Few would argue that our country’s healthcare system is broken. Most have obtained this perspective as a patient, subject to an increased lack of access and dwindling visit time with their doctors amid rising out-of-pocket costs. But others have gained perspective from functioning within the system. Medical providers have a unique place, as they serve the role of doctors and patients. In 2020 I received a reminder postcard prompting me to schedule my annual check-up. The reality of the system’s breakdown hit me hard when I called and was offered the first date available, eight weeks out. I knew from working inside the system that things were a mess. My once routine day at the hospital, sitting at the bedside and talking with patients, had been slowly replaced with phone calls and meetings focused on fighting to prove medical necessity. Only to be routinely denied regardless of the evidence provided. Patients were not getting the care they needed. They often had excellent insurance, yet the intentional barriers in the system prevented them from access. The barriers to care were multiplying at a pace with which I could not compete.
This was certainly no different in the outpatient setting. The required volume to meet productivity has reduced the visit time with your PCP to an average of 6 minutes. This has created a reactionary state of health care, and the consequences are dire. Two of the most obvious are the amount of pharmaceuticals patients are being prescribed, and the second is the growing chronic disease burden we face. We are spending more and have more medications than ever, yet getting sicker. We knew there had to be a better way—to give patients the time they needed and their health deserved. We needed to shift the focus back to preventative care and reducing pharmaceutical usage. This would take some time.
After two years of researching alternative models of care, it became painfully clear that the only way we could provide a better way was from the outside. On the outside, we could control the variables, remove the barriers, and restore the doctor-patient connection. Direct primary care was the ideal framework to accomplish our vision. We found that by removing the middlemen, we put the decision-making back in the hands of the patient and provider, and you eliminate the administrative costs associated with billing and processing claims. This means DPC doctors do not need the patient volume required in the typical primary care setting, which will only increase with continually decreasing reimbursement rates. Reimbursement goes down. Volume goes up. There’s not much room left to decrease visit time any further at this point. So it will be patient care that is sacrificed. Or worse, as we are starting to see, patients will avoid care altogether due to lack of access and increasing out-of-pocket costs. The DPC approach simplifies the entire process by eliminating the overhead of third-party billing. This allows for more extended visits and increased accessibility for urgent care needs.
It turns out that going outside is one of the most highly beneficial things you can do for your health and well-being.