How well do you truly know direct primary care? While you may think you have a good grasp on the benefits, there are a handful of misconceptions swirling around that lead people to believe DPC isn’t a fit for them – from pricing to politics. We’d like to debunk those myths and paint a clear picture of DPC at its core, so you can arrive at your own conclusions based on all the facts. In this blog post, we’ll dive deeper into four common myths of DPC, along with our explanation of why they’re untrue.
One of the main concerns physicians have around switching to DPC is the risks they associate with it, especially when it comes to the transition to true value-based care and developing a new source of income. When moving from a traditional fee-for-service model, physicians may also initially be nervous about managing a new practice and building their clientele base.
But fear not: there’s a significant group of established DPC providers who have gone before them. It’s crucial to prepare for the switch by doing your research, and luckily there are many resources available that share best practices for doctors moving towards DPC. Some physicians opt for a “hybrid model” to start, gradually switching from fee-for-service until they are able to fully move to a full direct care service.
Additionally, many physicians prefer DPC’s transparent, membership-based model, in which patients (or employers) pay their doctors directly on a subscription basis. This consistent membership fee covers the cost of all doctor visits and most primary care services, helping patients avoid unexpected out-of-pocket payments while providing a steady means of income for physicians. This model ensures doctors are paid for the value they bring to patients, removing the incentives found in fee-for-service models.
Another added value is that many DPC programs are covered by employers – some employers offer it in addition to health insurance coverage. This is helpful for all parties: patients get better access to their doctors, providers can expand their practice, and employers clearly see the ROI from healthier employees.
Wrong… When it comes to emergencies and catastrophic health events, insurance is very handy! There will always be unexpected life events that we cannot prepare for, and those are the perfect time to use insurance as a safety net. While DPC is often used in lieu of a typical insurance program when it comes to primary care, there is still a time and place for insurance -- for infrequent, unpredictable, large events.
Ideally, DPC and insurance work hand in hand – there’s no need to throw out the good uses for insurance with the bad. The underlying problem is that today’s healthcare system is set up so that every single medical cost goes through insurance, even if it’s smaller, predictable, and frequent. This begs the question: is it really necessary to bill insurance for regular visits to a primary care physician’s office or for minor procedures? Think of it like car insurance – if you visit the gas station to fill up your car, you’re not going to file a claim with insurance. Health insurance can serve this same purpose, without being a part of expected, routine care.
Of course, when patients have a trusting relationship with their primary care physician and make a point to go to regularly scheduled appointments, they’re able to take a more preventative approach to care and avoid more major health emergencies, saving money and peace of mind in the long run.
Related but less understood, DPC enables access to quality healthcare for many people who have no insurance and so would otherwise have poor care options. Most DPC providers actually care for more patients who have no insurance than they did when practicing in the traditional fee-for-service model! So DPC doesn’t attempt to replace the appropriate role of insurance, but rather it enhances service and access to primary care, the foundation of a well-functioning healthcare system.
As evidenced by our recent LinkedIn poll, this is one of the biggest misconceptions of direct primary care. On the surface, concierge medicine does have some similarities with DPC— both are membership-based practices that provide better access to physicians and high-quality care. However, they differ in that concierge medicine physicians charge both a membership fee and the insurance company for visits. In comparison, a DPC plan provides all-inclusive care at an agreed-upon price, no insurance involved.
Furthermore, concierge practices typically operate on full-year contracts, whereas direct primary memberships are typically offered on a monthly basis, allowing members to adjust membership much more easily throughout the year. Concierge medicine also tends to be more expensive than DPC, at a median membership fee of $162 per month vs. DPC’s $70 per month, according to our client data.
DPC offers providers and patients a way to escape traditional fee-for-service offerings and allows more control. For patients, it also provides better access to physicians and more one-on-one time to discuss health concerns. The ultimate goal is more satisfied patients and providers, better outcomes, and lower costs -- and that’s something everyone can get behind.
In the past, DPC has sometimes been associated with political leanings, but the movement is growing more and more popular across all political lines. Patients and providers are recognizing the benefits that DPC models can have on the healthcare system, and high-quality, life-changing, access to healthcare is an option that transcends political divisions. Ultimately, DPC is a stable, transparent, and bipartisan program that can lower healthcare costs while improving outcomes and satisfaction.
While these are the four common misconceptions of DPC we often hear, we’re always interested in what our community may be experiencing. Are there any others that you’ve considered? We’d love to hear from you to answer any lingering questions (and who knows, it may be featured in an upcoming blog post!). Drop us a line!