Thanks, Madhu, for this great news.
By Lydia Ramsey
March 19, 2017
He took some time off, then one day he got a call asking if he'd be up for doing a house call for a woman whose son was sick. He agreed, and by the end of that visit, he realized he wanted to treat patients without dealing with any of the insurance requirements.
Then he learned about a totally different way to run a doctor's office. It's called direct primary care, and it works like this: Instead of accepting insurance for routine visits and drugs, these practices charge a monthly membership fee that covers most of what the average patient needs, including visits and drugs at much lower prices.
That sounded good to him. In September, Hill opened his direct primary-care pediatrics practice, Gold Standard Pediatrics, in South Carolina.
Hill is part of a small but fast-growing movement of pediatricians, family medicine physicians, and internists who are opting for this different model. It's happening at a time when high-deductible health plans are on the rise — a survey in September found that 51% of workers had a plan that required them to pay up to $1,000 out of pocket for healthcare until insurance picks up most of the rest.
That means consumers have a clearer picture of how much they're spending on healthcare and are having to pay more. At the same time, primary-care doctors in the traditional system are feeling the pressure under the typical fee-for-service model in which doctors are incentivized to see more patients for less time to maximize profits.
Direct primary care has the potential to simplify basic doctor visits, allowing a doctor to focus solely on the patient. But there are also concerns about the effect that separating insurance from primary care could have on the rest of the healthcare system — that and doctors often have to accept lower pay in exchange for less stress.
How direct primary care works
This is an idea whose time has come.
Given what I've heard of physicians who are leaving their practice because of the inhuman stress of complying with insurance requirements, I think many of them will happily take the lower pay. And once patients learn there are doctors who can actually pay attention to them instead of having to enter data into a computer during the visit, they will flock to the new kind of medical care.