Direct Primary Care Delivers on Cost, Quality and Caring

In 2016, Senate legislation seeking to clarify that Direct Primary Care is not insurance did not make it out of the Georgia Senate. In 2017, the Senate unanimously approved similar DPC legislation and the House Insurance Committee reported favorably on the bill on March 20, but the House Rules Committee did not place the legislation on the calendar by March 30 for a House vote before Sine Die.

By Loren King

Dr. Loren King

Dr. Loren King

In primary care medicine, offices visits require understanding and knowledge of multiple complicated and interrelated medical, social and economic concerns to adequately parse decision making.

Health care is complicated and personal and, at its very foundation, it is conversation, friendship and hope. Unfortunately, the economics of an office visit have severely damaged its very foundation. The economic and bureaucratic intrusion of commercial and government insurers has robbed patients of their precious time with their doctor. A patient’s average face-to-face time with the physician has dwindled to a paltry three-to-seven minutes and has become impersonal, impractical, unbearable and, frankly, dangerous.

Every office visit has 15 others in the room with one hand in the patient’s pocket and another in the physician’s face. This does not have to be. There is a better way and families deserve better!

At least 85 percent of patients only need the services of a primary care physician – and nothing more – within any given year. Primary care services amount to only about 5 percent of an individual’s total spending on health care. So why do people buy insurance for primary care?

Only fools would buy insurance for the maintenance and fuel for the cars they drive; the dinner they prepare for their families, the hair salons they frequent. No resident insures the water out of their faucets or their monthly cellphone plan. These are all services most people would deem as necessary to everyday living.

Direct Primary Care is a model of paying for primary care cost outside of insurance. The individual paying for primary care pays a monthly fee often less than the typical cost of a cell phone plan. The average adult monthly membership is less than $75 per month.

Direct Primary Care physicians limit their number of patients, usually to 400-800 instead of the typical 2,000-4,000 patient panel. This allows for significantly increased time per visit, resulting in a more personalized, thoughtful approach at each visit and no waiting room time.

The longer visit allows physicians to use a personalized team approach, providing wellness coaching to better manage hypertension, diabetes, metabolic syndrome and other chronic medical conditions. Physicians can enhance any needed referrals by leveraging peer-to-peer consultation with specialists on the patient’s behalf.

Physicians also have time to incorporate free telemedicine, text and email communications at the patient’s convenience instead of just during typical office hours. With no copay, co-insurance or deductible collected, there is no impediment to patient access to the most important and cost-efficient care. Direct primary care physicians are able to obtain and pass on to patients, at greatly reduced cost,  wholesale generic medications, and lab work and pre-negotiated imaging and endoscopy services from other independent providers.

Eliminating third-party interference and intervention allows physicians to focus on implementing direct, patient-centric innovations and technology without onerous bureaucratic and commercial disincentives.  The physician becomes the patient’s personal health care fiduciary and, as all physicians have sworn, is actually able to return to a real commitment to the Hippocratic Oath.

The most valuable commodity in primary care medicine is time; it should be spent on what we value: health and happiness. The most common condition a primary care physician treats is, in fact, unhappiness. The greatest obstacle to treating unhappiness, however, is the physician’s own unhappiness. Fortunately, physicians who have discovered the model of direct primary care are sharing their renewed sense of purpose; some even call it joy.

Loren King, a Direct Primary Care physician practicing in Calhoun, Ga., wrote this commentary for the Georgia Public Policy Foundation. The Foundation is an independent, nonpartisan, nonprofit think tank that proposes market-oriented approaches to public policy to improve the lives of Georgians. Nothing written here is to be construed as necessarily reflecting the view of the Georgia Public Policy Foundation or as an attempt to aid or hinder the passage of any bill before the U.S. Congress or the Georgia Legislature.

© Georgia Public Policy Foundation (March 31 2017). Permission to reprint in whole or in part is hereby granted, provided the author and her affiliations are cited.