My Story

During the first decade of my career as a rural family doctor, I had the good fortune of working with one of my best friends. We were both employed doctors who took over the practice of a retiring physician with a 40-year legacy in the community. He was a legend in the community, and we both cherished the opportunity to continue his work. Despite being employed, our small-town employer granted us a significant amount of autonomy.

By God’s grace, we were highly successful in helping both our small practice and our rural hospital grow. We reached our peak with 8 physicians, but the erosion of our professional autonomy due to the merger of our small hospital with a larger system, the constant turnover of administrators, the loss of local governance, and the implementation of the EHR all led our group members to reconsider if this was the right place for them. Gradually, the group dispersed, with the final blow being my dear friend and colleague deciding to leave for an industrial medicine job, forever breaking up our "dynamic duo." It was a difficult loss both personally and professionally. He was there for me when my first wife passed away from breast cancer and he stood by me as my best man when I remarried.

As the option for direct primary care began to emerge across the country, he chose to return to our little town and set up the first direct primary care practice in our community. While in many regards we were now competitors, in reality, there were plenty of patients to go around. I was just happy to have him back in the medical community.

He has thrived as a solo practitioner, providing care to a select number of patients. With a solid business plan that he executed flawlessly, he has been successfully running his practice for over 5 years. During our recent coffee chat, he expressed his extreme satisfaction with his practice model. I encouraged him to consider writing a guest post for SimpliMD, so hopefully, you will hear from him soon.

Due to his experience and what I see happening all over the country, this version of a professional micro-corporation is here to stay.

If you have wondered if a professional micro-corporation would work for you, let me invite you to join the wait list for my new course that I will be publishing early this summer called “Doctor, You Are A Business”. If you follow this link, you can save $500 by joining the wait list now. This will be a fantastic course to take in preparation for starting your own micro-corporation.

While I personally opted for the employment lite option for my micro-corporation, direct primary care is one of the many choices available. I recently came across a great blog on KevinMD about direct primary care and thought you would enjoy learning more about this micro-business job option.

The rise of direct primary care in America

By Andy Bonner on KevinMD

January 2, 2024

Health care and how individuals receive it has been at the forefront of public concern for many years. Now, more than ever, a priority should be placed on discovering amenable solutions to address the incomprehensible challenges impacting this nation’s health care system. I believe that direct primary care (DPC) holds the potential to improve the way Americans access and experience health care. An article published by Medical Economics says DPC memberships are seeing an average annual growth of 36 percent, reaching a total growth rate of 241 percent from 2017-2021.

DPC has been around for many years. It is gaining momentum as a viable alternative to the traditional fee-for-service health care system. DPC shifts the focus from the complications of insurance billing to the heart of health care itself – the doctor-patient relationship. Here’s why DPC deserves our attention and support:

Patient-centered care. DPC puts patients first. In a traditional health care system, patients can often feel neglected and lost in a maze of paperwork. DPC changes that. It provides patients with a direct and personal relationship with a primary care physician. Doctors can spend more time listening to patients and understanding their concerns. This approach enhances the physician’s knowledge of the patient’s health history and lifestyle to deliver personalized care. This open dialogue encourages patients to continue regular visits with a physician, leading to routine health monitoring that can be beneficial in the early detection and treatment of serious issues.

Accessibility. One of the most frustrating things about scheduling an appointment with a doctor is the lack of availability on a physician’s schedule. Oftentimes, individuals must wait weeks if not months to be seen. DPC removes that barrier. An advantage of DPC is that a member can see a physician usually within a few days. This ensures that individuals and families can access health care quickly and without the fear of navigating the claims process, receiving surprise bills, and the need for extensive insurance coverage. When coupled with an offering of virtual care, it’s a model that makes health care accessible and affordable for everyone.

Preventive care. With improved access to physicians, DPC improves the frequency with which patients see a physician. Proactive monitoring of their health can reduce their health care costs down the road. Through DPC, members receive regular check-ups, and screenings, to help guide them through and keep them informed about their personal well-being. Continual monitoring of chronic health conditions and the discovery of serious health issues, before they become severe, helps them avoid costly treatment and possible hospitalizations, a cost no one wants to incur.

Quality of care. Unlike traditional health care where doctors are overwhelmed with processing patients quickly, in a DPC model, primary care physicians have the flexibility to spend more time with their patients. It allows them time to truly engage and delve into their concerns and ailments. This leads to more accurate diagnoses, strategic treatment plans, and improved patient outcomes. When doctors are not burdened by paperwork and insurance requirements, they can concentrate on providing an enhanced patient experience.

Cost-effectiveness. DPC is an affordable option. When you consider the cost of one urgent care visit or emergency room visit, often in the hundreds of dollars, the cost of a one-year DPC membership is negligible. According to the Society of Actuaries Report, Millman Study, DPC members experience approximately 40 percent fewer emergency room visits than those in traditional plans.

Enhanced doctor-patient relationship. As previously mentioned, DPC fosters a strong doctor-patient relationship built on trust and communication. Patients have more time with their primary care provider. The access to care is enhanced. DPC leads to extended appointment times, minimal wait times, and a more intimate relationship with the health care provider.

Reduced administrative burden. In a fee-for-service model, health care providers are burdened with dealing with insurance companies and coding complexities. This can lead to “bad debt.” That debt is made up of two components: insurance companies reevaluating charges at a significantly reduced rate or patients not paying their share of the bill. DPC eliminates the claims process and allows doctors to focus on what they do best, providing medical care.

Final thoughts

It’s important to note that DPC does not replace health insurance but is a great complement to traditional insurance health care plans. Patients still need insurance for specialized care, hospitalizations, and emergencies. However, by covering primary care through a DPC model, we can make health care more accessible, efficient, and affordable.

I’ve seen firsthand the positive impact of DPC on individuals, families, and employers. Our commitment to this model stems from our belief that it aligns with our mission to make quality health care accessible to all. It’s time for health care stakeholders, policymakers, and communities to come together and support the growth of direct primary care as a crucial part of the solution to our health care challenges. By doing so, we can build a health care system that is patient-centered, cost-effective, and sustainable for generations to come.