On Thriving – Part 2



Enter Direct Primary Care (DPC).

I discovered DPC almost by accident, while desperately considering my next step after deciding to resign from my current position.  Thanks to a little mindful perspective, I decided that I had no further interest in contributing to the problem of ‘factory medical care’ and didn’t know what to do next.  The concept of concierge medicine nauseated me a little, because I have always had a burden for the underserved and indigent, but I found myself looking at it anyway.  Articles on cash-based medical practice led me to this concept of retainer-based primary care with a monthly fee, one that might be affordable to the Average Joe.

It seemed too good to be true.  But I kept reading.  And reading.  And my craziest realization in all my reading has not been that DPC is too good to be true, but that the actual U.S. health care system is too broken and ridiculous to be true… but unfortunately is.  Everyone just takes it for granted because it is all we know now.  DPC is a tiny ray of common-sensical light amidst the morass of insanity that is somehow accepted in the world’s Greatest Nation as the means by which we prevent, diagnose and manage injury and illness.

I like to use the example of car insurance to elucidate where things have gone wrong.  In most states, it is illegal to drive a car without insurance.  But there is also a simple understanding of what it is meant to cover, and no one looks forward to filing a claim to their car insurance because that would mean something bad happened, such as an accident.  That’s the nature of what “insurance” was meant to be: a failsafe or backup when there is a disruption in the natural order of things.  There is value to having it there when you need it because accidents do happen.  But car insurance does not cover your oil changes, tire rotations, windshield wipers, or interior detailing — in other words, prevention and maintenance.  You pay out of pocket for those services to the degree that you find value in them.  You might go to a dealership, or you might go to the corner mechanic.  By the way, the corner mechanic isn’t going to stay afloat unless he does a respectable job with his services: back to basic free market rules.  Just sayin’.

Direct Primary Care is the corner mechanic for health care: prevention, maintenance, diagnosing the weird noise coming from under the hood, identifying the problem and fixing it to the best of his/her own ability with limited use of expensive specialized services (typically at cost to the consumer) unless absolutely necessary.  DPC is the small business on the corner that is invested in serving the local community with a personal touch.  It acknowledges that being a primary care physician is a lot of responsibility and when done right holds tremendous value.  And it simply cannot be done right by one person for thousands of patients without compromising quality (the average full time hurried/stressed/rushed PCP is responsible for the care of 2500 patients, but a DPC doctor will typically cap off at around 600).

DPC can, however, bring health care back to a time and place where these words actually meant care for health, instead of layers and layers of rules, guidelines, quality measures, and so forth that we currently uphold as setting the standard in the form of “having insurance.”  Having health insurance doesn’t make you any healthier than having car insurance makes you a safe driver.  It doesn’t prevent adverse events, just proposes to help when these happen.  Once you make insurance responsible for actual prevention, what else is it supposed to do besides control your habitual, day-to-day practices that may put you at risk?  All the manpower required to control every member of a health plan, by the way, costs a lot of money — where do you suppose that money comes from?  How about higher charges (in the form of premiums for insurance or taxes for government plans) to the consumer and decreased payouts to the producer?  Food for thought.

Perhaps we also should ask ourselves what is our definition of “health” to begin with?  Is it simply the absence of illness or injury?  Does that really cover what you are looking for when it comes to being healthy… mere survival?  Or would you like to feel well: alert, energetic, productive, and strong… in other words, to thrive?  Then what you are looking for goes far beyond insurance. The health plan you really need is one tailored between you and a medical professional who has a personal relationship with you: one who has the time to get to know your needs then educate and guide you towards that state of wellness you have been looking for, rather than throwing prescriptions at you for lack of a better solution within a 10-minute visit.

If that version of health care interests you, look into Direct Primary Care.  Thrive APC will be championing care that is Attentive, Personal, and Complete as we build and prepare to open this Fall.  Or, if you are not within hailing distance of Franklin, Massachusetts, then check out this link to find a DPC practice near you: dpcfrontier.com/mapper.

Reforming health care in this country will not take a new set of laws, but a redefinition of terms; not a re-shuffling of players but a complete change of the game.  Revolutions do not come from legislation, but from grassroots movements, history has taught us this time and again.  This post may be your first peek into a critical component of the new generation of health care redefined.  If you find that to be the case, then contribute to the movement by sharing, re-posting, forwarding, “liking”, or whatever you do with social media.  We can start a revolution, but I for one plan to do it one patient at a time.