Thursday, July 18, 2013

Family Medicine: Recapture the Dream with Direct Primary Care

Thoughts about Direct Primary Care

As we move ahead with more Direct Primary Care practices, I hope we in Family Medicine will  remain sensitive to the small practice that is a bit "counter-culture".  Many are looking at DPC to get away from "meaningless use" of the ACA and piles of administrivia from insurance companies.  Many of these physicians are looking for help to stay independent.  Some are looking for a loose connection to an organization that helps but remains non-invasive.  Very few might be looking for an umbrella organization that exposes them to oversight and more "phony quality initiatives" that detract from patient care.  Some want pure DPC, while some want a hybrid, some want to start with one and end with the other.

When I look at the model Kurt Stange introduced at the FMEC meeting last year from Ken Wilbur's book, A Brief History of Everything, I see DPC offering a broader human focused health care than the Medical-Industrial Complex which is driving everything toward External/Measurable Numbers (the right side of the Wilbur two by two model). 

Illness has always been a deeply human endeavor (if allowed) which allows people to better understand their humanity and the human condition.  The MIC is destroying the potential for understanding while DPC offers hope, especially for Family Medicine which used to be committed deeply to caring for and protecting our patients.  Now, the Family Physician is selling out to "the beast" and "accidentally" lining up patients for overexposure to unnecessary and expensive care to get "good numbers".

DPC offers renewed hope that the internal aspects of the humanity of the individual patient can be enhanced through relationship driven dialog with their family physician in the context of health care.  Insights generated through the internal dialog leads to broader cultural inputs which expand tribal boundaries of cultures to better relate to other tribes and better understanding of our shared humanity.  Ian McWhinney clarifies the role of the Family Physician nicely in his writings about our specialty.

More later

1 comment:

  1. I agree completely -- that's why I am starting my own direct primary care practice as well in Madison, WI. It is always inspiring to read about other doctors who have done the same, and see how they have done it. I really think this practice model gets to the core of what a family doctor is meant to do.

    Will Schupp, MD