The most common question I hear when I tell people that I am starting a direct primary care is, “Do you take insurance?” 

My answer: “You don’t need insurance to see me.  Insurance can cover the cost of medicines, additional tests and studies, but 90% of what I do is covered by your monthly membership fee”.

In the past, you would see your doctor for an acute problem.  You’d probably get a prescription, take it for a few days and be completely better.  However, much of medicine now is chronic disease management, which requires frequent changes to the treatment plan.  This results in lots of messages to the doctor, giving feedback about the treatment plan or unexpected side effects, and what to do next.

In traditional fee for service, the only way the doctor gets paid is to ask you to come back into the office.

Compensation is aligned with inconvenience in the traditional system.

The DPC model honors both the patients’ and doctors’ time by decoupling reimbursement from the office visit.

It allows the flexibility to provide service in the most efficient and effective manner for both parties.  This means that I have more time to answer portal messages, or I can even call or video you to adjust the treatment plan and talk about the next steps.

A recent article highlights this issues and explains how other systems are adapting.

So, I take all the insurance (aside from Medicare and Medicaid).  I just don’t bill it.  Your monthly membership fee allows you to get the care you need, when you need it, and the peace of mind to know that you always have a doctor in your corner. (and in many cases, flexible spending dollars and Healthcare Savings Account money can be used to cover the monthly membership fee)

And that makes all the difference.

*we are not currently taking Medicare or Medicaid, but plan to in the spring. We can add you to a wait list.