COVID-19 Reveals Key Benefits to the Direct Primary Care (DPC) Approach

COVID-19 has transformed society in the weeks since social distancing and quarantine became regular points of conversation across America. Healthcare is no exception. These conversations within the medical community have shed light on an inevitable truth: There is no going back to the old ways of doing healthcare. Instead, we must all adjust to a new normal.

Reflecting on this “new normal” in a world with COVID-19, it is clear DPC provides key benefits when compared to traditional fee-for-service practices.

DPC Avoids the Fee-for-Service Barriers to Medical Care

The healthcare system and its workers responded admirably to the many challenges inherent to providing care during a global pandemic. Locally, the hours and leadership put into the effort to quell southern Maine’s COVID-19 outbreak have been remarkable. The incredible service these personnel provided southern Maine cannot be emphasized enough. However, it must also be said that the conflicts/barriers within large healthcare organizations also make effective mobilization more difficult.

These mobilization delays, in turn, also slowed the ability to practice safe, effective care for patients and healthcare providers alike. The increase of telehealth and phone visits in response to COVID-19 is a perfect example of these delays.

Traditional healthcare, with its fee-for-service model, centers around a patient being seen in-person and in a physical room by a healthcare provider. As a result, providing telehealth and/or phone visits in the earliest days of COVID-19 would have led to a significant loss of income for fee-for-service practices.

The end result was patients not receiving care via telehealth methods until fee-for-service practices had a way to get paid for this form of care. This delayed a helpful form of medical care by weeks, and even now telehealth reimbursement remains a tricky issue to navigate since reimbursement may vary depending on state policies, healthcare services provided or third-party payers.

The subscription plan model of DPC eschews the fee-for-service model altogether, and this key difference helped DPC providers avoid the barriers and delays to COVID-19 care that impacted the fee-for-service model.

DPC Colleagues Were Already Equipped to Provide Telehealth Visits

COVID-19 was an unforeseeable pandemic, but this does not mean all healthcare providers were unequipped to provide care in the earliest days of the pandemic. Talking to DPC colleagues, it became clear that many practices already possessed the technology needed for:

• Telehealth visits

• Video consults

• Email and text communication with patients

Most importantly, the DPC model’s reliance on a subscription payment plan ensured that these providers could immediately utilize these technologies without reimbursement worries that delayed telehealth care under the fee-for-service model.

DPC providers who already implemented virtual office technologies were prepared for an unforeseeable pandemic to such an extent that medical decisions and care were provided in the same manner post-pandemic as pre-pandemic.

DPC Enabled Providers to Put Patients First in a Pandemic

The essential takeaway from my conversations with colleagues is that DPC practices were able to put the needs of patients first at the outset of an unexpected pandemic. Instead of unnecessary barriers and reimbursement concerns, the DPC practice model equipped providers to focus on people’s well-being.

This emphasis on people first is an aspect of DPC that I cannot take for granted. Over the past two decades, I came to realize there was a slow, yet constant shift away from putting people first in medical practice. Rather than making decisions based on what was best for the patient, medical decisions were also being based upon:

• The interests of the corporation

• The amount of documentation the visit would produce

• The amount of time visits would take

• The amount of patients that could be seen

These are treacherous waters for the practice of medicine, which are far removed from the principles of the Hippocratic Oath. It pains me to admit that these aspects of traditional medical practice fundamentally undermine the Hippocratic Oath I took 25 years ago.

DPC returns healthcare providers to the first principles of medicine, empowering doctors to make decisions based on the best interests of the patient. During a pandemic, it is more important than ever to prioritize people over profit and relationships over reimbursement.

By opening a DPC practice, I gained the freedom of practice autonomy, which restores the doctor-patient relationship and produces necessary changes to medical practice during COVID-19 and the years to come.