Reinventing the personal physician

by reestheskin on 06/07/2018

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Davidson had had enough. “I wasn’t even making 6 figures, and I was killing myself,” she recalled.

“Frustrated, she googled “ideal practice” one sleepless night and came across Atlas MD in Wichita, Kansas. That practice does not accept insurance, although patients still need to have insurance to cover health care beyond the scope of primary care. Instead of co-payments and deductibles, Atlas MD patients pay a monthly “membership fee” that covers all of the primary care their physician provides. But more importantly, this retainer guarantees unhurried, same-day appointments and round-the-clock accessibility to their physician, who would get to know their story “inside and out,” thanks to having to care for only around 500 patients.”

The most interesting thing in this article is the lengths the opponents go to to oppose such a change:

“For now, said Weisbart, chair of the Missouri chapter of Physicians for a National Health Program, there’s no evidence to support the argument that DPC [the model describe here], by allowing physicians to spend more time with patients, can prevent expensive downstream medical problems. “If they could prove it, I’d be one of their advocates,” he said, adding that he understands the attraction of DPC for physicians. “They can see a third or a quarter of the number of patients (as fee-for-service practices) and preserve their income.”

“Weisbart remains skeptical, though. Direct primary care practices might attract a different population of patients. The only way to compare how well the 2 models improve health and cut costs would be to conduct a trial that randomly assigned patients to DPC or fee-for-service practices. But, Weisbart added, such a trial would be difficult if not impossible to conduct. For one, it’s unlikely that a representative sample of US patients would agree to enroll in a study in which they were randomly assigned to a primary care physician. “And,” he added, “it would have to be large to show meaningful impact, which means the study would be expensive.”