‘Concierge’ Medicine Gets More Affordable, But Is Still Not Widespread

‘Concierge’ Medicine Gets More Affordable, But Is Still Not Widespread

Publication date: Jan 14, 2020

Dr. John Dunlap runs a direct primary care practice in Overland Park, Kan. , offering patients direct access to him by phone, and longer appointment times.

Barrett Emke for NPR hide caption toggle caption Barrett Emke for NPR Dr. John Dunlap runs a direct primary care practice in Overland Park, Kan. , offering patients direct access to him by phone, and longer appointment times.

That $133 is in addition to Westbrook’s monthly insurance premium, which he still needs to cover whatever Dr. Dunlap can’t handle in his primary care practice, like specialist visits, hospital care, and more.

More than 1 in 5 wealthy people pay an extra fee for direct access to their doctor, according to a new poll from NPR, the Robert Wood Johnson Foundation and the Harvard T. H. Chan School of Public Health.

The idea behind concierge medicine – and its newer, lower-cost sibling, direct primary care – is that patients could have a closer, more personal relationship with their physicians, with less waiting and bureaucratic interference, and that could result in better health.

Westbrook’s doctor, John Dunlap, runs a direct primary care practice, which works in a similar way, but without the emphasis of luxury services.

But that’s also why – even at this lower price point – the direct primary care model isn’t available to most people.

“There are approximately 1,000 [direct primary care] practices in 48 states serving approximately 300,000 U. S. patients,” says Sullivan from Harvard, citing the Direct Primary Care Coalition.

There are also many patients seen at hybrid practices, which charge you an extra fee for some of the same perks these other models offer, but also bill your insurance, like a traditional doctor’s office.

There’s a basic math problem here – if doctors see fewer patients, there would need to be many more primary care doctors practicing in this country for this model to be more widespread.

“To have [providers] suddenly hopping over to this model would continue to probably decrease access for patients to primary care. “

Still, Sullivan appreciates that the promoters of the direct primary care model are experimenting – trying to disrupt a system that needs improvement, where doctors are burned out and patients have long wait times to get appointments.

Direct primary care has generated enthusiasm from some Republican politicians, who have long argued that the kind of comprehensive health insurance required by the Affordable Care Act is unaffordable.

This model provides an avenue for people with cheaper, high deductible insurance plans to still have access to basic preventative care – and appeals to those who emphasize the need for consumer choice in the health care realm.

One recent push with bipartisan support: last month, several senators, including Bill Cassidy, R. -La. , introduced legislation to allow people to use tax-exempt health savings accounts to pay direct primary care monthly fees.

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Semantics

Type Source Name
drug DRUGBANK Tropicamide
drug DRUGBANK Ranitidine
drug DRUGBANK Etoperidone

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