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Direct Primary Care Vs Concierge Medicine
What is Concierge Medicine?
Tired of sitting in waiting rooms all day? Feel like your life is passing you by waiting hours just to see your doctor? Well, concierge medicine is here to solve this problem for you! More and more Americans are signing up for concierge medicine and direct primary care healthcare models.
Concierge medicine, simply put, refers to direct access to a primary care physician. In this delivery care model, which is also known as concierge care, the patient has round-the-clock access to their physician via telephone or email, appointments on the same day, along with individualized and personalized in-depth care.
The idea of concierge medicine is also framed as luxury medical care because of its high cost, as the patient may pay up to 25000 dollars per year. This cost is in addition to regular health care insurance premiums and excludes consultations with specialists and costs of hospitalization. People describe concierge medicine as a ‘personalized, intimate encounter’ with your doctor, which is much needed in the field of medicine. This creates a more satisfied doctor and patient relationship.
What is Direct Primary Care?
Direct primary care refers to a financial arrangement organized between the patient and their health care provider. This model gives patients an alternative to insurance billing, which operates on a fee-for-service model, charging a fee annually, monthly or quarterly. In general, this fee covers a range of services, such as consultative services, care coordination and comprehensive care management. Direct primary care removes insurance providers from the equations and nullifies the need for providers and patients to file health insurance claims.
Direct primary care does not accept any kind of insurance. However, patients that use DPC often enroll in high deductible health plans as well. In general, a monthly fee for DPC services is up to 100 dollars or more. The fee grants a patient unlimited and one-on-one access to their doctor. Fees are generally determined on the basis of age, size of the family on the plan and the type of practice. Generally, the fee covers primary care services like preventative care, lab tests, comprehensive care, consultations and care coordination.
The direct primary care model allows family physicians to focus their time and effort in caring for their patients in a direct, one-on-one manner without being hindered by overbearing administrators. Care becomes much more personalized and individualized, as it becomes stress-free for the patient and the doctor involved. The model also allows patients to save up on more money while also giving them more time with their physicians.
Pros and Cons of Concierge Medicine
There are several pros and cons to concierge medicine.
- More time for the patient: The physicians tend to book fewer appointments during the day with their patients and schedule an ample amount of time for the visit. The patient can, thus, interact with him or her directly without having to communicate via other staff. In general, this allows for a better relationship with the doctor and leads to excellent healthcare for the patient.
- Preventative care: In other healthcare models, the doctor operates robotically to treat the patient and does not expend much time on their wellness and preventive care. Care focuses on treating the illness rather than digging up the root cause and can be reactive in nature. The concierge model allows the physician to spend time digging into the reason behind your symptoms and help you get on the track to a healthier and well-rounded life.
- Extra support for those who need it: It is beneficial for patients that need unrestricted access to their doctor for support or smoothing out anxieties, such as people with chronic illnesses. Concierge medicine operates on the basis of unrestricted physician access; over the phone or in the office.
- Expensive: Concierge medicine is luxury medical care, in a nutshell. It has several out-of-pocket medical expenses that many people cannot afford, as people have to pay retainer fees in addition to insurance premiums. In addition, fees vary according to location. Direct access to your doctor comes at a hefty cost.
- Little or no coverage: The American healthcare system is unequal. There is a wide disparity between how lower-income families experience the healthcare system in comparison to higher-income families. The latter gets better care, and this model is an example of that. Membership-based care services limit access to good healthcare for low-income families. In addition, since doctors get to select which patients to take one, the set-up can be riddled with bias.
Is concierge medicine the same as direct primary care?
There are several key differences between the two independent healthcare models:
- Direct primary care involves fees paid by patients or the patient’s employer, while concierge medicine features an annual, monthly or quarterly membership contract with higher fees. The latter is more expensive and exclusive, catering to wealthier people.
- With concierge medicine, patient fees cover only in-depth physical exams and screenings; while in DPC, fees cover clinical, lab, consultative and care services along with care coordination and comprehensive care management.
- Direct primary care services do not accept insurance and rely solely upon patient fees. On the other hand, Concierge care accepts insurance plans and government programs. It also charges insurance companies for services rendered.
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Dr. Josh is a physician who's helping spread the knowledge about Telehealth and its advantages. At SmartClinix, he's providing his expertise and knowledge in the form of engaging articles on various health & tech related topics.