Emergency room (ER) departments play a vital role in delivering emergency care, but they are increasingly being used for conditions that are not true emergencies. According to the U.S. News & World Report, many ER visits are avoidable. Primary care physicians (PCPs) can significantly reduce these visits by offering timely, proactive, and comprehensive care to their patients.

Direct Primary Care (DPC) is revolutionizing how patients interact with their physicians by offering more personalized and proactive care. This shift away from a reactive system — where patients only seek medical help when sick or in an emergency — toward a patient-centered model focuses on achieving the best possible health outcomes. A study conducted by Milliman/Society of Actuaries found that employees enrolled in DPC saw a 40% reduction in ER visits and a 53% lower ER spend compared to those in traditional health plans. This proactive care approach not only promotes whole-patient wellness but also reduces unnecessary ER visits.

Avoiding Unnecessary ER Visits

Primary care providers can do a lot to prevent avoidable ER visits, and DPC is designed to offer immediate, accessible care, giving patients direct access to their physicians via texts, calls, or virtual consultations. This empowers patients to make informed decisions and eliminates the need for many urgent care or ER visits. Additionally, incorporating preventive care strategies, such as RPM and Chronic Care Management, helps detect and address issues early, before they escalate into emergencies.

These proactive strategies lead to measurable outcomes: employees in DPC saw a 12.6% decrease in overall claims costs, a 20% reduction in hospitalizations, and an 8% lower inpatient spend, further proving the model's effectiveness in avoiding high-cost emergencies.

• After-Hours Care: Many ER visits occur simply because patients don’t know where else to go after hours. DPC addresses this by providing after-hours communication and alternative care options. Patients should save their provider's after-hours contact number and know how to schedule urgent appointments, even outside regular office hours. By giving patients access to timely care, DPC reduces the need to use ERs for non-emergency issues.
• Follow-Up Care: If a patient does visit the ER, DPC providers ensure proper follow-up care within 30 days to avoid future visits. This follow-up care helps manage the patient's condition and prevent unnecessary readmissions.
• Patient Education: Educating patients on the appropriate use of the ER, along with clear communication about when to seek urgent care or make a same-day appointment with their DPC provider, empowers patients to make informed decisions. This helps reduce ER crowding and improves overall patient outcomes, as patients are less likely to use emergency services for non-critical issues.

When to Contact Your Primary Care Physician

Your primary care provider is your first point of contact for non-emergency health concerns, including:

• Routine Checkups and Preventative Care: One of the biggest advantages of DPC is its emphasis on prevention. Regular physicals, lab work, and health screenings help detect and manage conditions before they worsen, avoiding the need for ER visits. By having regular checkups, you stay on top of your health, identifying potential issues early.
• Medication Management: Poor medication management is a leading cause of ER visits, especially among seniors. Taking medications incorrectly, such as stopping suddenly or not following dosage instructions, can worsen existing health conditions. DPC practices often provide personalized medication management support, including in-house pharmacists, to guide patients and avoid these issues. This ongoing support helps ensure that patients follow their prescriptions correctly, reducing the need for emergency interventions.
• Common Illnesses and Infections: Symptoms like sore throat, fever, or sinus infections can often be managed with your PCP. With the accessibility of telehealth in DPC, virtual visits allow your physician to assess whether in-office care or a prescription is necessary, helping you avoid unnecessary urgent care or ER visits.
• Chronic Condition Management: DPC practices excel in managing chronic conditions like diabetes, heart disease, and asthma. Through more personalized and comprehensive care plans, including longer appointment times and team-based approaches, your DPC provider can help you manage these conditions effectively. Keeping chronic conditions under control reduces the likelihood of complications that could lead to an ER visit. In fact, DPC’s focus on coordinated care—especially for diabetes—ensures that specialists like dietitians and pharmacists work together to keep patients healthy and out of the ER.
• Telehealth and Remote Patient Monitoring (RPM): Remote monitoring tools allow DPC providers to keep an eye on high-risk patients from the comfort of their own homes. This proactive approach helps detect early warning signs, allowing physicians to make adjustments to care plans before minor issues escalate into emergencies. Telehealth also offers timely access to care, ensuring that urgent concerns are addressed quickly without needing a trip to the ER.
• Access to After-Hours Care: One of the key reasons people use the ER is due to a lack of after-hours access to healthcare. DPC providers make after-hours care a priority, with easy-to-reach contact numbers, same-day appointments for urgent needs, and clear instructions for what to do if an issue arises outside of regular office hours. Many DPC practices partner with nearby urgent care centers to ensure patients have access to care when needed, further reducing the need to visit the ER.

When to Go to the ER

While DPC helps prevent many ER visits, certain situations still require emergency attention. Major trauma, chest pain, difficulty breathing, or severe injuries should be treated immediately in an emergency room. However, for most non-life-threatening issues, your primary care provider can offer a better, more comprehensive solution.

In conclusion, Direct Primary Care provides timely, personalized care that emphasizes prevention and patient education, ultimately reducing unnecessary ER visits. With access to after-hours support, telehealth, and medication management, patients are empowered to take control of their healthcare, ensuring they seek the right care at the right time. DPC is not only a cost-effective solution but also a powerful tool for improving overall health outcomes.

Enhancing the Patient-Provider Relationship

By understanding when to contact your primary care physician and utilizing tools like virtual consultations and RPM, patients can avoid unnecessary ER visits while receiving proactive, personalized care. Patients take a more active role in their care and feel empowered to follow medical advice and make important lifestyle changes, leading to better health outcomes and fewer emergency visits. Direct Primary Care ensures you have a dedicated physician who can manage your health comprehensively, reducing the need for reactive, urgent care. 

Are you a physician ready to take the first step towards providing better healthcare? Learn more about how to build a practice that prioritizes meaningful patient relationships, innovative care models, and a sustainable work-life balance, by downloading our DPC Playbook.

Resources:

“Direct Primary Care: Evaluating a New Model of Delivery and Financing”(independent, risk-adjusted cohort study), Society of Actuaries and Milliman, 2020.