No surprise here but I am a big proponent of Direct Care (DC) models. Trinergy Center For Integrative Psychiatry is also a direct care practice. Today in the US, health care costs are staggeringly high, especially compared to other developed countries, but our population is becoming sicker than ever. The current health care model (which is mainly insurance based) is unsustainable for both practitioners and recipients. No wonder, physician burn out is at an all-time high.
In response to these problems of our health care system, some early pioneering physicians have come up with what is known as the Direct Care model. Concierge practice is another name for this model. DC model has been applied successfully to various specialties, as diverse as surgery to psychiatry. My patients find the same benefits that other DC clinic’s patients are reaping.
- Timely appointments: I am able to fit in new clients within a week (from first phone call to first visit). So, when someone is in a crisis, they don’t have to wait months to see a psychiatrist.
- More than enough time is devoted to each client for a thorough and comprehensive evaluation. A new patient typically spends 1.5 to 2 hours for their first visit in my clinic.
- Hands on access to their physician (me). Many first-time callers are surprised when I answer the phone. They get to know me (and me them), from the first phone call itself. No answering service or anything else in between. I anticipate continuing this model of accessibility as I can control the size of my practice.
- Once a patient is established in my practice, I use a state-of-the art, but very user friendly, electronic health care system which is fully HIPAA compliant. I send treatment recommendations, articles, even lab and other test results through this system. Have you ever tried getting your own lab results from any other hospital here? You know what I am talking about :).
- Patients can access me via secure email through this software. If they need any letters from me to other providers/entities, it is a breeze (for me as well). And it is all electronic, so I am not killing any trees! Do you know how many faxes are printed in an average-sized medical clinic in a day? Too many!
- Transparency of costs: Patients know how much they are paying, what they are paying for, etc. All prices are clearly mentioned on my website and also in the policy forms. No surprises here. A study recently found that an average patient is paying 68% more for a doctor in a hospital vs a doctor in a DC model (forgive me but I cannot find the link to this study. So, take it or leave it). Of course, this is not immediately apparent but comes in as little after shocks (in the form of EOBs: explanation of benefits from insurance companies and bills from the hospital/clinic). I had a personal experience of this when I took my 2 kids for their annual blood tests to Children’s hospital. Because my deductible was not met, I ended up paying $2500 for 2 sets of very common blood tests. That’s when I discovered anylabtestnow.com. And to my dismay, I found that I paid $289 for a Vitamin D test at Children’s that would have cost only $79.00 in a direct pay lab!
- Click here for a fun little comparison of costs.
- Patients are more involved/engaged: As you know how much you are spending and what my services are worth, you are going to be more engaged. Most of my patients are almost fully compliant with my recommendations. When it is tough for them, they seek my guidance/support. Because we are both super invested in making this work! Truly it is a 50-50 partnership and leads to better outcomes. Those that are unwilling to make changes, drop out or do not seek me in the first place. After all, I cannot help anyone that is not ready to help themselves.
- Overall this model is efficient, timely and cost effective. The first year sees patients putting up more money for therapies, supplements, etc. But in the second year, they are investing in “life” and less on such treatments. And, of course the benefit of being healthy is invaluable. Who knows, you may even get reimbursed by your insurance -especially if you have out-of-network benefits.
- Finally, it is rewarding and satisfying for all involved: patients and providers.
Have you had any experience with a DC model or with the conventional model? Please share your experience with me here.