On Doctors and Having the Courage to Practice Independent Direct Care Medicine

Have The Courage To Be Direct.

Title of book, Anthony  K. Tja, Harvard Business Review Press

I shall be direct.  I have just watched a 4 part video recording the proceedings of an August 10 conference on direct pay medicine. I recommend you view it too.

Dave Racer,  a St. Paul, Minnesota based publisher who has written or published 8 books on health reform,  organized the conference in conjunction with the American Association of Physicians and Surgeons.

You can view the 4-part video at You Tube http://www.youtube.com/watch?v=5PiEE9AiusCQ  or by going to aapsonline.org.   The video features 14 physician speakers – 11 primary care physicians and 3 surgeons – who have plunged into independent direct pay practices.  These practices also go by the names of concierge, direct, retainer,  and cash only practices.  These practices  share one thing in common – they function outside the realm of 3^rd parties -  health plans,  Medicare, and Medicaid.  These and other 3rd parties  do not oversee or pay for physician services.

These things struck me about the physician presenters

·         Courage of converting to independent practice without  3^rd party financial parachutes.

·         High level of personal happiness.

·         Satisfaction at spending more time with patients.

·         Feeling of renewed closeness to patients.

·         Diversity of approaches  -some retainer, some not.

 

•  Refuting  of  notion that doctors care  only for the well-off.

·         Diversity of patient populations – some insured, some not.

·         Lower costs and more convenience for patients.

·         Simplicity of business models

·         Smaller staffs – many with only one assistant.

·         Skepticism in efficacy of  pay-for-performance,  team care,  evidence-based care, affordable care, accountable care, and practice guidelines.

·         Relief at shedding the encumbrances, expenses, and hassles of 3^rd party oversight and payment.

·         Less concern and worries about cash flow

·         Freedom of using clinical judgment to serve patient rather than insurers.
 

None of these things mean that direct pay independent practice is a wave of the future.   These types of practices go against the grain of Obamacare and managed care.   But these types of practices represent a belief among doctors that they should have the freedom to practice what they were trained to do – evaluate and treat patients - rather than to serve as representatives and intermediaries  of 3^rd party payers.

Tweet:  Independent direct pay practices appeal to physicians because of more direct, more time, and  personal  relationships with patients.