What is Direct Primary Care?

This practice and payment model typically involves monthly or annual fees consumers pay for medical administrative services. Direct primary care can be especially practical for lifestyle medicine (LM). This model has been shown to improve short- and long-term health outcomes of patients and populations.3 Health care delivery can be enhanced using the DPC model. There are many benefits to this model when compared to the traditional system of third-party insurance coverage.

Increased Accessibility

Instead of waiting months to get an appointment to see a physician, patients can be seen regularly every couple of weeks, depending on availability. Some examples of Direct Primary Care include membership plans which have a clear outline of what type of services are provided. Access to high-quality care is more likely since appointments can be in person, through virtual meetings, and even through phone calls. Visits are more convenient and personally catered toward the patient's specific needs.

More Time With Healthcare Provider/ Patient

Patients can spend less time in waiting rooms and have more one on one time with their physician. Physicians have more time to focus on improving health outcomes for patients. The average time patients are seen in direct primary care physicians is 30-60 minutes vs 7 minutes at traditional providers.6 Trusting relationships can be developed over time as physicians get to know a patient's health history, and this creates a better opportunity to personalize care.

Patients can spend less time in waiting rooms and have more one on one time with their physician. Physicians have more time to focus on improving health outcomes for patients. The average time patients are seen in direct primary care physicians is 30-60 minutes vs 7 minutes at traditional providers.6 Trusting relationships can be developed over time as physicians get to know a patient's health history, and this creates a better opportunity to personalize care.

Cost Transparency

Monthly or annual membership fees paid by patients cover not only clinic visits but also laboratory services, consultative services, and care coordination.2 Prices and fees are usually flat rates that do not vary based on the services provided. This eliminates confusion on what services the patient is being charged for and how much the cost of a visit or service is. DPC may suggest alternative pricing options for services such as x-rays, medicine, and labs which lowers the cost of services in comparison to traditional practices. DPC also offers the ability to work with already existing insurance plans. The monthly fees cover primary care consultations and insurance plans can help cover additional testing.

Individuals who cannot afford health insurance plans benefit from the fixed-price plans offered by direct primary care because it gives patients the ability to receive services not covered by their insurance. Traditional fee-for-service plans prevent patients from receiving care beyond what is included in the fixed fee which does not allow patients to have adequate service.9 Those without insurance bypass the restrictions imposed by insurance companies which allows a better healthcare experience.

Reduced Administrative Burden

The DPC model allows physicians to be in control of patient care instead of health insurance companies indirectly affecting tests, procedures, and treatment plans. Physicians can spend less time dealing with third-party influences and more time with patients.4 This also provides freedom and flexibility within one's practice. It creates an environment in which the physician is able to provide care in a way that aligns with their values.

References:

Direct primary care. AAFP. https://www.aafp.org/about/policies/all/direct-primary-care.html. Published December 12, 2019. Accessed September 30, 2022.

Direct primary care. AAFP. https://www.aafp.org/family-physician/practice-and-career/delivery-payment-models/direct-primary-care.html. Published November 15, 2019. Accessed September 30, 2022.

AR; M. Direct primary care: A successful financial model for the clinical practice of Lifestyle Medicine. American journal of lifestyle medicine. https://pubmed.ncbi.nlm.nih.gov/34646107/. Accessed September 30, 2022.

LE; C. Defining the place of direct primary care in a value-based care system. WMJ : official publication of the State Medical Society of Wisconsin. https://pubmed.ncbi.nlm.nih.gov/30193018/. Accessed September 30, 2022.

Julacreative. Direct primary care physician: Family and lifestyle medicine specialist. Dr. Lifestyle. https://www.drlifestyle.org/directprimarycare/. Published August 11, 2022. Accessed September 30, 2022.

Tou LC, Jeyakumar SJ, Siddiqui TA, Ravi S, Prakash N. Understanding patient perceptions towards direct primary care: A FOCUS Group Study. Journal of patient experience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9350501/). Published August 1, 2022. Accessed September 30, 2022.

A. B, F. B. Pros & Cons of Direct Primary Care. Optimum Direct Care. https://optimumdirectcare.com/what-is-direct-primary-care/pros-and-cons/. Published April 25, 2019. Accessed September 30, 2022.

What is direct primary care? how DPC works and the pros and cons. GoodRx. https://www.goodrx.com/insurance/health-insurance/direct-primary-care. Accessed September 30, 2022.

Tou LC, Prakash N, Jeyakumar SJ, Ravi S. Investigating social determinants of health in an Urban Direct Primary Care Clinic. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7606193/. Published October 4, 2020. Accessed September 30, 2022.

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