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Why Direct Primary Care?

"I'm leaving to open my own practice," I proclaimed. My colleage's eyes widened with surprise. Perhaps her feelings echoed within my own mind as I was beginning to wrap my head around what I was actually trying to accomplish. I was not starting any old typical medical practice, I was starting a Direct Primary Care practice (commonly DPC). I was yet to meet someone familiar with how DPC worked and I wasn't quite certain I fully understood DPC myself. Why not just open a typical primary care practice? Why Direct Primary Care?


Before we get into why DPC, lets understand the current medical system. How does a clinic or hospital actually survive financially? First, it is critical to note that money comes through a third party, not directly from a patient. The medical system lives off insurance. You want medical services, you go to a medical delivery facility and they provide you care then bill your insurance company for whatever medical care you were provided. A system set up this way removes the decision maker, the patient, from the financial implications of any decision made. So, if you need a medication to treat a condition and there are a few options for which medication to take, you are likely to desire the BEST medication as long as it is COVERED, even when a less expensive option would likely provide the desired result. Patients rarely consider price when the medical service is covered by insurance.

The business side of a medical facility as well as an insurance company desire to increase their profits. Rising healthcare costs benefit insurance companies by allowing them to raise premiums to justify those rising costs, if they only get one slice of the pie then make the pie as big as possible. Medical facilities are able to charge more since the company paying them, insurance, actually wants higher expenses to increase their profits. Patients, the ones paying the actual money, stop caring about rising medical costs as long as their insurance pays for the care. End result: No one takes a direct interest in keeping healthcare costs down.

The second reality of the current system is payment comes through a fee-for-service system. This means someone needing care goes to a medical facility that provides a possible solution. That facility then bills the insurance company for whatever care was rendered so long as the symptoms justify the treatment provided. Even if none of the treatments provided actually resolve the health concern, full payment will be made. Regardless of the number of test and treatments given, full payment will be made.

Within the fee-for-service model, how does a medical facility maximize its profitability? Simple. Increase the number of highly expensive services rendered in as little time as possible with the least expensive means available. Meaning, replace expensive highly trained medical providers whenever possible, see more patients, see them faster, and do as many expensive tests as possible if you can justify them. Multiple return visits are desirable as each return visit is a separate billed appointment, therefore, don't address all concerns in a single appointment. End result: Fee-for-service billing encourages highly expensive medical services over as many appointments as possible without significant concern to the outcome.

I felt that our medical system does a whole lot to patients without doing very much for them. Despite this, I believed that I am one small piece of a large system and couldn't do much, so just live with what we have and hope that things improve in the future. Anyway, I was doing the best I could within the system that we had and eventually things will change.


My wake up call came amidst the COVID19 pandemic. It was one of the best worst periods that I have been through. I was working in the Emergency Department at a U.S. Air Force base in England when news first broke about the COVID19 pandemic. We faced stressful lockdowns, isolation, a canceled family trip back to the United States, our own family health crisis, as well as a sudden and unexpected deployment.

Meanwhile, my mental, spiritual and physical health seemed to be nearing a precipice. I was obese, the heaviest I had ever been in my life. I had faced intermittent depression and heavy feelings of guilt. I was not receiving any improvements with my

overindulgence of media entertainment and high-calorie snacks and knew something needed to change. My wife and I began a simple journey of rediscovery, though I admit I didn't feel very optimistic.

Our plan: wake up early, exercise and study scriptures. That was about it. Nothing extravagant. No plans to lose weight. No cancel our netflix and binge marathons. No dietary modifications. However, though the plan was simple, the desire for real change was ever present. There was an understanding that we were undertaking a journey that would not end. We were looking for something more. We were hoping for real change. We found it.

Our plan started simple and became a journey that included a diversity of growth. (I anticipate blogging about many of these topics that have, in essence, saved my life.) I have lost 60 pounds and maintain a healthy weight. I engage in healthy eating and exercise regularly. I practice cognitive behavioral therapy techniques regularly. I feel a deep power within me through the possibility of change. I am the healthiest I have ever been right now.

I discovered the power of small consistent efforts in creating significant change.


So, now that you know a bit about me and about our healthcare system, lets get into DPC. Direct Primary Care is a subscription based model for providing medical services where a patient pays directly to the clinic for health services. In essence, the reason the clinic makes money is because patients are satisfied with the medical services and choose to continue with their subscription. If the DPC practice is meeting the needs of their patients, they will continue to make money. The person paying and receiving medical services are the same, therefore, if the costs are too extreme then they will cancel. End result: The DPC system helps keep costs reasonable.

Additionally, the patient makes a monthly payment for unlimited medical services. This means, if a patient has multiple concerns to address and has never had a primary care appointment, the DPC system encourages addressing all of these at the same time. **GASP** Yes, Direct Primary Care encourages convenience, even addressing issues via telephone or other methods as money isn't made for doing things to patients but doing what is best for patients. End result: Direct Primary Care promotes addressing all concerns to the satisfaction of each patient in the method most conenient to their patient.

Most doctors don't like many aspects of the current healthcare system but are just dealing with it because it is what we have. My health journey has proven that small consistent effort will lead to significant lasting change. I am starting a Direct Primay Care practice because it is a better system for health seekers to receive care that meets their needs. I am starting a Direct Primary Care practice because it allows providers to focus on individuals and provide excellent personalized care. I am starting a Direct Primary Care practice because I believe it is one small change that will help to fix our failing healthcare system.

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