In, recent years a new system of cash for service has come up in the country especially in the Midwestern states. Based on a free market model, it is known as Direct Primary Care (DPC).
The model has revolutionized healthcare by allowing patients to directly pay the physicians for their care. Insurance companies are eliminated from the billing process under DPC and in no way are able to influence the care a patient desires. The term DPC encompasses different healthcare delivery systems that are based on financial relationships between the patient and the doctor.
Benefits of Direct Primary Care
Many stakeholders of healthcare have promoted DPC for the benefits it brings. First and foremost, it helps patients save expenses on primary care and other ancillary services such as clinical tests. The system also allows patients to have more time with their doctors and choose whom to receive care from.
You also have timely appointments and reduced wait times due to absence of formalities and process put in place by insurance companies. On top of that there are no deductibles, insurance co-pay or additional costs increasing the overall overhead. Another variation of DPC allows collaboration with self-funded or self-insured employers enabling patients to access primary care even for free or significantly reduced charges.
Doctors under DPC are paid over time instead of services rendered which puts the patient’s health at top priority. Due to the framework, doctors are more keen to deliver preventive care because of the economical gain. Independent physicians can dissociate themselves from the control of corporate insurance companies and eliminate all hassles of insurance bureaucracy.
DPC can serve as a great model and help independent physicians only if it is implemented in the right way. It shows that the physicians are raising their voice and are ready to take the responsibility of fixing healthcare in their own hands. The nature of the profession and service deems physicians to be independent as they are not mere laborers getting paid for their service.
Is DPC a Viable Option for Fixing Healthcare?
DPC is a great tool but can lead to independent physicians being taken over by corporate companies making the situation worse. A group of lawmakers recently introduced the “bipartisan” Health Savings Account Improvement Act of 2018 (H.R. 5138). This bill allegedly “expands” HSA coverage to allow use at “retail-based” (e.g. CVS, Target) or “employer-owned” clinics (e.g. Amazon) without losing eligibility to make tax-advantaged contributions to their HSAs. Increasing the flexibility of HSAs is aClear intention yet, this legislation herds Americans like sheep into Minute Clinics for the benefit of corporate shareholders.-surely we don’t want it to happen!
DPC is lucrative and the corporate world will be looking to gain control over it. That adds up to another fight for the doctors who are currently resisting managed care and insurance companies. Businesses which have no relation with healthcare will be ruling the scene which is not at all wanted.
Physicians need to be compensated but their top priority is treating and making a person healthy which in itself is a big reward. But will the new system allow the profession to flourish once again and not turn into some monopolistic profit seeking machinery?
How can we Implement DPC Successfully?
In my previous posts, I have talked about the hardship of physicians with the way we get reimbursement tomorrow. I have also stressed the importance on physician independence and discussed how most of them are getting burned out. I have asked for the opinion of many physicians and they all feel the same.
The first thing is to develop patient care. If patients trust you, the treatment becomes a lot easier. While getting the right patient data was often a problem before, it isn’t any more.
We now have the technology and solutions to deliver best care. The proactive group of physicians who are promoting DPC has done a good job but they all are missing one thing- they are not preparing themselves to prevent the takeover by big corporate entities, politics and money.
They need to team up and form a corporation that backs their struggle without losing their independence. We need to bring a system that will empower both patients and physicians. The push for DPC is a strong indication that doctors are educating their patients and they themselves are taking things in their own hands.
To be successful, we need to gather more support and rope in more physicians under the same philosophy. We can also collaborate with other groups that encourage independence even if their approach is different.
Can we Stay Independent under DPC?
Some people think that only cash based model can garner independence while DPC can lead to takeover by big corporations. But I say you can also get dependent on corporations even when your working model is cash based. Are we looking to replace insurance bureaucracy with cash based monopoly?
We will need the full support of our patients and that is not very difficult to achieve. Patients want to trust their doctors and eliminate all bureaucratic hassles when the doctor-patient relationship is harmonious.
You really don’t need to stop accepting insurance and can adopt the various reimbursement options favored by the patient. We need to align ourselves with our consumers or patients and listen to them- even if they have self diagnosed themselves using Dr. Google!
Making the Changes
You have to adapt to your patients if they sound unreasonable and guide them the right way. We need to change the whole culture and any position that doesn’t adapt will definitely be left behind. Physicians cannot afford to stay silent anymore when healthcare is being commoditized. And that’s a reality that you cannot ignore as a medical professional. There is a need to carry out due diligence to ensure that we can potentially change this commodity culture that has crept it.
For that to happen, we need to change our attitude, make informed and educated decisions and provide all tools and resources to empower the positions and delivery of care. Only then doctors will gain a competitive edge over the large corporations and healthcare without boundaries will be established.