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Direct primary care: the doctor is in

 

By JACK WEATHERLY

The Affordable Care Act, or Obamacare, has been a radical departure from the traditional way of delivery of health care in the United States.

It is all about insurance. So is its replacement that is being hammered out in Congress.

But there is a movement afoot in the models of health-care delivery that de-emphasizes insurance.

It’s called direct primary care.

Practitioners of such care comprise about 2 percent of the nation’s 900,000 practicing physicians.

NewCare MD in Madison, which opened its doors Jan. 3, provides 90 percent of what a person needs in the way of health-care needs without resorting to insurance, according to Dr. Micah Walker, one of the two founding physicians.

The clinic offers:

– Unlimited same-day appointments.

– Telemedicine.

– House Visits, “when medically appropriate.”

– 30-minute office visits, with little or no waiting.

– No limit on calls, texts and emails to the physician.

– No co-pays or deductibles.

– Prescriptions dispensed in the clinic.

NewCare now has about 300 patients, with an ultimate goal of 1,000 to 1,200 patients, according to Walker.

Membership fees are $60 a month for adults up to age 50; $75 for adults 51 and older, and $150 for a family of four, with additional children for $15 apiece and a cap of $180.

If the clinic recommends tests beyond its in-house capabilities, the patient can be sure that the tests are not being done for monetary reasons, because they are done at the physician’s costs, Walker said.

That, he said, provides “transparency” that traditional medicine does not offer.

“Before we do the blood work, you have a sheet that tells you what the labs are going to cost,” Walker said.

“You wouldn’t shop at a grocery store that doesn’t have prices on the shelves.”

Walker will finish his residency at the University of Mississippi Medical School on July 1. Dr. John Vaderloo, who was one of his professors, is now his partner in the clinic.

Vanderloo has been in family practice for about three and one-half years, but he had decided that the bureaucracy involved in mainstream medicine was rapidly wearing him down and taking away from what he loved to do – help people.

“This system allows family physicians to continue their autonomy and manage a practice not owned by a hospital system,” Vanderloo said.

“I did a house call on a 90-year-old, and he said, ‘The last time I had one of these was when I was about 5 years old,’” Vanderloo said.

There are two other direct primary care clinics in the state, according to Walker: The Kosy Direct Care in Kosciusko and White Oak Family Medical Clinic in Oxford. All operate under the Mississippi Direct Care Act signed by Gov. Phil Bryant in March 2015.

Direct primary care is endorsed by the American Academy of Family Physicians. “Direct primary care benefits patients by providing substantial savings and a greater degree of access to, and time with, physicians,” the academy states on its website.

“DPC practices often suggest that patients acquire a high-deductible wraparound policy to cover emergencies,” the academy states.

Walker said, “We don’t advise that anyone not have insurance.”

Which means that whether or not a member of NewCare MD uses coverage provided by an employer, he or she must still pay for a share of the cost of the premium.

“Most of our patients have insurance provided through an employer,” Walker said. That can come handy for expensive treatments beyond the scope of direct-care clinics.

Walker likened health care to car maintenance and more costly items.

“Your insurance covers the collision-repair center. It doesn’t cover the oil changes and the day-to-day things that you need.”

Qliance Medical Group in Seattle, Wash., claims to have saved members about 20 percent “compared [with] the cost of their care to that of non-Qliance patients who worked for the same employers.”

“The savings were driven by a marked reduction in expensive emergency room visits, inpatient care, specialist visits, and advanced radiology, which more than made up for the higher investment in primary care for Qliance patients,” the firm claimed.

BloombergBusinessweek reported that Qliance founder and internist Garrison Bliss shaped his model “for middle-class patients” after the advent of so-called concierge care, which is more expensive.

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About Jack Weatherly

2 comments

  1. This is something that Congress and Trump really need to take a hard look at, and somehow include in the repeal and replacement of Obamacare. It has the real potential to bring down health care costs.Then people could buy an very inexpensive catastrophic insurance policy to cover hospitalizations for serious injuries and illnesses.

    I would like to help such practices to proliferate.

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