FAQ

What is direct primary care (DPC)

Instead of billing insurance companies for your medical care, which requires doctors to abide by many insurance regulations that are not necessarily in your best interest clinically, Direct Primary Care brings the relationship back to simply and directly between the primary care doctor and the patient. This means I do not accept any insurance (no private insurance, no Medicaid, no Medicare, etc.). Instead, patients will pay me a monthly fee that gives them access to unlimited office visits, discounted prices for lab and medication, extended office visits (30 to 60 minutes at a time), etc.
 

Who can benefit from having a direct primary care doctor?

People with no health insurance definitely can benefit from this model and can receive quality medical care, but so can people who have health insurance but a high deductible that has kept them from going to the doctors or have any tests done. Since the insurance fee-for-service model results in management pushing for shorter office visits and more patient visits per day, people who have complex medical problems and need longer office visits (more than the usual 15-20 minute appointments that are shorted further by the rooming requirements) can greatly benefit from having a visit where your doctor actually has the time to listen to you and explain your condition and medications. Due to the administrative burden and cumbersome requirements put on the clinic staff and doctors, it is difficult to “squeeze” patients in an already full day, so patients who find themselves not being able to see their doctor for an acute problem and always going to Urgent Care can also benefit from DPC. Even if someone only goes to the doctor once a year for a insurance-covered routine physical, he or she may still benefit from DPC by having ready access to a medical professional for any health-related questions and recommendations.
 

How will I reach my dpc doctor?

As a DPC patient, you will have my direct phone number to call or text for any urgent matters outside of office hours. For non-urgent issues, you may email me through the patient portal. During office hours, please text me for anything urgent. I may be with a patient, so I will check my voicemail two times a day to get back to any non-urgent messages. Of course, if it’s a medical emergency and you can’t reach me, please go to the Emergency Department for evaluation and treatment.

During the year, I will take 2 weeks of vacation, but I will notify you through email ahead of time (unless you don’t have an email and prefer receiving notifications through traditional mail). If I’m at a conference, then I would still have access to phone and email, so I can take care of some things remotely. If you need someone to examine you, however, then I may recommend for you to go to an Urgent Care. One future possibility I’m exploring is sharing call with local DPC doctors, so we will be able to see one another’s patients when one of us is out of town.
 

Do I still need insurance, then?

Yes. If you don’t have any health insurance, I recommend getting a catastrophic insurance to cover for in the event you need to go to the hospital, Emergency Department, or have other major medical expenses. If you already have insurance through work, then please continue this benefit, as you may be able to use your insurance for lab, medication, imaging, and specialist visits, as well.
 

Can I use health savings account for my monthly fees?

Since DPC membership is NOT insurance but IS a healthcare spending, one would think we should be able to use HSA to cover for the membership fee, but as the current IRS tax law stands, HSA funds CANNOT be used for membership fee payment, which, unfortunately, includes DPC monthly or yearly payment. This is one area of advocacy that is needed to allow for HSA to be used for DPC payments hopefully in the near future.

CAN I USE FLEXIBLE SPENDING ACCOUNT FOR MY MONTHLY FEES?

How one can use the funds in their Flexible Spending Account is up to the employer’s discretion, so please talk to your Human Resources or Benefits department for clarification on whether they’ll allow payment for Direct Primary Care fees to come from your FSA funds.
 

How does lab work?

I have an account with LabCorp to be able to have labwork done at a discounted rate. When you get blood work done there, they will bill me the cash-pay price, and I will add the cost to your next month’s membership fee. I charge a 10% fee for administrative costs, and you will know before you get the blood work done what labs I ordered and how much they will cost you.

For pap smear and skin biopsies, I will need to send out for pathologists to review them and give us the diagnosis. You will also know how much this will cost before you agree to the procedure.

If your insurance has good coverage for laboratory tests, however, please let me know, and I can make a note of that in my lab orders, so you would use your insurance for the lab tests.

how does imaging work?

Another example of price transparency is I will be able to give you a price for imaging when I order it, so there are no surprises. The two main places I have quotes for are Metro Imaging and Greater Missouri Imaging. If I find out about other resources, I will add them to my options for my patients. If your insurance has good coverage for imaging tests, however, you are still welcome to use insurance for this.

how does medication savings work?

I am able to dispense some common medications from the clinic at near wholesale prices. For the medication you need, we can always compare how much it is through your insurance, medication savings coupons (such as GoodRx), and the price I get through a wholesale company, to see what would work best for you. I charge a 10% fee for the supplies and administrative cost, but an example would be 100 tablets of metformin costs $4 for me to get, so I’d charge the patient $4.40.

I will not be dispensing controlled medications from the clinic, however. Controlled medications will require for you to take a paper prescription from me to your pharmacy.

Is Direct primary care concierge medicine?

From what I understand, concierge medicine and direct primary care are similar in that both have a monthly membership fee and allow patient direct access to the doctor; however, usually concierge medicine cost more and may provide more catered or specialized services, and concierge medicine still bills insurance. My DPC practice is a traditional family medicine clinic, with office hours and after hour urgent care, but I will not be able to tend to patients’ non-urgent needs on a 24/7 basis, as some might expect of a concierge practice. Some people might think of DPC as “concierge medicine for average folks”, if concierge medicine to them means having good access to a doctor they’re familiar with and receive un-rushed personalized medical care, as well as coordination with specialists.

how does Direct Primary Care help me save money again?

No copays for office visits. Pay for the actual cost of healthcare, instead of the inflated costs for labs, imaging, or medication. See your own doctor the same day or the next day when you have an acute problem, instead of needing to go to Urgent Care or ER or wait for 3-4 weeks for an appointment. Overall become healthier with having your health taken care of, so you won’t have to spend as much money on seeing doctors and getting tests anymore!