Simply defined, direct primary care (DPC) is a medical payment model where patients pay the physician a membership fee to be a part of the physician’s practice. In fact, direct primary care is not a new concept. In the past, it was how doctors practiced medicine before insurance companies began to play such a massive role in our healthcare system.
Today’s Health Insurance Coverage
The purpose of health insurance is to protect patients from the crushing debt that can come with emergency medical care. Think of it like a car, home, or life insurance policy and its protections. Instead, what has happened in the years since the creation of health insurance is quite the opposite. People pay for insurance and still are not able to afford their medical expenses.
This change is due, in part, to the idea that all healthcare is expensive, so insurance should not just cover emergencies but rather cover everything—from surgeries and procedures to lab work and checkups. Instead of serving its purpose as emergency protection, it has become a payment system. And the sad irony is because we use insurance to pay for everything, premiums have increased so much that many Americans cannot afford them.
Can we fix our dependence on health insurance? That’s where DPC practices come in. Primary care is not expensive—once you remove the insurance middleman.
Most DPC physicians do not bill or accept payment from insurance companies. The membership fee typically covers most of the services the physician provides in the office, including treatments that would be billed separately under the insurance model.
Tests like EKGs, spirometry, urinalysis, and pregnancy tests, for example, are included with membership. Furthermore, doctors can include procedures such as joint injections, sutures, and skin lesion removal in the membership. There are usually only additional charges if a sample is sent to the lab or pathology for processing.
Because membership fees don’t cover specialist or hospital tests or treatments, DPC physicians continue to recommend some form of catastrophic or high-deductible health insurance coverage for unplanned events.
Direct Primary Care Offers Advantages
DPC offers patients some significant advantages. One of the biggest is patients can build a real relationship with their doctor. DPC physicians limit the number of patients their practice accepts, allowing them to spend more time with each patient and provide high-quality care.
Another benefit is that DPC patients receive transparent pricing. Unlike traditional insurance, DPC has no copays or billing since monthly membership includes most services. If a patient has to receive specialized care or procedures, their DPC doctor becomes their advocate, helping them navigate the complicated healthcare system.
Finally, DPC physicians are easy to access. They answer emails and phone calls and have regular office hours, often accommodating same-day visits. This access results in better health outcomes and fewer urgent care and emergency room visits.
Ready to Try DPC?
Interested in a new healthcare model? We invite you to give DPC a try. A personal relationship between your physician, you, and your family can change your life. Also, it can save you money by reducing your monthly insurance premium to cover only catastrophic needs. At New Freedom Family Medicine, we have direct primary care offices in Hermann, Washington, and O’Fallon, Missouri. And we are accepting new patients. Join us today.