History of direct primary care practices

Although the concept of the direct primary care (DPC) practice actually harkens back to before the days of insurance payments and regulations, the DPC model itself has only been around since the turn of the 21st century. The DPC model operates on patient membership fees. DPC practices generally do not accept insurance, although most will encourage patients to secure catastrophic insurance for those services not provided in their basic membership.

The DPC was originally the brainchild of three doctors, who had the “idea to go insurance-free, charging monthly fees instead and freeing up time to enjoy practicing medicine.” Their goal was to establish a practice that would provide quality care at a predetermined cost, so patients would know what to expect.

The practice these three doctors formed, Qliance, was backed by Amazon CEO Jeff Bezos and Dell founder Michael Dell. Qliance had built its membership up to over 25,000 patients before it closed its doors in 2017 (apparently due to reasons unrelated to the DPC model).

DPC’s concept is for the independent physician to provide quality, personalized care to a smaller patient panel. This idea has been appealing to a growing number of providers who have launched their own DPC practice over the past couple of decades. While patients must usually be educated as to the model’s structure, the DPC is particularly enticing given the rising costs of healthcare and insurance coverage.

DPCs gained a bit more traction recently when the American Academy of Family Physicians (AAFP) issued a statement that “the DPC model is consistent with the American Academy of Family Physicians’ (AAFP) advocacy of the advanced primary care functions and a blended payment method of paying family medicine practices.”

AAFP cited the fact that the “DPC contract fee structure can enable physicians to spend more time with their patients, both in face-to-face visits, and through telephonic or electronic communications mediums should they choose, since they are not bound by insurance reimbursement restrictions.”

The DPC has a relatively short history, but is a growing concept and by most accounts, is a medical practice model that is here to stay.