Saturday, June 1, 2013

Health Care Heats Up: Will Direct Primary Care be a Useful Alternative?

I notice slowly increasing intensity in all aspects of health care recently.  Obamacare hits October 1st with the Medicare offerings and state "insurance" exchanges.  January 1st, 2014 is all or none day for America.  We don't yet know what that means, but physicians caring for any federally subsidized patients will have to align with "quality" initiatives and "meaningful use" criteria for electronic Medical Records.  I'm cringing.

Massachusetts passed a law that physicians can't be licensed in 2015 unless they have competence in the use of EMR's, online prescribing and "meaningful use" plus a couple of lesser skills.  That could be a disaster as many physicians may not like the tightening noose around their professional necks that traps them as a coder instead of a carer.  We love to help patients.  Let us do it!

The Direct Primary Care ( subscription practice movement is picking up steam as more frustrations mount for Family Physicians and we look for a better connection point with our patients.  Going through an insurance company or the government is polluting the practice of medicine and watering down patient care, while significantly adding to the bankrupting of America by the medical - industrial complex.  More physicians face burn out as administrivia piles up to extend the work day, detract from the patient-physician relationship and irritate their home lives.

Direct Primary Care offers a business model that decompresses the stress for many physicians and patients.  It's generally cheaper than cable TV and less traumatizing. The patient pays an enrollment fee, then a monthly membership fee and, in many practices, a copay.  Most include basic family medical care in those fees, while many practices have other fees, such as labs that are sent out of the practice and x-rays.  The hard part for patients is that each DPC practice is different, due to varying practice styles and business strategies for each physician.  Web sites and the confusion of ObamaCare (and RomneyCare in MA) will help many people to get motivation to learn more about Direct Primary Care.

What do you think?

More later.


  1. The concept is good but...what about the person or family who makes too much money to qualify for government assistance for Medicaid or whatever,and cannot afford a membership fee and monthly dues? mas

  2. Thanks for your comment, mas. They may not fit in this model, which is just like Medicaid- not for everyone. No one model of payment will fit everyone. apj

  3. Thank you, Dr. Jonas, for writing about DPC. DPC will grow exponentially as consumers and employers realize its potential as a quality-care model for affordable costs. In fact, I believe it will be the future of private practice primary care in our country.

    Sam Qamar, MD