patients are not the only ones who are frustrated. Some doctors are taking bold steps to solve problems by working with their patients apart from the third-party payer system, offering direct primary care.
Direct Primary Care is a small but growing movement. A second annual national conference for doctors is being held this July in Kansas City. Forbes, Time, and the New York Times have reported on it recently, and there’s more to it than just a better model for providing primary care.
Pricing is simple and clear. For example, the monthly membership fee could be $75 for an individual or $150 for a family. A membership includes as many visits as you want and in-office services like lab tests, shots, stiches, and EKG. If you’re not a member, and prefer to pay fees for an appointment and specific treatment, the prices are listed on their websites as well.
Same or next day appointments are common. If you need to have a long discussion about a health issue you are facing, the doctor is able to do that. You have the doctor’s personal phone number and email to discuss things, or for simple things that don’t require a visit. Sometimes a picture taken with your phone is enough for the doctor to diagnose and prescribe treatment. And DPC doctors make good old-fashioned house calls when it makes sense.
Many of the tests and services that DPCs include in the membership are things you would be charged separately for in a traditional practice. DPCs often have arrangements with other providers in the area for discounted prices on tests and treatments that aren’t available in their office, frequently arranging savings of up to 95 percent. Some have in-office dispensaries for common over-the-counter and prescription medications. And the DPC doctor is your advocate when you do need a referral to a specialist.
Three Samaritan members are doctors who are among the innovators who have implemented these changes in their practices. Here is more about them and their practices.
Dr. Bruce Jung was frustrated when the federally qualified community health center he worked for moved in a direction that wasn’t in the patients’ best interests. He bought an old doctor’s office, embraced the retro feel it had by decorating it with a 1960s theme, and opened The Doc Shoppe, in Corbin, Kentucky.
He says, “My patients have come to understand that I work directly for them and not for a health insurance company, the federal government, or their employer. In the past I was mainly paid by these other third-party payers and so in essence was working for them and not the patient. In a typical fee-for-service office, a patient is not much more than a tool from which to obtain the best ICD-9 diagnosis code possible to justify the highest reimbursable CPT procedural code possible to bring in the most revenue possible with each encounter. In our model I am paid directly by the patient, and so I am motivated ethically, financially, and medically to do what is in their best interest alone.”
“I have, in effect, kicked out the negative aspects of insurance and government interference from my office. This results in a much more efficient delivery of health care in my practice. With no insurance verification of coverage, no cumbersome coding requirements to get reimbursed, no pre-requirements before treatment, and no government audits to bully the doctor with, the doctor-patient relationship is greatly enhanced. Remember: health insurance does not equal health care.
“It is a well-known fact that doctors have to practice differently to meet government and insurance requirements. One of the worst of these is the mandate for doctors to participate in electronic medical records. EMR not only comes between the doctor and the patient during the office encounter (lack of eye contact, only half listening, paying more attention to the computer … ), but it represents a serious threat to patient health confidentiality. How many times have you heard of computer systems being hacked? My paper charts are secure.”
Dr. Eric Potter has been building his practice, Sanctuary Medical Care, mostly by doing house calls in the Nashville, Tennessee area. He also works out of an office in a pharmacy about half an hour south of Nashville. He says, “By opting out of Medicare and Medicaid, I don’t spend my time attempting to comply with confusing and burdensome programs. I am then free to guide care, based on what is best for the patient rather than what bureaucrats say should be done. Less time arguing with bureaucrats means more time with patients.”
Dr. Potter also finds that the DPC model allows him the freedom to practice medicine consistent with his theological and medical convictions.
“Regardless of whether I serve you as a consultant or as your primary care physician, my care will begin from a Biblical worldview. This means I am committed to God’s authority in my care for you, and my aim is Biblical health care.
“This commitment includes excellence, honesty, time, compassion, and covenantal care. A covenant before God with my patients holds me to God’s authority and your best interests with greater force than would a legal contract or government regulations.
“With longer visits and other interactions, I can also integrate the best of natural remedies with the best of conventional medicine, while educating patients on how to care for their own health.”
If what these Samaritan members are saying about Direct Primary Care appeals to you, visit iamdirectcare.com to begin your search for Direct Primary Care in your area.
Editor’s Note: This article is not an endorsement of a particular medical provider. Members are free to choose their own providers. Members may be able to have some of their Direct Primary Care membership fees shared when they are receiving treatment for an illness or injury. Contact member services for more information and see the “Direct Primary Care” item in section VIII.B of the Guidelines.