Early in February, I had the opportunity to attend the Direct Primary Care Deconstructed Conference in Tampa, Florida. The conference was educative, the people were kind, and the weather was beautiful. I was excited about receiving a BRI scholarship to attend the conference because direct primary care is a concept I knew almost nothing about, and I am passionate about learning of healthcare models that provide affordable, effective and accessible care to individuals.
Direct primary care (DPC) is a medical practice framework for primary care physicians where patients are charged a flat monthly or annual fee in exchange for access to a broad range of primary care and medical administrative services. It works quite like being a member of a “club” where you pay a monthly or an annual “membership fee” to have access to the club’s facilities.
For instance, Dr X runs a direct primary care service and has a basic plan that costs $41/month. If you purchase this plan, you have access to a yearly physical examination, complete blood count, complete metabolic profile, PSA (if male), PAP smear (if female), pelvic ultrasound, thyroid function test and HBA1c if necessary. In addition to the monthly fee, you would pay $20 per visit. This also includes unlimited access to your physician throughout the month (often via phone, email or text messaging). Further, you would enjoy highly personalized, comprehensive and coordinated care. After a shorter time in the waiting room, you would also have longer face time with your doctor.
The DPC model is also beneficial for the physician in that he has more business autonomy, true independence, decreased non-clinical bureaucracy/paperwork, better familiarity and firmer patient relationships and an overall improved quality of life. (Because he owns his practice and can structure his practice time effectively…he’s not burned out!).
From my understanding, DPC would work well in a country where the primary healthcare system is well established, and the people are economically better off, which is not the case in my country. Nigeria lacks in both the technical and financial savoir-faire to run a DPC model. Presently, about 70% of the Nigerian population live below $1/ day and as a result would be unable to afford “membership fees” sufficient to provide efficient healthcare. Secondly, the primary healthcare system in Nigeria is poorly developed, lacks coordination and funding.
To cater for the majority of Nigerians, a healthcare financing system that demands less from the people in terms of economic input would be a way to go. There is, however, a growing middle class that would benefit from the direct primary care model if introduced.
Zainab Odufuye is a final year medical student at the University of Ibadan, Nigeria. She is a member of Benjamin Rush Institute and a recipient of the DPCMH Conference Scholarship. She is passionate about learning about and providing affordable and accessible healthcare to members of her community.