Getting the Healthcare You Need

Teamwork between doctors, pharmacists, and patients is key to good healthcare. I love it when my patients tell me they're satisfied and comfortable with their primary care providers. Many patients feel they have adequate access to, good communication with, and trust in those providers. That's the way it should be, and that's what's necessary to get the best health outcomes from medical care.

But way too often, I hear the opposite from patients. Some have trouble getting an appointment when they need it. Some feel like their doctor is looking at a computer rather than listening. Or feel that they don’t get clear answers to their questions. Some can't even FIND a doctor who is taking new patients, or accepts their insurance.

It’s critical to point out here that most often those things aren't the doctor’s fault. There are a lot of physicians out there who are disappointed with the turn medical practice has taken. They sometimes feel they can't even practice medicine the way they intended. Instead they have limited availability, limited time with patients, and the need to “check all the boxes” to satisfy payors (insurance companies).

Healthcare insurance offers a lot of benefits. It’s nice to know we have coverage for our healthcare needs. The problem comes when insurers start to dictate how providers treat patients. Limitations on decision-making, strict charting requirements, and other rules tie the hands of providers. Because of that, doctor-patient relationships suffer. But what’s the alternative?

Enter the Direct Healthcare Model.

Direct Healthcare is a relatively new business model in medicine. You can see examples in primary care, dentistry, physical therapy. Even Better My Meds is a direct healthcare model. These medical practices are built on the need for healthy patient-provider relationships. Relationships that aren’t dictated by a third-party payor (i.e. insurer). What’s different is the financial relationship – it’s directly between provider and patient. There’s no insurer to sets fees, make rules or set limitations.

The difference is an important one. Medical practices that bill insurers must adhere to the insurer’s rules. How much time can be spent with each patient, what tests must be run, what meds can be prescribed, or what treatment guidelines must be followed. Billing the payor and getting timely payment is a whole other hurdle. These traditional practices often find that it’s nearly impossible to provide patient care in the way they’d like to.

The newer model takes third-party payors (insurers) out of the picture entirely. It allows healthcare providers to treat patients as individuals. Putting the patient first, taking time to listen, developing relationships, and making exceptions to “usual” treatment guidelines to fit the patient’s needs. Direct healthcare provides necessary, reliable, and evidence-based care in a lower-cost and simpler manner. No insurance required.

How does it work?

We’ll focus here on Direct Primary Care (DPC). Primary care providers (PCP’s) are usually the providers we see most often. They focus on preventative care and the treatment of common health problems. They’ll refer patients to specialists when needed, but can handle the majority of problems most of us face. The PCP is the person we want to feel comfortable with, be able to see when we think there’s a problem, and feel like we’re being heard.

DPC takes the insurance payor out of the picture. So instead of focusing on the rules and limitations the insurer dictates, the provider can focus on you. And you don’t need insurance to be a patient. You pay a set monthly fee, sometimes based on your age, sometimes on the size of your family. There is no co-pay for appointments. And you can see your provider when you need to, without a weeks- or even months-long wait. With Direct Care you can get plenty of time to talk with your doctor about your health concerns.

DPC providers often dispense prescribed medications right from their clinics. They carry a variety of common medications at a low cost, no insurance needed. And many practices are affiliated with low-cost facilities that can provide necessary testing. If you need labs, X-rays, scans, or other tests you can have them done affordably.  

You get the care you need, in a timely manner, from a doctor you trust, all at a low and predictable cost. Hard to beat!

What about specialist care? Hospitalization?

No healthcare insurance is needed with DPC. But you may still want to keep, or obtain, some healthcare insurance. It’s best to have insurance that covers hospitalization. And most specialist physicians bill through insurance as well. So in the end, if you already have healthcare insurance, you might want to keep some of all of its coverage. Talk with a DPC provider to learn how the costs and benefits balance out for you.

Get acquainted with Direct Healthcare!

DPC practices have been around for years. Better My Meds has been affiliated with one local practice since 2018. Scroll down our About Us page and you’ll find information about Beyond Primary Care – a direct Primary Care practice right here in Ann Arbor! There's also a convenient directory that can help you find a practice near you.

If you’re looking for a Primary Care provider that better fits your needs, consider DPC. Other Direct Healthcare practices are becoming more common, too. They are all models that put the provider and patient in control instead of an insurer. Better My Meds uses a direct model to counsel and educate patients. It allows us to spend the time each patient needs to get the best health outcomes from their medications.

If you have experience with a DPC practice, or other Direct Healthcare practice, we’d love to hear about it in the space below. You can also post questions in that space. Or contact us directly at Better My Meds -- we love hearing from you!

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