What is Direct Primary Care (DPC)?
DPC is an emerging medical model in which the patient and doctor engage in a straightforward relationship without the involvement of a middle man. Patients pay a simple monthly fee, similar to a gym membership, as opposed to the doctor billing an insurance company. There are now over 1000 DPC physicians in the United States, and the number is only growing.
What are the advantages of DPC?
Under the traditional primary care model, billing insurance companies is an inefficient process which requires the doctor to hire billing specialists, increasing overhead and ultimately, costs for the patient. To compensate, the doctor may have to see up to 3,000 patients. By contrast, the average DPC physician usually cares for around 600 patients. This allows for longer, more relaxed office visits, convenient access, thorough care, and an overall better experience for the patient.
Do I need to get rid of my insurance?
No – we encourage all patients to continue their healthcare coverage. Having insurance is important if you need hospitalizations, surgery, scans, or specialty consultations. This was the original intent of insurance – to cover the most expensive aspects of medical care. If you have insurance, we will keep it on file in order to help facilitate your care (e.g. prior authorizations, referrals, etc), but we will NEVER bill your insurance for our services.
What about labs?
We draw your lab studies in our office, and there is no additional charge for basic tests such as blood counts, metabolic panels, glucose, and cholesterol. For labs that are not included in the membership, we can provide incredibly discounted rates from their ordinary prices, or our reference lab can file with your insurance. It’s always your choice.
Can you still refer me?
Yes, we’re able to refer you for x-rays, scans, procedures we don’t already perform in the office, and to specialists if needed (there are a few rare exceptions). We have recently added the services of RubiconMD, an online consultation service, giving us access to a number of board certified specialists around the country who can provide education and guidance concerning your care.
What if I go to the hospital?
We perform social visits when our patients are in the hospital, but we cannot practice medicine there. However, we can always refer you to the hospital of your choice, interface with their staff, and access your records when appropriate.
Can I use my HSA or FSA to pay the fee?
The legislation on this is currently unclear. Please check with your HR department or tax advisor. Future legislation should clarify this issue very soon, allowing patients to use FSA and HSA plans for DPC care.
What if I change my mind?
If you decide to leave our practice at any time, for any reason, we will gladly refund the unused portion of your membership fees. We want our patients to be satisfied with the care they receive.