Well that’s a novel concept, isn’t it?!? I was reading an article today in the Wall Street Journal about the rising costs of healthcare and how deals between hospitals and insurance companies are contributing to the problem. Try reading this piece… doesn’t it make your head spin? Hospitals do this and try to block that, and insurance companies do this and switch plans and so on and so on. In the end, none of these decisions and maneuvering are really about patient care. They are strictly about market share, controlling health care utilization and profits. Too much of our current healthcare system places multiple barriers in between doctors and patients. Additionally, many medical decisions now are based solely on insurance coverage and their “protocols,” and not what is best for the patient. 

If you’re someone who travels a lot for work or pleasure, or you just happen to find yourself on the rare trip, you may imagine a scenario where you fall ill and need care.  You’re away from home and from your primary care doctor.  You’re in an unfamiliar location where you don’t recognize the local medical options.  This is a scenario many of us have experienced or at least have known someone who has.  

What do YOU do when this happens?  The most common answer is that you go to the local emergency room or urgent care.  This may be fine OR it may result in a big bill or in care that is disjointed from your typical doctors.  Disjointed care sometimes leads to patients being prescribed medications that cause side effects or interfere with existing medications or issues, which renders them in worse shape in the long run.  If you don’t need to see a doctor at a more emergent setting, you may be charged a larger copay for having gone there instead of to primary care (even though you couldn’t get back home to do it!).  

So let’s say you’re young and relatively healthy. You can’t remember the last time you went to a doctor for anything. You are not on any prescription medications and do not require many routine screenings at your age. You also have a busy career that makes the slog of a traditionally inefficient practice impossible to deal with but cannot imagine paying a monthly fee for a Direct Primary Care Practice… why would you do that?

Well I can think of a few reasons, actually. I bet if you think back over the past couple of years, something came up at one point that required a visit to a doctor. You probably went to an urgent care or ER since you had no established primary care doctor. It may have been for a laceration that needed a few stitches, or an ankle sprain while playing sports on the weekend, or a bad cold that you just could not shake at home and needed to be seen. All of these things can easily be handled by a primary care doc who is easily accessible and can see you that day. Without that access however, many patients have no choice but to visit a much more costly health care setting and spend hundreds to thousands of dollars on a one time visit fee. For this same cost, you can get several months to a year of direct access to your personal doctor. Many of our younger patients have high deductible plans. So even if they do not utilize our services frequently, they often save money by avoiding expensive health care costs. 

Have you ever had to call your traditional primary care doctor's office for a general question? It probably goes something like this:


Patient calls at 9am, and before getting a word out:


Receptionist: “Thanks for calling Slow Family Practice, please hold.”


10 minutes later: “How may I help you?”


Patient at 9:10am: “Hi, I have a question for Dr. Too Busy and was hoping to speak with him.”


Receptionist: “Let me check with his nurse to see if he’s available.”


10 minutes later: “Dr. Too Busy is currently with patients, but I can have him call you back when he’s available.”


Patient at 9:20am: “Ok, please have him do that.


Several hours later:


Nurse: “Hi this is Dr. Too Busy’s nurse returning your phone call.”


Patient at 12:30pm: “Oh hi, I had a question about a rash that I’ve had and my blood sugars today.”


Nurse: “Ok, well why don’t we schedule an appointment for you.”


Patient: “That would be fine, though Dr. Too Busy can probably help me over the phone.”


Nurse: “Well we really need to see you in the office. He has an opening 2 weeks from today!”

While we have many patients in Direct Primary Care Practices, like here at Direct Doctors, who do not have many or any chronic medical conditions, we also have a number who do.  Patients dealing with chronic illnesses or unexplained symptoms often feel bounced around from specialist to specialist, test to test, either without answers or without organization. ​

While some patients often think of preventive screenings for young and healthy individuals, much of our recommended screenings happen later in life. For older patients (50 and up) there is much to discuss when it comes to what screenings are appropriate for them. Unfortunately, in traditional primary care settings where visit times are quite short, these conversations rarely happen. Typically, a doctor tells a patient what to get and when without much discussion on personal preference, risk, age, family and personal history, etc. While not the best way to maintain a good doctor-patient relationship, this also often leads to over screening, as reported in a recent NY Times article.

At Direct Doctors, like many other Direct Primary Care practices around the country, we work hard to make ourselves accessible to our patients.  While we can’t guarantee 24/7 access, we do ensure our patients can reach us on our cell phones, can text us, and can even email us when they need to ask a question or run something by us - and by us, I mean one of the doctors!  We also make sure patients can be seen when it is convenient for them and not 3 months from now.  ​

A common question from our patients in their 60s and up is, “How could your practice at Direct Doctors actually make sense with my medicare?”  It is a smart question.  It’s important to understand how medicare works when you have a doctor, like Dr. Henseler, who does not bill medicare (aka a doctor who is “opted out” of medicare).
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At Direct Doctors, patients in the age group of 65 and above will pay a membership fee to have convenient access to their physician.  They will be able to reach their primary care doctor when and how it works for them.  They will avoid long wait times at the office or on the phone.  And, they will have a meaningful relationship with a doctor who knows them well and spends the needed time listening to their needs.  ​
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It’s that time of year again! No I’m not referring to pumpkins, leaves changing color, cool weather or football. It’s time to renew or change your health insurance plan. Open enrollment on the health exchanges start November 1, 2018 (and ends December 15th).  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. ​

Last year we 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 hope over the past few years we’ve made a good case about why Direct Primary Care practices like Direct Doctors are good for patients.  But, we felt it worth mentioning...DPC is great for Docs too!

If you’re a patient looking for a doctor, you may say, “Why do I care if this is better for doctors?”  Well, you should care and I will explain why!

​Do you know that nearly 50% of primary care physicians are experiencing “burnout” - meaning they feel overwhelmed, overworked, or underappreciated in their jobs?  What does burnout lead to?  It means your doctor might be retiring early, his care might be sub-par, or he might be cutting back on his hours.