I think it is best example of freedom of choice and an appropriate balance between patient and doctor. The doctor must give a healthcare quality and continuous and the patient has a medical to can turn when they need it, knowing both the annual cost, as in every single visit. It is a perfectly balanced relationship.

  2. Mike Robertson August 13, 2013

    I have discussed the DPC model with several physicians that have opted for this method as their practice model. Unfortunately, no one has a good answer for the following scenario. My wife is a solo Internal Med physician, small town Indiana. There are no hospitalists, she is on a call group with other FPs in town. She is the only IM who is on staff at the hospital, goes to nursing homes, and also does onsite visits at a local convent. If she goes DPC, how can she effectively bill and receive payment from those areas. A hybrid system seems to defeat the purpose. Would love to hear a possible solution to this problem.

    • Mary Pat Whaley August 19, 2013

      Hi Mike,

      To be sure, most DPC physicians do not have hospital practices or nursing home practices and do not accept insurance. I think it would be quite difficult (but not impossible!) to implement DPC for inpatient/nursing patients. Your wife would have to reorient the patients and might, if there are enough docs in town, lose a good number of patients, although a DPC practice typically has less patients anyway.

      One of the great unknowns is how things will change in January. Will everyone, or most people, have insurance, and if they do, how will DPC fare?

      A hybrid system, for instance accepting insurance but requiring a subscription fee of all patients (or just Medicare patients since Medicare pays the least in most places and often takes the most resources), could be the best of both worlds. It allows the physicians to continue seeing patients and taking their insurance, but adds a healthy amount to the bottom line so less patients need to be seen to have a financially viable practice.

      My question is: what problem are you trying to solve? Too many patients for too little income? Quality of life? The solution can be found to solve the problem!

      Best wishes,

      Mary Pat