What is direct primary care (DPC)?
DPC is a new way to get high quality, comprehensive healthcare from a doctor who cares, all for a low, flat monthly fee.
DPC doctors ditch the broken healthcare system, leave their hellish hospital jobs, and start providing care at reasonable prices. It’s that simple. No insurance, no corporate health system, no middlemen. Just doctors and patients.
Practically speaking, DPC is a membership model for healthcare. Every patient pays a flat monthly fee to become a member of the DPC practice. What are the benefits of membership? Put simply: access to a doctor that cares about you.
To get a far more detailed answer, check out the DPC Nation homepage.
What are the benefits of a direct primary care membership?
Put simply: your DPC doctor is there when you need them.
You get unlimited office visits at no additional charge—and they’ll be as long as you need. Typically, you’ll be able to book a same-day or next-day appointment, sometimes directly through the practice’s website. Often, you’ll have access to your doctor’s cell phone number, so you’ll be able to call or text them any medical questions as needed. Some simple diagnostics (e.g., strep tests) and blood tests may be performed in office for a small additional charge (or no charge at all). If you have a major issue, your doctor will coordinate any specialist referrals or hospital care.
Below is a comprehensive list of services provided by most direct primary care practices. Most of these services are provided as an included perk of membership; others are often provided for a small additional fee. Talk to the DPC practices near you to understand exactly what their memberships include.
- Treating common everyday problems like colds, flu, strep throat, rashes, burns, joint injuries, and other wounds.
- Keeping you up-to-date on all recommended preventative screening, like colonoscopies, pap smears, and EKGs.
- Managing chronic conditions like asthma, diabetes, high blood pressure, high cholesterol, or thyroid disorder. Your doctor will work with you to formulate a long-term personalized management plan.
- Performing minor procedures. If you need a minor procedure like a mole removal, joint injection, stitches, or a simple cosmetic procedure, your primary care provider may be able help with that. When joining a practice, ask your doctor what procedures are in their scope of practice.
- Providing a slew of additional services. A growing number of practices offer chronic pain treatments (joint injections), sleep disorder treatments (sleep studies and CPAP), minor cosmetic procedures, osteopathic manipulation, migraine treatments, osteoporosis tests (bone density testing), and athletic performance testing (VO2 max). These services are often offered for a small additional fee.
- Managing your specialist care. If you have a medical issue that can’t be handled by your primary care physician, you’ll be referred to a doctor that can continue your treatment. And your DPC doctor won’t just shoo you out the door; they’ll work closely wih the specialist to make sure there is seamless continuity of care. Many DPC doctors have access privileges at nearby hospitals, so they’ll be able to check up on you and take an active role in your care.
- Providing an annual full-body physical and checkup. Often, your doctor will do a comprehensive review of systems at your very first in-person appointment.
How much does direct primary care cost?
The typical monthly fee is about as much as your cell phone bill. At Collier Family Medical it starts at $65 per month, plus a one-time enrollment fee of $100. That’s a small price to pay for a level of care you literally can’t get anywhere else. Imagine asking your hospital doctor for their personal cell number—they’d probably laugh out loud. Or call your local hospital and ask to schedule an appointment for tomorrow—not likely. Those things—and many more—come free with a DPC membership.
Not to mention: the membership fee can often pay for itself. Most DPC practices have an established relationship with local laboratories and radiology centers. That means you can get blood tests, pathology screens, X-rays, MRIs, and more for low cash prices. Most DPC practices dispense medications in-house at near-wholesale prices, so you can both save money and avoid extra trips to the pharmacy. Plus, as a DPC member, you may be able to save a lot of money on insurance by switching to a high-deductible plan. Learn more about saving money with DPC here.
In short: being a member of a DPC practice is like having a doctor in the family. Your doctor will always be in your corner, working to keep you as healthy as possible. It’s an amazing feeling.
Can direct primary care save you money?
You bet! Let’s go over some common scenarios where a DPC membership can save you money.
- #1 You’re taking multiple medications. If you’re taking multiple medications and paying with insurance for all of them, your co-pays are probably stacking up. Direct primary care practices frequently dispense common medications directly from their offices, so you won’t need to do an extra trip to the pharmacy. Plus, your DPC doctor will purchase these medications at wholesale prices from a free-market vendor like Andameds or Henry Schein, and they pass those savings through to you. Some practices add a small markup (say, 10%), others sell these medications at cost. The value of this service depends on which medications you’re taking. Often your insurance provider will only cover a drug from a particular drug manufacturer, or they’ll require you to use a brand-name version even though a cheaper generic is on the market. If that’s the case you can easily be paying hundreds of dollars a month on medications—money you could save as a DPC member.
- #2 You get injured. If you get in an accident, break a bone, need stitches, or require emergency medical care of any sort, you’ll probably go to an urgent care or the emergency room. Going to either of these is a surefire way to drain your pocketbook. In the best base scenario, the urgent care center is in your insurance network and you pay a high co-pay—up to $100 in some cases. But that’s only if you’re lucky. Insurance coverage of emergency care is spotty at best, and urgent care centers are known to mislead patients regarding the true costs of care. Even if you verify multiple times that your insurance will cover your care, you can still get hit with big bills. Often urgent cares don’t know if you’re insurance is actually valid, or they’ll intentionally mislead you.
Emergency rooms are even worse: you’ll often have to pay a co-pay of $1000 or more just to get seen, PLUS the cost of any additional scans or treatments. There are dozens of horror stories online about unwitting patients who we’re financially ruined by insane ER bills they thought we’re covered by insurance. One bad day can cost you thousands of dollars—enough to cover years of a DPC membership. As a DPC patient, you know exactly who to call when you need help.
- #3 You’re overpaying for insurance. If you’re on an insurance plan named after a precious metal, you shouldn’t be. Health insurance companies have been over-reaching for years—to read more about this, check out our essay on the healthcare crisis. Even the cheapest health plan your employer offers covers WAY more than it should, so don’t get conned out of more money by picking a low-deductible “Platinum” plan.
As a DPC patient, the majority of your healthcare will be taken care of by your DPC doctor. All standard care, wound treatment, blood work, preventative screens, and physicals will either be included in your membership or provided at a fair price by your doctor. If your DPC doctor isn’t equipped to deal with a medical issue, it’s probably serious. And if it’s serious, then you’ll very likely hit your out-of-pocket maximum (OOP). (This OOP is what it sounds like: the maximum amount you can possibly spend on healthcare before your insurance plan starts footing 100% of the bill.)
Here’s the thing: the OOP for the cheapest and most expensive plans don’t vary that much. Aetna’s cheapest plan costs roughly $600 per year and has an OOP of $6650. Their most expensive plan costs $4200/year with an OOP of $4000. That means you’d be paying a guaranteed $3600 extra dollars ($4200 – $600) to avoid the small chance of paying an extra $2650 (6650 – 4000) on your healthcare. That doesn’t make sense! Unless you’re expecting to suffer a major health crisis every 9 months, you’ll be better off on a cheaper plan. Otherwise, just join a DPC practice and take the cheapest insurance you can find!
Do none of those scenarios apply to you? Here’s one more:
- #4 You care about your health. Here’s the thing: direct primary care is the best game in town when it comes to healthcare. Think of it this way: before DPC, only movie stars and the super-rich were able to afford a personal doctor who works tirelessly to keep them healthy. To keep a personal doctor on staff costs around thousands of dollars per month. The rest of us had to a) wait until we were sick before talking to a doctor, then b) schedule a visit weeks in advance just to c) spend 10 minutes with a doctor we’d never met.
With DPC, everyone can have a personal doctor on speed dial for a shockingly low amount. Having a medical expert at hand to answer questions, keep track of your preventative screenings, advise on your diet and lifestyle, and actually care about your happiness was simply not possible before. Now it is. By splitting hairs over tens of dollars per month, you’re missing out on the best deal in healthcare.
Why is direct primary care a monthly membership?
If it seems like everything is a subscription these days, that’s probably because it is! And with good reason: subscriptions are the best way for a business (of any kind) to offer high-quality service and support over a long period of time. If you long for the days when software cost hundreds of dollars and came in a box, DPC might not be for you.
The alternative would be itemized, “usage-based” pricing—the exact pricing scheme used by the traditional healthcare system. And that didn’t work out so well for anyone. There are a hundred little perks of being a DPC patient—check out a comprehensive list of benefits here. Frankly, the benefits of being a DPC patient are too varied and rich to be broken down into a “menu of services”. Paying your DPC doctor for every thing they do would be like paying Netflix for every episode of TV you watch. Sounds awful.
Is direct primary care the same as concierge medicine?
You may have heard of a similar model called “concierge medicine”. While there are similarities with DPC, the two are different in some fundamental ways. For starters, concierge practices often bill your insurance in addition to a monthly fee (though some don’t—which makes them DPC practices!). This means they’re still a part of the insurance industry’s ridiculously complex reimbursement system, so they have to hire administrators to handle all the paperwork. This gets reflected in your monthly fee; the average concierge practice bills $200-300 per month. By comparison, DPC memberships cost approximately as much as your cell phone bill. Concierge was a step in the right direction, but it didn’t go far enough. To bring sanity back to primary care, you need to cut insurance out of the picture entirely.
Do I still need insurance as a direct primary care patient?
Yes, you’ll still need insurance, though you may be able to reduce the amount you pay.
Your DPC membership is not an insurance plan; you’ll still need insurance if you have a major health problem. (But when those problems arise, your DPC doctor will be next to you to guide you through the system and coordinate your care.) That said, you may be able to save money on your insurance! Since all routine care is covered by your membership, you can switch to a “high-deductible” health plan that costs less per month.
Recently, some alternatives to traditional insurance companies have been gaining in popularity. You may actually be able to save money by joining a healthcare cost-sharing community. To learn more about how these communities go hand-in-hand with DPC, check out this article by Sedera Health.
Should I join a direct primary care practice if I’m healthy?
Absolutely! To be sure, your DPC doctor will always be there for you if you’re get sick or hurt. But they also work proactively to keep you healthy, happy, free of preventable diseases, and living a good lifestyle.
It’s hard to break out of the mindset of the insurance-based healthcare system. In “the system”, everything is centered around treating illness. It’s very hard for a doctor to get paid by an insurance company for detecting early warning signs of diabetes or encouraging a lifestyle change to decrease risk of heart disease. Doctors just aren’t rewarded for encouraging all-around good health.
By being in constant contact with your DPC doctor when you’re healthy, you’ll be able to stay that way. By the time you’re being treated for a chronic disease, it’s usually too late. But if you spend your healthy years under the watchful eye of a doctor that cares, you’ll be able to stay out of the hospital for years to come.
Can you send me for x-ray, MRI, or CTs?
Yes! As your primary care provider, we can send and receive to review the results. Most often this is quicker and within the same day or week of request.
Do you accept Medicare?
We are taking a list of patients on Medicare and will get back to you as soon as this is available. Call 704-240-5260 or email firstname.lastname@example.org to be placed on that list.
Do you accept Medicaid?
We can take patients with Medicaid. We do not bill and you have to sign a waiver stating you understand we are not utilizing your Medicaid benefits. Payment is due upon receipt.
What if someone doesn’t have insurance but doesn’t want a membership to begin with?
Yes! Cost depends on what service is requested. Office visits without a membership start at $120 per visit, plus $50 for enrollment one-time fee. Medications can be refilled with a limited supply just as an urgent care would do, but much cheaper.
Is this month-to-month or is there a contract involved?
Yes, an initial 3-month contract is required. After the initial 3 months you are able to cancel, although we hope you won’t want too!
What would a family of 4 cost?
Is this a pain management Doctor?
$120 for adult couple +$20/dependent under the age of 22, 22-26 for only $30/ dependent and a one-time $100 enrollment fee.
We can manage conditions: high blood pressure, diabetes, trigger points, acute pain, knee pain, etc. We can evaluate and refer if needed.
What does a membership include?
Membership includes: unlimited office visits with no copays, some free medication, all low cost if not free, free routine lab work. After hours care, and texting available. You will always talk to YOUR provider not another provider about your care. Also, we have a collaborating doctor that reviews charts that is an MD and a collaborating pharmacist that reviews all prescriptions. So, three for the price of one.
Am I or my family required to be vaccinated to receive care?
We do not have a vaccine mandate for care. If there is a specific question for families then the provider can discuss with them and give them guidance. We treat all families, shapes, sizes, colors, vaccinated and non-vaccinated.
Can I submit charges to my insurance for reimbursement?
Yes, we will be happy to provide you with an itemized receipt. We will have no knowledge whether you get reimbursed and do not guarantee your insurance company will reimburse you.
For more information about our practice, visit, www.collierfamilymedical.com
For more information about Direct Primary Care, visit, www.dpcnation.com