Concierge and direct primary care medicine appeal to patients who seek personalized attention.
NOVEMBER 2015 ISSUE of 435 MAGAZINE – NOVEMBER 2, 2015 | Kansas City, MO — Do you have a nagging sore throat? How about your sudden case of hives? What do the results of this blood test mean? Do you need to talk at length to a medical professional about your sinus infection, arthritis or any other health concerns that are worrying you? Imagine a world where you have quick access to the primary care doctor of your choice, and he or she knows you on a deep, personal level. They grow to become an invaluable part of your life and know your medical needs and concerns inside and out.
To some people in the metro area, that world is already here — or rather, here again, reviving the idea of the family doctor who may also make house calls — and growing.
It comes in the form of concierge medicine and its younger and emerging cousin, direct primary care, or DPC. Though they are different and can vary widely in their structure and payment requirements, these health-care delivery systems are often referred to interchangeably because both are cash-based in exchange for personalized medical attention.
“When I’m done with a physical, I know the patients so well that when they call me, I can help them out,” says Dr. Michael Monaco, whose concierge medical practice at Menorah Medical Center in Overland Park is so popular that he basically has stopped taking new patients. “I can usually deal with the problem off the top of my head and take care of my patients instantly because I know them personally.”
At their core, both systems provide patients with prolonged visits with their doctor because the physicians see much fewer patients than traditional medical practices. In a typical primary care office, a doctor has 3,000 to 5,000 patients, whereas a typical concierge practice has 600 or fewer patients per physician, and a direct-care physician has less than 1,000, according to the Direct Primary Care Consumer Guide: Closing the Gap between Your Doctor, Your Health & Your Wallet, by Michael Tetreault and Catherine Sykes, who also edit The Direct Primary Care Journal, an independent trade journal and online news reporting publication that covers the DCP industry.
Basically, in direct primary care (DPC), patients pay a monthly fee and can opt out at any time. In concierge medicine, patients pay an annual fee or retainer, which may or may not be in addition to other charges. Generally, direct primary care physicians opt out of insurance plans, whereas concierge physicians accept them.
Depending on the practice, direct primary care costs for one person typically range from $100 a month or less, whereas concierge medicine ranges in cost from $1,200 to $3,000 yearly, according to Tetreault.
Direct primary care practices don’t accept insurance because of their belief that third-party insurance middlemen get in the way of patient care.
“When you think of Andy Griffith-style medicine, the doctor had a clinic in the local town,” Tetreault writes. “It’d be strange from him to say, ‘What kind of insurance does Opie have?’”
DPC works with insurance carriers to co-create blended plans that integrate direct primary care with high-deductible insurance. Patients are urged to carry at least major medical health insurance that covers catastrophic illness or injury.