Direct Primary Care: Improving the patient-physician relationship

Have you heard about the Direct Primary Care model?

When you visit your primary care doctor, would you like to have more face-to-face time? How about more time interacting through tele-visits or e-visits? Do you like the idea of being able to connect to your primary physician directly?

If you answered yes to any of these, the DPC model might be for you.

The DPC model centers around a flat fee or a recurring monthly fee. Think of it as a membership contract or practice retainer. It is paid directly to the physician and covers a full range of services, including regular checkups, routine appointments, and preventative care. 

The fee is often split up monthly, quarterly, or yearly. It can cover laboratory, consultative, and clinical services. 

No Middle Man.

Physicians overhead are greatly reduced (40%) by eliminating the need for insurance filing. It also cuts down on negative incentives. In a fee-for-service model, third-party-payer billing encourages physicians to take on more patients. When volume over value drives motivation, the quality of healthcare decreases. Leading to doctors spending less time with patients. 

However, with DPC, the physician devotes more time to the individual. 

Somewhere along the way, we lost the importance of the 'patient to primary care physician relationship.' It is common sense that spending time with someone helps determine the value of that relationship. You should like your primary physician. You should be able to share information comfortably. Inside the dialog and communication are vital insights for both doctor and patient.

DPC even limits wait times for office visits, and this results in the majority of an office visit being with the physician. Some DPC doctors are available for contact 24hours a day. They offer e-visits and direct interaction. The net results yield better patient experiences and improved clinical outcomes.

When the doctor-patient relationship is unhurried, we create an environment conducive for discussions on lifestyle, treatment, and long-term well-being.

With DPC, patients choose their primary physician. When given the right to choose, we take a pro-active approach to our life. The entire healthcare system regardless of payment model needs to move from ‘taking in the sick’ to an integrative wellness program that follows you throughout your life, even when you are healthy.

Population Health Management benefits from the DPC model too. When office visits are part of a wellness plan, people can begin the healthcare journey in a more positive way. With patients more involved and willing to participate in the idea of wellness care, we will gain more access to data. Physicians and DPC providers will improve outcomes by gathering more pertinent health information earlier in a patient's life.

Here, at RHITC, we have developed a technology solution to help transition & enable the DPC providers to capture and utilize the immense opportunities for valuable insights. The DPC providers will take new learnings back and educate the patients further. It becomes a powerful data cycle of information growing upon itself. A data flow, ever working towards the wellness of our populace.

Direct Primary has this to say about the stewardship and responsibility; “DPC providers believe that healthcare must provide more value to the patient and the system. Healthcare can, and must, be higher-performing, more patient-responsive, less invasive, and less expensive than it is today. The ultimate goal is health and well-being, not simply the treatment of disease. The defining element of DPC is an enduring and trusting relationship between a patient and his or her primary care provider.”

Here is a video from R-Health explaining their version of DPC:

Dr. Michael Ciampi, a South Portland doctor offering DPC, had this to say about the benefits of DPC;

“What we love about this is that in most traditional medical practices you only get paid if you have people come into see you. So it puts you in the very uncomfortable position of waiting around and hoping for people to get sick so you can make a living. We really want to get away from this paradigm. (With the DPC model) the healthier I keep my patients, the less hard I work and the better I do financially.” via

In regards to possible emergencies and out of area coverage, patients of a DPC should carry a catastrophic high-deductible wraparound policy tooo.

The organization Medlion explains how the DPC model can drive down the overall health cost.

Currently, 23 states offer some form of the DPC model. You can visit to learn where to find a DPC provider. They also have legal information on Medicare and how the laws and policies affect the DPC model. Monthly fees range from $50 to $125 for full family coverage. It is on par with having a quality gym membership.

Most DPC physicians also provide prescription medication and lab tests at a reduced cost. The savings can be anywhere from 50% to 90% off for fee-for-service providers.

If you are interested in more information on Direct Primary Care, you can visit the sites below. They are an excellent resource and starting point to finding a DPC provider. Alternatively, if you are a physician looking to begin offering a DPC program, you can find help there too.