In Defense of Direct Primary Care.

Direct primary care (DPC) is a growing movement across the United States involving at least 429 practices in 47 states. Family medicine physicians operating DPC practices share several characteristics: • They charge a periodic (monthly or annual) fee for a defined set of primary care services, • They do not bill any third parties on a fee-for-service basis for the services covered by the periodic fee, • Their per-visit charges are less than the monthly equivalent of the periodic fee. DPC practices differ considerably from concierge practices in both legal design and practice operation. Pure DPC practices do not bill any forms of traditional insurance, and this lowers practice overhead and allows these physicians to spend more time with the patient rather than wasting time on busy work requested by insurance companies. In contrast, concierge practices “double dip” by continuing to bill in a traditional fee-for-service fashion and by charging a membership fee. Overhead in a concierge practice is not reduced, and these physicians must be willing to spend less time with patients who decide not to pay their monthly fees, which are usually much higher than DPC monthly fees. Ignorance of the distinction between DPC and concierge models is often a source of attack against DPC, which I have addressed elsewhere. This article will address three common misconceptions about and criticisms of the DPC model. 1. Is direct primary care legal?