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    Solving the crisis in primary care

    Direct pay models could buy physicians more time with patients to improve care and reset a fractured payment system


    Direct primary care

    What does DPC offer? Expanded service primary care, offering same or next day appointments lasting as long as needed and 24/7 access via the PCP’s cell phone.

    Often it means generic medications at wholesale prices and reduced cost laboratory and radiology testing. It means much improved care quality, satisfaction and lessened frustrations for patient and doctor alike.

    READ: Is direct pay the future?

    Despite a widespread belief, DPC is not just for the elite, the rich or the 1%. In fact, it can be quite reasonable for working families. When DPC is combined with a much less expensive high deductible health insurance policy, the savings for patients are substantial and the total costs of all care decline quite dramatically.

    A small but steady migration of PCPs to DPC is occurring today. To drive the process at a faster rate, the need is for patients to become educated and then to demand the type of expanded primary care that can come from a more reasonable number of patient visits per day.

    If patients want to benefit from much better care, if they want a doctor that is not frustrated and can spend time with them listening, if they want their total costs of health care to decline rather than rise, then they will need to educate themselves and then advocate—to legislators, to insurers, to employers and to their doctors.

    Concerted patient action will force the issue and make change occur. When the PCP has more time, care gets better, frustrations come down, satisfaction goes up and total costs come way down and, as an added bonus, many more students will select to become primary care physicians thus resolving the PCP shortage.

    Together, this crisis can be solved. It will be a win for everyone.


    Stephen C. Schimpff, MD is a quasi-retired internist, professor of medicine and public policy, former CEO of the University of Maryland Medical Center, senior advisor to Sage Growth Partners and is the author of “The Future of Health Care DeliveryWhy It Must Change and How It Will Affect You.”


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