Need A Specialist in Albuquerque: Why Not Through A Direct Primary Care Provider?

ALBUQUERQUE, N.M – Your employees may need to see a specialist or medical consultant at least once in their lifetime. 

For example, do they have persistent symptoms that a clinician failed to identify an exact cause for? Or do they have a persistent cough that does not seem to respond to recommended medications? These are some of the reasons people consult specialists.

You can find them in specialty clinics and large medical facilities. They do, however,  charge higher than clinicians, but direct primary care (DPC) providers offer in-house consultants at a reduced cost. Find out what, why, and how:

• Specialist defined
• Reasons to see one
• Benefits for employees and employers
• Most common specializations in Albuquerque
• Consultation and professional fees
• Medical consultants nearest you
• Bottomline

What Is a Specialist?

When your employees are not feeling well, they’d usually seek medical advice. A visit to a general practitioner or a family medicine clinic is typical. It’s also called primary care, a broad scope of healthcare delivery. Primary care oversees the overall health of your employees.

In contrast, secondary care is when your employees need to be checked for specific health conditions. It happens when the primary care provider refers them to a specialist.   They are experts in a particular body part and its condition. Unlike DPC clinicians, they have advanced education or training in a specific medical field. 

There’s a long list of specialties and subspecialties for various health conditions. For example, a cardiologist specializes in heart and blood vessels. On the other hand, your employees with hormone and thyroid problems or diabetes would visit an endocrinologist. Or they would see an oncologist if they have been diagnosed with cancer.

Your employees don’t have to go to them right away. Frequently, DPC clinicians resolve a health problem. Therefore, they refer your employees to one only when necessary.

Why Do Your Employees Need to See One?

DPC clinicians may or may not advise your employees to see a specialist. But here are some reasons why people need to see one.

1. They’re not getting better

Your employees continue to feel the symptoms, despite taking drugs suggested by a clinician. Additionally, they may have unrelated symptoms which persist. As a result, they physically and mentally suffer. It also impacts your business due to poor work performance or absenteeism.

2. They want a second opinion

Your employees receive a diagnosis after a thorough health assessment. It includes lab tests like blood samples and x-rays. The results of the tests may be good or bad. Your employees would usually seek a second opinion for an alarming finding. It’s a way of either confirming or opposing the diagnosis.

3. They have complex, rare, or chronic conditions

A DPC clinician can diagnose your employees with the condition that requires special care. Examples are diabetes, heart muscle disease, and asthma. A specialist best manages these conditions. They handle health issues that require monitoring for potential complications. It also includes frequent medication and dose changes.

4. They have a life-changing condition.

Health assessment and lab tests may reveal a severe illness. For example, your female employee has breast cancer, this dreaded condition radically affects her life. Thus, she must see an oncologist for the right medical therapy and lifestyle adjustments. Constant monitoring is also needed to prevent cancer progression.

5. They need a new or advanced medical intervention.

A DPC clinician may not be familiar with specific therapies for a certain condition. These tools or therapies may be new or advanced technology. Specialists go through more training to use these technologies. For example, they may know more about nano-medicine or nanotechnology than a DCP clinician. 

What Are the Benefits of Consulting a Specialist From a DPC Provider?

The benefits are two-fold. It suits your employees and is good for you as an employer. 

1. For employees

A survey shows no difference in the health status of people who visited a specialist and those who saw a generalist. Moreover, it reveals that people who visited them were from urban areas. They were more educated and had higher incomes.

In contrast, a 2022 systematic review reveals insulin education by a diabetes expert was more effective than standard care. 

Regardless of the results of conflicting studies, it’s noteworthy to mention the overall impact. Your employees receive the proper care for their specific health conditions. They won't spend much on repeated follow-ups and medications that don’t work. As a result, their performance and quality of life improve.

2. For employers

DPC providers offer fixed membership fees lower than insurance. They bring down your cost by reducing the use of ER and admissions. Some DPC providers also include referrals to specialists. 

They are part of the DPC providers’ network. DPC clinicians serve as a bridge when your employee needs one. They talk directly to a medical consultant and discuss your employee’s case with their consent. Thus, you and your employee won’t have to pay high consultation fees.

Further, there’s continuity of health care. Your employees don’t have to leave work to visit another clinic. It results in less absenteeism and supports productivity.

What Is the Most Common Specialist in Albuquerque?

Every person is unique, but every place has its prevailing health conditions. According to the Bernalillo Community Health Profile, some of the common chronic diseases in Albuquerque are:

• Asthma
• Diabetes
• Heart problems
• Cancer
• Arthritis

Your employees could have any of these health problems. It is thus crucial to help them cope with these conditions since they last a lifetime. In collaboration with a consultant, a DPC clinician can effectively manage your employees’ specific health problems.

• Allergist, immunologist, or pulmonologist for asthma
• Endocrinologist for diabetes
• Cardiologist for heart diseases
• Oncologist for cancer
• Rheumatologist for arthritis

There are other specialties and subspecialties in Albuquerque. But it is best to talk to us if you think you need specialized care.

How much are the consultation and professional fees?

Specialist fees vary depending on the nature of the condition and location. They are expensive compared to primary care clinicians. Examples of the cost per visit without insurance, labs, and diagnostic tests:

• Allergist: $160 to $330
• Endocrinologist: $120 to $265 
• Cardiologist: $200 to $500
• Oncologist: $90 to $130
• Rheumatologist: $150 to $500 

Further, fees are unregulated so that they may charge more than others. A 2017 study reveals they practice price discrimination. They charge higher fees to people who can afford them with higher incomes.

The cost of consultation fees also varies for employees with insurance. For example, your employees may pay upfront about $25 to $50 if they’re insured. But DPC providers may refer your employees to a specialist at a lesser cost. 

Where Can Your Employees Find the Nearest Specialist?

There are many DPC providers to choose from in Albuquerque. Some offer referrals to in-house consultants, but others do not. 

Often, your employees won’t need one at all. DPC providers offer preventive medicine and health counseling. Your employees’ health concerns can be addressed at the primary care level. 

If they already urgently need one, a DPC provider works with the specialist to manage a chronic or rare condition. The membership fee may or may not cover the consultation fee. But it’s generally at a lesser cost than a fee-for-service without insurance.