Direct Primary Care vs. Concierge Doctor
It’s harder and harder to find a doctor these days. And when you do find a doctor, it’s nearly impossible to get in to see them when you need them. If you do manage to get in touch with your doctor’s office, they usually need you to come into their office and be seen to get your medication refill or lab tests ordered.
These are all common issues with traditional (insurance-only based) doctors’ offices. These facts have driven the rise of doctor offices where you pay a fee up-front, and the doctor offers some set of services to you which set them apart from traditional physicians’ offices. There are two kinds of practice models that you’ll see mentioned when you’re researching these practices. Some practices refer to themselves as “concierge medicine.” Others call themselves “DPC,” or Direct Primary Care.
But what IS the difference?
In a lot of ways, a DPC practice is an evolution of traditional concierge medicine practices. You’ll notice a lot of similarities between these two types of offices. But there are a few differences that tend to pop up (though these are not set in stone):
1) Price
Most of the time, a practice marketing itself as “DPC” has a monthly fee of $150 or less. Concierge medicine practices can run higher in cost, and some concierge doctors charge thousands of dollars per month.
2) Services offered
DPC doctors are generally very focused on primary care. Think of things like routine chronic disease management (like asthma, diabetes, or high blood pressure). Concierge doctors tend to have more wellness services that are available as part of the practice or as an add-on (like fitness centers, saunas, and salt rooms).
3) Payment options
Concierge doctors usually take a monthly fee and also bill insurance for services rendered. DPC doctors usually take only the monthly fee and don’t bill insurance at all. Both DPC and concierge doctors still work with patients who have insurance, which will still cover things like prescriptions, labwork, specialists, etc., and many will still do things like prior authorizations to help you navigate your benefits.
Of course these are general rules only. There are concierge doctors that are very focused on primary care, and DPC offices that do added services for additional fees. One thing that attracts doctors and patients to these practices is the flexibility that’s offered!
Opening a DPC practice in St. Louis
When I was deciding on a practice model, I chose the DPC structure. I had a lot of reasons for doing it this way. I had already done a primary care/family medicine practice within a traditional insurance structure, and I felt like it wasn’t possible to provide the best care and patient relationships within that structure. These were my reasons for choosing DPC:
Overall, I wanted to escape the broken insurance payment system that sucks value out of the healthcare system. Not having to deal with insurance is a breath of fresh air, and I think that (sadly) it saves people time and money. This means I didn’t want to do a traditional practice at all, and having a hybrid practice wasn’t something I wanted to deal with.
I wanted to keep costs low so that more people could access the practice. I recognize that even the relatively low price we charge is a lot for some people, but managing the practice at a lower price point was important to me.
My focus is mainly on evidence-based primary care services. I’m not as interested in offering a lot of ancillary services like wellness centers. I understand why people do that and I don’t have any problems with it — it’s just not what I wanted to do.
Truthfully speaking, I had a lot of folks I respect point me toward the DPC model, and I sort of fell in love with the independent-thinking ethos of the whole thing. I know I don’t look like it, but I’m a rebel at heart, and I hate following rules! DPC gives me freedom to run the practice the way I think is best for myself and my patients.
It seems like every day I hear about more doctors leaving their traditional practices to start a boutique doctor’s office, either DPC or concierge. And hopefully, patients will follow along!
If you’re wondering how to choose a PDC practice, check out this article.
