In the United States, a common form of healthcare is traditional fee for service (FFS) systems in which patients pay a monthly premium in addition to deductibles, co-payments, and co-insurance that differ depending on the type of insurance plan. In recent years, many individuals frustrated with the FFS system have turned to direct primary care as a way to circumvent insurance companies.
Direct primary care was first introduced in the early 2000’s, and individuals pay a monthly subscription fee directly to their doctors and receive care. There are no insurance companies, and the idea is that patients can be better connected with their doctors and avoid unnecessary bureaucracy and complex hospital systems. While this system of care sounds promising, what does direct primary care look like in the long run for patients?
Direct Primary Care (DCP) vs. Traditional Fee for Service (FFS)
The following list breaks down the differences between direct primary care and traditional fee for service:
- Patients Seen by Physician: DCP physicians have an average panel of around 600 patients while FFS physicians see anywhere from 2,000-3,000 patients.
- Time with Physician: Patients in the DCP system spend an average of 45 minutes with their physician whereas patients in the FFS system spend an average of 7 minutes with their physician.
- Amount of People: In the DCP system, there are only two people involved – the patient and the doctor. This stands in stark contrast to the FFS system in which there is the patient, doctor, insurance company, hospital system, and many other entities.
- Fees: The DCP system offers a flat, recurring monthly membership. Fees in the FFS system vary due to deductibles, co-insurance, and other out-of-pocket expenses.
What should be noted is that many individuals who are enrolled in a direct primary care program still have insurance for emergency events. With low premiums, emergency insurance and direct primary care can still be more affordable than traditional FFS systems.
Benefits for Patients
Direct primary care is extremely beneficial for patients. Eliminating the administrative burdens of insurance companies means that patients can cultivate a meaningful relationship with their physician and receive more individualized care. This relationship is also beneficial for preventative care: a physician who has spent years with his or her patient will be able to more quickly notice and addresses any changes in health than a doctor’s office evaluating a patient for the first time.
Further, many patients enjoy the direct primary care model because of its easy access to doctors, medication, and specialists. Depending on the direct primary care center, patients may have 24/7 access to their physician via text or email, and direct primary care centers are also typically open later and on the weekends. Depending on where the practice is located, physicians may even be able to prescribe medication directly. Imagine being able to text your doctor to refill a recurring prescription!
Direct primary care physicians also work to save their patients’ money by contracting with local specialists to give discounted rates. In the instance that a patient needs to see a specialist, their direct primary care physician will refer them to a specific location with that discounted rate. WebMD describes two instances when Kevin Boyd, 64, broke his ribs. The first time, Boyd drove himself to the ER, got an MRI, and received shots to manage his pain. The total bill was $14,000, and he only paid $2,600 due to his insurance. The second time Boyd broke his ribs, his direct primary care physician referred him for an X-ray and directly gave Boyd pain medication. The total cost was $70.
Benefits for Physicians
Just like your goals as a patient are to receive maximum health with the lowest cost, a physician’s goals are to dispense the best medical help for individuals with the least hassle. The direct primary care model appeals to physicians just as much as it does for individuals. Physicians want to feel a sense of fulfillment in their careers, and that often isn’t achieved in the FFS system.
WebMD quotes Dr. Jeffrey Gold, “I was seeing 20 to 22 patients a day, […] and I was thinking of either quitting medicine completely or teaching at a local medical school. I saw no sustainability in seeing people in 10-minute increments daily for the rest of my career.” After starting up a direct primary care practice in Massachusetts, Dr. Gold found he was able to be more present for his patients, either directly when they were at the office or if they had a question between appointments.
Spreading out patients also allows for physicians to spend more time completing research and honing their craft. If physicians spend their entire work day seeing patients, there isn’t time to grow and develop. In the same WebMD article, Dr. Jeffrey Puglisi describes what he wants out of his career: “I want to provide better care, be healthier as a person, and be smarter every year in this practice.” Having a direct primary care practice allows him to see patients but also lecture around the country and spend time researching other fields of medicine to increase his general knowledge.
Broadnax Primary Care
There’s a lot to navigate when it comes to healthcare in the U.S. Reach out to Broadnax Primary Care today to learn more about the benefits of direct primary care!