Why choose a DPC (Direct Primary Care) physician?

by Dr. Jill Green

My hold time was over 20 minutes when I finally got through to my son's pediatrician office only to have the human voice I had waited for for so long bark at me "name and date of birth." Many more questions and patient identifiers later, I was allowed to state why I was calling. I had a concern about my son and was asking to be seen that week. Next available appointment with my pediatrician? 4 months. My frustration was through the roof. As concurrently a patient, a mother, and a physician, I was done with health care.

When I first learned about direct primary care (or DPC) in 2013, I thought it was too good to be true. Now, nearly 2 years into my own DPC practice, I realize that it is a little hidden gem that is making healthcare great again. What do I mean by great? Affordable, transparent, personable, and with way fewer hassles in setting up appointments or obtaining care. There is also the ease of getting care over the phone or while traveling as well as talking to a real person when you call. It's all of that and so much more.

The hashtags #takebackmedicine and #bethechange are seen widely throughout the DPC community as primary care physicians like myself have pushed back against the traditional model of churn and burn that we know doesn’t work and we know isn’t providing the best care for our patients. Whether its pay-for-performance or a volume-driven metric being shoved at us, physicians are tired of being squeezed by third parties from all sides: insurance companies, pharmacy benefit managers, big hospital conglomerates, CMS/Medicare. When you cut these middlemen out of the relationship between the doctor and the patient, you are left with a simple solution to a problem that had worried so many: how to get good, affordable healthcare. DPC is that answer.

What is DPC?

Admittedly, even though I have been involved with DPC since 2016, my own husband still occasionally questions what DPC looks like, so I realize change takes time to accept. However, I would leave the practice of medicine altogether rather than go back “in the system” that I know doesn’t work and can’t work for my patients because it is not physician-driven... it is dollar-driven, and there are too many drivers in the driver’s seat.

DPC, simply put, is low-cost primary care that you get through a monthly membership fee charged by your doctor that allows the member (you, the patient) to get care from me, the doctor, without the interference of third parties. This means same-day or next-day visits for urgent care concerns by a physician who knows you. No 2-hour urgent care waiting times for a doc-in-the-box or an expensive ER visit because it’s 10pm and you need care. You get to see the same physician every time you need care, and you get to know me as I get to know you and what you need and how you approach your care. This means the same real person picking up the phone when you call.

Beyond just great access to care when you need it, it also means saving you lots of money, which means that small monthly fee pays for itself. While paying a monthly fee to your doctor is a new concept, it allows me to run the practice with very small overhead and pass on cost savings directly to you. That cost is about $2.46 a day per patient for the average adult and 65 cents per day per patient for children under 18.

How DPC can save you money

How can you save with DPC? Well for one: price transparency. I can tell you exactly how much something will cost before you do it, so you can manage your healthcare costs. Need a cholesterol test? $4.44*. Need a blood count panel? $1.04*. Need a mammogram? $90*.

Do you need something expensive like an MRI? You will be surprised to find out that they aren’t as expensive as your insurance and hospital conglomerate would have you believe: $295*.

By the way, a typical hospital charge for an MRI would be around $3,000 or more. So if your deducible is $5000, then that $295 MRI will cost you $3000. Even if your deductible is $500, you’re still overpaying.

What if you’ve already met your deductible and you just have to pay your co-insurance rate of 10-15%? Yes, you are still paying the full actual cost and more for the MRI. In other words, you’re paying 100% of the actual cost plus more.

I could on and on (cholesterol medication: $1.93* for 1 month, depression medication: $0.90* for one month, EKG: free* in my office, getting stiches: $15* in my office).

Hopefully you can see how paying a little up front can save you tons down the road - kind of like how insurance is supposed to work. Best of all, you get the added benefit of being part of a small, intimate practice where we know you well and we aren’t too busy to care for you.

We do this same price transparency and cost savings for prescription and over-the-counter medications (a bottle of 100 Tylenol is $0.78*). The money you save between labs, imaging, and medications more than covers your monthly membership fee.

What about people who only come to the doctor once a year (or even less) and never need any labs, imaging, or medications? Those people pay the monthly membership fee as a hedge against not having to access costlier insurance-based care or emergency room care in the event of an emergency.

If you think DPC doesn’t make good economic sense, you are gambling. Even healthy “never-get-sick” types get sick, get cancer, need stiches, or get appendicitis. Believe me, I do this all day long. You’re worth the $2.46 a day and your kid is worth the 65 cents.

DPC isn’t the perfect solution in every situation, but it is far far better than the alternative: being stuck in a murky, rigid, and costly system that is in a death spiral. #Bethechange

*Note: costs listed reflect rates current as of the time the article was written