What is Direct Primary Care and Who Benefits?

What is Direct Primary Care? 

Have you heard the term, Direct Primary Care (DPC)? If you haven't you're not alone. I hadn't heard of this term either until recently. I was on the hunt for a new primary care physician and I stumbled across a couple of practitioners who utilize this model. According to the American Association of Family Physicians, "The direct primary care (DPC) model gives family physicians a meaningful alternative to fee-for-service insurance billing, typically by charging patients a monthly, quarterly, or annual fee. This fee covers all or most primary care services including clinical and laboratory services, consultative services, care coordination, and comprehensive care management." 

Basically, practices that use DPC do not accept insurance, and instead, collect a set fee that covers all their services. Most of the practices I researched charged these fees on a monthly basis and charged between $60-$120 a month. But, that fee typically covers an unlimited amount of appointments, e-visits, paperwork for FMLA & service animals, and prescriptions. 

Who Would Benefit From Direct Primary Care? 

My favorite feature of DPC is the way this model approaches office visits. With most doctors, you have 15 minutes with them in their office. So, if you have multiple issues you need to schedule multiple appointments to address them all. Not to mention, 15 minutes isn't a whole lot of time for the doctor to problem solve and think through your issues. With a limited amount of time, warning signs can easily be overlooked or dismissed by even the best providers. 

In my (humble) opinion, those with chronic illness(es) would greatly benefit from this type of care. Often, we have many concerns that need to be addressed in one visit. For those of us that work or have trouble arranging transportation, sometimes scheduling appointments can come with major hurdles. Not to mention, even those of us that don't work and can get around easily often don't want to make more than one appointment, if possible. I hated having to schedule two appointments in the same month with my PCP. One would be for my heart (yay POTS and heart arrhythmias!) and one would be to get antibiotics for a sinus infection. And, I actually had a really good PCP. He just didn't have the time to take care of everything in one visit. 

Also, many DPC providers allow you to e-mail them and make e-appointments. So, if you forget to ask about something? You can just send them a quick e-mail explaining your issue. Or, if you do struggle with mobility or arranging transportation you can schedule an appointment from the comfort of your own home.

DPC providers may also be a good option for those without insurance or those underinsured. If you have a high copay, it may be unaffordable for you to schedule doctor appointments. But, many DPC models can charge similar or lower amounts than a standard copay. Some DPC models even cover blood work and other laboratory services, saving even more money for those that are uninsured. 

DPC might also be a good option for those that live in rural areas and might have to travel long distances to see their PCP. 

Who Might Not Benefit from Direct Primary Care? 

Since you have to pay fees out of pocket (and no, you can't pay for it with either your HSA or FSA) DPC might not be a good option for everyone. For some, it's simply unaffordable. 

Typically, DCP providers are also private practice. So, those that want to keep their care within one hospital network may not like using a PCP in private practice. 

Finally, doctors that use the DCP models tend to be more holistic. This may pose a problem for clients who only like utilizing Western Medicine and don't like taking supplements or trying alternative treatments (i.e. acupuncture, chiropractor, etc). 

Final Thoughts

Overall, I do like how Direct Primary Care works. I understand there are disadvantages, but it seems to be more beneficial for me. Many of you know I'm a military spouse, and that we move a lot. With DPC, I can take my doctor with me and researches and finds specialists for me near my new home. This takes a lot of anxiety out of finding a new care team for me. He also coordinates my care with other doctors and acts as my advocate. In my particular area of the country, many PCPs are unwilling to prescribe any psychiatric meds. But, since I'm already established on both my prescriptions my doctor will prescribe them, eliminating another specialist appointment from my regular routine. 

Those aspects make the additional cost worth it to me! And, overall, I feel like it gives me more power over my healthcare and encourages me to be a better advocate.