Things You Should Know About Direct Primary Care

ALBUQUERQUE, N.M. (Direct Primary Care)

Are you spending thousands on healthcare insurance and your employees can’t even find a primary care provider?   

Primary care providers across the country are taking back control of healthcare…and helping businesses take back control too.  If you want a better health benefit package that recruits and retains employees, increases employee satisfaction and even saves money on your total healthcare spend, direct primary healthcare may just be the one for you.

We are sharing with you a bird’s eye view of Direct Primary Care. We compare it with concierge medicine, which has been used as an interchangeable term.

Unlike concierge medicine, DPC is focused on saving money for both the employee and the employers, while still providing an outstanding experience and improved outcomes. We explain to you DPC’s most significant feature as a kind of client-centered care and concierge medicine. And how it can be integrated with alternative healthcare.

What is Direct Primary Care?

DPC is an innovative way of giving healthcare services to clients at a lower cost. A DPC provider like Well Life ABQ offers a flat affordable monthly fee for all primary care services.

DPCs serve to lessen  the reliance on third-party health insurance coverage for routine services.  It focuses on forging a client-clinician relationship to achieve better access to health care delivery services.

As a DPC, our goal is to provide convenient and high-value health care services. We intend to improve the health of your employees. And help them reach their optimal health and well-being through a personalized professional relationship built on trust.

4 components of DPC according to the American Academy of Family Physicians:

1. Consultation: 

It’s hassle-free. Your employees may book an appointment and get to visit our facility the following day. The consultation is highly personalized and in-depth. Your employees spend more time with our clinicians. 

They thoroughly discuss health status and needs. And because our clinicians have more time with each patient, they are able to manage many conditions that would normally be referred out.  This saves your company and your employees money.

2. Clinical and laboratory tests:

After consultation, your employees may have to take lab tests to confirm their diagnosis. They won’t have to go to another facility to get this done. Our facility offers various in-house lab tests. Some of the common tests are the following:

• Complete blood count
• Chemistry panel
• Thyroid panel
• Vitamin D
• Blood sugar test
• Cholesterol panel
• Testosterone (male)
• Hormone panel (female)

3. Care management: 

DPCs like us use the care management approach. Care management delivers the appropriate healthcare service for your employees. Client-clinician engagement is vital. 

Your employees and our team of clinicians collaborate. It’s a way of managing your employees’ health conditions effectively. It goes beyond the treatment of the disease. It aims to achieve an ideal wellness status through proper coordination that is cost-effective. 

Care management differs from case management. It involves suitable interventions in a specific population to lower the health risk and cost (Agency for Healthcare Research and Quality). It’s client-focused that promotes trust. 

Care management acknowledges and supports the concept that the first-level of care is self-care.  While case management concentrates on your disease. Its components are assessment, planning, facilitation, care coordination, evaluation, and advocacy.

4. Care coordination: 

In a DPC set-up like ours, care activities are organized and shared among a team of clinicians. In a technical review, researchers identified five key elements in care coordination:

• A team of clinicians is involved in care coordination. The team consists of medical practitioners, nurses, pharmacists, and support staff.
• Members of the team coordinate when they depend on each other to carry out the activities in a client’s care plan.
• To carry out these activities, a member of the team must know about their respective roles and resources.
• Communication among all members of the team is needed to carry out all the activities.
• The goal is appropriate delivery of health care services to the client

Care coordination requires communication among the client and the team of clinicians. To support communication, systems and technology must be in place. Electronic medical records (EMR) is an example of a health information technology.

It shows a client’s medical and health profile, history, and other related information. The typical primary care provider rarely has time to consult with another clinician even if it dramatically improves care coordination.  DPC clinicians CAN and often do this!

DPCs offer various services. It includes treatment, prevention, chronic conditions, referral, and consultation. These are the following 6 specific services we offer for you and your employees:

What are the specific services of a direct primary healthcare provider?

1. Healthcare for the whole family

DPC abides by Article 25 of the Universal Declaration of Human Rights. It states that “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services…” 

Primary healthcare is for your employees and their families. We are a family practice clinic. The same clinician manages the care plan of your employees and members of their families. This makes it convenient and practical for them instead of going to different medical practitioners.

It’s a go-to facility when your employee gets sick from common illnesses. These include colds, cough, flu, sore throat, minor cuts, or rashes. There’s continuity of care. We keep them up-to-date with their annual physical check-up, vaccines, and preventive screenings. 

2. Discounted medications and medical supplies

Your employees won’t have to go to a pharmacy once they receive their prescriptions. There’s an in-house pharmacy that dispenses many of the most common drugs.  Other than convenience, your employees get in-house medications at a discounted rate. They can save on the cost of medical supplies, too.

3. Acute Care

Acute care is within the scope of primary care. The World Health Organization further defines acute services as the promotion, prevention, treatment, rehabilitation, or palliative actions. The actions aim to improve the health status of people promptly on time.

Your employees can set an appointment to see our medical practitioner. It may be a minor, short-term, or self-limiting disease. Or it may be complex symptoms.  Our 24/7 telemedicine services provides your employees and their family access to care anytime of the day or night.  This keeps them out of the high-cost emergency room for minor things.  This saves you on claims and them on co-pays.

4. Chronic disease management and acute care

Director of Health Care Policy of the John Locke Foundation, Katherine Restrepo said, “For the nation’s health care system to slow the growth of healthcare spending and better manage the prevalence of chronic disease and its association with disabilities, patients need better access to health care… providers need flexibility to spend more time with their patients, Direct Primary Care has a good record of addressing these concerns.”  

In her report, Restrepo emphasized that DPC medical practitioners can help manage clients with chronic illnesses. These clients are more at risk of disabilities and complications. She further said that medical practitioners can treat 80% of the clients’ needs. The quality time spent by a client with the medical practitioner proves beneficial.

A DPC efficiently manages chronic conditions. At Well Life ABQ, our clinician works with your employees to design a long-term care plan. It may be for common diseases like high blood pressure or cholesterol, diabetes, or asthma.Our service is more than diagnosis and prescription. We empower your employees by giving them information about lifestyle, nutrition, and medication compliance.

5. Lab tests

Once the clinician has ordered a lab test, your employees won’t have to waste time driving to the lab.  Our in-house  lab further improves convenience.  We are also able to bypass marked-up insurance claims.  Our direct prices save your company money…lots of money.  Electronic services and telemedicine 

Your employees may have other options instead of visiting our physical facility. Virtual visit appointments are possible when medically appropriate. Your employees can send text messages, e-mail inquiries, or chat with us. Representatives from our telemedicine receive calls everyday and anytime of the day or night.  

What are the benefits of primary healthcare services?

Direct primary healthcare benefits your organization in 8 ways:

1. Convenience and accessibility to various health services

We offer a wide variety of health services. This ranges from consultation, lab tests, medicines, monitoring, health education, to medical follow-ups.

Your employees won’t have to take a leave from work to see a clinician. We offer virtual ways for consultation. It can be through electronic technology or telemedicine. Your employees can communicate with us through email, phone, text messaging, or video calls. Or if your employees need to get physically checked, they can get same-day or next-day appointments for urgent issues.

2. Continuity of care improves quality of care

Your employees see one “family” clinician who knows their medical history. There’s a smooth flow of one health care activity to the next. We are also able to manage many conditions that are traditionally referred out.  These things are referred out because traditional primary care providers don’t have time to provide higher levels of care.  Often traditional clinic administrators forbid certain minor procedures because insurance reimbursement is too low.  This increases overall cost to your company and wastes so much time and creates disjointed healthcare.  

3. Savings on healthcare cost

Your employees receive outstanding  personalized healthcare services and your company benefits on many levels.  Bid goodbye to copays and say hello to long-term savings. Your employees have unlimited access to our clinicians anytime. They’re also entitled to discounts which may not always be covered by insurance.

4. Disease prevention, early detection, and health maintenance

We emphasize prevention. Our clinicians review screening recommendations and updates each member on current recommendations.  Each visit includes customized lifestyle and nutrition advice that may be contributing to a current or potential problem. This helps us take the needed action to prevent your employees from developing a disease. If your employees are healthy, we help to keep it that way through nutrition counseling. Regular check-ups and screenings are equally important. We can help detect a disease in its treatable stage before it becomes serious and expensive. 

5. Referral to specialists

A need for specialists can largely be avoided through prevention, early detection and in-house management options. When your employee does need a specialist, we stay up to date on the best local clinicians.  

6. Employee performance: Less absenteeism, better recruitment and retention advantage 

Your business can dramatically increase employee benefits for only $75 per month.  Your employees can enjoy the benefits of convenient and quality healthcare service. In good health, your employees work efficiently resulting in fewer sick leaves.  This unique benefit stands out and attract a larger pool of qualified candidates. And it keeps your existing employees satisfied, happy, and healthy

7. Employee productivity 

We help maintain your employees’ health to prevent them from getting sick. We resolve acute and chronic health issues efficiently getting your employees back to work.  We work with your employees to achieve their optimal health. 

8. Health-oriented culture 

We advocate for a health-oriented culture in your business. We focus on optimal health…not just sick care.   A health-oriented culture in your business means better performance and productivity. As a result, your business won’t suffer losses. Instead, your business gains a positive work environment that contributes to your profit.

What are the controversies about direct primary healthcare?

1. Limited healthcare services 

Health insurance may still be necessary to cover costs beyond primary care. These include emergencies, hospitalizations, and specialists. However, your company can choose lower cost, higher deductible options without worrying that your employees will defer/avoid  healthcare due to high-deductibles.

2. Health-oriented culture Limited number of clients and Shortage of clinicians

DPC model limits the number of clients being served. A medical practitioner working under a retainer arrangement can’t treat as many clients. This argument claims that DPC will worsen the availability of primary care.  The counter-argument is that the model of DPC will attract more clinicians to primary care.  Right now, most medical students do NOT plan on going into primary care.  Low insurance reimbursement, massive patient loads and onerous insurance paperwork requirements for even simple things are the main reasons.  Many articles have been written that actually claim DPC is THE FIX to the primary care shortage because it will attract more clinicians. 

What is Concierge Medicine?

Today defines concierge medicine as membership-based healthcare. Medical practitioners give 24/7 medical care to clients. It can be through face-to-face consultation or cell phone calls. Most DPC clinics provide concierge -like service without the hefty pricetag.

What are the similarities between direct primary care and concierge medicine?

Concierge medicine is an umbrella term that includes various health care models. DPC is one of them. According to Concierge Medicine Today, DPC and concierge medicine work on the same principle. Both healthcare delivery models bypass insurance. Instead, there’s a direct financial transaction between clients and medical practitioners. Both healthcare models provide comprehensive care and preventive services within a reasonable budget. 

The quality of care is personalized. The facility is convenient and accessible. Communication can be coursed through various channels. 

What are the differences between direct primary care and concierge medicine?

Direct primary care and concierge medicine are often used interchangeably. But these are two different models of primary care. Here are the eight differences between the two health care delivery models.

What are the services offered in concierge medicine?

A wide array of services may be offered depending on the membership coverage. Services in DPC are almost similar to concierge medicine. Some of these are the following:

• 24/7 hotline or telemedicine
• Acute care visits
• Annual and executive physical exams
• Baby check-ups
• Coordination of care while traveling
• Electronic access to medical records
• Home delivery of meds
• House visit
• Lab tests and screenings
• Lifestyle and nutrition counseling
• No waiting on appointment schedule
• Referral to specialist
• Unlimited appointments
• Weight management

What is patient-centric care?

Direct primary care focuses on the client. Patient-centric care according to the Institute of Medicine means “Providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions.” 

What are the misconceptions about patient-centric care?

• Patient-centric care is not just material service. It’s more than a world-class and five-star facility. The focus is quality experience. We give attention to you and your employees’ needs without being conscious of the time. It’s listening to what you and your employees have to say. It’s answering concerns with clear explanations.
• Patient-centric care is not based on the quantity of clients. It’s not the number of clients, but the number of quality services delivered. The value lies in the service, which is founded on compassion, empathy, and respect.
• Patient-centric care is not about forcing a treatment plan. A medical practitioner doesn’t call the shots but facilitates your employees’ health. It’s empowering your employees to take an active role in their care plan. The relationship between your employees and our medical practitioners fosters engagement and participation.

What are the elements of patient-centric care?

The Picker Institute and Harvard Medical School identified eight elements of patient-centered care. These elements apply to hospital and clinic or ambulatory facilities, such as DPC providers.

1. Respect for patient’s values, preferences, and expressed needs

Health care professionals must possess core competencies in dealing with clients. You and your employees preferences and values are taken into consideration. Respect and sensitivity to your employees’ religion and cultural customs are observed. And they get to be involved in the decision-making process.

2. Information and education

Information, communication, and education are equally important in responding to you and your employees’ needs. Your employees receive the right information about their health at the right time. These include their health status, medical test results, diagnosis, procedures, alternative treatments, and prognosis. Your employees get to hear feedback and follow-ups often as part of the care. Health education based on their specific condition is discussed as well.

3. Care Access

Researchers in a study said access to satisfactory health results depends on factors. These services must be effective and relevant to the people. One way is the ease of scheduling appointments through a call. On the appointment day, your employees won’t have to wait. Whenever possible, they can obtain the things needed to comply with their treatment plan including lab draws, medications, supplements and some procedures.  

4. Emotional support to relieve fear and anxiety

The emotional state is as important as the physical condition. Fear and anxiety are common emotions when your employees are sick. They’re not alone. Health anxiety is experienced by 20% of people with chronic illnesses. Examples are heart disease, diabetes, and cancer. It affects your employees’ emotional, mental, behavioral, and perceptual aspects. During this time, your employees are supported in every stage of their health care. We give them the right attention and information.

5. Involvement of family and friends

You and your employees’ family and friends play a role in the care. Family and friends are involved in tailor-fitting the preferences, decisions, and interventions. They are enjoined to participate in the health care journey. Your employees’ family and friends may expect quality service throughout the care. Since they, too, are accommodated and recognized as part of the health plan.

6. Continuity and secure transition between health care settings

A study found out that continuity of care improves outcomes in various medical settings. These are general health, maternity and child health, preventive medicine, psychological and mental health, and chronic illness management. You and your employees get detailed information about medication, nutrition, and other therapies. A coordination plan for ongoing interventions is provided, too. This includes information on where to get extra support for care. 

7. Physical comfort

The physical aspect of the facility and its surroundings influence you and your employees’’ physical comfort. Our facility is calm and inviting.  Appointments are not rushed and our staff is friendly and helpful.  

8. Coordination of care

You and your employees’ health care can be considered as a giant puzzle. Every healthcare activity is a piece of that puzzle. The whole experience is integrating each piece to come up with your health care results. This reduces your employees’ feelings of anxiety when they see how these pieces come together.

What is alternative healthcare?

Complementary and alternative healthcare or CAM is a group of various medical and healthcare system. It involves practices, and products outside conventional or mainstream medicine. Let’s define the terms associated with it. Complementary medicine means non-mainstream practices with conventional medicine. Alternative medicine means non-mainstream practices only, without conventional medicine. Integrative medicine means all or a combination of appropriate healthcare approaches. It focuses on holistic results.

The National Center for Complementary and Alternative Medicine came up with five categories of CAM therapies:

1. Alternative medical systems
2. Mind-body interventions
3. Biologically based treatments
4. Manipulative and body-based methods
5. Energy therapies

The John Hopkins Medicine further categorized CAM by six (6) types with sub-types:

1. Traditional alternative medicine

• Acupuncture

• Ayurveda

• Homeopathy

• Naturopathy

• Oriental medicine

2. Body

• Body movement therapies

• Chiropractic medicine

• Massage

• Tai Chi

• Yoga

3. Diet and herbs

• Dietary supplements

• Herbal medicine

• Nutrition

4. External energy

• Electromagnetic therapy

• Reiki

• Qigong

5. Mind

• Biofeedback

• Hypnosis

• Meditation

5. Senses

• Art, dance, and music

• Guided imagery and visualization

What are the differences between conventional or mainstream medicine and complementary alternative medicine (CAM)?

Are CAM therapies effective and safe?

Studies have been conducted about CAM. Many studies found that CAM therapies are effective compared with conventional medicine. Other results though proved otherwise. Clinical trials have yet to be pursued to support claims on its efficacy. As for safety, many studies reveal positive results of various CAM therapies. Most of these studies show a benefit to a part of a body, but not for the treatment of a disease. 

How can CAM work with direct primary care?

• Over the years, CAM therapies have gained popularity. The Federation of State Medical Boards (FSMB) of the US developed the “Model Guidelines for the Use of Complementary and Alternative Therapies in Medical Practice.” 
  
  The FSMB said that the Model Guidelines enjoins the medical community “to adopt consistent standards, ensuring the public health and safety by facilitating the proper and effective use of both conventional and CAM treatments, while educating physicians on the adequate safeguards needed to assure these services are provided within the bounds of acceptable professional practice.” 

• The Institute of Medicine or IOM (US) Committee on the Use of Complementary Medicine and Alternative Medicine by the American Public supports the initiative. The goal is effective and safe comprehensive care that uses various therapies. Collaboration among healthcare practitioners is also encouraged. 
  
• Researchers created an approach on how to integrate CAM into primary care. They used literature review, interviews, focus group, and field testing as sources. The approach starts with a client requesting advice from a primary care clinician. The clinician assesses the CAM therapy to be used. The clinician then refers the client to a CAM practitioner. The CAM practitioner should be knowledgeable and aware of safety involved in the therapy. Open communication between clinician and CAM practitioner is maintained. The clinician also keeps constant communication and monitors the client’s progress.

What are the 10 Rules of a comprehensive approach promoted by the IOM Committee?

The IOM created the 10 rules outlined in the IOM report “Crossing the Quality Chasm: A New Health System for the 21st Century.” These rules can be adopted by direct primary care providers that integrate CAM into their services. 

1. “Care based on continuous healing relationships;
2. Customized based on patient needs and values;
3. Patient as the source of control;
4. Shared knowledge and the free flow of information;
5. Evidence-based decision making;
6. Safety as a system property;
7. Need for transparency;
8. Anticipation of needs;
9. Continuous decrease in waste; and
10. Cooperation among clinicians”

Direct Primary Care a Cut Above the Rest

Direct primary care, concierge medicine, patient-centric care, and alternative healthcare are models of care. These concepts exhibit qualities of responsive and personalized delivery of health services. DPC, a type of concierge medicine is also patient-centered. DPC can integrate complementary and alternative healthcare as part of its service.

According to the Direct Primary Care Coalition, there are about 1,200 DPC practices in 48 states. They’re providing primary care to more than 300,000 Americans. These figures are rising daily  as people search for better health care services.

What makes DPC a cut above the rest? DPC’s goals go beyond caring for you and your employees. A study reveals the quadruple aim of DPC:

1. Enhance patient experience
2. Improve the health of the population;
3. Reduce the cost of health care; and
4.  Improve the work-life of clinicians”

Direct Primary Care Near You

There’s the Senate version bill (S. 2999), the Primary Care Enhancement Act. An excerpt explains that the DPC model “encourages patients to develop personal relationships with their primary care physician, including extending access to care beyond office visits and business hours through telemedicine. It focuses on prevention and primary care, relying less on specialist and hospital referrals…” 

Well Life ABQ agrees with this bill as it benefits you and your employees. We are a medical home sweet home near you. We are a membership family practice where you and your employees work with us. We help you and your employees overcome health problems and achieve optimal health at a lower cost. Talk to us about the health needs of you and your employees. Call us at 505-585-2345 or send an email to hello@wellifeabq.com.