Simply put, direct primary care is a model of healthcare delivery that goes back to the way medicine used to be practiced: you, and your doctor. That's it. No middlemen in the form of insurance companies, pharmacy benefit managers, third party plan administrators, etc. to get in the way of your treatment plan. In the typical "pure" DPC practice, you contract directly with your doctor with a membership subscription in exchange for an included menu of services (typically quite comprehensive). Additionally, because your doctor doesn't bill insurance for services, you can get access to wholesale savings on prescriptions, laboratory and imaging studies, and pathology services. At Dogwood Primary Care, this is the model we practice, with very real savings for our members.
How else does DPC differ from insurance-based practices? For starters, DPC practices typically have a smaller panel size, usually 400 to 600 members when full, as compared with over 2,500 for an insurance-based family physician. This is possible because the DPC physician doesn't have the overhead of insurance billing specialists. The benefit is that the DPC physician can spend extended amounts of time with patients, ensuring excellent attention to your needs.
Additionally, by not participating with insurance companies, DPC practices are not bound by insurance companies' rules. For instance, there's little incentive for an insurance-based physician to perform telemedicine, either by phone or video, since these services are rarely compensated (and may not be allowed under HIPAA). The DPC physician can absolutely utilize modern technology to keep communication as convenient for you as possible.
We get asked all the time, "Isn't that concierge medicine?" Well, yes - and no. There are certain similarities, among them small panel size and a subscription-based membership. However, concierge practices typically charge a substantially higher membership fee, and most will also bill your insurance as well. Because of the higher entry point for membership, concierge practices have a reputation for exclusivity. By virtue of our lower price points, we like to think of ourselves as "concierge medicine for the rest of us."
We also get asked all the time, "Why should I pay for additional healthcare access when I already have health insurance?" It's a valid question, and in a cash-strapped world, not one to be taken lightly. We like to reframe that question by asking "How healthy are you really with your current insurance plan?" Think back on the last year or two of healthcare experiences: were there one or more visits where you were rushed through your appointment and didn't get to address a concern you had? Are there realities about your life that you wish your doctor knew, because they impact your ability to be healthy? Has your healthcare been fractured by visits with providers you've never met before, who barely knew anything about you? Perhaps you've answered "yes" to one or more of these questions, and if so, we might gently challenge you to take charge of your healthcare; you can't afford anything less than to be as well as you can!
Feel free to take a look at dpcnation.org for a really good description of DPC, and to find a practice near you!