Have you visited an emergency room lately? They’re practically empty thanks to the COVID-19 pandemic, even though people aren’t any healthier. In fact, America may see an increase in deaths related to strokes, heart attacks, and other critical issues because of missed emergency care.
It doesn’t have to be this way. A new study shows that you can avoid the emergency room without risking your health by using primary care doctors who don’t take insurance, are incentivized to get you healthier, and charge far less than insurance-based doctors.
The model is called Direct Primary Care (DPC), the study comes from the Society of Actuaries, and the results are stunning. DPC patients went to the emergency room 40 percent less than traditionally insured people, sought medical care 12 percent less often, and saw their doctor either from home or after spending just four minutes in the waiting room. Doctors often visited patients at their homes after scheduling a same-day appointment.
Avoiding the emergency room for the right reasons means real differences for Americans and their families. The UnitedHealth Group estimates that an ER visit is 12 times as expensive as an average primary care physician visit and 10 times more expensive than an urgent care visit. The group also estimates that two-thirds of insured Americans who go to the ER don’t need to – which means 18 million people could save $32 billion in unnecessary spending, almost $1,800 per person.
The DPC model gets these results by creating the right incentives for everyone involved in the continuity of care. Patients pay a monthly membership fee and see a price list for additional care options like X-rays provided by their doctors, so they know exactly how much their care costs and what’s included. Doctors are paid by results, not per service provided, so they are incentivized to provide true preventive care.
The study found that DPC doctors spend an average of 38 minutes with patients — not the 14 minutes most primary care physicians spend — because they only have one-quarter of the patients. Text messaging between doctors and patients was common, as were home visits. Fully 88 percent of doctors provide telemedicine and other additional services at no cost.
All of it is meant to create a true patient–physician relationship — and it works. Even though the study found that most DPC doctors make less than their insurance-based counterparts, they were happier and felt that they were back to practicing real medicine. And patients spent less time traveling to and from appointments without sacrificing their health.
The study did find that since most DPC doctors require a small up-front fee, there was a 1.3 percent increase in initial costs to get on the patient rolls. My patients view this as an investment in their future because emergency room visits are obscenely expensive — avoiding the emergency room and seeking less care overall far outweighs these small initial fees. And during the coronavirus pandemic, avoiding busy waiting rooms and receiving high-quality care is like getting a Jaguar for the price of a used pickup truck.
Emergency room prices have skyrocketed in recent decades, putting patients in the position of paying too much and doctors in the position of working too long. Many efforts have been made to fix this, such as Oregon’s 2008 Medicaid expansion. Unfortunately, that experiment led to more people going to the ER because they didn’t have a trusted PCP.
The solution to getting Americans great preventive care is high-quality, personalized attention. This is what is provided by DPC doctors like me, and the Society of Actuaries proved that it works. There’s no need to have worse care because of the pandemic. You can save money, spend more time with your loved ones, and be healthier simply by finding the right doctor for your needs.
Dr. Josh Umbehr is a board-certified Family Physician and the Founder of Atlas MD, a Direct Primary Care medical practice.
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