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During the COVID pandemic, as many insurances started to see the necessity of telemedicine (i.e. video and telephone calls in place of in-person visits), many types of “healthcare providers” and services jumped to the forefront for these types of visits. Services like Teladoc, having been around a long time, started getting more notoriety for the virtual service they offer. It’s important to understand the differences between telehealth and virtual services and telemedicine appointments with your own doctor.
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. Your average physician’s office cannot accommodate the needs of the 2000+ patients that they have per doctor in the normal day. If the doctor is full or not in the office that day, they will often either recommend that you come in and see a non-physician practitioner or go to the local urgent care where you can walk-in anytime you need it.
At Direct Primary Care practices, like Direct Doctors, we do our best to be available to you when you need it. While we can’t guarantee 24/7 in-person access, we can be sure to get back to you when you have an urgent need. Our patients text, email and call us when they have an urgent concern and they hear back from their doctor directly within hours (and usually within minutes!). When scheduling allows and the need requires an in-person assessment or treatment, their doctor directly schedules them to come in for what they need. 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:  Since then, we’ve continued to share our wholesale medication pricing with our patients. Some of the most common medication savings we pass on to patients are:
Because in RI doctors are able to wholesale order medications for their patients when clinically appropriate, we can cut out the pharmacy/insurance middle men and offer direct pricing to our patients at cost. This reflects a savings to patients, especially on chronic medications, that is not found in the typical primary care practice. These are just examples but we are always happy to help interested patients compare pricing to see if the addition of medication-cost-savings may tip the scale in favor of a DPC membership. Check us out at www.directdoctors.org for more info!  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. This is a common question in the Direct Primary Care world. Now that DPCs, like Direct Doctors, are popping up all over the place, patients want to know what options there are to pay the monthly fee (which is billed to patients directly rather than through insurance as in a typical practice).
Let’s start with the FSA - or flexible spending account. These accounts allow employees to put aside a certain amount of pre-tax dollars to be used on healthcare costs. FSAs are administered and run by various third parties. In our experience, whoever the third party administrator is will determine whether the FSA can be used to cover monthly fees. They allow doctor payments to be covered almost universally, but whether they allow you to set up a monthly direct debit varies from one to the other. For those who prefer not to do monthly fee coverage, they will often allow you to submit a few times a year to request a lump sum reimbursement for the fee you’ve paid up until that point as “doctors fees.” Bottom line - check with your FSA’s third party administrator on what they prefer! Patients of Direct Primary Care (DPC) practices, like Direct Doctors, have really come to love the ability to reach their doctor through modern technology. We’re all used to texting and emailing our friends and family - so, why is the traditional medical world so behind on using this form of communication?
There are a few main reasons that your doctor isn’t letting you text them: This is one of the more common questions we get from patients wondering why they’d pay a monthly fee to join our practice. Many patients “only go to the doctor once a year for a physical,” or “aren’t on any medications.” Others cannot fathom paying for primary care on a monthly basis when they are used to the slow, inefficient traditional primary care practices that are impossible to get in contact with.
However, we have many of these patients in our practice. They come to realize that direct primary care practices like Direct Doctors are beneficial for many reasons, even for generally healthy patients. For one thing, many patients realize that they probably use a physician more than they think. Whether it’s an urgent care visit for a sore throat, an ER visit for stitches, or just a simple medical question that required an in person visit at a traditional practice, patients often underestimate the amount they use the medical system, or would use it with a better overall experience. All of these can be handled at our practice, at no charge on top of the monthly fee, in a patient friendly and efficient manner. And that ER visit for a simple laceration repair most likely costs more than a year of membership to our practice. |
AuthorLauren Hedde, DO; James Hedde, DO and Mark Turshen, MD are Family Physicians and Co- Founders of Direct Doctors, Inc. a Direct Primary Care Practice. Archives
April 2023
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