By Brian Lanier, Med Student
MAY 2014 – I was honored to be asked to serve on the steering committee for this year’s Direct Primary Care (DPC) summit, which will take place in Washington, D.C. in June. I’ve written here before about about DPC, how I became aware of the practice model and how I felt that it was the only solution that truly addresses the problems plaguing primary care. DPC will allow me to practice in a way that makes the patient, not the third-party payer, the center. However, I often hear the following three questions about DPC: (1) How will it survive under the Affordable Care Act? (2) Isn’t it just for rich people? and (3) How can old-fashioned primary care embrace innovation? So I want to answers those questions here.
But first, direct primary care is a model that removes the third-party payer from the equation. Third-party involvement in primary care adds an enormous burden of cost and time – a burden that doesn’t add to, but actually detracts from, the quality of care. When that burden is removed, the savings are dramatic, and the whole physician paradigm shifts from chasing reimbursement to providing the best care possible. In DPC, the patients pay the physician directly for service through an affordable subscription or transparent a-la-carte pricing. A subscription might include same-day or next day appointments; little or no wait time; email, phone, text or even Skype access; and sometimes house calls.
Now that most Americans are required to have health insurance under the Affordable Care Act (ACA), many people wonder what role a practice that doesn’t take insurance could have. Direct Primary Care has an important role in health reform. There is a provision in the ACA that allows for DPC services to be offered with policies sold on the exchanges, and this is already happening in the state of Washington. The Direct Primary Care Coalition is working feverishly to enact or modify legislation to allow more people to benefit from DPC.