Why I chose the Direct Primary Care (DPC) model
Updated: Feb 14
I decided to start Dignity Integrative Health and Wellness because, after 30 years in medicine, I came to the belief that promoting healthspan requires a true partnership with patients.
The only problem with that belief is that the traditional way of paying for healthcare simply wasn't conducive. What is the traditional way of paying for healthcare? In a word: insurance. There are two big problems with the standard health insurance system that I want to address here.
The first is the problem of incentives. In a traditional insurance system, the doctors provide health care to patients, but then bill the patient's insurance company for the services. This is known as "Fee For Service," meaning the more services, the more fees. In other words, the incentive for healthcare providers in this system isn't to make you more healthy, it's to provide you more healthcare services.
The second problem with traditional insurance is that neither the doctor nor the patient knows up front what something will cost — and it's nearly impossible to figure out ahead of time. In this system, costs are determined by a complex set of factors, including whether the doctor is 'in' or 'out' of network, whether they are a 'preferred provider,' how the insurance plan is designed, and the relative negotiating power between the insurance companies and the care providers.
On top of this, the traditional system is a constantly changing process as insurance reimbursement rarely keeps up with costs, so doctors make the decision to drop certain insurance plans. You, as a patient, are then left to pay additional out of pocket dollars or make the decision to change doctors.
That's the system patients are currently stuck in, and take it from me: it's tough to practice good medicine in that kind of environment, and even tougher to establish a true partnership to improve your patients' health and wellness.
What is Direct Primary Care?
So what is Direct Primary Care? Direct primary care (DPC) is when the patient pays the doctor directly, with no insurance companies involved. Sounds simple, but the implications are actually quite profound.
In DPC, the patient is truly the customer, meaning that's who I as a physician am accountable to. I don't depend on an insurance company to say whether they pay for a certain procedure or a particular test, and how much. Instead, I establish a direct patient-provider relationship, for a flat fee.
The direct relationship ensures I'm accountable only to my patients. The flat fee ensures I'm incentivized only to make you healthier, not to perform needless tests or procedures.
The Dignity Integrative Model
At Dignity Integrative, once the initial evaluation and plan are complete, your monthly fee will not change. What you pay monthly, called a subscription fee, pays for your monthly visit with our health coach to work through the personal plan we have jointly developed. It also allows access to me through the patient portal at any time.
This model allows Dignity Integrative to maintain a small patient base and provide personalized service. What you will notice is an unhurried approach where we take time to get to know you and your personal history and desires for optimal health.
What to Expect in the First Year
The initial appointment is scheduled for 90 minutes. While you may not need that much time, our intent is to dive deep into your medical history and understand your personal priorities for health and wellness. Once we have taken reviewed all of your medical history, conducted a detailed physical exam and combined it with selected lab tests, we craft a personal plan for success.
During the second visit, we meet together with your health coach to review the plan and make modifications based on your feedback. We then plan monthly followup meetings (conducted virtually) with the health coach who acts as a guide to ensure progress towards your goals, reviewing the plan and making adjustments as necessary.
At the six-month mark there is 30 minute virtual or in person visit scheduled to determine next steps. The six-month time period serves as a mid-year check in for your health and wellness.
At the end of one year, you have the option to continue with the monthly subscription.
Over time we will be developing important tips on maintaining your health and will send out that information no more than once per month. This is another benefit of the subscription model. Since we have access to the latest medical and integrative news, it will serve as a constant update on longevity and optimal health.
At Dignity Integrative Health and Wellness, we look forward to serving you on the road to better health.