Even during “normal” times, administrative work and worry over finances can become a huge burden on an independent physician. Researchers investigating social determinants of health recently published their findings, which included the fact that physicians in a traditional healthcare model spend almost a fourth of their time on non-clinical work. During the COVID-19 pandemic, further worries over financial stability have become huge stress factors. However, most direct primary care (DPC) physicians experience less stress and less burnout, even during these challenging times.
The researchers found that the integration of DPC offers a significant reprieve from the stress that is so often experienced by physicians dealing with third-party billing, especially. The DPC model also enables the physician to provide meaningful patient care that results in an improved patient experience. Given that they have less administrative work and reduced pressure to see a high volume of patients, DPC physicians are able to revitalize a value-based care system rather than one focused on the number of patients seen.
Administrative burden is one of the leading causes of stress and resulting burnout for physicians in the US. Independent physician may spend as much as 25% of their time on administrative work such as coding, billing, and dealing with insurance companies, as their revenues depend on reimbursement. This preoccupation and excessive time spent on administrative work, in addition to the pressure of needing to maintain financial sustainability, means that these physicians have less quality time to spend with their patients. Since DPC practices typically do not accept insurance, this stress factor is significantly reduced or even eliminated.
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In the midst of the pandemic, many physician offices that depended on the number of patient visits and on insurance reimbursements for financial stability were forced to reduce staff or close their offices. For DPC practices, given that their model is based on monthly membership fees rather than visit fees, revenue has remained stable during COVID-19, alleviating much of the stress involved with financial stability concerns.
The simplified payment model benefits physicians and patients, especially during the pandemic. The model reduces practice overhead and administrative burden, so the DPC physician can spend more time with patients. That simplified, predictable revenue stream contributes significantly to reducing stress in a particularly challenging environment such as the one most physicians are experiencing now.
In addition, experts say that the DPC model can be a lifeline for primary care physicians who are reaching their breaking point, mentally and financially, after many years of burdening overhead expenses, cumbersome administrative tasks, and underfunding. The COVID-19 pandemic is costing primary care practices about $15 billion, according to Harvard Medical School and American Board of Family Medicine researchers.
The decline in visit volumes, 58% in March and 69% in April at the peak of the pandemic, will result in about $65,000 in lost revenue for each fee-for-service primary care physician. As emphasized in a position paper published in the Annals of Internal Medicine, the increase in administrative tasks and reimbursement worries has been linked to greater stress and burnout among physicians practicing in the traditional model. The administrative burden, and the accompanying stress, may be one of the factors in keeping physicians from entering or remaining in primary care.