You know the feeling… you finally decide you need to see your doctor for that nagging issue, only to call and be told you can’t get an appointment for weeks, even months. Or, you finally make it to the doctor, and she only spends eight minutes with you, most of which is looking at a computer screen.
Many doctors have felt the same discontent. In fact, two new practice models have emerged in response to physicians’ desire to get back to focusing on patients’ needs. These two models – concierge medicine and direct primary care – have similar benefits, but different costs and purposes.
Concierge medicine charges patients an access fee, allowing physicians to limit the number of patients in their practice.
Direct primary care (DPC) is about access and personalized care, but also about eliminating third party payers to save patients money. “The DPC movement started based on the desire to get back to the purpose of being a doctor – to spend time with patients and get the diagnosis right,” says Molly Rutherford, MD, MPH, board certified in family medicine and founder of Bluegrass Family Wellness.
Compare these two models with traditional primary care to see which type of practice might be right for you:
• Costs: Each concierge practice is different, but patients may pay between $1500-$4000 per year. This fee does not cover medical services, which are billed to insurance just like traditional primary care practices.
• Services: Concierge medicine provides a full complement of primary care services with additional benefits, such as coordination of subspecialists, wellness consultations, same day appointments and 24/7 access, including cell phone calls and email.
• Benefits: With fewer patients, concierge physicians can spend more time with patients, scheduling visits up to an hour if needed.
Direct Primary Care (DPC)
• Costs: Monthly fees are age-based and can range from $10 for children to $50-$100 for adults. The fees cover medical services. DPC practices do not bill insurance.
• Services: The monthly fee typically includes annual wellness evaluations, unlimited office visits, same day appointments, technology visits, house calls and hospital visits, collaboration with sub-specialists as needed and most in-office procedures.
DPC doctors are more likely to offer a broader range of services than insurance-based practices because they have more time. They offer everything from joint injections to skin biopsies.
• Benefits: DPC physicians typically serve 400-800 patients rather than the traditional 2000-3000.
In addition to access and service, cost savings may be a surprising benefit. DPC practices negotiate wholesale pricing on labs and pathology reports, and many offices also offer a wholesale in-office pharmacy. (Controlled substances are not offered.)
Traditional Insurance-Based Primary Care
• Costs: Costs vary based on the patient’s insurance carrier and plan. All services are billed to insurance or to the patient in the event insurance is not available or does not cover a service.
• Services: According to Medline Plus, a website of the National Institutes of Health, a primary care provider’s role is to oversee common medical issues, provide preventive care and refer to a specialist when needed. This can include everything from treating a cold to routine gynecologic care to managing chronic conditions, such as high blood pressure.
• Benefits: The traditional practice is still the most common model utilized in Kentucky. It has a place particularly for those who cannot afford the monthly or annual fees of boutique services, as well as for those who rarely go to the doctor.
How Do I Choose?
If you are a patient who visits the doctor frequently, has a chronic condition or takes multiple prescriptions, it may be worth considering a concierge or DPC practice.
Many of these practices offer complimentary meet and greets. Ask questions and consider costs carefully. It is important to note that DPC practice fees do not cover specialist or inpatient care, so physicians typically recommend patients maintain high-deductible plans or alternatives like health sharing or limited benefit plans.
If you’re looking for better access and service, be sure to choose a physician that’s a good fit for you.
Boutique Primary Care in Lexington
600 Gribbin Drive | Lexington
Marshall Lifetsyle Medicine
2251 War Admiral Way #125 | Lexington
Direct Primary Care:
Access Med Direct
535 Wellington Way, Suite 330 | Lexington
Epoch Health and Wellness
2121 Richmond Road Suite 201 | Lexington