New Practice

Returning to the “old fashioned” concept of direct access to a physician, extended office visits, and a personal relationship in which the physician and patient are able to truly engage with each other, direct primary care (DPC) has established itself as the wave of the future in healthcare. DPC is becoming more popular with patients concerned about rising healthcare costs and the decreasing amount of time they spend interacting with their physician. Even hospitals are looking at DPCs as options for their own employees.

The DPC model was launched in the late 1990s as a return to the days when physicians provided personal service to their patients. DPC practices charge a monthly membership fee that typically covers all basic primary care services. Some practices also include labs as part of the fee or offer reduced prices on such services. Depending on the state’s laws, some DPC physicians also dispense prescriptions from their offices to save the patient money and offer more convenience.

DPC Frontier estimates that there are currently 1243 DPC practices in the US, up significantly from the 125 practices operating just five years ago. They also state that approximately 250,000 patients are participating in a DPC practice, a number that has also increased significantly from the roughly 6,000 DPC patients five years ago.

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A survey conducted in 2018 of 398 physicians (148 of whom actively practiced in a DPC model), found that:

• The vast majority of DPC practices represented in the survey were in their infancy, having been open three years or less.
• They’re also still growing. Only 17% reported a full patient panel (the average panel size was 345 patients, and the average target was about 600).
• The majority of respondents in DPC clinics charge individuals $50-$75 per month and families less than $175 per month.
• Eight-seven percent of surveyed DPC practices do not charge a per-visit fee.
• Roughly 80% are either currently participating in or are negotiating employer-based contracts.

Those employer-based contracts may soon include a number of hospitals across the country. A recent article published by the American Hospital Association (AHA) asks, “Would providers benefit by experimenting with DPC programs for their own employees?”

Catholic Health Initiatives (CHI) is one major healthcare system that began offering DPC care to a small group of its employees in 2017 and the results have been positive. CHI CEO Cliff Robertson, MD, stated that the DPC model enables primary care physicians to take a needs-driven approach rather than being driven by a reimbursement model. Robertson firmly believes that DPC plans are the future of primary care.

Physicians are seeing the benefits of the DPC model from their perspective as well as from the patient’s. Dr. Todd Rice recently experienced a challenging and expensive diagnosis and treatment plan as a patient of a large medical group. After researching the DPC option, he found that “despite a monthly fee, DPC pays for itself (and then some) in many forms of savings and benefit.” He concluded that “DPC may be medically superior as this model allows physicians the time and flexibility to know their patients and accommodate their needs.”