Opinion: Daily Journal

Direct Primary Care as ‘Netflix Medicine’

“I’m packing apples, water bottles, and phone chargers. Should we bring a couple of books?” I asked my bloodied fiancé, who was elevating his leg and applying pressure to a deep, 3-inch laceration across his calf.

I had been to the emergency room enough growing up to know that we were in for at least three or four hours of waiting before we were seen. When he announced that the average cost of stitches in the emergency room was well over $1,000, I told him to enjoy those apples because his paycheck as a recent graduate probably wouldn’t cover fresh fruit next month.

Fortunately for my fiancé (and his wallet), we opted for a more convenient, affordable solution: direct primary care. Instead of spending thousands of dollars and many hours of discomfort in the emergency room, we were back home eating dinner an hour later, stitched up, and out only $100.

What is this direct primary care wizardry that was able to save us so much time and money? Dr. Amy Walsh of doctor direct describes it as the “Netflix of medicine.”

At her direct primary care practice, patients sign up for memberships of $50 per month ($15 for kids) and receive 24/7 access to their doctor, an in-house lab and pharmacy, hourlong appointment slots, telemedicine opportunities, and more — all without with the hassle of a co-pay or insurance.

Since primary care physicians can treat up to 80 percent of medical conditions, her office is a one-stop shop for things like stitches, lab tests, pap smears, vision care, and more. When patients need a specialist, Dr. Walsh refers them out and keeps up with the care they receive.

The goal is to provide affordable care and flexibility while encouraging a real relationship between the doctor and patient.

Sound too trendy to be legitimate? Don’t be fooled — the model isn’t new. Dr. Walsh is just one of many primary care physicians making the switch to the direct primary care model. States such as Washington, Wisconsin, and Colorado are among those with a growing network of 20+ direct primary care practices.

It’s also perfectly legal under Obamacare. Patients can couple something like a catastrophic insurance plan with their monthly membership fee at a direct primary care practice in order to maximize the benefits of this model.

My fiancé and I had exactly the kind of experience that highlights the benefits of this model. It was a Sunday evening, and our only option looked like a visit to the ER because urgent care centers were closed.

Instead, we were able to text a picture of the cut to Dr. Amy. She determined that it was a simple fix and did not require a hospital visit. Fifteen minutes later, she was cleaning, numbing, and stitching his calf.

Five stitches and two adhesive steristrips later, she instructed him to text her pictures of his leg over the next two weeks to monitor the healing process.

Leaving her office after spending only $100 and monopolizing 45 minutes of her time almost felt like stealing. It turns out, however, that direct primary care is as good for doctors as it is for patients.

Prior to launching doctor direct, Dr. Walsh worked in a traditional hospital practice. The hassle of filing claims with an insurance company and having bureaucrats dictate what care she could provide her patients almost drove her from medicine.

“I was ready to quit,” she said. Instead of building relationships with her patients, Dr. Walsh spent her time filing paperwork and fighting with insurers on the phone.

Running a direct primary care practice allows Dr. Walsh to rediscover why she became a physician in the first place. She gets to form real relationships with patients, who know they can get a full hour appointment. She even makes herself available by phone 24/7.

I was initially skeptical of how that kind of practice model could be viable. How many doctors would want to be constantly on-call? In Dr. Walsh’s case, she has actually found herself coming in less than when she was in a hospital practice.

Having such direct access to Dr. Walsh naturally makes her patients more respectful of her time, especially since the lighter patient load she has taken on in order to do direct primary care translates into increased face time with each patient during appointments.

“You know how many times I’ve been called in on a weekend this past year?” she asked brightly. “Once.”

Direct primary care is a “back to the basics” model that gives physicians the freedom to know and care for their patients. With the future of American health care looking increasingly expensive and convoluted, let’s hope the direct primary care model continues to catch on.

Kayla Nguyen is Blundell Fellow at the John William Pope Foundation.