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Brandon Sick M.D. Blog

Direct Primary Care Versus Concierge Medicine

4/14/2017

2 Comments

 
First, let’s take a brief look at the state of primary care today. Patients often feel rushed when visiting their primary care physicians, and that’s unlikely to get better. In fact, the Association of American Medical Colleges now expects there to be a shortage of 91,500 doctors by 2020, which means that doctors will have more patients to see in a day’s time, further shortening the time they can spend with each one.

Then there’s the whole issue of health care insurance, with premiums increasing and the status of the Affordable Care Act being fiercely debated. Not surprisingly, a percentage of primary care physicians are seeking a better way to provide care, with two models gaining attention: direct primary care and concierge medicine. Here’s an overview of each.

What is Concierge Medicine?

There are multiple methods of providing concierge care, but they typically focus on a patient paying a monthly fee to their doctor to ensure direct access to him or her. Doctors following the concierge model of medicine also accept insurance, which means that the challenges associated with insurance today are part of a typical concierge medicine experience.

What is Direct Primary Care?

This is usually a non-insurance model, one where doctors keep their practices small. Practices that don’t contract with health insurance companies eliminate the need for collecting copays, filing the paperwork and so forth. This reduces the need for and expense of medical office staff whose primary job is dealing with the requirements of insurance companies.

Some direct care patients find extra financial value through purchasing a less expensive, high deductible insurance plan for hospitalizations and catastrophic events while others just simply find value in the personal service and high quality care.

Direct Primary Care Analogies

The monthly fee paid to the primary care physician typically covers the costs of:

  • all visits
  • annual physicals
  • in-office procedures
 
This is comparable to paying for a gym membership. You pay a monthly fee and then use the gym’s facilities and equipment without worrying about hidden charges or extra fees. You can also compare direct care to auto insurance. You use your auto insurance, for example, if you are involved in an accident, but not for typical vehicle maintenance such as changing your wiper blades and/or oil, or routine fixes such as with a flat tire. Can you imagine how complicated it would get if your auto insurance company decided how much of this routine maintenance is covered, what brand of wiper blade replacement blades you can use and so forth?

NPR Takes an Objective Look

NPR first acknowledges that a “growing number of primary care doctors” are “spurred by frustration with insurance requirements” to find a better way, adding that direct primary care is a “much less pricey” model. The article also lists multiple additional benefits of direct primary care, including that:
  • “doctors can focus on treating patients, since they no longer have to wade through heaps of insurance paperwork”
  • “They [doctors] spend less on overhead, driving costs down”
  • “physicians say they can give care that’s more personal and convenient than in traditional practices”
 
Rock Hill Primary Care Uses Direct Primary Care

We use an insurance-free, lower-cost primary care membership model. We aren’t against insurance – but we are against the idea that your primary care should be determined by the type of insurance that you have. By eliminating the need for insurance for your primary care visits, we can provide patients with multiple benefits, including:

  • lower costs
  • longer visits
  • more access
  • low costs medicines
  • lower costs ancillary services (x-ray, ultrasound, etc.)
  • wholesale labs
 
To schedule a consultation with Rock Hill Primary Care, call 803-329-SICK (7425) or drop by our office 724 Arden Lane, Suite 235, Rock Hill SC 29732 (behind McAlister's Deli)
2 Comments
Joy Butler link
7/18/2018 09:08:06 pm

I really appreciate you helping me learn more about their differences. It really helped when you said that the doctors following the concierge model of medicine also accept insurance. I'd be interested to learn more about for future use.

Reply
rachel frampton link
1/7/2020 02:48:04 pm

My dad has been wanting to apply for health insurance, but he couldn't decide what type shall he get. It's great that you shared this article; It's great to know that direct primary care covers the cost of all the visits, annual physicals, and in-office procedures. Maybe it's best if we'll start looking for a health insurance company.

Reply



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