What Truly Defines Excellent Primary Care for Rhode Island Families
If you are searching for the best family doctor in East Greenwich, you are probably not just comparing office locations or credentials. Most patients are looking for something much more personal.

They are looking for a physician they trust.

A doctor who listens carefully.

A doctor who takes time to understand their health.

A doctor they can rely on for years.

For many families in East Greenwich and throughout Rhode Island, these qualities matter more than anything else when choosing primary care.

The best family doctors are not defined by how many patients they see. They are defined by how well they know the patients they care for.
 
What Makes a Family Doctor Truly Exceptional
Many practices offer similar services on paper. Annual exams. Preventive screenings. Chronic disease management.

What separates excellent family physicians from average experiences often comes down to how care is delivered.

Families searching for the best family doctor in East Greenwich often prioritize:
Time to fully discuss concerns
Depth of medical expertise
Access when questions arise
Continuity with the same physician
Evidence-based recommendations
Long-term relationships built on trust

These factors shape the patient experience far more than most realize.

Why Time With Your Doctor Matters More Than Most Patients Realize
Time is one of the most important yet often overlooked factors in primary care.
Across Rhode Island, many traditional practices operate under significant scheduling pressure. Physicians are often asked to see large numbers of patients each day, which can limit how much time is available for each visit.

Patients may experience this as:
Feeling rushed during appointments
Saving questions for another visit
Prioritizing only one concern
Limited opportunity for discussion

This is not a reflection of physician dedication or expertise. It is a reflection of how healthcare systems are structured.

When physicians have adequate time, everything about care changes.
They can listen more carefully.
They can ask better questions.
They can identify patterns.
They can think more comprehensively.
Time allows doctors to practice medicine the way it was meant to be practiced.
 
The Difference Between Transactional Care and Relationship-Based Care
Many patients in East Greenwich and across Rhode Island describe traditional healthcare as feeling transactional.
You schedule a visit.
You address one issue.
You move on.
Relationship-based care looks very different.
When patients see the same physician consistently, that doctor develops a deep understanding of their health patterns, lifestyle, and goals.
This allows physicians to notice changes others might miss.
A change in sleep patterns.
Subtle shifts in energy.
Stress affecting physical health.

This level of attentiveness cannot be replicated without continuity.

Families searching for the best family doctor in East Greenwich often discover this relationship is what they value most.
 
Why Physician Expertise Matters
Family medicine requires broad medical knowledge across all stages of life. Family physicians are trained to diagnose, manage, and coordinate care for a wide range of conditions.

Physician training typically includes:
Four years of undergraduate education
Four years of medical school
Three or more years of residency training

During residency, physicians manage complex patient cases while working under experienced specialists. By the time they enter independent practice, they have developed thousands of hours of clinical experience.

This depth of training prepares family physicians to manage:
Chronic conditions
Preventive care
Mental health concerns
Medication interactions
Complex symptom patterns

For Rhode Island families, this expertise provides reassurance that their doctor can guide them through both routine and complex health decisions.
 
Why Access Builds Confidence
Another hallmark of quality primary care is access.

Patients often do not think about access until they need it. A question arises between visits. A new symptom develops. A medication concern comes up.

When patients can communicate with their physician or receive timely guidance, it changes how secure they feel about their healthcare.

Across Rhode Island, patients increasingly say that knowing they can reach their physician provides peace of mind.
 
Whole-Person Care Requires Time and Attention
Family medicine is designed to treat the whole person, not just individual symptoms.

Physical health, mental health, sleep, stress, and lifestyle all interact. The best family doctors recognize these connections.

Many East Greenwich patients first discuss anxiety, burnout, or lifestyle concerns with their primary care physician.

When physicians have time, these discussions become part of routine care rather than separate issues.

This is what whole-person care truly means.

Not just diagnosing conditions.

Understanding the person behind them.
 
Preventive Care Is Where Primary Care Has Its Greatest Impact
One of the most important roles of a family physician is helping patients stay healthy long term.

Preventive care includes:
Screenings
Risk assessments
Lifestyle guidance
Early intervention
Long-term health planning

These conversations cannot be effective if they are rushed.

When Rhode Island physicians have adequate time with patients, they can help identify risks early and develop thoughtful strategies to support long-term health.

Why Many Rhode Island Families Are Choosing Physician-Led Care
Across Rhode Island, more patients are becoming intentional about how they choose primary care.
Instead of focusing only on convenience, many families now ask:
Will I see the same physician every visit?
Will my doctor have time for questions?
How accessible is my physician?
Can I build a long-term relationship?

These questions reflect a shift toward quality-driven healthcare decisions.
Patients are not just looking for availability.
They are looking for excellence.
 
The Direct Doctors Difference
Direct Doctors was founded in Rhode Island in 2014 with a clear mission: restore the physician-patient relationship that many patients felt had been lost.
Today, the practice cares for more than 1,800 Rhode Island patients through a model built around physician continuity, thoughtful appointments, and relationship-driven care.

This structure allows physicians such as Dr. Laura Henseler, who focuses on comprehensive family medicine and whole-person care, to spend meaningful time with patients.

Patients seeking women's health expertise can also work with Dr. Erin Kunkel, whose work in gynecology and menopause care complements comprehensive primary care services.

At Direct Doctors:
Every visit is with a physician
Patients see the same doctor consistently
Appointments are designed to allow meaningful conversation
Care decisions are grounded in evidence
This allows physicians to focus on quality rather than volume.

What Patients Often Notice First
Patients transitioning to this model often describe similar experiences.

One Rhode Island patient shared:
"I felt like my doctor finally had time to understand what was going on instead of just addressing one issue."

Another patient explained:
"It feels different when your doctor actually knows your history. I feel much more confident about my care."

These experiences reflect what many families are seeking when they search for the best family doctor in East Greenwich.
 
Why Continuity Improves Care
Continuity allows physicians to develop deeper insight over time.

When physicians know their patients well, they can:
Recognize patterns earlier
Track long-term trends
Provide more individualized recommendations
Offer more proactive care

This type of continuity builds both medical insight and patient confidence.
 
Choosing the Best Family Doctor in East Greenwich
Every family has different priorities. Some focus on location. Others prioritize physician relationships.

If you are evaluating options for the best family doctor in East Greenwich, consider asking:
How much time is scheduled for visits?
Will I see the same physician?
How accessible is my doctor between visits?
How does the practice support continuity?
​
These questions often reveal the true structure of care.
 
Why Time May Be Healthcare's Most Valuable Resource
Medical knowledge continues to grow. Technology continues to advance.
But one of the most important resources in healthcare remains unchanged.
Time.
Time allows listening.
Time allows thoughtful decisions.
Time allows trust.
Trust is the foundation of excellent primary care.
 
Schedule Your Consultation
If you are looking for the best family doctor in East Greenwich and value time, physician expertise, and relationship-based care, Direct Doctors may be a good fit.

You can schedule your consultation by completing the new patient form at:
directdoctors.org
Because the best family doctors do more than treat conditions.
They build relationships that support your health for years to come.

Why Time With Your Doctor May Be the Most Important Factor in Your Care
If you are searching for the best primary care in Rhode Island, you may assume the most important factors are credentials, technology, or location.

But many Rhode Island patients discover something surprising after experiencing different types of practices.

The biggest difference often comes down to one simple factor:
Time.
Time to talk.
Time to ask questions.
Time for your doctor to actually know you.
For many Rhode Island families, that difference completely changes how healthcare feels.
 
The Reality of the Modern 7-Minute Appointment
Primary care physicians across Rhode Island face increasing pressure to see large numbers of patients each day. Many traditional practices schedule appointments in short blocks, often leaving very limited face-to-face time with the physician.

This is rarely because doctors want it this way. It is usually the result of healthcare systems built around volume rather than relationships.

Many Rhode Island patients recognize this experience:
You wait weeks for an appointment.
You wait again in the office.
Then the visit feels rushed from the start.
Patients often leave thinking:
"I forgot to mention something."
"I didn't want to bring up another issue."
"I could tell my doctor was under pressure."
This is not a reflection of physician expertise. It is a reflection of how the system is structured.
 
What Changes When Your Doctor Has Adequate Time
When appointments are unrushed, the entire experience of primary care changes.

Instead of focusing on just one symptom, physicians can evaluate the full picture of your health. Conversations become more thoughtful. Medical decisions become more individualized.

Patients searching for the best primary care in Rhode Island often say this is the first difference they notice.

Unhurried appointments allow physicians to:
Listen without interruption
Understand how symptoms may be connected
Address multiple concerns in one visit
Review medications carefully
Discuss prevention strategies
Build trust over time

This is what primary care was always meant to be.
 
The Question Many Rhode Island Patients Never Think to Ask
When choosing a doctor in Rhode Island, most patients ask:
Do you accept my insurance?
How soon can I get an appointment?
Where is your office located?

But one of the most important questions is rarely asked:
 
How much time will my doctor actually have for me?
This question often reveals more about your future healthcare experience than anything else.

Because time determines whether care feels rushed or relationship-based.
 
What Fits Into a Rushed Visit vs an Unrushed Visit
Many Rhode Island residents do not realize how much healthcare quality is shaped by time until they experience both models.
 
What typically fits into a rushed visit:
One primary concern
Medication refill discussion
Basic vitals review
Quick treatment decision
 
What fits into an unrushed appointment:
Multiple concerns addressed
Mental health discussion
Medication review and optimization
Lifestyle factors affecting health
Preventive care planning
Long-term health strategy
The difference is not just comfort.
It is quality.

Rushed medicine treats symptoms.
Unrushed medicine treats people.
 
Why Being Heard Matters in Primary Care
Many Rhode Island patients do not realize how much they have adapted to rushed healthcare until they experience something different.

In fast-paced environments, patients often edit themselves.

They skip concerns.
They delay questions.
They prioritize what seems most urgent.

Sometimes important details never get discussed.

When appointments are structured to allow time, patients do not have to make those compromises.

They can talk about sleep issues.
Stress.
Medication questions.
New symptoms.

Often the most valuable part of healthcare is simply having space to talk openly. That is when patterns emerge. That is when better decisions happen.
 
Why Relationship-Based Care Changes Outcomes
Primary care works best when it is built on long-term relationships.

When Rhode Island patients consistently see the same physician, that doctor develops a deeper understanding of their health history, lifestyle, and baseline patterns.

This allows physicians to notice subtle changes.

They may recognize when fatigue is unusual. When stress may be affecting blood pressure. When small symptoms may deserve further evaluation.

This level of attentiveness requires continuity and time.

It cannot happen in a revolving-door system.

Many families looking for the best primary care in Rhode Island discover this is what they were really searching for all along.
 
Whole-Person Care Requires Time
Many physical symptoms have underlying lifestyle or emotional contributors. Anxiety, stress, sleep disruption, and burnout frequently appear in primary care visits throughout Rhode Island.

When physicians have time, these conversations happen naturally.

Patients feel more comfortable discussing concerns. Physicians can better understand how life circumstances affect overall health.

This is what whole-person primary care means.
Not just treating conditions.

Understanding the person behind them.
 
Preventive Care Works Best When There Is Time
Preventive care is one of the most important services primary care provides. It is also one of the first things lost when appointments are rushed.

Preventive care includes:
Screenings
Risk assessments
Lifestyle discussions
Early intervention planning
Long-term health guidance

These conversations cannot happen effectively in short visits.

When Rhode Island physicians have adequate time, they can help patients stay healthy rather than only reacting to problems after they develop.
 
Why More Rhode Island Families Are Seeking Physician-Led Care
Across Rhode Island, patients are becoming more intentional about how they choose primary care.

Many now ask:
Will I see the same doctor every visit?
Will appointments feel rushed?
Will my physician have time for my questions?
Can I build a long-term relationship with my doctor?

These questions reflect a shift in what patients value.

Patients are not just looking for access.

They are looking for quality relationships and thoughtful care.
 
The Direct Doctors Difference
Since 2014, Direct Doctors has focused on providing physician-led primary care for Rhode Island families who value time, access, and relationships.

Today, the practice serves more than 1,800 Rhode Island patients through a model built around continuity, expertise, and evidence-based care.

This approach allows physicians like Dr. Laura Henseler and Dr. Erin Kunkel to focus on thoughtful medical decision-making rather than rushed scheduling.

Patients benefit from:
Unrushed appointments
Direct physician access
Continuity with the same doctor
Evidence-based care plans
Long-term doctor-patient relationships

Patients interested in learning more about the physicians can explore:
Dr. Laura Henseler – Primary Care
Dr. Erin Kunkel – Women's Health and Menopause Care
 
What Patients Often Notice First
Many Rhode Island patients transitioning to this model describe similar experiences.

One patient shared:
"For the first time, I felt like I could talk about everything without feeling rushed. It felt like my doctor actually had time to understand what was going on."

Another patient said:
"It feels different when your doctor remembers you and your history. It feels more like a partnership than an appointment."

These experiences reflect what many patients are truly looking for when they search for the best primary care in Rhode Island.
 
Choosing the Best Primary Care in Rhode Island
Every family has different priorities. Some focus on convenience. Others prioritize physician relationships and continuity.

If you value expertise, access, and relationship-driven care, it may help to ask:
How long are appointments scheduled?
Will I see the same physician?
How accessible is my doctor?
How does the practice support continuity?

These answers often reveal more than marketing materials.
 
Why Time May Be Healthcare's Most Underrated Resource
Healthcare continues to evolve. Treatments improve. Technology advances.

But one of the most important resources remains unchanged.
Time.
Time allows listening.
Time allows understanding.
Time allows trust.
Trust is what makes healthcare work.
 
Schedule Your Consultation
Primary care should feel personal. If you are looking for the best primary care in Rhode Island and value time, expertise, and physician relationships, Direct Doctors may be a good fit.
​
You can learn more or schedule your consultation by completing the new patient inquiry form at:
directdoctors.org
Because the best primary care is not just about medicine.
It is about having a physician who has time to care.

Many women begin searching for a menopause specialist in Rhode Island after leaving yet another appointment feeling unheard.
 
The symptoms are real. The sleep changes. The brain fog. The mood shifts that seem to appear overnight.  But the conversation ends quickly. You are told it is normal. You leave without clear answers.
 
Menopause is not a minor inconvenience. It is a major hormonal transition that can affect nearly every system in the body.  Finding a physician who understands menopause and takes the time to listen can significantly improve the care experience.
If you are looking for a menopause specialist in Rhode Island, knowing what to look for can make a meaningful difference in the quality of care you receive.
 
Why Menopause Care Requires Specialized Expertise
Menopause is not a single moment in time. It is a gradual hormonal transition that often begins years before a woman's final menstrual period.  Perimenopause alone may last four to ten years.
 
During this transition, shifting hormone levels affect many bodily systems, including sleep, metabolism, cardiovascular health, bone density, and cognitive function.
 
Women commonly experience symptoms such as:

• hot flashes and night sweats
• disrupted sleep
• anxiety or mood changes
• brain fog or memory difficulties
• weight gain
• joint pain
• reduced libido
• vaginal dryness

 
These symptoms are real, and they are common. However, they are also frequently minimized or misunderstood.  A qualified menopause specialist in Rhode Island understands both the symptoms and the long-term health considerations that come with menopause.
 
What Makes a True Menopause Specialist
Not every gynecologist focuses on menopause medicine.  When searching for a menopause specialist in Rhode Island, there are several indicators that a physician has deeper expertise.  One of the most respected credentials in menopause medicine is the Menopause Society Certified Practitioner (MSCP) designation.
 
Physicians with this certification have completed advanced training in menopause care and maintain ongoing education in evidence-based treatment.
Dr. Erin Kunkel holds this certification and is among a small number of physicians in Rhode Island with this level of menopause specialization.
 
Evidence-Based Hormone Therapy Knowledge
Hormone therapy is one of the most effective treatments for many menopause symptoms.  However, confusion about hormone therapy has persisted for decades due to outdated information and conflicting advice.
 
A menopause specialist should be able to clearly discuss:

• when hormone therapy is appropriate
• the different types of hormone treatments available
• benefits and risks based on individual health history
• non-hormonal treatment options

 
Evidence-based care means evaluating each patient individually and developing a treatment plan based on symptoms, medical history, and personal goals.
 
Expertise Beyond Hormones
Menopause care involves much more than hormone levels alone.
A comprehensive menopause specialist should also consider:

• bone health and osteoporosis prevention
• cardiovascular risk factors
• metabolic health and weight changes
• sexual health
• emotional wellbeing

Menopause affects the whole body. The best care reflects that reality.

 
Why Time Matters in Menopause Care
One of the most common frustrations women share is feeling rushed during medical visits.  Menopause symptoms cannot be understood in a seven-minute appointment.
Understanding menopause requires conversation, context, and time.  Sleep patterns, stress levels, lifestyle changes, family history, and symptom patterns all influence treatment decisions.
 
At Direct Doctors, Dr. Erin Kunkel provides unhurried appointments so patients have the time needed to fully discuss symptoms and explore treatment options.
 
When appointments allow real conversation, patients can:

• describe symptoms clearly
• ask meaningful questions
• understand treatment options
• develop a personalized care plan

 
Time is one of the most important ingredients in effective menopause care.
 
Why Direct Access to Your Doctor Matters
Another challenge many women encounter is difficulty reaching their physician after an appointment.  Symptoms change. Questions arise. Adjustments may be needed.
In many healthcare systems, follow up communication can take days or even weeks.
 
At Direct Doctors, patients have direct access to their physician.  This allows questions to be addressed quickly and treatment plans to evolve as symptoms change.  For women navigating menopause, this continuity of care provides reassurance and clarity.
 
What a Thoughtful Menopause Appointment Should Include
A meaningful menopause appointment involves far more than reviewing a list of symptoms.  A menopause specialist should take time to understand the full picture of a patient's health.
 
A thorough visit often includes discussion of:

• detailed symptom history
• menstrual and reproductive history
• sleep patterns and stress levels
• metabolic changes
• lifestyle habits
• treatment goals and preferences

 
When physicians have time to listen carefully, they can provide treatment strategies that truly improve quality of life.
This type of thoughtful, comprehensive approach is exactly how Dr. Erin Kunkel practices menopause care at Direct Doctors.
 
Meet Dr. Erin Kunkel
Dr. Erin Kunkel is a board-certified gynecologist and Menopause Society Certified Practitioner providing comprehensive women's health care in Rhode Island.
 
Her clinical focus includes:

• perimenopause and menopause management
• hormone therapy
• PCOS
• abnormal uterine bleeding
• weight management
• general gynecology care

 
Dr. Kunkel previously practiced as a general OB GYN in Rhode Island for more than seven years before dedicating more of her work to menopause care.  She has also completed advanced training in women's integrative and functional medicine and holds board certification in obesity medicine.  Her goal is to help women understand what is happening in their bodies and to guide them through evidence-based treatment options with clarity and support.
 
When to Look for a Menopause Doctor in Rhode Island
Many women assume their symptoms are something they must simply tolerate.
 
However, it may be time to see a menopause doctor if:

• symptoms are affecting daily life
• appointments feel rushed
• hormone therapy has never been discussed
• you want a deeper understanding of treatment options

 
Working with a physician who specializes in menopause can bring clarity and reassurance during this transition.

 
Finding the Right Menopause Specialist in Rhode Island
If you are searching for a menopause specialist in Rhode Island, a few questions can help guide your decision. 

• Does the physician have menopause specific training?
• Are appointments unhurried and designed for meaningful discussion? 
• Do patients have direct access to their physician between visits?
• Is care evidence-based and tailored to the individual patient?

 
These factors often determine whether menopause care feels supportive or frustrating.
 
Taking the First Step
Menopause is not something women simply need to endure.  With the right physician, symptoms can be understood, managed, and treated using evidence-based care.
 
Dr. Erin Kunkel is currently accepting new patients in East Greenwich, Rhode Island.  If you are looking for a menopause specialist in Rhode Island who takes the time to listen, you can learn more and sign up by completing the new patient form.  Because menopause care should never feel rushed.  And every woman deserves a physician who truly takes the time to listen.

It is easy to think that substance use can't affect us - until it does. Substance use disorder does not discriminate and should not be shamed or shunned.  It is a disease just as much as diabetes or asthma.  That is why Dr. Delaporta offers substance use disorder treatment as part of her primary care practice.

Like other chronic illnesses, there are medications available to help with substance use disorder.  Opioid use disorder is the over use of or addiction to things like vicodin, percocet, oxycodone, heroin, or fentanyl. Buprenorphine-naloxone (brand name suboxone) has been well established as a very helpful part of promoting recovery for people with opioid use disorder.  There are also medications that can help people with alcohol use disorder.  Medications like oral or injectable naltrexone (brand name vivitrol), acamprosate (campral), and disulfiram (antabuse) have been proven helpful in recovery from alcohol overuse. ​

​Just when we thought Amazon had already conquered all the industry spaces, they have recently come out with a new health offering.  According to their site’s tagline, they can “quickly treat common conditions with 24/7 video visits and messaging with a clinician. Upfront pricing. No appointments, and no insurance needed.” Sounds a lot like Direct Primary Care, doesn’t it? Or does it!?

Wow… this was unexpected! Almost a year ago, Lifespan and Care New England, along with Brown University, announced a proposed merger. At that time, I wrote a blog about why this was such a horrible idea. While the physicians at Direct Doctors completely understood the downsides of such a merger, especially in this small state, we did not think Rhode Island would get this right! Well today, the Attorney General denied the merger while at the same time an FTC advisory board voted 4-0 to file a joint lawsuit to do the same. While news organizations are calling this “stunning,” this is likely only because we tend to get these decisions wrong all the time. There is not necessarily anything stunning about realizing that having one organization in charge of 80% of inpatient care in a state is a bad idea! It seems obvious to us, given the mountain of evidence that AG Neronha cites, that health care monopolies cause prices to go up, access to go down without any appreciable change in care. 

    Now, Rhode Island still has a long way to go to fix our broken health care system. We need to focus more on primary care including incentivizing more primary care physicians to practice here. We need to give innovative practices (like Direct Primary Care) more of an opportunity to thrive. We have to work on giving patients more choice while also lowering costs. We are doing that here at Direct Doctors and will continue to do so as we grow in the future. ​

Dr. Ashley Lakin DO is "over the moon" to be starting her own branch of Direct Primary Care with the help of her friends at Direct Doctors.  Dr. Lakin, trained at Brown with Drs. Turshen & Hedde.  As a fellowship trained Maternal-Child Health Family Physician, Dr. Lakin is excited to add prenatal care and lactation medicine to Direct Doctors.  With a special interest in primary care for newborns and whole families, Dr. Lakin is a great addition to the Direct Doctors' family.   Drs. Hedde & Turshen "are so excited to have a colleague joining us as we expand the services and locations of Direct Doctors direct primary care practices in Rhode Island.  Dr. Lakin is a long-time colleague & friend as well as a phenomenal and caring physician."  Dr. Lakin is currently accepting new patients and will be working out of the East Greenwich office until her new practice location is up and ready in Riverside, RI where she plans to stay long-term. ​

In 2019 we discussed the basics of why patients wait a long time to hear back, get through on the phone lines, or be seen with a primary care doctor.  Unfortunately, this problem seems to have worsened acutely with the COVID epidemic. As an update to that blog, we want to begin by highlighting again that according to Merritt Hawkins, the average wait time for a new patient appointment with a primary care doctor is 29 days, up 50% from 2014. In Rhode Island, the wait continues to be much longer. We’ve heard of patients quoted a six to twelve month wait period before they can see a doctor as a new patient! ​

The Direct Primary Care movement has picked up steam over the last seven years since we started Direct Doctors in RI.  According to DPC Frontier, a site owned by a DPC physician/lawyer who was a founder of the movement, there are now over 1500 clinics doing pure Direct Care across the nation.  There are likely many more than have been officially labeled on the map.  Looking back to 2014, when we began, there were less than 100. ​

Direct Doctors will be celebrating our 7 year anniversary this August! Over that time, we’ve come to really appreciate the direct primary care model that we are using to deliver efficient, evidence based and personal care to our almost 1,000 patients. Like many of the other DPC practices across the country, we’ve noticed many benefits (for both the patient and physician), while also discovering a few barriers. ​

The two most common types of health insurances that we see today (outside of medicare and medicaid) are called PPOs and HMOs.  

The majority of our blogs focus on the healthcare system in general, and how direct primary care can help fill in some of the gaps. Currently, I’d like to highlight some concerns with a more local healthcare issue that has been in the news lately. If you haven’t heard, the long anticipated merger between Lifespan and Care New England has been announced. This deal also involves Brown University who only noted the positive aspects of such a merger in their press release. The Providence Journal conversely, ran a much more balanced assessment article .
 
            Every time large health organizations merge or consolidate, the purported benefits are advertised far and wide: continuity of care will improve, costs will go down, quality of care will go up and the health ecosystem will dramatically change. In this case, we are told that all of Rhode Island will be better off with the two largest healthcare organizations combining powers to produce a health care utopia.... except all the data we have to date shows the exact opposite. 

We have mountains of evidence that whenever this happens, costs go up! When there is a monopoly on services and reduced choice for consumers, patients (or their insurers which eventually trickles down) end up getting charged more for the same services. There is evidence that the same thing happens when physician practices merge or get bought by larger organizations. You want more data? Here’s an article from 2018 showing that though hospital operating costs are reduced 15-30% by this kind of merger, costs still go up!  And how about that “increase in patient care” that is touted. Here’s an article from Harvard just last year that indicates that hospital performance does not improve and patient satisfaction actually goes down. 
 
Interestingly, we do know that one of the only things that does decrease health care costs is access to good primary care. Neither Lifespan nor CNE have ever prioritized primary care, which is consistent among most large health care providers.
 
What is the incentive for large hospitals to have great primary care that keeps patients away from their biggest revenue generators? 
 
Care New England allowed Memorial Hospital to close, displacing the main Family Medicine Residency in the state, which disproportionately affected the large minority population in the Pawtucket/Central Falls area (despite everyone's calls to improve health disparities). Brown Medical School, like many large academic institutions, loves to highlight their students who go into flashy specialties as opposed to holding those who love primary care in similar esteem. So those who are interested in primary care medicine are really exposed only to corporate medicine, PCMH and the types of practices we think need to be changed in the first place. 
 
Rhode Island, as a whole, already has a primary care shortage due to many factors which drives more patients to urgent care and ER facilities subsequently driving up costs for everyone. To combat this, these large organizations are turning more to mid-level providers (PAs and NPs) in their primary care setting. These providers historically order more tests, refer more to specialists, etc… which, you guessed it, also drive up costs. To assist with all of this “continuity,” these large organizations turn to bloated, insanely expensive, electronic medical record and billing software. Then to make up for these costs, primary care doctors are forced to see more patients, leaving little time for good medicine or pension for over prescribing, ordering and referring (as we’ve mentioned in the past)

We do understand that there can certainly be an increase in academic research and improved specialty consultation within these institutions, so it’s not all bad. But in the end, the combination of poor primary care, hospital monopolies and the introduction of more HMO plans into the mix are setting our Rhode Island health care system up for increasing costs, decreasing patient choice without any change in outcomes or patient satisfaction. At Direct Doctors, we will continue to do our part in assisting patients with quality primary care access, lowering their medical costs and improving their overall care!

We often hear from patients interested in Direct Primary Care practices, like Direct Doctors, that they “have regular insurance, so why do I need this too?”  We’ve reviewed the “why” in many prior blogs, but here is the “how” it works. 

Over 95% of our patients have insurance.  They still use it.  If they have specialists to see, colonoscopies to undergo, meds to fill, or labs to get - they still use their insurance.  Direct Doctors can send the order to the lab, refill your prescription at the pharmacy, or refer you to your chosen specialist (we don’t have to stick in the networks like some corporate PCPs) all through your insurance.  This all feels just exactly like you’re used to with a fee for service PCP office.  ​

​We’ve done a few blogs about health care pricing (medications, office/ER visits, etc). Another big health care cost hurdle that patients deal with quite often is the cost of labs or blood work. If you’re a patient with typical insurance, have you ever received a bill from a lab for several hundred dollars for “routine blood work?” You probably assumed insurance would “cover” everything because you pay for an expensive health insurance plan. Or maybe you’re a patient without insurance or a high deductible plan that has to pay for many costs before insurance even kicks in. Have you ever wondered why labs cost so much? Or why the typical primary care practice you were going to didn’t warn you about the costs or ask your financial situation to be sure you could pay for such costs? Most likely, the pricing you received on your bill didn’t look like this:

Every year we release a blog about the open enrollment season and things folks should think about when purchasing health insurance. Most of the information is consistent this year, though I’ve updated things a bit below:

Whether you purchase your insurance through the state, government, employer or directly from the vendors, this can be a daunting process. There are often many choices, with slight differences that are difficult to decipher. Beyond that, because price transparency is such an issue in healthcare, it is often hard to plan or budget for future costs when there is no way to find out how much these services actually cost! Below, I’ve tried to outline a couple tips while going through this process.  ​

Over the past few years, we’ve highlighted the savings of over $3000 in 2 years that the Smith family was able to keep on hand because of being members of our DPC practice at Direct Doctors.

In 2016, we highlighted the following cost savings on medications:

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In past years we have visited the Smith Family, a typical working family of three looking to reduce their healthcare expenses through a membership with our Direct Primary Care practice, Direct Doctors.  We looked at how they were able to save $1350 during their first year as members of Direct Doctors just by switching to a higher-deductible, lower-premium health insurance and joining the practice for their primary care.  ​
 
We eliminated costs for their family by helping them keep their care in the primary care office setting.  We decreased (in fact, eliminated) their need for specialist visits and handled their urgent issues in our office or via text/email/cell phone when necessary.
 
In their second year as patients, they found additional savings benefits through reduced medication co-pays and laboratory co-pays.  This is no mystery - labs and meds cost more when you use third parties.  ​