Direct Primary Care FAQs for Patients

What is Direct Primary Care

Direct Primary Care (DPC) is a health care model that restores a personal relationship with your provider. The goal is to simplify the finances in order to provide more time with your provider, more personal care, and to place the incentive on keeping you healthy rather than on paperwork or getting paid. This is accomplished by removing insurance companies from the relationship between the patient and primary care provider.

How does this make my experience as a patient better?

The most common feature of DPC is plenty of time spent between patient and provider, creating an enduring doctor-patient relationship. Supported by unrestricted access to care, DPC has unrushed visits and frequent discussions to assess lifestyle choices and treatment decisions aimed at overall health and wellness rather than illness. Making the Patient/Provider relationship stronger and improving the patient’s engagement in their health care is important to improving health outcomes, lowering costs, and an enhanced patient medical experience.

Am I restricted to a certain network or provider like insurance companies dictate?

Patients in DPC choose their own personal provider and are not restricted by narrow networks determined by insurance companies. Patients need to be given accurate information on costs and decisions at the time of service or even before as patients are engaged in making their own medical and financial choices. Transparent pricing is the mainstay of DPC practices.

What are the main benefits for patients?

1. Reduced out of pocket costs for most patients
2. Plenty of time with provider-no rushed visits
3. Same day appointments available
4. Usually much shorter or no time in the waiting room
5. Can get care through advanced technology like video visits over smartphones
6. Great Patient/Provider relationship with no middleman to interfere
7. Emphasis on health and wellness rather than just sick care

Should l have insurance if I go to a DPC practice?

We encourage patients to have insurance to cover catastrophic costs that can be associated with health care like hospitalization and surgery. However, this model makes primary care affordable even if you do not use insurance. For patients that do have insurance, they can still come to this type of practice, sometimes even for less out of pocket expense than going to a practice that takes and files insurance.

How are DPC practices paid differently as compared to conventional practices?

DPC minimizes or gets rid of fee-for-service (FFS) incentives in primary care. These incentives cloud healthcare decision-making by rewarding more procedures and visits versus keeping patients healthy. This can erode the integrity of the patient/provider relationship and rewards expensive and sometimes unnecessary testing, inappropriate referrals, and treatment. DPC replaces the “only get paid when the doctor does something to you” strategy with a simple monthly fee that allows all of your primary care services to be provided at a much lower cost.

How Does DPC Work?

The idea is to use health insurance only for unexpected and expensive problems. This is similar to how people commonly use car insurance. In the same way, you would not use car insurance for an oil change or a tune up. A Direct Primary Care practice can take care of 90% of your health care needs for a lower cost than an insurance based medical practice can. Insurance can then be used when really expensive and unusual health costs arise. In a similar manner, if you totaled your car, your car insurance would pick up the tab after the deductible making it an affordable expense. If car insurance worked the way health insurance does, your premiums would be much higher.