Primary Care Personnel (PCP) Slave At The Chocolate Factory
By Bill Rusteberg
Traditional fee-for-service office visits these days reminds one of the iconic and chaotic Chocolate Factory Scene from “I Love Lucy.” High speed conveyor belt care, meeting with patients five minutes at a time followed by a prescription coupled with time consuming after encounter recordkeeping is chaotic and inefficient.
Professional providers continue to be squeezed by managed care contracts they can’t control under the belief they must subscribe for financial survival. Patients suffer and are becoming increasingly frustrated with a broken system. And so are their doctors.
Primary care physicians are hard pressed with low reimbursement rates. They must see 40-60 patients a day to make ends meet. Their overhead takes 40-50% off the top and Uncle Sam takes 15% or more of what’s left. They dream of more control and independence but lack cohesive leadership required to accomplish that. Doctors are great body mechanics but make for lousy businessmen, otherwise they would leave a system that holds them hostage and steals their money.
Some have gifted their clinics to hospitals in exchange for employment. Others are considering retirement or are seeking other means to provide health care services outside the managed care box.
Others are turning to Direct Primary Care either by joining one managed by a DPC vendor for a promised paycheck or starting their own practice. The latter is scarier than hell as it takes guts, commitment and ingrained rebelliousness to take that plunge.
Market demand for Direct Primary Care services is a direct result of a broken system that demands change. Consumers are willing to pay $50-$100 or more per month for unlimited same day or next day access to primary care services without office visit time restraints. More employers are moving to a Direct Primary Care centric health plan model for better patient experience, lower plan costs and more productive employees.
The return on investment is without question.
