“I think I would be interested in primary care if it didn’t involve so much paperwork.”
This is a theme I have encountered surprisingly often when discussing career paths with my second-year medical student peers, and I am often left wondering where primary care is headed. When speaking with older members of the field, I am always struck by the entrepreneurial spirit that seems so common among the previous generations of primary care providers. Along with a desire to develop long-lasting meaningful relationships with patients, many physicians were drawn to the field by the prospect of using their business acumen to construct their own sustainable practices. Yet, in my past experiences, this innovative outlook has seemed much less pervasive in current discussions of primary care.
This past fall, a scholarship from BRI allowed me to attend a conference hosted by the American Academy of Private Physicians (AAPP) in San Francisco. At this event, I learned about a whole new take on primary care delivery. In the Direct Primary Care (DPC) model, patients pay a set fee that covers access to the physician of their choice as well as all the primary care services they may require. By bypassing federal funding and insurance reimbursements, physicians can cut out the overhead associated with reporting to these agencies. Since less money is lost in the billing process, doctors can afford to schedule fewer appointments each day, and thus can devote a greater amount of time to each patient. Without having to focus on reimbursements for specific reporting measures, doctors can also provide the type of care they see best fit for each person.
Like any new model of healthcare delivery, there are issues to be addressed, such as assuring this model doesn’t exacerbate the shortage of primary care physicians or exclude patients who are unable to pay monthly fees. One response is that DPC doctors typically have fewer patients and therefore have more time in their schedule to set aside for charity care to serve those who cannot afford typical clinic fees. Despite the potential problems, the ideas presented at this conference were discussed with a sense of optimism for the field that I had not previously encountered, and I walked away understanding that there are many opportunities after graduation that extend beyond just being someone else’s employee. I am extremely grateful to have been exposed to a new model of healthcare delivery that eliminates unnecessary healthcare expenditures while providing an exceptional quality of care.
Sarah Olofsson is a second-year medical student at the Saint Louis University School of Medicine.