By Brian Gans, Second year medical student at Penn State Hershey
APRIL 13, 2014 – When the global financial system collapsed in 2007-2008, a lot of people were completely shocked. However, there were prominent economists who predicted that the housing bubble was going to burst. The same thing is about to happen with healthcare – the statistics concerning how much we pay for healthcare in America and those of our health outcomes are sickening. Our healthcare system is not sustainable, and the bubble is going to eventually burst. When my roommate (also in the Penn State Med Class of 2016) told me about Direct Primary Care (DPC) I was completely shocked. I have never been so excited about the future of medicine as the day when I realized that this healthcare model existed.
DPC is the solution to the chaos that I see before me as a future physician. When I practice taking an H&P and I am limited to 15 minutes, I have to remind myself that I just have to suffer through it because medical education is stuck in an antiquated rut. When I am fully licensed and practicing on my own in a DPC system I won’t have such an archaic limitation. How can you practice good medicine when the current system is not conducive to it?
DPC will fix a lot of problems currently plaguing traditional primary care, including the malignantly high number of patients that primary care physicians have to manage in order to stay solvent in their practice. With the way insurance reimburses primary care currently, patient panels go up and appointments get shorter for clinics to avoid going under – it’s bad medicine, and insurance is the problem. Good primary care is not expensive, and the exciting thing is that there are several prominent DPC clinics (Atlas MD, Qliance) that are proving that this type of medicine is thriving and waiting for me when I graduate. These clinics have patient panels of about 400-600 per physician, and the shockingly beautiful thing is that these physicians are working fewer hours and being reimbursed better than their fee-for-service colleagues.
The reason DPC is exciting is that this type of healthcare model took a specialty (Family Medicine) that was very attractive to me and took away all barriers to considering it after medical school. The main problem I ran into when I thought about Family Medicine was that I absolutely would not practice in an environment where I am limited to 15 minutes with a patient and 45 minutes of billing/paperwork for reimbursement. After watching several webinars presented by the physicians at Atlas MD and Qliance, I was shocked to find out how much overhead is needed for billing/coding. I couldn’t believe my ears when I heard how DPC practices eliminated most of the overhead when they cut out insurance.
Direct Primary Care is the kind of medicine I want to practice when I graduate. I want to find a way to make better and more affordable healthcare for patients. I want to create my own healthcare start-up that is modeled after the things I like about the prominent leaders in DPC. Innovating primary care is something I can do when I am not dependent on insurance companies. DPC is the key to transforming the whole healthcare system.