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NELSON, MD: “Direct Care: More Than An Alternative Model” By cmtdpcjournal • December 15, 2015

DECEMBER 15, 2015 – The “Direct” in Direct Primary Care refers to dealing solely with patients by purposefully excluding the insurance contract from the professional relationship. Since Direct Primary Care physicians operate without the restraints and mandates of insurance contracts, they are free to focus on the real needs of their patients; as opposed to representing the insurance network as a “subcontractor”.

This direct engagement enables a level of lifestyle-friendly involvement that naturally leads to a more satisfactory patient-doctor relationship and potentially superior clinical outcomes, which are not currently attainable in our third-party controlled healthcare system.

DPC returns us to a simpler way of obtaining medical care that existed before massive third-party intervention and complex billing & payment protocols forced us to be dependent on expensive health plans and bureaucratic networks for care.

Direct Primary Care or Direct-Pay Medicine is the really nothing new. Some have called it the “oldest new idea in healthcare”. Patients and Doctors working directly together without an intruding third party was the norm for a long time in this country; it was also an era where healthcare costs accounted for less than 6% of our nation’s GDP. This “old fashion” system, now known as Direct Care, served us well for many generations and we didn’t have the rampant runaway medical price inflation that we have now.

Then came Medicare and employer-sponsored health plan. These prepaid health plans (not really insurance) brought us impersonal networks, mountains of regulation, red tape and soaring costs that now consume over 17% of GDP!

I believe Direct Primary Care (DPC) is much closer to the way medical care is supposed to be. And like many physicians and patients who have experienced it, I am convinced it is more than just an alternative practice model, but a real solution to improve access, lower costs and improve quality of primary medical care.

A personal direct engagement between doctor and Patient can never be achieved in a system of third-party networks where the doctor is a “provider” of services paid by someone else and the Patient is relegated to a passive “network subscriber”. Primary Care needs to become relevant again by servicing patients directly and being available and offering the kinds of broad services that family doctors used to offer.

Only returning to broad-based primary care that is affordable such as DPC and other third-party free medical care, and being available to keep our patients out of the ER and urgent care will solve the fragmentation of medical care, as is obvious by the burgeoning Retail Clinic & Urgent Care market.

I say we get “back to the future” by restoring healthcare to the way it used to be; the way it works the best: One Patient. One Doctor. No interference.


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