What is a “DPC?”
A DPC or Direct Primary Care practice is a model of health care that allows patients to pay a predictable monthly or annual membership fee to their doctor in return for a broad range of primary care services without the physician billing traditional insurance. It acts as a “subscription” for more personalized and comprehensive care such as longer visit time with your physician, prompt acute care access, telemedicine services, home visits, and 24/ 7 on call support by your physician. A DPC practice does not bill insurance for any included service.
The DPC model was structured to emphasize and prioritize the intrinsic power of the patient physician relationship with a goal of improving health outcomes and lowering overall health care costs. Bypassing traditional health insurance has several advantages:
- Removes the influence of insurance/ third party payor on your health care and restores the patient physician relationship
- Smaller patient panels allow for a more intimate working relationship between the patient and physician permitting more personalized and comprehensive care.
- Flexibility in visit “types.” For example, due to greater flexibility in the daily schedule as a result of smaller patient panels, visit times can often be extended to 60 minutes or 90 minutes depending on the complexity of the patient/ condition. Telemedicine visits can often be utilized as can home visits depending on the nature of the care needed. We decide, not insurance!
- Same day or next day access for acute care is more readily available (by your own physician) often allowing for avoidance of an urgent care or emergency room (which can increase health care costs for the health care system and for the patient)
- Emergency coverage 24/7 by your own physician is often allowable given the reduced panel size
- Reduced burden of insurance bureaucracy reduces overhead costs by allowing for smaller staff sizes and improved/ reduced stress and strain on the staff.
What a DPC is NOT
- We are NOT concierge medicine.
o Concierge medicine is a practice model that often accepts membership fees in addition to utilizing traditional insurance billing for revenue. Patients often pay a much higher monthly/ annual membership fee than a DPC practice in addition to the co-pays and deductibles that are determined by their health insurance. Concierge services also offer extensive wellness visits, executive physicals, and specialized coordination of care.
- We are not a replacement for health insurance.
o Patients who are members of a DPC practice will still need health insurance. Health insurance is needed for any services provided or ordered outside of the offerings of the DPC practice such as laboratory testing, prescription coverage, diagnostic imaging, specialist care, emergency room and hospital stays.
Who is a DPC most suited for:
- People of all ages and from all backgrounds will benefit from the comprehensive and personalized care that is offered at a DPC.
- Patients who want to take a more proactive and interactive approach to their health and to staying well.
- Patients who are interested in the “whole person” approach to maintaining health and wellness, treating illness, and managing chronic disease.
- People with high insurance premiums, high insurance deductibles, or no insurance at all.
Direct Primary Care is endorsed by the American Academy of Family Physicians and the Massachusetts Medical Society as a valuable and ethical model of delivering primary care that allows for patient and physician choice and improving care outcomes.
(study references here)