Why don’t more doctors practice the way I do? Mostly because they can’t. They’re stuck in a high-overhead business model where economic reality and bean counters force them to see too many patients in a day. When you take medical insurance, you have to devote a lot of extra time and resources to getting insurance companies to pay you. To cope with all of the administrivia that goes with the insurance, doctors hire billing and coding specialists. Add in the additional overhead from medical assistants, nurses, receptionists, and a practice manager to run it all, and soon the doctor’s focus has moved from taking care of patients to seeing patients as fast as possible to make the numbers work. I call the result the “treadmill/referral” model of primary care practice: In essence, it involves (1) doctors running as fast as they can to see as many patients as possible, (2) quickly shooting from the hip when a problem looks familiar at first glance, or (3) referring to a specialist when a problem looks too complex or unfamiliar to sort out quickly.
How did I escape from that business model? I took a bold step. I fired my old bosses (the insurance companies) and figured out ways to slash my overhead enough to be able to work directly for my patients while giving them as much time as possible. This approach is termed Direct Primary Care (DPC). What should be understood is that Direct Primary Care is not luxury care — unless you consider it a luxury to have a great working relationship with a doctor who takes a proactive approach to keeping you healthy.