Editor's Note: which features contributions from members of the medical community. These blogs are an opportunity for bloggers to engage with readers about a topic that is top of mind, whether it is practice management, experiences with patients, the industry, medicine in general, or healthcare reform. The series continues with this blog by Glen Stream, MD, FAAFP, MBI, a family physician practicing in La Quinta, California, who is also past president of the American Academy of Family Physicians. He serves as the president and board chair of Family Medicine for America’s Health. The views expressed in these blogs are those of their respective contributors and do not represent the views of or UBM Medica.
It’s often called “concierge medicine for the masses,” the colloquial name given to direct primary care, a growing practice model that charges patients a flat monthly fee—averaging $25 to $85 a month—for office visits, lab tests and even phone or email communications. In some respects, direct primary care (DPC) harkens back to the way medicine was practiced decades ago when patients paid their physician directly.
Further reading: Is DPC a viable way to MACRA-proof your practice?
Today, insurance mostly dictates the way we pay for healthcare—from basic primary care to hospital stays and treatment for cancer and other catastrophic illnesses.
To Garrison Bliss, a Seattle internist and one of the early leaders of the direct primary care movement, the changes in the way we pay for healthcare have had a profound effect.
“To a very real extent,” Bliss told Forbes several years ago, “when patients do not pay or control the payment to their physicians, their power and influence in health care declines.”
The result, according to Bliss, has been a decline in the perceived value of primary care, a massive dependency on medical technology and a focus on higher-cost medical procedures over prevention and results-oriented care.
In the news: Bill could allow health saving account use for DPC
Today, while only a small percentage of the country’s 926,000 physicians are involved in this type of membership-based practice model, a growing number have embraced direct primary care—from small offices to large mass market practices like Qliance, the practice in Seattle that Bliss helped establish in 2007. For a flat age-adjusted monthly fee, Qliance members get 24/7 access to primary care doctors and health care teams for “the care you need when you need it.”