Since hearing about the concept, I personally have been a fan of the direct primary care (DPC) model. The benefits of the system are obvious, as it facilitates patient-centered care and physician autonomy, both of which seem to be neglected in the typical high-paced primary care setting. Despite DPC being a spawn of concierge medicine, it is not only for the rich. In fact, many of the practices using this model are very affordable for middle-class families.
However, this article is not about convincing everyone that DPC is the best payment structure and is the way of the future. This is written for those practitioners who are intrigued by the concept and want to know more about it. Being a new resident with limited managerial experience, I did what I do very often at this stage in my career: I turned to my seniors!
I reached out to one of the most active promoters of DPC, Dr. Josh Umbehr from Wichita, Kansas. He is full of optimization for DPC and is very determined to help other physicians make the leap to this alternative model. It may also be helpful to know that Dr. Umbehr was brave enough to start his practice, AtlasMD, straight out of residency.
Why are physicians making the change to DPC?
Dr. Umbehr: I think many physicians are migrating to DPC because the current insurance-based system is not sustainable. They have seen their professional and personal satisfaction erode over the last decade. They have increasingly less time with patients and are now spending more time on documentation. More importantly, however, the system is not working for their patients. It makes it increasingly difficult for patients to schedule an appointment, get quality time with their doctors, and afford essentials like medications, labs, and procedures. Ultimately, we’re all paying a higher cost for healthcare and getting a lower return.
In contrast, direct care models allow physicians to spend more time with their patients while lowering prices and improving quality. It is a more logical model that removes healthcare insurance from the process of getting routine maintenance care. [In the past, Dr. Umbehr has compared this concept to car insurance, which typically covers emergencies, but not wear-and-tear items like oil, tires, batteries, etc.] A model that allows for unlimited visits without copays, procedures included in the membership price and wholesale medications and labs is able to provide enormous savings for the patients and physicians alike. That value can then be shared with employers and ultimately insurance companies. DPC is gaining popularity because it aligns with the fact that health insurance is a completely necessary service but has ample room for improvement in affordability.
What advice do you have for physicians fresh out of residency?
Dr. Umbehr: Starting fresh from residency is a viable option and we’re helping a number of physicians do just this. Most residents worry that they need a large budget to start a new practice but I think it can be done for well for $10-30k in start up costs. Dr. Joseph Sheppard started this summer and was profitable in just 2 months because he was able to manage his start up expenses and worked diligently on recruiting patients.
How would a physician with an existing practice make the conversion?
Dr. Umbehr: Converting a practice is even easier because the physician already has a target audience that is familiar with their care and appreciate their service. We recommend an 8-12 week conversion process that includes a series of letters to the patients and a few town hall meetings. Many physicians are converting and pre-enrolling several hundred patients before their launch date. Not surprisingly, this often makes the first month of the new DPC practice more profitable than the an average month under the insurance-based model.
Where can readers learn more?
Dr. Umbehr: We actually offer all of our consulting free of charge because we’re that passionate about growing the DPC movement. Rising tides raise all ships and we need every DPC doctor to be successful. That will be how we can continue to attract the support of patients, employers and insurance companies throughout the country.
Our team has made process of transitioning to DPC as turnkey as possible via sample contracts, enrollment forms, wholesale lab, medication, and imaging pricing, checklists and more.
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