Oftentimes we hear tales how in the “good, old, days” medical care was personal, accessible and affordable.  Direct Primary Care (DPC) is a movement among family physicians and patients to return to those old principles.  For physicians it’s a way to get back to the roots of their profession. For patients it’s a way to access high quality care.  After all, it’s all about you and your doctor.

DPC abandons reliance on middle-men (most notably insurance companies). That means patients agree on payments directly with their physician. It also means less red tape and less interference from outside parties. As a result, DPC doctors are not working for some corporate entity – they work for you. Once that happens we can have real doctor-patient relationship again.

Because of their philosophy, the terms are often mistakenly used interchangeably. In both cases patients contract directly with the physicians and receive more access to the provider. However, that’s where similarities end. In the case of DPC, the membership fee covers most or all physician services (more on that below). In the case of Concierge Medicine that may or may not be true. Such practices usually have higher “retainer” fees, may charge extra per visit, and may also bill your insurance. In general DPC practices try to bring quality care to the masses (or at least, one patient group at a time). On the opposite side of the spectrum, Concierge Medicine practices are often criticized as promoting a two-tiered health system that favors the wealthy.

It depends… It takes the right doctor and a right patient. And it is not even a question of how sick or healthy you are. Instead it is an issue of just how involved are you willing to be with getting better and then keeping your well-being. If you are interested, I am here to offer you health care tailored to your needs.

First, you will be treated like a living, breathing person again.  Then you are getting real access. Many patients can be seen the same day.  Most visits can be scheduled within two days. Visits are usually scheduled for 30, 45 or 60 minutes (physicals can take longer).  Your visit will be long enough to cover all your concerns. And if you forget to ask about something? Well… your membership fee covers as few or as many contacts as you may require.

First, your family’s primary care expenses will become predictable and well-known – not much different from your cable or cell phone bill. All office visits are included. Phone consultations are included. Many routine procedures that can be performed in my office come included as well. So what’s not included? If I have to send it out (such as radiology, pathology or lab work), you will be billed additionally. You can choose then to either go through your medical insurance, or pay discounted rate that I have negotiated.

DPC is not meant as a replacement for a traditional medical insurance. However, with DPC many patients enroll in a lower-cost, high deductible / catastrophic insurance plans that kick-in if a major disaster strikes. They save by lowering their premiums and payroll deductions, and by eliminating (primary care-related) deductibles and copays. This is actually analogous to having a car insurance – it covers a fender-bender but you wouldn’t use it to pay for an oil change.

There is no one simple answer here as IRS regulations are a bit “fuzzy” in this regard.
Please do not construe the information below as professional advice.
For most patients a typical answer goes like this:
HSA – typically “no”
HRA – “it depends”
FSA – typically “yes”
Individual patients and employers purchasing DPC membership for their employees need to consult with their tax attorney or accountant to verify their particular circumstance and tax treatment.

For many patients their privacy is of utmost importance. While I keep medical records just like all other physicians, those records stay put at my office. Unless you specifically direct me otherwise, they will not be shared with 3rd party medical billers, your insurance company, a health delivery network, a hospital or clinic, and they will not be floating on some server on the Web.