“Family practice is not what it used to be. You’ve gone through too much school and assumed too much debt not to go on and specialize in something.”
These are actual quotes from a few of my preceptors that I’ve encountered on clinical rotations during my last years of medical school. They all are without doubt wonderful primary care physicians and teachers, but each responded honestly when I told them my plans to seek a career in family medicine. As a medical student, almost every encounter with a physician is a special chance to learn from and admire a person who has been-there and done-that—who has stood in our shoes during the travails of medical curriculums and come out on the other side, equipped and passionate to make a positive impact in peoples’ lives.
Hearing those words from established physicians really made me second-guess my decision towards family medicine as a future career.
They cited how government’s increasing regulation and insurance-driven influence in their exam rooms have made it nearly impossible to practice the art of medicine and carry on a true doctor-patient relationship. Rising costs, shorter encounter times, one-problem visits, and prior authorizations are just a few reasons why physician satisfaction is falling, and notably also for patients.
During medical school, we learn about an infinite number of diseases and treatments, but nearly nothing about the actual delivery of health care. Luckily for me, I was introduced to Benjamin Rush Institute, a non-profit organization that partners with medical students to shed light on healthcare policy, economics, ethics, and innovation.
I first heard about the concept of direct primary care (DPC) at a BRI event and later was fortunate enough to attend a DPC conference in Dallas, TX where I solidified my understanding about the future of primary care. I met hundreds of physicians who were actively seeking or currently practicing the doctor-patient relationship that they always intended. In a DPC practice model, health insurance takes the role it was always meant to play, and patients can contract directly with physicians for almost all of their everyday primary care needs.
The physicians currently practicing DPC boasted longer time spent with patients, less meaningless paperwork, and most importantly, more confidence that the care they were providing was truly what was best and most appropriate for each individual—not “cookie-cutter” medicine. They are able to spend extra time with each patient and get beyond the problem-focused visit, practicing true preventative medicine that keeps patients out of the hospital and promotes a wellness lifestyle.
Some of the advantages these DPC practices have are:
- Dispense at-cost wholesale medications,
- Individually contract for at-cost labs and imaging, and
- Provide a vast array of in-office services without expensive mark ups or insurance-skewed pricing
Financial incentives aside, it is the value at which this kind of care is delivered that sets the model apart. Most of these practices provide their services with unlimited office, phone, text, email, and even home visits for their patients eliminating regulation-induced barriers that stand between a patient and doctor in today’s healthcare system. DPC doctors design their practices uniquely tailored to their own strengths as physicians, and to provide the best care possible for their particular communities. This kind of custom, innovative medical business model is exactly what is lacking in today’s system and will lead to the kind of competition that increases quality, while driving down consumer costs.
Throughout the entire weekend, I could not help but notice the palpable excitement that all these physicians shared as they discussed the potential for direct primary care’s role in the future of medicine. Now, more than ever, I feel more inclined to listen to those preceptors who heeded my interest in family medicine. I agree that a career in family medicine employed under a traditional hospital network is not the kind of medicine I wish to practice, but greater fulfillment may lie in a DPC practice.
I want to thank the Benjamin Rush Institute and The Physicians Foundation for allowing me to learn the ins and outs of direct primary care and meet physicians who are excited about the future of primary care—and the sanctity of the doctor-patient relationship.
[Ed. Note: Jeremy Vollmer is an MS4 from Marian University and past BRI chapter leader.]