Lots of people are working on the many issues of American healthcare. One of the big challenges: episodic care vs. ongoing care.
With the rise of urgent care facilities and the convenience they offer, primary care (the “family doctor”) has certainly suffered. Patients just go in with they have something wrong, and they get treatment.
The problem that I’ve noticed and have discussed with others is that there’s no real coach in the process. The patient (all of us) has to figure out what’s the next step each time.
Two models really intrigued me for ongoing care. Concierge medicine and direct are both fascinating ways to try and incentivize patients to work with their doctors more often. Both models require some sort of subscription or monthly payment to the doctor’s office.
Concierge care seems to run at a higher cost for patients, while Dr. Farnsworth describes direct primary care as “concierge for the masses”.
Dr. Farnsworth, our guest on the podcast, is obviously very excited about the possibilities of direct primary care. His practice highlights a number of inefficiencies that exist in the way that traditional practices are run.
For example, through an arrangement with various medical labs, Dr. Farnsworth can offer patients drastically reduced costs on many different types of tests that are necessary. One of the reasons that he is able to offer this advantage to patients is because Dr. Farnsworth and his practice pays the lab directly in cash. Instead of having to collect from a wide range of patients, the lab is able to build the practice directly and get paid in a timely manner. There are so many extra costs that go into billing patients, following up with them, and having to write off certain costs.
We Have Choices
I’m less concerned about having to advocate for specific model. My goal is for patients to understand that they have options. I feel like we, as patients, often feel like we are stuck with whatever we are given.
Sometimes, the scenario may be to the healthcare system’s advantage for us to not feel like we have choices. Other times, it isn’t as nefarious as all of that. It may be simply a way of giving patients the most direct route to take in their care. I often think of the book Paradox of Choice. Giving too many options can be just as debilitating.
I am fascinated by the model of direct primary care, and I intend to follow-up with offices here in the New Orleans area to ask questions like:
- Do you treat patients with chronic illness?
- Is it advantageous to use direct primary care if I have good insurance?
I certainly don’t know the answers yet, but I’m thrilled to be able to be able to ask them. It can take a lot more work to be engaged in our healthcare this way, but this is one of the advantages of our current dynamic in this country. We have options, and not all of them have to be prohibitively expensive.
Check out the Podcast
Hear our interview with Dr. Kirby Farnsworth: