Physician’s Weekly co-hosted another installment of the #PWChat series on Wednesday, February 13. Molly Rutherford, MD, MPH, FASAM, (@UnbridledMd), joined us to discuss what you and your patients need to know about direct primary care. Topics discussed included: what exactly direct primary care is and what sets it apart from traditional primary care; what differentiates direct primary care from concierge, or VIP, medicine; whether or not it is unfair to claim that direct primary care caters to wealthy, health patients and why, and much more!

Below are the highlights from the chat. You can read the full transcript here, by scrolling down to the corresponding responses.

Click here for a look at our #PWChat schedule and recaps.

 

 

Question 1

Q1: What exactly is Direct Primary Care (#DPC)? What sets it apart from traditional primary care?#PWChat

— Physician’s Weekly (@physicianswkly) February 13, 2019

A1: #DPC removes 3rd party billing from primary care, allowing more time w/ pts, better access (same day), wholesale meds (in most states), discounted labs, telemedicine, & access to your Dr. for urgent concerns after hrs for an affordable monthly fee #PWChat https://t.co/hd7Qm16boq

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019

A1: Traditional primary care is “transactional” while #DPC is relational, i.e. in a traditional practice, payment depends on a billing code, requiring administrative tasks/overhead that interferes w/ a Dr.’s ability to provide excellent care #PWChat https://t.co/hd7Qm16boq

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019

DPC patients have 24/7 access to their doctor via smartphone from anywhere. DPC docs help keep patients out of the ER and the hospital. For catastrophic situations, health sharing plans and AHPs/STLD policies offer alternative to traditional insurance at much lower cost.#PWChat

— John Chamberlain (@misterchambo) February 13, 2019

 

 

Question 2

Q2: What differentiates direct primary care from concierge, or VIP, medicine?#PWChat #DPC #directprimarycare

(just RTing with the image so the question doesn’t get lost and will do so going forward) pic..com/Fu98UgpN2E

— Physician’s Weekly (@physicianswkly) February 13, 2019

A2: VIP/concierge practices bill insurance. They charge a monthly fee mainly for access & some “non covered” services. #DPC physicians do not bill insurance (except a few hybrid practices) #PWChat https://t.co/VrlRoXOhnO

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019

A2: Their monthly fee is generally MUCH higher than a #DPC membership fee. Average monthly fee for #DPC is $79, some VIP practices in Louisville charge $500 a month. #PWChat

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019

 

 

Question 3

Q3: Is it unfair to claim that DPC caters to wealthy, health patients? Why?#PWChat #DPC pic..com/QPwwueWK3W

— Physician’s Weekly (@physicianswkly) February 13, 2019

A3: Another benefit to having time w/ pts is reversal of disease such as type 2 diabetes. Through lifestyle change, several pts no longer need meds. #DPC docs do not “cherry pick” #PWChat

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019

T3 It’s absolutely unfair. True for concierge where annual memberships can go as high as $40k, but not for DPC which averages $600/yr for 25–44 y.o. Very affordable. Not to mention savings on meds, imaging and labs.#PWChat

— John Chamberlain (@misterchambo) February 13, 2019

Why? What is the basis of that presumption? Almost every single PCP I know who actually does DPC model tells a different story that that. There are some ongoing efforts to get data on this point, but the critics who claim such do so on a purely speculative basis.#pwchat

— Dr. Neu (@NeuCare) February 13, 2019

 

 

Question 4

Q4: What makes DPC preferable to urgent care/minute clinics/convenience clinics as well as to telemedicine?#PWChat #DPC pic..com/dUPANUpuc7

— Physician’s Weekly (@physicianswkly) February 13, 2019

A4: #DPC docs offer the same services but w/ relationship & continuity, which are critical for the best health outcomes. #PWChat

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019

T4 24/7 access to YOUR physician. Not whoever is “on” at the Urgent Care or retail clinic or flavor of the month telemedicine platform. YOUR doctor knows you and your family. #PWChat

— John Chamberlain (@misterchambo) February 13, 2019

Your #dpc doctor KNOWS you, your history and has an on going clinical knowledge of your health keeping your medical record all in one place. Continuity. It also includes telemedicine providing the support, advice or treatment from home, work or on vacation when possible. #PWChat

— The Town Doctor (@thetowndoctor) February 14, 2019

 

 

Question 5

Q5: Can specialties other than primary care adopt a DPC model? How?#PWChat #DPC pic..com/HJOU5KJViF

— Physician’s Weekly (@physicianswkly) February 13, 2019

A5: Yes, I’m an addiction specialist & offer addiction treatment w/ a membership model. Cost is based on level of care. Also @McknightmdEllen @kksheld & @SurgeryCenterOK practice outside of a 3rd party billing system @AAPSonline #PWChat

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019

A5: My psychiatry practice is fee-for-service direct physician care (DPC) based on time. Other psychiatrists do DPC based on time and complexity. Any physician-led model of direct care works. #PWChat https://t.co/QakpFykFSu

— Brian J Dixon MD (@DrDixonFtW) February 13, 2019

T5 Other non-hospital dependent specialties like dermatology, ophthalmology and rheumatology are using the DPC model as well. #PWChat

— John Chamberlain (@misterchambo) February 13, 2019

 

 

Question 6

Q6: What makes DPC an ideal option to help address physician burnout in traditional primary care? #PWChat #DPC pic..com/60lJVAntHS

— Physician’s Weekly (@physicianswkly) February 13, 2019

A6: We know burnout is directly related to administrative burden. #DPC gets rid of most of the admin burden. #PWChat https://t.co/iVlK0u2cP9

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019

T6 Getting off the hamster wheel. Taking way better care of patients. Practicing medicine the way you were trained not the way the “suits” tell you to. And many more…#PWChat

— John Chamberlain (@misterchambo) February 13, 2019

 

 

Question 7

With only 1 min left (officially), gonna drop this last question:

Q7: What other issues of traditional primary care can/does DPC help address? How?#PWChat #DPC pic..com/9ItSht7pq3

— Physician’s Weekly (@physicianswkly) February 13, 2019

A7: Already mentioned wholesale meds, but we also help pts get imaging & other procedures at steep discounts. We have time to practice full scope primary care, so specialty referrals are fewer. E.g. I treated hep C for a pt in collaboration w/ specialist #PWChat

— Molly Rutherford, MD (@UnbridledMd) February 13, 2019