Okay! The more and more I researched Direct Primary Care, and looked into how headache clinics around the country were structured, the more I realized this could really transform headache care across the nation and beyond – perhaps. Once I had a working idea, I began to “pitch it” to other physicians, my patients and friends.
Interestingly, after some explanation, most patients and friends almost immediately grasped the model and embraced the power of membership-based care. On the other hand, many physicians – not all of whom were headache specialists or neurologists – were skeptical of the model and why I would take the risk. Below is the type of feedback I got, mostly well-meaning:
“You are starting a solo practice? Young doctors are moving less and less toward that direction, don’t you have a family to think of?”
“Oh, so you are doing ‘concierge medicine’ and a ‘cash only’ clinic? I can introduce you to some folks who run that type of clinic.”
“So, you are going to be ‘on call’ all the time? How is that going to work?”
I respect these individuals, their experience and knowledge. I’ve taken this and other feedback as an opportunity to reflect and shape my response.
This is Direct Care, going back to the way medicine started, but with the improvements of technology allowing for easier access to care. Monthly membership fees decrease costs and include clinical visits (regardless of the number of visits), so it is not a fee-for-service model where each subsequent visit would increase the expense for the patient – whether cash pay or insurance reimbursement. Concierge medicine is retainer fee based with access to practitioners, but frequently also bills to insurance for clinical visits.
In Direct Care, no insurance plan is involved. In order for patients to be members of the clinic, we go over expectations from both a physician and patient perspective. There is a mutual understanding that the provider will advocate for the patient and the patient will take charge of his/her medical condition while also realizing that doctors are people too. The model is intended to break down the barriers between the physician and patient by providing real-time communication via modern technology, affordable care and predictable costs, as well as a support system for members while also allowing an avenue to make real-time medical decisions.
This is a revolutionary headache and facial pain clinic, taking into account both the needs of the patient but also those of the physician and support staff. If a working model can be effective, it might change healthcare delivery, empower patients to take an active role, invigorate sprouting doctors to become headache specialists, and maybe - make insurance companies more accountable.