Address: 10100 S. Mingo Rd, Tulsa, OK 74133

Hours: Mon-Fri: 8:30am – 5:00pm | Sat-Sun: Closed

Clinic Number: 918-878-7733

Is Direct Primary Care Right for You? The Pros and Cons

medical doctor speaking at a direct primary office
medical doctor speaking at a direct primary office

What is Direct Primary Care?

Direct Primary Care (DPC) is a healthcare model that disrupts the traditional system. Instead of relying on insurance billing, DPC operates on a membership model.

 

Patients pay a predictable monthly or annual fee. Patients gain access to a wide range of services beyond just sick visits. This model focuses on longer appointment times, allowing for in-depth conversations and a focus on preventive care.

DPC practices also make it easier for patients to access their doctor. Same or next-day appointments and reduced wait times are common features. This fosters stronger relationships between doctor and patient, which is a key factor missing in many traditional practices.

It’s no wonder this model is gaining traction. A recent Gallup poll revealed a significant drop in American satisfaction with healthcare quality.

Only 72% of patients rated their healthcare as good or excellent in 2022. This rating is down from 82% in 2020. DPC offers a compelling alternative, providing personalized care and improved access, factors many Americans are clearly seeking.

Direct Primary Care Benefits

Those who are uninsured, or considering alternatives to traditional insurance, may find direct care particularly appealing. Small business owners and independent contractors who have trouble with expensive insurance or limited choices often find it helpful. Direct primary care operates on a flat monthly fee. It helps patients avoid uncertainty and potentially high costs associated with traditional insurance plans.

Beyond cost savings, this model facilitates strong doctor-patient relationships. It fosters easier access to care as well. Gone are the days of rushed 20-minute appointments plagued by long wait times. DPC allows for in-depth conversations during extended 35-minute consultations.

This direct approach is free from insurance company interference. Doctors can create personalized care plans focused on preventive measures and early detection of potential health issues.

Patients who choose DPC can use it for more than just one purpose. You can use it in addition to certain types of insurance. Catastrophic plans, high-deductible plans, and health sharing ministries are among them.

Key Advantages of Primary Direct Care:

  • Cost-effective: Flat monthly fee avoids high insurance premiums.
  • Accessible: Easier scheduling with same or next-day appointments and reduced wait times.
  • Personalized Care: Longer appointments allow for in-depth consultations and customized treatment plans.
  • Preventive Focus: Proactive approach to catching potential problems early on.
  • Streamlined Care: On-site prescription dispensing in some practices.
  • Direct Doctor-Patient Relationship: No insurance company interference in treatment decisions.
  • Potential fit for various needs: Suitable for the uninsured, those with high-deductible

Potential Drawbacks

While direct patient care boasts many advantages, you should consider some potential drawbacks before making a decision. Unlike traditional insurance, DPC membership fees typically don’t contribute towards your deductible.

This means you’ll likely still face out-of-pocket costs for specialist visits, hospitalizations, or other unforeseen medical needs. Direct Primary Care (DPC) is a useful primary care option. However, you may need additional insurance for specialized care or major emergencies.

Additionally, the membership fees may not be compatible with Health Savings Accounts (HSAs). This can be a drawback for those seeking tax-advantaged medical savings options.

In some places, this healthcare model may not meet the health insurance requirement of the Affordable Care Act (ACA). This means that in certain areas, DPC may not qualify as health insurance under the ACA.

Key Drawbacks of Direct Primary Care:

  • No Effect on Deductibles: Fees don’t contribute towards deductibles.
  • Additional Insurance Might Be Needed: May not cover catastrophic events, specialty care or hospital stays.
  • HSA Incompatibility: Membership fees may not qualify for contributions to Health Savings Accounts (HSAs).

ACA Individual Mandate: Depending on your location, DPC might not meet ACA health insurance coverage requirements.

Weighing the Pros and Cons of DPC

While direct medical care does have some limitations, the overall benefits often outweigh the drawbacks. DPC fees do not count towards deductibles or cover specialist care. On the other hand, the consistent monthly cost can be much lower than traditional insurance premiums.

This is especially true for those who rarely utilize specialists. In addition, some Direct primary care clinics offer on-site prescription dispensing. Some dpc doctors provide referrals to specialists with whom they have negotiated lower rates. This can reduce out-of-pocket costs.

When you factor in the advantages of DPC, like extended appointment times, it can lead to better long-term health outcomes. Patients can potentially lower healthcare costs down the line. Another benefit of this model is easier access to your doctor, and a focus on preventive care.

DPC is a great primary care option for those seeking healthcare alternatives. It focuses on personalized care and building a strong bond between doctor and patient.

Hi, I’m Dr. Melita Tate with Grassroots Healthcare. Hi, I’m Brook Schaive with Grassroots Healthcare. I’m a board-certified pediatrician, and I’m a board-certified Internal Medicine physician, so we take care of babies all the way up to grown-ups. The majority of our practice, I think, is grown-ups, but we have quite a few young people as well. What we want to talk about is our direct primary care, how you can have access to your physician. So when you need someone to help you decide if you need a visit, sometimes with direct Primary Care, you can just text us a picture of that toenail that’s hanging off. We can let you know if you need to come in and see us or if it’s something that you could just tape up at home, you know, different things like that. It sounds crazy, but we can save time if you’re trying to just get in quickly, leave a urine sample, head back to work. We can call you, say, “Hey, what are your symptoms? Here’s what we found. This is what we’re going to do next.” You know, it doesn’t have to always be that you come, sit in the waiting room for a long time, sit in the patient room waiting on us for a long time. We can kind of expedite things. That’s one helpful thing about direct Primary Care, being able to get a hold of your physician whenever you have questions or need them. And then also, you know, patients have access to appointments. So if there’s something new about your case, one of the things I don’t like about conventional medicine is that frequently when you go in, the doctors or the staff members will say, “Now Miss Jones, you can only tell the doctor one or two complaints today because your visit is limited.” And if it’s 12 complaints that could lead the doctor to the right diagnosis, then we’re really missing the boat, and all we’re doing is treating symptoms instead of coming to the conclusion of what’s really at the root cause of it. And so I love that we have enough time. I mean, I feel like I always have plenty of time. My patient’s a priority for us. We know to allot that time with each patient so you get a full visit when you come, and you feel well taken care of when you leave. That’s always our goal. And if we still feel like there’s things that we haven’t got to address with you, you know, say we have a long visit but we’re still looking, we always schedule our patients for follow-ups to come back, you know, to make a little progress and then re-evaluate where we’re at and progress forward. We get patients with a lot of chronic problems that the conventional medicine world has maybe failed to adequately address or figure out, and so we try looking for, you know, a root cause for all of these symptoms. And so we do see patients that are fairly complicated and have had a long history in and out of the so we try to support our patients, we try to support their families and the community with education, and we want to be here for you. And if that sounds like something that’s appealing to you, please call our front desk and talk to Jane or Ally, and we’ll get you all the information you need.

Frequently Asked Questions

How do specialty healthcare services factor into direct primary care (DPC)?

DPC focuses on primary care, but specialty care needs are still important. Here’s how they work together:

  • Referrals: Your doctor can provide referrals to qualified specialists within your network or based on your insurance plan.
  • Potential Cost Savings: Some practices have established relationships with specialists, potentially offering negotiated lower rates for their patients.
  • Complementary Care: It complements, not replaces, specialist care. It can help manage chronic conditions and potentially reduce the need for specialist visits in the long run.

Is direct primary care worth it?

The value of DPC depends on your individual needs. Here are some factors to consider:

  • Cost: It can be more affordable than traditional insurance, especially if you rarely use specialists.
  • Accessibility: Prioritizes easier access with same or next-day appointments and longer consultations.
  • Preventive Care: The focus on preventive care can lead to better long-term health outcomes and potentially lower overall healthcare costs.

How does direct primary care work with Medicare?

Currently, Medicare typically doesn’t cover DPC membership fees directly. Some DPC clinics may accept Medicare patients and bill them separately for services not covered by Medicare.

How much does direct primary care cost?

The cost of DPC memberships varies depending on the practice, location, and services offered. You can find our current membership fee information on the Grassroots Healthcare website: Please note these fees are subject to change.

Criticism of Direct Primary Care:

One criticism of DPC is that it may not be accessible to everyone. particularly those with complex medical conditions requiring frequent specialist care. However, the dpc model’s focus on preventive care can help patients better manage chronic conditions. Additionally, some physicians offer services that can address some specialty care needs, reducing overall healthcare costs.

What is concierge medicine vs direct primary care?

Both concierge medicine and DPC offer enhanced access to primary care physicians. Key differences exist though.

  • Cost: Concierge medicine typically comes with a higher price tag than DPC, often including an annual retainer fee on top of per-service charges.
  • Insurance: Concierge medicine often operates outside traditional insurance networks, while DPC can sometimes work alongside some insurance plans.
  • Focus: While both prioritize accessibility and personalized care, DPC has a stronger emphasis on preventive care and managing chronic conditions.

Still Have Questions?

Reach out to us at Grassroots Healthcare. We would love to help you get started on a path to better health.

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