It’s time for doctors and patients to get off the medical merry-go-round


By Tom Campbell - N.C. Spin



We’ve talked for decades about healthcare reform but the only significant attempt to change the skyrocketing costs of health insurance, escalating pharmaceutical costs and deepening dissatisfaction has been Obamacare. Even its ardent supporters agree The Affordable Care Act is flawed and has not yielded the hoped-for benefits.

Patients are fed up with the impersonal treatment and mind-numbing paperwork at doctors’ offices. Insurance premiums and deductibles are rising faster than the cost of living. Patients question why our pharmaceutical prices are so outrageous while other countries costs are lower and wonder why millions are spent on television ads promoting drugs. Medicaid and Medicare ranks swell every month, increasing the role of government in healthcare decisions.

Doctors, especially primary care doctors, are equally frustrated, awakening to the reality they no longer work for their patients but instead are working for insurance companies. To be economically viable our fee-for-service system requires primary care docs to schedule four to five patients per hour; they don’t have the time to improve patient wellness and are essentially relegated to treating symptoms all day, filling out endless forms to receive established Medicaid, Medicare or insurance company reimbursements. After a frantic day seeing patients many go home to complete paperwork. No wonder doctor burnout is rampant and few medical students want to go into primary care.

So the medical merry-go-round continues. Nobody can get off, but they can’t hang on much longer. There is good news, a radically different approach to healthcare called Direct Primary Care (DPC).

Patients pay a monthly fee to become “members” of a practice, usually ranging from $15 to $60 per month, depending on the patient’s age. Doctors in DPC typically schedule only one patient per hour, ensuring they have much longer than the 7 minutes or less previously spent with a patient. Not only do DPC physicians treat chronic or symptomatic conditions but spend more time working with patients to improve overall health and wellness. Some have onsite nutrition and exercise consultants and frequently offer an in-house pharmacy or discounted prescription drugs by mail. But DPC practices do not accept, nor will they file insurance claims to the government or insurance companies.

The benefits are dramatic. Patients are significantly happier, report greatly reduced admissions to hospitals, take fewer prescription drugs and are healthier, restructuring their health insurance to cover major medical events. Recognizing the significant overall cost savings, a growing number of employers are signing up workers as members. Doctor burnout is reduced, since they no longer race from one patient to the next and their operating overhead is cut by as much as 40 percent due to the reduced paperwork.

DPC is not without problems. Only those able to afford the monthly fee can join. If DPC is to be the new model for healthcare something must be done to resolve this situation.

Direct primary care is a growing trend across the county and in North Carolina. Over 15 practices with more than 22 physicians now operate in communities as small as Nashville and Williamston and as large as Raleigh and Charlotte. The number of providers and patients is increasing daily as this has promise to be the healthcare revolution that gets doctors and patients off the medical merry-go-round.

Tom Campbell is the Executive Producer and Moderator of N.C. Spin.

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By Tom Campbell

N.C. Spin

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