The other night I was chatting with my husband (who is a primary care doc in “the system”) about the differences between what I do and what he does. We realized, the biggest differentiator between how we practice has to do with what incentivizes us. We can all pretend we don’t get swayed by incentives, but if we put that aside - here is the real difference.
At a traditional fee-for-service practice, doctors have to bring you into the office in order to get paid. In other words, if you aren’t seen for a visit, they cannot send a bill to your insurance company, so they cannot bring money into their practice. For example, any portal messages you send are not billable if they spend time responding. Currently, phone calls aren’t able to be billed either. Ultimately, they are incentivized to keep bringing you into the office. Do healthy people want to go to their doctor’s office all the time? Most do not. Not that traditional FFS doctors are trying to keep you unwell, but you can see where the incentive lies in terms of visits.
Now consider Direct Primary Care practices like Direct Doctors. We are paid by a monthly membership fee - much like a gym membership. If a patient comes in for 10 visits a month or 1 visit a year, we are paid the same. If we talk to someone on the phone or email them with an answer to a concern, we are paid the same. We save our patients time and money by helping with their concern (without an unneeded visit!) when medically appropriate in whatever way works best (i.e. text, cell, email). So, then, what is our incentive? We want to keep you healthy! Imagine that. Our goal is to have people need us as little as possible. Of course, we would love to see patients who are not sick (i.e. want help with diet, need some advice on one thing or another, or just have some questions to check in about), but ultimately a DPC practice who keeps its patients healthy is doing a great job and not suffering from a lack of visits (like a regular practice would).
If you’d like someone who can be driven by wanting you to be healthy and not just wanting to respond to sickness, check out how we practice primary care differently at www.directdoctors.org.
Lauren Hedde, DO and Mark Turshen, MD are Family Physicians and Founders of Direct Doctors, Inc. a Direct Primary Care Practice.