DPC stands for "Direct Primary Care." This means that a person pays directly for the primary health care he/she receives at their family doctor's office. The major benefits of this type of payment arrangement with a physician include not only reduced cost for services, but more time available with the physician at encounters, increased convenience of services and a more personal relationship with the doctor.

Because a DPC physician does not need to hire a bunch of extra personnel to file insurance claims, match diagnosis codes with procedure codes, deal with rejected claims, bill patients, collect payments due the office, on top of dealing with private and public health insurance regulations, the physician has a lot less financial overhead, stress and subsequent need to see an endless backlog of patients just to make ends meet.

The advantages to patients are multiple. Today we will discuss the first one.

The cost of services at a DPC physician's office are typically way lower than they would be by using a third party payer. In the "old" system, a patient would have to pay a "co-pay" at the time of the doctor's visit. This is usually around 10-20% of the eventual bill. Then the patient would receive a statement in the mail (called an "EOB" or "Explanation of Benefits") which is supposed to "explain" what the insurance will and will not pay based on the contract the patient has with the health insurance company. Most insurance plans have a "deductible" which is the amount the patient has to pay of all "covered" medical services before the insurance will pitch in and pay anything. Nowadays it is not uncommon to see deductibles range from $1,000 for an individual up to $12,000 for a family. Basically this means that the average person will eventually receive a bill from the doctor's office showing that he/she is liable for the entire cost of the office visit (until the deductible has been met for the year). Because a DPC doctor does not have to go through with all these insane steps, or pay someone else to do them, a DPC doctor's prices are generally quite a bit cheaper. Most DPC physicians actually post their list of prices right up front in the waiting room and on their websites just like we do. There are no hidden "surprise" charges which many patients discover later on when they receive their "EOB."

Some DPC physicians (like The Doc Shoppe) offer a "membership" model of primary health care payment. This is not insurance, but a payment plan that offers a package of available primary care services at a fixed regular (usually monthly) price. More on that next time...

Posted
AuthorBruce Jung